Dr. John Warren: Awakening to the Damage of Circumcision and the Value of Foreskin

Dr. John Warren (MB, BChir, DCH, FRCP), founder of NORM-UK, discusses his personal discoveries regarding:

  • The harm of Circumcision
  • Foreskin “restoration”
  • The movement to protect the genital integrity of all children.

(slightly modified)

There were 3 stages in my becoming an intactivist, starting from the age of 4 [years].

I'm the youngest of 3 children; I have an older brother and an older sister. My dad was a doctor (I never knew him, because he was killed in the Second World War [(WWII)]). When I was about 4 or 5 [years old] and having a bath—mother bathing me and my brother—I noticed that his penis was different from mine, and obviously—as you do—I thought there was something wrong with his penis, so I asked my mother why it was like that. She explained to me that I had had an operation [wherein] a piece of skin [had been] removed from my penis because it was “a bit tight”, and that [my brother] hadn't had this done [to him]. Then she added:

Your father didn't approve of it.

Even though I was a very young child at the time, I've always remembered that ever since; it's always been in the back of my mind—that it was something which I suppose I sensed was controversial even then. I didn't think much more about it—quite a lot of the boys [back then] were circumcised (I think it was about 50%).

I took up medicine like all the other people in my family. One of my teachers in Cambridge was a man called Douglas Gairdner who had written a paper published in 1949 (many years before I met him) called:

Fate of the foreskin: A study of circumcision

which was very influential on the history of circumcision (in at least Britain, [and] perhaps also [in] some other English-speaking countries, [namely New Zealand and Australia]). [I think that] as a result of his studies, [routine] circumcision was not taken up by the National Health Service in Britain when it was set up.

I went on to be a junior doctor, and I did some surgery. I wasn't destined to become a surgeon, but in the training system, you had to do 6 months of surgical training [in] whatever branch of medicine you were going [to practice]. So, one day, I was in an operating theater as the most junior person there with all of these more senior people to meet, and they [wheeled] in a child ([perhaps a 5-to-7 year old boy], anesthetized), and they [said]:

Oh, this boy is going to have a circumcision.

and they tell me I am [the one who is going] to do it. So, I carried out the circumcision, being told what to do by the senior surgeons there:

  • You cut here.
  • Put a stitch in.
  • Do this.
  • Do that.

and this was the first time [that I had really] seen a foreskin; [we] completely unraveled it to see how big it was, how much tissue there was, etc.

This was, I think, my next epiphany or awakening after the moment in the bath. Seeing [that the foreskin in this case] was perfectly normal healthy tissue—I could see that! (it wasn't diseased in any way)—I thought we shouldn't really be doing this. I didn't say anything to my senior colleagues, obviously; you didn't argue with them—not in those days!

I thought very hard about what I was doing; I didn't like it—I was thinking all the time:

Somebody did this to me!

I think I had a few sleepless nights after that; I had seen lots of other operations and all the common things ([appendectomies, herniotomies], and all this), and they hadn't bothered me, but this circumcision really upset me. We were doing this [destructive act] to this normal looking boy's penis. It struck me that it was a bit like taking a little rose bud that hasn't opened [yet] and peeling off all [of its] petals and so on—just spoiling it; that I never forgot, and I never did another circumcision.

Then, the next job I did after the [surgery rotation] was in pediatrics. That was in 1968, and I was studying for a pediatric exam. So, I was reading all the literature as it appeared in the library, going through back copies of the pediatric journals. In the summer of 1968, in the latest copy of:

Archives of Diseases of Childhood

appeared a paper by a Danish doctor named Jakob Øster:

Further Fate of the Foreskin: Incidence of Preputial Adhesions, Phimosis, and Smegma among Danish Schoolboys

It was a continuation of the study which had been done by Gairdner, who [had] only studied what happens with the development of the foreskin up to about the age of 4 years; this Danish doctor pursued the fate of the foreskin—how it develops—right through to age 18 [years] (virtually to adult life).

Whereas Gairdner's paper had shown that at the age of [around 4 years old], about 10% of foreskins could still not be retracted, Øster continued to observe these Danish boys beyond that [age] and did not intervene [with the inability to retract]—they weren't circumcised—and [he] showed, as far as I recall, that [only] about 1% [of the boys] were still not able to retract [their foreskins] by the age of 17 or 18 [years]; in other words, of the 10% that Gairdner perhaps thought were abnormal, the vast majority of them actually did continue to develop [normally]. [NOTE: In 1999, Shankar and Rickwood published the following 2-year study:

The incidence of phimosis in boys

which found that:

The incidence of pathological phimosis in boys was

0.4 cases/1000 boys per year, or 0.6% of boys affected by their 15th birthday,

a value lower than previous estimates and exceeded more than 8-fold by the proportion of English boys currently circumcised for ‘phimosis’.]

I read [Øster's] paper in 1968 and thought:

Well, that's a very important finding!

[Now people will see that] it [isn't] necessary to do all these circumcisions like the one I had [to do] a few months earlier. You don't need to do that [to] boys this age! If you just leave them alone, they'll come around. Circumcision will obviously disappear now after this [finding]. It's not necessary.

[Eventually], I was getting middle-aged, and I became aware that I really had very little feeling in my own penis—that it was very insensitive, [and] that during sex, I didn't really know what was happening down there; [I] couldn't feel much at all, and I thought:

This can't be right! The [head] of the penis, which is [commonly thought of as being so sexually sensitive] really has no sensation.

