The un-word (
uncircumcised) is dead:
It no longer has a use in a modern, respectful society!
By William. G. Wallace, PhD
Like most American men who were born in the mid 1960s, I was welcomed into this world with a knife put to my genitals. I am not sure when it was that I had first heard the word circumcision (it was likely at church as part of a bible reading), but it was certainly not in a middle school or high school health class, nor was it something that had ever been discussed or explained in my household. Thinking about it now, it is more likely that I had first heard it (circumcision or the word circumcised) as part of a punchline on a TV show! A punchline – that’s an interesting thought; the idea that it is somehow funny that an infant boy is strapped down soon after his birth and is physically altered in the most intimate of ways! Yeah, that’s real funny!
That’s the world that many of us know: a world where “it’s just what you do.” It is true, most parents were simply following the advice of the medical community or were simply modeling (or rather, molding) their sons to fit the dominant social norm or were bowing to the general consensus touted by the masses, championed by the medical establishment: it’s cleaner, it’s healthier, it prevents disease.
Social acceptance of routine infant circumcision (RIC) is therefore propagated by accepting the status quo and not asking important or perhaps difficult questions: is this really necessary? Is this ethical? Is this really what is best for my son?
About 20 years ago I had moved from NY to CA to take a temporary position as a stepping stone in my career. While in CA I stumbled upon a radio talk show where the host, Dr. Dean Edell took calls and answered medical questions on the air.
Prior to hearing this radio talk show (and the expectant mothers calling about the issue), I had never once given much thought to the fact that I had been circumcised or questioned the prevailing idea that “it’s just what you do.” Needless to say, after hearing the history of this practice in the US (introduced by Dr. Kellogg to curtail the sexual pleasure of boys) and the spurious/questionable research studies that support the health benefits, I started to question the efficacy of this practice. I only lived in CA for about three years, but when I moved back to the east coast I brought with me a view on this matter that was, sadly, uncommon in our culture. RIC circumcision is unnecessary and unethical.
For about 18 years I held these views quite privately, not mentioning my opinion to anyone – besides, of course my wife. It’s an awkward subject. How do you bring it up to family and friends? It’s almost taboo. So, regrettably, I remained silent and during those 18 years countless boys were born to family members and friends and, most certainly, a majority of them were, like myself, welcomed with a knife!
The above sets the stage for what follows.
About two years ago I had heard of a news story that inspired me to become outspoken and very vocal on this issue. A mother in Florida was trying to protect her son (who was four at the time) from being circumcised at the wishes of the boy’s father (http://abcnews.go.com/US/wireStory/arrest-ordered-woman-fled-son-circumcision-29533586). When I had heard of this story (and of the brave and courageous mother standing up against such an engrained social norm), I decided that I could no longer sit on the sidelines, being silent on this issue. I had to find my own courage to speak out!
My first efforts were to disclose my feelings on social media. Indeed, some might think it ill-advised (perhaps even inappropriate) to use such a forum for a topic as delicate and private as this. However, I felt I had a moral obligation to reach as wide of an audience as possible (though I only had about 100 “friends”). Sadly, though not unexpectedly, my postings draw little attention (few “likes” or comments), however I am certain they did turn a few heads and pried opened a few eyes!
My next effort was to join a small (very small!) protest at a local hospital.
It took me a good ten minutes upon arriving at the venue to actually leave my car and go pick up that sign! I felt as though I was about to confront the entire world! Standing on that corner (just the three of us) felt so uncomfortable to me; I felt exposed – almost like I was standing alone on the corner in Time Square shouting to the world “THE EMPEROR HAS NO CLOTHES!” Indeed, passersby saw my sign, and a few even stopped to chat. However, in the end I realized that street protesting was likely not the best path for me. I had to find another way, a better way, a way that was “uniquely” mine to reach that audience.
I am standing on the left on this street corner near Robert Wood Johnson University Hospital in New Brunswick, NJ; December, 2014. To the right is Craig Adams of Intact New Jersey.
My third effort (as described below) was where I felt I had hit my stride! Where I felt I belonged! Where my time and my energy and my experience could be leveraged to indeed reach not only the WIDER audience that I had longed to reach, but also the AUDIENCE that I needed to reach! The medical community!
After all, it was THAT AUDIENCE that had engrained in my parents (and the rest of society) the idea: it’s cleaner, it’s healthier, it prevents disease.
