Sex and Male Circumcision: Women’s Preferences Across Different Cultures and Countries: A Systematic Review

Abstract

Introduction: Women's choices for a sexual partner are influenced by numerous personal, cultural, social, political and religious factors, and may also include aspects of penile anatomy such as male circumcision (MC) status. Aim: To perform a systematic review examining (i) whether MC status influences women's preference for sexual activity and the reasons for this, and (ii) whether women prefer MC for their sons. Methods: PRISMA-compliant searches were conducted of PubMed, Google Scholar, Embase, and the Cochrane Database of Systematic Reviews. Articles that met the inclusion criteria were rated for quality using the SIGN system. Results: Database searches identified 29 publications with original data for inclusion, including 22 for aim (i) and 4 of these and 7 others pertaining to aim (ii). In the overwhelming majority of studies, women expressed a preference for the circumcised penis. The main reasons given for this preference were better appearance, better hygiene, reduced risk of infection, and enhanced sexual activity, including vaginal intercourse, manual stimulation, and fellatio. In studies that assessed mothers' preference for MC of sons, health, disease prevention, and hygiene were cited as major reasons for this preference. Cultural differences in preference were evident among some of the studies examined. Nevertheless, a preference for a circumcised penis was seen in most populations regardless of the frequency of MC in the study setting. Conclusion: Women's preferences generally favor the circumcised penis for sexual activity, hygiene, and lower risk of infection. The findings add to the already well-established health benefits favoring MC and provide important sociosexual information on an issue of widespread interest. Morris BJ, Hankins CA, Lumbers ER, et al. Sex and Male Circumcision: Women's Preferences Across Different Cultures and Countries: A Systematic Review. Sex Med 2019;7:145e161.

Critical evaluation of arguments opposing male circumcision: A systematic review

“…The reasons given by women for favoring MC were also esthetics, vaginal penetration, hygiene, and reduced infection risk . A systematic review of all 29 relevant publications found the same, as did a smaller systematic review …”

“…The reasons given by women for favoring MC were also esthetics, vaginal penetration, hygiene, and reduced infection risk. 149 A systematic review of all 29 relevant publications found the same, 150 as did a smaller systematic review. 151 A list of "16 functions of the foreskin" 152 (Table 3) compiled by opponents, and widely circulated on the Internet will now be evaluated in relation to data, when available, there being no evidence to assess the veracity of some of the claims.…”

“…The purported lubrication provided by "gliding" should reduce pain during intercourse (dyspareunia). However, most studies reported either no difference or less pain in circumcised men, [119][120][121][122][124][125][126][127]165 and their female sexual partners 149,150 (Table 5). Contrary claims appeared to be based on speculation, anecdotes, or low-quality studies.…”

Critical Evaluation of a Survey Claiming “Long-Term Adverse Outcomes from Neonatal Circumcision”*

“…Since the scientific evidence finds no adverse effect of MC on sexual function and satisfaction one might suspect that the views expressed had arisen from the "information" provided by the online groups the participants were affiliated with. "Prominent circumcision scar(s) 63%" and "Drastic skin tone variance on either side of the scar 46%" might apply to some adult MCs, but contradicts the favourable cosmetic result and appearance consistently reported for the circumcised versus uncircumcised penis by women [105]. Moreover, skin tone variance applies to the uncircumcised penis when erect if the foreskin retracts.…”

“…Willingness by men was particularly high for getting their sons circumcised (e.g., see [94] [102] [103]). Most women in different countries would encourage an uncircumcised partner to get circumcised, and most preferred circumcision for sons (see systematic reviews [104] [105]).…”