Circumcision is a Consent Issue12/26/2022 An Interview with Sex & Kink Educator Winter Tashlin  Bodily autonomy is key to consent. “My body, my rules” is a common catchphrase of the feminist movement — and rightfully so! When we think about bodily autonomy, we often think of the right to choose whether or not to have an abortion or have sex (both of which are incredibly important rights!). But other bodily autonomy issues often get overlooked, minimized, or even scoffed at. For instance, infant circumcision is incredibly common in the United States, despite the fact that it is rarely medically necessary, and it is irreversible. Much like gender reassignment surgeries of intersex infants, routine infant circumcision is mainly performed for cosmetic or cultural reasons, and always without consent (since infants are incapable of giving consent). I recently spoke with sex and kink educator Winter Tashlin about what’s wrong with the current approach to circumcision in the U.S., how to teach about penis anatomy, and where the sex ed field is missing the mark. Pleasure Pie: How did you become interested in sex and kink education? Winter Tashlin: I was lucky enough to experience OWL (Our Whole Lives) comprehensive sex education as a teen in the 90s. It left a real impression on me in terms of how to think and talk about sex as a holistic part of the human experience. Then in college, I saw a presentation from Kim Airs talking about her life and about her sex toy shop, that likewise left me really impressed and excited by the spectrum of human desire and imagination. But my journey to becoming a sex/kink educator is a weird one. I got my start in public speaking/presenting because I have Tourette Syndrome, and when my symptoms got severe I gave a presentation to my whole middle school explaining what TS is and why I now barked like a dog. After that, I started doing presentations on TS regularly for schools and medical organizations alongside my mother, who was a special education teacher. From there, I started presenting in the pagan community in my early 20s. In 2006, I became friends with kink/spirituality educator Lee Harrington through the spirit worker community, and he, knowing that I was kinky in the bedroom, arranged for my first time presenting at a BDSM event. I absolutely bombed, but had such an incredible time that I set out to get good at presenting for that community. In the years since, I’ve presented across the country, been the assistant producer for a kink event company, and done TV, podcasts, and online video. PP: How did you become interested in circumcision? WT: Having been circumcised was an issue for me on both a psychological and physiological level from when I was very young. My penis always felt weird to me. As far back as I can remember, I would try and push it into my body to feel the glans covered. I was cut very tightly, and throughout childhood and adolescence erections were often painful, with the skin sometimes tearing from how tight it was. Having worked with multiple therapists and experts, I was eventually diagnosed with body dysphoria around my genitals, specifically having been circumcised. I was cut very tightly, and erections were often painful. Put simply, my brain never really adapted to the surgical alteration of circumcision, continually sending signals that my bits were wrong somehow. It’s hardly a universal experience, even among men who resent being cut against their will, but I’m also far from unique. I’ve done foreskin restoration intermittently over the years, which resolved the skin tightness, but I haven’t been able to take the process as far as I’d like because it still causes issues with dysphoria. PP: What are the functions of the foreskin? What are the effects of removing it? WT: The foreskin has several important functions. The glans of the penis isn’t covered in skin, but mucosa. It’s an internal body part, and being permanently exposed can cause it to become dry and keratinized. This, combined with constant stimulation from rubbing against clothing, can over time reduce the sensitivity of the glans. The same can be said of the inner foreskin — it’s also mucosa, rather than skin, with a mucocutaneous junction found most commonly at the end of the foreskin. A good anatomical analogy would be the eyelid, which is skin on the outside, mucosa on the inside, with a junction at the bottom of the lid. For many people, the frenulum is the most pleasurable part of their penis. The next important thing to understand about the foreskin is that it has a great deal of nerves and erogenous tissue. Many intact people find that the frenulum (the band of tissue that connects the foreskin to the glans) is the most sensitive part of their penis. Many people who are circumcised have some remnant frenulum and similarly report that it’s either the most pleasurable part of their penis, or plays a vital role in their penis’ erogenous responses. Then there’s the ridged band at the end of the foreskin, which is densely innervated. It is best thought of as being similar to the ridges of a fingerprint, which pack in more nerve endings in a small area than would be possible on a flat surface. The mucosa of the inner foreskin is also very sensitive for many people, be they intact or circumcised (the inner foreskin of a circumcised penis is the differently colored tissue found between the circumcision scar and the base of the glans). Moving on from there, we have the function of the foreskin in sexual activity. The gliding action of the foreskin greatly facilitates sexual activities, be they partnered or solo. Many people with intact penises forgo lubricant for solo play, and a mobile foreskin can greatly reduce the need for lubrication, and reduce a partner's discomfort during penetrative sex. So with all that in mind, let’s talk for a moment about the consequences of removing a foreskin. First off, we’ll address the best case scenario, which assumes that the surgery, aftercare, and recovery all go as well as can be hoped. For reasons I’ll touch on in a moment, this is far from a given, and circumcision complications are rather common. But on to the best case: a circumcised penis where everything has gone well will still have had between forty and sixty five percent of its skin surgically removed. This will include all of the sensitive ridged band, some, if not all, of the sensitive frenulum, and a significant portion of the inner foreskin. Some gliding action may remain, but it well may not. The internal portions of the penis have been made into external anatomy. In this