Upon hearing the story of the mother in Florida, I thought it prudent to dig deeper into the scientific literature on circumcision. And what I had noticed was that very few peer reviewed scientific research articles used the term intact when referring to the natural state; uncircumcised was the overwhelming word of choice. I do not know the specific history of when the word intact was injected into the lexicon regarding the natural, unaltered state of male anatomy, but it certainly seems more fitting of a term, from a scientific perspective, than a word that dates from antiquity having previously been synonymous with heathen or uncivilized (The Holy Bible). Also, a majority of the world’s males are in the natural state (World Health Organization), so why are they relegated to the 'un-group?' It would be absurd for someone to suggest that the majority of women on this planet should be considered unmastectomized!
I had mentioned above that I had spent three years in CA. I found myself in the City By The Bay as a result of pursuing a career path to become a College Biology Professor/Research Scientist; at this moment I partly wonder if the below developments are the real reason fate had brought me to the west coast to be awakened by Dr. Dean Edell!
My background is in marine science (I hold a PhD in Oceanography) and my research focuses on various aspects of pollutant toxicology in marine organisms. As of this writing, I am lead or co-author of 30+ peer reviewed scientific research articles that have been published in a variety of journals in my field of study. I provide this information not to be boastful (and I hope it does not come across that way), but rather to highlight the fact that I realized that this experience in publishing in the scientific literature might put me in a unique position uncommon among other “social media posters” or “street protesters” speaking out against circumcision. I am in no way associated with the medical field, but my profession and experience might afford me the opportunity to successfully inject an “outsider’s” opinion into the medical literature on this issue.
Being a research scientist, and always trying to approach my research from an unbiased perspective, I realized, if a researcher is using the word uncircumcised (which suggests that the default state of male anatomy is to be circumcised) there is NO WAY they can truly be unbiased! The research question (what is better? to be circumcised or to be uncircumcised) is flawed as it has this bias embedded in it! I realized what I needed to do. I had found my way to protest! I would highlight to the scientific and medical communities why it is inappropriate to use this offensive, pejorative and outdated term in the scientific literature!
I started penning my letter of protest (a “Letter to the Editor” to a medical journal) but struggled with initial drafts. I needed a good “hook” - an iron clad, an undeniable thread of logic for why the term needed to be changed – but nothing was coming to me. Then, from out of the blue it hit me: The medical community has, in the past, up-dated its language and had universally adopted a more respectful term to describe a “state of being” once the offense was officially pointed out to them! And this change in medical terminology trickled down to society as a whole!
The term “Mongolism” had been replaced with the term “Down syndrome” [Allen, G. Benda C.J. et al (1961). Lancet corr. 1, 775; http://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC1932135&blobtype=pdf]. This was my hook! Not only had a previous, offensive term (Mongolism) been replaced with a more clinical, more respectful term, but the old term had become so “out of vogue” that it has essentially vanished from common usage in both the clinical and social setting!
This graph shows the usage (from ~1960 – 2010) in the scientific literature of a variety terms that have described the condition now referred to as Down’s Syndrome; citation - Rodríguez-Hernándeza, ML, Montoyaa E (2011). Lancet corr. 378, 402); note the precipitous drop in the use of Mongolism from ~1960-1980 - http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(11)61214-2.pdf
I then built my argument around that precedent – evidence that the medical community and society can indeed adopt new language when presented with obvious and undeniable logic regarding the need for such a change. I submitted my “Letter to the Editor,” and after two rejections, my letter was accepted and published by the third journal, the Journal of Clinical Anatomy.
An Undeniable Need for Change: The Case for Redefining Human Penis Types (Wallace 2015a)Wallace, W. G. (2015), An undeniable need for change: The case for redefining human penis types: Intact, circumcised, and uncircumcised (all three forms exist and all are different). Clin. Anat., 28: 563–564. [http://onlinelibrary.wiley.com/doi/10.1002/ca.22541/abstract]My original intent was to simply solidify the idea that from henceforth males in the natural, unaltered condition should be referred to as being intact. However, because of my familiarity with the idea of foreskin restoration, I thought it appropriate to also include this condition in my thesis. Previous authors had referred to these man as being uncircumcised because they had “un-done” the previous circumcision (Bigelow J. 1994. The Joy of Uncircumcising!: Exploring Circumcision: History, Myths, Psychology, Restoration, Sexual Pleasure, and Human Rights. Hourglass Book Pub, second ed. 242 p.; http://www.amazon.com/The-Joy-Uncircumcising-Circumcision-Restoration/dp/093406122X). Although I echoed this usage, I acknowledged the confusion this might cause, but as of the writing of that article the medical community had no term for this condition. The below figure and final few sentences from An Undeniable Need for Change: The Case for Redefining Human Penis Types (Wallace, 2015a) summarize the ideas presented in my “Letter to the Editor.”