Why is this? Nature [couldn't] have intended that!

Then, of course, I thought back:

Oh yes, well… circumcision. That's the reason—it must be; it can be the only explanation that I have no feeling in the glans [or “head”] of the penis, because it's so insensitive.

Other parts of the penis were a bit more sensitive, but the front end really had no feeling in it at all [NOTE: See the above link]. I got quite upset about this, and [wondered]:

Does anyone know this? Are people aware of this?

I started to look in the medical literature. [At that point in time], it was very difficult to find much being published about the [purpose of the] foreskin, about feeling in it, or anything like this. It was just around that time (1993) [that] I opened my ordinary daily newspaper one day [to discover] a review by the medical correspondent:

They took my foreskin, and I want it back

Some men feel their circumcision at birth was an assault. Now they can be ‘uncircumcised’ without surgery, writes Cherrill Hicks.

[The article was] about a book which was being published in California:

The Joy of Uncircumcising: Restore Your Birthright and Maximize Sexual Pleasure

By Jim Bigelow, Ph.D.
Forward by James L. Snyder, M.D.

[The book is] about “foreskin restoration”, and [the article says] there [are] many in California who [were] circumcised and [aren't] happy with this result, and I think [the article] probably [talks] about sensation and that [men are] stretching their skin to get it to cover the glans again.

I thought this was of great interest. [I acquired the book]. I didn't know quite what to expect—I thought [that] maybe this is some [crackpot] thing (“This will be nonsense!”), but when I opened the book, I immediately saw that [it is] a scholarly work, properly researched [and] referenced, written by a man who had obviously thought very deeply about this [issue].

[The book] really echoed my own feelings, which I had thought privately for some time—that the foreskin [is] an important organ, that it [produces useful] sensation, [and] it [is] there for a purpose.

I am a great [proponent of the theory of] evolution; in my study of the human body, [I discovered that] there's always a reason for a structure being present—it has a function. Sometimes, scientists are not always [certain about] the reason, but I'm sure there is a reason [for whatever structure might be in question]—[the process of] evolution doesn't [allow for keeping around many] stupid mistakes.

Obviously, the foreskin is there for a reason, and if it isn't in the medical textbooks, [that's] just because it hasn't been discovered, or investigated, or reported, but surely it has a function. I [had] been thinking this for a long time:

Obviously, its function [has] to do with sensation as much as anything [else].

Then, when I read this book by Bigelow, it echoed my thoughts—it expanded them; there was a lot more [information] there [about which] I hadn't thought, [such as the revelation of] the rolling action of the extra [tissue provided by the foreskin]—when I say “extra” [tissue], I mean normal [tissue] on the penis (of course, I had never experienced [this]).

So, [reading this book] was [my] third and final awakening.

I was so intrigued by this book that I contacted Mr. Bigelow and had lengthy trans-Atlantic telphone calls [with him]. [Eventually], I said:

Well, you know, I think I need to come over to California and meet you, because there's nobody in Britain who is aware of what you're doing.

A few months later I did [go] over to San Francisco—it was the first time I had been to the United States. I met Jim Bigelow and a number of other people involved in [the Intactivist Movement] and the Foreskin Restoration Movement. I became aware of the important work which was going on [in San Francisco] with regard to preventing circumcision and helping men who had been circumcised. When I left, I said:

Look, if you get other British men contacting you about this subject, by all means, put them in touch with me; I'm a doctor, [and] I'm quite happy to take calls about this sort of thing.

So, gradually over the next few months, I started getting letters and telephone calls from men—not very often, but they were coming through—and I would have these men saying:

I've never talked to anybody about this before. I was circumcised when I was a child, and this is how it has affected me…

They had never talked to anyone before, and yet all their stories to a large extent overlapped—they were consistent with one another; there was obviously what we might call in medical terms a sort of post-circumcision syndrome—symptoms, which I kept hearing again and again.

  • They were complaining [about] loss of feeling—usually loss of sexual feeling.

  • Some men would say that clothing [rubs on the exposed glans penis, constantly producing] an unpleasant sensation.

  • They lacked normal, enjoyable sensations from the penis during sex.

  • Others would say they were so ashamed—they were deeply ashamed—of the fact that they had been mutilated. They felt mutilated. They were so ashamed, they wouldn't undress usually in front of other men (they were [often] more ashamed in front of other men than women), though some would say they were ashamed in front of any person and were quite unable to have any sort of sexual contact because they were so deeply ashamed of what had been done to them. Many would say:

    I won't go in a changing room—I stopped doing sport; I can't risk anyone seeing me in a shower or anything like that, because [I'm] so ashamed of [my] mutilated genitals, really.

I contacted these people, and [asked whether they] would like to come to a meeting about circumcision, because there [were] quite a number of men now who [had] been contacting me. This meeting took place, and I think we had about 20 men there, and I just let each man tell his story around the room, and it was a very moving experience—I had heard their stories before, but of course they hadn't; it was just an electric atmosphere in the room—I had never seen anything like it, really. Out of this, I said at the end:

Shall we have another meeting? Do you want to talk about restoration?

Of course, most of them did! So, that's how NORM-UK was born.

We ran support groups for men who wanted to restore, but of course, [we] couldn't just confine [our] activities to foreskin restoration; all [participants] wanted [to discuss how we could stop this assault from happening to the next generation].

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