sense, it is not inaccurate to say the penis has been turned inside out. The penis, which is naturally moist, will be dried out. The glans will likely lose some measure of sensitivity due to exposure and stimulation, a process that continues throughout the lifespan. Another issue that isn’t discussed often is that if a circumcised person grows up to find that they are a woman and wants to have a vaginoplasty as part of gender confirmation surgery, the significant reduction in available tissue will likely mean that she’ll need painful skin grafts from other parts of the body, while women with intact penises can often forgo skin grafts or require far smaller ones. But as I said, complications of circumcision are horrifyingly common. The foreskin is bonded to the glans of the penis at birth with connective tissue very similar to that which bonds the fingernail to the nail bed. This brings us to the first and most obvious complication: pain. Circumcision is a horrifyingly painful process, often excused with the fact that most people who experience it don’t remember it. Neonatal anesthesia is a far from exact science, and many babies show signs of significant pain during the operation even with anesthesia, which is still not used in all cases. Not to mention that pain during healing is significant. There have been studies looking at the consequences of that pain, and it can be concerning. Then there’s the fact that while the foreskin is torn away from the glans before the operation, that leaves a raw wound, and without careful and vigilant attention, the remnant foreskin can fuse into the glans, forming skin bridges that can be both unsightly and in some cases painful. The most commonly reported complication, however (mostly because it can require further surgical intervention, while other complications may be underreported) is meatal stenosis, which is estimated to affect around 23 percent of male circumcisions. This is when scar tissue builds up on the meatus, the opening of the glans through which urine and semen pass, causing it to narrow. This scar tissue can be a result of the operation itself, or of abrasion of the exposed meatus against a diaper, or exposure to fecal matter. If the meatus is too severely narrowed, it will need to be cut back open by a doctor. It’s an issue unheard of in an intact penis, in which the meatus is protected by the foreskin throughout infancy. Then there are some of the issues I personally experienced, such as a procedure that was too radical and removed far more tissue than was appropriate, not to mention people whose brains never adapt, like mine didn’t. Finally, there’s death. Somewhere around one hundred babies die every year due to circumcision complications, most commonly from excessive bleeding. PP: What problems do you see with the ways in which circumcision is practiced in the U.S.? WT: The biggest issue with how circumcision is practiced in the U.S. is that there’s a deep lack of understanding of intact penile anatomy and the value of having intact genitals. That’s closely followed, and deeply intertwined, with the fact that circumcision is a big money maker for doctors and hospitals, which gives a financial incentive to push the operation on parents. Aside from being able to bill for circumcision, which generally costs around $600 - $1000, hospitals routinely sell the amputated tissue for medical research, skin grafts, and to cosmetics firms. (Oprah famously touted the benefits of a skin cream made with cells that have been reproduced from amputated infant foreskins.) Circumcision is a big money maker for doctors & hospitals. We still see the circumcised penis as the default here in the States. That’s why we talk about “uncircumcised” penises, which makes about as much sense as describing someone as “untattooed.” Being unmodified should logically be the default. That also means that even if someone brings home a baby without the operation being performed, they may spend the next ten or more years of that child’s life trying to avoid doctors wanting to cut off or otherwise mistreat part of that child’s genitals. The foreskin naturally retracts over time, yet doctors and nurses routinely want to forcibly retract children’s foreskins. This means tearing the connective tissue bonding it to the glans, which is both painful and greatly increases the chances of complications that could require medical intervention in the future. Likewise, people with penises can get yeast infections, just like people with vulvas and vaginas can. Those yeast infections are easy to treat, but I personally know multiple people who’ve had circumcision recommended as a treatment for something that can be resolved with antifungal cream or medicine. Doctors in the U.S. often aren’t taught anything about foreskins other than how to cut them off, and when all you have is a hammer, every problem starts to look like a nail. PP: What advice would you give to sex educators for teaching about penis anatomy and circumcision? WT: Most people who are circumcised didn’t choose to be, so it’s vitally important to strike a balance between acknowledging the reality of intact penile anatomy without being overly negative about surgically altered anatomy. So for instance, I teach a whole class on penile anatomy, inventively called “Penile Anatomy for Play” and I always teach it with an intact live demo model. When I’m talking about how to understand and pleasure a penis in the class, I talk about the intact anatomy, and then I relate it back to what you might find in someone who has been circumcised. I focus on what anatomy you are likely to find, rather than what will be missing as much as I can. Even so, as educators we have to be prepared for the fact that sometimes what we have to say can unsettle people in a variety of ways, and when teaching Penile Anatomy for Play I’m always prepared for the possibility that I’m going to need to hold space for someone who finds themselves either upset due to what they’ve learned, or more often, having something they’ve felt for a long time suddenly make more sense after being given more information. Education always has the potential to be a tool of productive destruction, no matter what the topic, but especially when we’re working in areas as sensitive and intimate as sexuality. In that, we have to both tread with care, but also be aware that we can’t ever ensure that what students learn from us won’t be hard for them, and we can’t assume the burden of responsibility for having opened their eyes to something they hadn’t seen before. PP: Do you have any