“…There would then be three useful, respectful and scientifically sound terms to refer to the possible penis types that exist: intact (those in the natural state), circumcised (those with the prepuce removed) and uncircumcised (those with a restored prepuce or pseudo-prepuce)(as in Fig. 1). For the medical community to not change the vernacular describing penis types, given all of the above, would be UNCONSCIONABLE! And isn’t conscionable the preferred state?...”
[Wallace, W. G. (2015), An undeniable need for change: The case for redefining human penis types: Intact, circumcised, and uncircumcised (all three forms exist and all are different). Clin. Anat., 28: 563–564; http://onlinelibrary.wiley.com/doi/10.1002/ca.22541/abstract]The publishing of this “Letter to the Editor” was my way to stand on the street corner holding a sign of protest, shining a spot light on something so obvious! This biased and pejorative term had to be stricken from the scientific literature! Interestingly, while preparing Wallace 2015a I had heard that some journals would not even publish research findings if the authors used the term intact, thereby forcing them to use uncircumcised. If this is indeed true, this suggests a DEEP BIAS in the scientific and medical communities!
This, making the case to replace the word uncircumcised with the word intact was where this story was supposed to have ended. However, something quite unexpected and quite serendipitous unfolded as a result of the publishing of Wallace 2015a (An Undeniable Need for Change: The Case for Redefining Human Penis Types).
Upon reading Wallace 2015a, another author (R. Hill), although agreeing with the proposed replacement of uncircumcised with intact was not comfortable with the suggestion of using uncircumcised to refer to those men who have reversed at least some of the damage caused by circumcision. He thought it better to use the word restored and penned his own “Letter to the Editor” (Hill 2015) in response to mine (Wallace 2015a).
Altered Anatomy Demands Dedicated Terminology (Hill 2015) Hill, R. V. (2015), Altered anatomy demands dedicated terminology: A response to Wallace (2015). Clin. Anat., 28: 960–961. [http://onlinelibrary.wiley.com/doi/10.1002/ca.22594/abstract]
Indeed, many men who have pursued reversing their circumcision through various skin expansion methods refer to themselves as being restored. So, agreeing with R. Hill’s critique and suggestion was most appropriate.
The editor of the journal was kind enough to give me the opportunity to officially respond to this criticism (of which I wholeheartedly agreed – and regretted not having proposed restored in the first place) and published my second “Letter to the Editor” (Wallace 2015b) along with Hill's letter (Hill 2015) in the same issue of the journal. Beyond thanking R. Hill for the critique, I seized upon the opportunity to highlight not only the benefits of foreskin restoration, but also challenged the medical community and society at large to extend to circumcised men who seek “wholeness” the same level of compassion and respect that is extended to others who pursue “wholeness” following an anatomical loss (the woman following a mastectomy, the solider who lost an arm in war or the girl who lost a leg in a car accident). These victims are almost universally referred to as being BRAVE! In my second “Letter to the Editor” I asserted that men who seek “wholeness” due to this most private of anatomical losses are also, if not more so, deserving of the title BRAVE as THEIR LOSS was not the result of a disease or the horrors of war or a terrible accident, but rather, in most cases, THAT LOSS was imposed upon them at birth!
An Undeniable Need for Recognition: What do you call a man who has undergone foreskin restoration? (Wallace 2015b)The above conversation* constitutes a dialog in the scientific literature that is long overdue. Not only should the un-word be replaced with intact, but those men who seek a renewed sense of wholeness following that loss should not only be proud of their efforts, but the medical community and society should recognize their plight and consider them as being MOST BRAVE!
Wallace, W. G. (2015), An undeniable need for recognition: What do you call a man who has undergone foreskin restoration? “Uncircumcised”? “Restored”? How about just BRAVE?A response to Hill (2015). Clin. Anat., 28: 962–963. [http://onlinelibrary.wiley.com/doi/10.1002/ca.22600/abstract]
And this brings us full circle.
A BRAVE mother in Florida, standing up for the rights of her son helped to inspire me to speak out. Her bravery, in the end, resulted in the publishing of the above letters that are now preserved in the scientific lecture. They are there for anyone to find, those in the medical field in particular, should they search the key words: circumcised, uncircumcised, intact, restored or foreskin restoration. This, my ultimate form of protest, now can reach every computer screen in the world (not just those on my “friends list”) and potentially every eye (not just those passing my sign on the street corner)!
