Does Male Circumcision Adversely Affect Sexual Sensation, Function, or Satisfaction? Critical Comment on Morris and Krieger (2013)

Boyle, Gregory J.

doi:10.4236/asm.2015.52002

Cited by 7 publications

(12 citation statements)

References 34 publications

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“…Gregory Boyle, a psychologist with a track record of opposition to male circumcision, recently published a critique [2] of our systematic review. In essence, he disputed our high rating for two randomized controlled trials by scientists with strong track records and objected to the low rating we gave several studies with flawed study design, data interpretation and one-sided arguments.…”

Section: Introductionmentioning

confidence: 99%

Male Circumcision Does Not Reduce Sexual Function, Sensitivity or Satisfaction

Morris¹,

Krieger²

2015

ASM

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We disagree with Boyle's recent article questioning our systematic review in Journal of Sexual Medicine in 2013 (Volume 10, pages 2644-2657). In particular, he disputed the quality ranking we assigned to 7 of the 36 articles that met our inclusion criteria. These had been ranked for quality by the Scottish Intercollegiate Guidelines Network (SIGN) grading system. We found that, "the highest-quality studies suggest that medical male circumcision has no adverse effect on sexual function, sensitivity, sexual sensation or satisfaction." This conclusion was supported by two randomized controlled trials, regarded as high-quality (1++) evidence and the majority of surveys and studies involving physiological measurements comparing uncircumcised and circumcised men. Here we explain why the 2 randomized controlled trials merit a 1++ ranking and why 4 reports that Boyle believes merit a higher ranking only meet the criteria set down for low quality (2−) evidence according to the SIGN system. We therefore stand by our conclusions. These are supported by a meta-analysis of sexual dysfunctions and by a recent detailed systematic review of the histological correlates of male sexual sensation.

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Section: Introductionmentioning

confidence: 99%

Male Circumcision Does Not Reduce Sexual Function, Sensitivity or Satisfaction

Morris¹,

Krieger²

2015

ASM

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“…A meticulously conducted systematic review of all studies found that, overall, MC had no adverse effect on penile sensitivity, sexual arousal, sexual sensation, or pleasure . Criticisms of that study were shown to lack merit . The findings were consistent with a systematic review of histological correlates of sexual sensation showing that the sensory receptors responsible for sexual pleasure (genital corpuscles) reside in the glans, not the foreskin, meaning loss of the foreskin by MC should not diminish sexual pleasure .…”

Section: Physical Harmmentioning

confidence: 54%

“…Several studies concluded that MC diminishes sexual pleasure for men and their female sexual partners. [131][132][133][134][135][136][137] Evaluation of these identified multiple flaws. 119,[138][139][140][141][142][143][144] Other studies, [145][146][147][148] including RCTs, [125][126][127]149 found MC had no adverse effect.…”

Section: Sexual Pleasurementioning

confidence: 99%

“…Frisch & Simonsen 2015 93 Bauer 2015, 101 Morris & Wiswell 2015, 94 146 Kigozi et al 2009 149 Zulu et al 2015 148 Boyle & Bensley 200 132 Morris & Krieger 2013 119 Kim & Pang 2007 133 Willcourt 2007 138 Sorrells et al 2007 134 Waskett & Morris 2007, 139 Morris & Krieger 2013, 119 Cox et al 2015, 143 Bossio et al 2016 144 Frisch et al 2011 135 Morris et al 2012, 140 Morris et al 2013 119 Bronselaer et al 2013 136 Morris et al 2013 141 Boyle 2015 137 Morris & Krieger 2015 142…”

Section: Autism Spectrum Disordermentioning

confidence: 99%

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Critical evaluation of arguments opposing male circumcision: A systematic review

Morris

Moreton²,

Krieger

2019

J Evidence Based Medicine

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Objective To systematically evaluate evidence against male circumcision (MC). Methods We searched PubMed, Google Scholar, EMBASE and Cochrane databases. Results Database searches retrieved 297 publications for inclusion. Bibliographies of these yielded 101 more. After evaluation we found: Claims that MC carries high risk were contradicted by low frequency of adverse events that were virtually all minor and easily treated with complete resolution. Claims that MC causes psychological harm were contradicted by studies finding no such harm. Claims that MC impairs sexual function and pleasure were contradicted by high‐quality studies finding no adverse effect. Claims disputing the medical benefits of MC were contradicted by a large body of high‐quality evidence indicating protection against a wide range of infections, dermatological conditions, and genital cancers in males and the female sexual partners of men. Risk‐benefit analyses reported that benefits exceed risks by 100‐200 to 1. To maximize benefits and minimize risks, the evidence supported early infant MC rather than arguments that the procedure should be delayed until males are old enough to decide for themselves. Claims that MC of minors is unethical were contradicted by balanced evaluations of ethical issues supporting the rights of children to be provided with low‐risk, high‐benefit interventions such as MC for better health. Expert evaluations of case‐law supported the legality of MC of minors. Other data demonstrated that early infant MC is cost‐saving to health systems. Conclusions Arguments opposing MC are supported mostly by low‐quality evidence and opinion, and are contradicted by strong scientific evidence.

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“…Evidently, many circumcised men feel so distressed about having been subjected to involuntary genital cutting as non-consenting infants or children, thereby depriving them of normal sexual responsivity, that they feel compelled to endure years of difficult and sometimes painful penile skin-expansion "foreskin restoration" efforts. Some passages in the preceding section have been adapted from Boyle[119].…”

mentioning

confidence: 99%

Circumcision of Infants and Children: Short-Term Trauma and Long-Term Psychosexual Harm

Boyle¹

2015

ASM

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Non-therapeutic infant male circumcision is a permanent surgical alteration to the penis that may cause significant physical, sexual and psychological harm. Physical harms include unintended adverse effects of the surgery itself (e.g., complications such as bleeding, infection, excessive removal of foreskin leaving insufficient shaft skin to accommodate erections, etc.), as well as the inherent loss of healthy, functional tissue. Sexual harms that necessarily follow from circumcision include the loss of all sensation in the foreskin itself, and the loss of all sexual functions that involve the physical manipulation of the foreskin. Additional sexual harms that may follow circumcision include reduced sexual sensation in the remaining penile structures, difficulty with masturbation, increased chafing in both the circumcised man and his sexual partner, as well as reduced overall psychosexual/psychological tension relief and subjective satisfaction. Psychological harms include short-term trauma as well as the potential for long-term emotional disturbances, including sadness, frustration, distress, and anger-akin to post-traumatic stress disorder (PTSD). In this paper, the extent and severity of these various harms are considered and it is argued that they are more serious and more widespread than is commonly believed.

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Does Male Circumcision Adversely Affect Sexual Sensation, Function, or Satisfaction? Critical Comment on Morris and Krieger (2013)

Cited by 7 publications

References 34 publications

Male Circumcision Does Not Reduce Sexual Function, Sensitivity or Satisfaction

Male Circumcision Does Not Reduce Sexual Function, Sensitivity or Satisfaction

Critical evaluation of arguments opposing male circumcision: A systematic review

Circumcision of Infants and Children: Short-Term Trauma and Long-Term Psychosexual Harm

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