advice for how to talk about circumcision with other sex educators who haven’t yet questioned or reflected on it much? WT: The number one thing is that it’s important to step outside of our own experience and biases. One thing I hear from sex educators who haven’t really thought about the topic is that either they (or partners of theirs who are circumcised) are perfectly content, and therefore they don’t consider it a topic worthy of discussion or concern. We are the products of our upbringings and societies, and in the U.S. there is still a cultural norm around circumcision, for all that the rates of the operation vary heavily from decade to decade. Circumcision is a cosmetic procedure. That makes it an issue of consent. But as sex educators, we should be thinking and talking about consent first and foremost. Circumcision is regarded by every major medical association, including the American Academy of Pediatrics, as a cosmetic procedure with dubious medical benefits that can’t be considered to outweigh the risks. That makes it a clear issue of consent. Moreover, we should strive to be inclusive in our work, and even in the States, we’re going to have students who are intact or whose partners are. PP: What would you want a parent who is considering circumcising their child to know? WT: Don’t do it. There’s no good medical justification (especially as the African project of mass circumcision to prevent HIV has collapsed in a mess of bad data) and plenty of reasons to be wary of performing cosmetic surgery on someone who can’t consent. If one's concern is religious in nature, it’s worth looking into Brit Shalom for folks who are Jewish. More and more Jews around the world (including in Israel) are choosing to leave their children intact, and Brit Shalom is one path to doing so. After all, for folks of the Reform and Reconstructionist sects (and some Conservative) baby namings for children assigned-female-at-birth don’t involve any surgical alterations. I sadly don’t have any great resources for folks whose family traditions around circumcision are connected to Islam, though it isn’t as universal across Muslim sects and traditions as it is in Judaism. As for concerns about looking like dad, that’s easy to explain to a child, and having genitals that look different from your father just isn’t as traumatic as some folks want to imagine. Likewise, concerns about teasing are as easily coped with as for other physical differences. Besides, the odds are good that an intact kid isn’t going to be the only one among their friend group these days. The last point I want to make, and it ties a bit back to the point about looking like dad, is that parents considering circumcision need to take a really serious look at their motivations. Ask yourself if this is something you are contemplating because you think it’s best for your child, or best for yourself. I’ve personally talked to fathers who wrestled with not circumcising because leaving their child(ren)’s genitals intact would mean that maybe their own circumcision wasn’t in their best interests. That’s a hard truth to sit with. Likewise, I’ve known parents who didn’t want to circumcise their child(ren), but felt that the familial pressure was too strong to resist, saying “is it really worth fighting with (the grandparents, in-laws, etc.) over it?” PP: What can someone do if they experience negative physical or psychological effects — or even trauma — due to circumcision? WT: Therapy can be valuable of course, but only if one can find a sympathetic and understanding therapist. In my experience, as well as what I’ve heard from others, is that this can be difficult to do. (Editor's note: We are working to compile a list of affirming therapists for circumcision trauma. You can find the in-progress list here.) There are good communities online as well, though I’m going to caution that there is a clear and distressing pipeline between the intactivist (anti-forced genital cutting of boys, girls, and intersex children) movement and the alt-right, misogyny, and antisemitism that people need to be cautious about. On the physical front, there are vast resources now for people who want to pursue non-surgical foreskin restoration, from detailed guides on manual techniques, to all sorts of devices intended to aid in the process. I’ve been blown away by the results I’ve seen from folks I know who have put in the time and effort to pursue restoration. Here are some helpful resources: PP: What advice would you give someone who is new to the field of sex education, generally? WT: Becoming a sex educator is an enormous responsibility. We have the power to shape people’s lives in incredibly intimate ways, and we can’t ever lose sight of that. It should scare the crap out of you, because that means we can fuck up people’s relationships to themselves, their bodies, their partner(s), their families, and their communities if we aren’t careful. People are often trusting us with their most intimate selves, and we always should strive to be worthy of that trust. As sex educators, we have the power to shape people's lives in incredibly intimate ways. At the same time, it’s very easy to lose sight of our own needs in all of that, especially because we can feel like we have to measure up to some herculean ideal of perfection because we are positioning ourselves as authority figures in matters of the heart, mind, and erogenous zones. We’re human, and need to be taking care of our own needs and hearts or what is the point of it all? PP: What is a hard truth about sexuality and pleasure that people aren’t ready to hear but you think it’s time? (I stole this question from my fellow sex educator Goddess Cecilia who asked me this during our conversation for her Raw Bar Podcast and I thought it was a great question!) WT: Sexuality education, be it the kind that we’re giving kids or the kind one finds at a modern sex and BDSM conference, and everything in between, consistently misses and fails a variety of vulnerable populations. From disability and neurodiversity, to race, class, age, language grouping, religious affiliation, sexual orientation, gender identity, and so many other forms of population, information and (more importantly) resources, are all too often incomplete and/or not reaching the people who could benefit from them most. I know as educators we’re trying, but we also need to recognize that we miss as often as we succeed, and there’s a world of work still to be done.  Sex & kink educator Winter Tashlin Comments are closed.
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