Will these “Letters to the Editor” help change the vernacular on this topic? Will they help reframe the discussion and change the research question to: what is better? to be circumcised or to be intact? Who knows. But by simply using the word intact to begin with, a completely new connotation emerges – one that, perhaps, the medical community may not want emphasized! Intact is synonymous with whole, complete, which then begs the question; why is there a need to alter “the whole” or alter “the complete?” To win the fight for the rights of infant boys, perhaps the battle is best waged at the most basic of levels. Destroy the offensive term; have it pass into to history, like so many other offensive terms! Once the word describing this state of being has been replaced with something more respectful, then, perhaps the condition itself (i.e., being natural, whole, intact) will start being respected as well – and not viewed as something that needs to be remedied upon arrival into this world! And then, once RIC falls out of fashion, the need for men to reverse this imposed anatomical loss (and be BRAVE while doing it) will no longer be necessary!
I hereby dedicate my first “Letter to the Editor” (Wallace 2015a) to that BRAVE mother in Florida. Had the un-word passed into the history books long ago, perhaps there would not have been a need for her to make a stand first place!
And in a sad twist of fate, while writing this review (~11/2015), it came to my attention that this mother lost her fight to protect her son. I therefore now dedicate my second “Letter to the Editor” (Wallace 2015b) to this boy. Unlike most males who had had circumcision imposed upon them at birth, this boy was fully aware of his body before experiencing this loss. Should, upon coming of age, he ever seek to reverse what was done to him, it is my hope that the medical community and society recognize how BRAVE he truly is (and how BRAVE he has had to be)!
I regret that for 18 years I sat silent, afraid to utter a word out of fear of making those in my world uncomfortable. However, during that time countless boys were born to family and friends, and most were likely modified soon after their arrival; perhaps I could have saved them?
However, now I am silent no more. I declare in the most undeniable of ways that from hence forth, not only should the natural state and the majority of the males on this planet be referred to as being intact, but with the help of R. Hill, affirm that the only possible remaining use and purpose of the un-word is to offend, degrade and oppress those unlike the circumcised – which, historically, was essence of the word’s original purpose (The Holy Bible)!
The un-word is dead!
Use it, and be viewed as [from Wallace 2015a):
uninformed (as research shows that the male prepuce has a function [Hill, 2007]);
unethical (as there are risks associated with removing healthy tissue [Hill, 2007]);
unenlightened (as a majority of the world’s males have their foreskins and should not be considered as being in an ungroup because of that fact [W.H.O., 2007])
William G. Wallace, PhD
[*For those without online access to the Journal of Clinical Anatomy these articles are available upon request form the authors or by emailing SavingSons@gmail.com]
Allen G, Benda C. E., Book J. A., et al. 1961. Mongolism. Lancet 1(775): 426.
Bigelow J. 1994. The Joy of Uncircumcising!: Exploring Circumcision: History, Myths, Psychology, Restoration, Sexual Pleasure, and Human Rights. Hourglass Book Pub, second ed. 242 p.
The Holy Bible: 1 Chronicles 10:4, Genesis 34:14, Isaiah 52:1 & Ephesians 2:11 (among others).
Hill G. 2007. The Case Against Circumcision. J Men’s Health and Gender. 4(3):318-23.
Hill R. V. 2015. Altered anatomy demands dedicated terminology: A response to Wallace (2015). Clin Anat, 28:960–961.
Rodríguez-Hernándeza, M. L., Montoyaa E. 2011. Fifty years of evolution of the term Down’s Syndrome. Lancet corr. 378, 402.
Wallace W. G. 2015a. An undeniable need for change: The case for redefining human penis types: Intact, circumcised, and uncircumcised (all three forms exist and all are different). Clin Anat 28:563-564.
Wallace W. G. 2015b. An undeniable need for recognition: What do you call a man who has undergone foreskin restoration? “Uncircumcised”? “Restored”? How about just BRAVE? A response to Hill (2015). Clin Anat, 28: 962–963.
World Health Organization, Department of Reproductive Health and Research and Joint United Nations Programme on HIV/AIDS (UNAIDS). 2007. Male circumcision: global trends and determinants of prevalence, safety and acceptability. 44 pages.(ISBN 978-92-9173-633-1).
INTACT: Let's use correct terminology (Frisbie, 2008)
Thank you Dr. Wallace, I support your efforts to shed light on this deplorable practice. "Intact" does change the nature of the discussion, but, "ruined" more clearly describes a butchered penis. While the look can be restored, the function of the nerves of the foreskin is lost forever.ReplyDelete