Circumcision and the "Fear of Being Cut"
"Parents do not know what they are choosing, and physicians do not feel what they are doing."
The word “trauma” has been so extensively hijacked by politics that hearing it has created a sort of knee-jerk reaction of a feeling of annoyance. Still, I do think it is proper here to refer to circumcision as both physical and psychological trauma. This article won’t be about the religious significance of this procedure, or the multi-million dollar companies that have fashioned and incorporated it into their beauty products; it will be an attempt to present the endocrine and behavioral changes that follow when a newborn is circumcised (although you could argue its nearly impossible to separate and compartmentalized this topic because it’s much more than a “routine and harmless procedure”).
The hypothalamic-pituitary-adrenal axis is the main mechanism or pathway of an organism’s adaptive capacity in stressful situations, and its activation in early life is crucial in how an organism perceives the adequacy of its environment. If an increase in stress hormones mediates a newborn’s first experience of post-natal life, regardless of the specific reason (a newborn cannot distinguish between the stress of “routine” surgery or malnutrition, for example), development shifts and compromises are made. Circumcision increases serum cortisol levels by 3-4 times during the first hour, coupled with increased crying (Gunnar et al., 1981), and the stress response extends and is observed into the 2-6 hour/3-5 day timeframes (Talbert et al., 1976).
Multiple studies have observed an increase in wakefulness and a decrease in deep/REM sleep following the procedure (Anders et al., 1974, Gunnar et al., 1981).
There are various factors involved in SIDS and multiple theories exist about the reasons for its increasing rates. SIDS is more common in males than females, and I remember someone posting about serotonin’s role as a possible factor in its “development”. Because serotonin is an energy-modulating hormone that lowers the rate of respiration, heart rate, and lung function in preparation for hibernation, it doesn’t seem far-fetched to conclude that death can occur when there is an overall decrease in bodily functions and metabolism, especially during early life. There is good data to suggest circumcision and SIDS are positively associated (Elhaik, 2019), and as previously mentioned the act of being strapped down no doubt induces a state of helplessness followed by an increase in brain serotonin levels. Interestingly enough, Landshark shared an excerpt about the possible relationship between the decrease of DHEA (which regenerates during sleep and is depleted in stress) and SIDS, the effect of which is compounded by swaddling and the inability of the infant to move.
Serotonin’s role has also been implicated in autism, so it’s no surprise that the latter is so powerfully associated with circumcision.
“Ritual circumcision among Danish boys is linked to an overall 46-62% increase in ASD risk in the first 10 years of life…more strikingly the risk was 80-83% increased in the first 0-4 years of life.“ (Frisch et al., 2015).
Only recently did I learn about the existence of a high number of androgen receptors in the foreskin, of which the density peaks around the age of 18 and reduces thereafter (Roehrborn et al., 1987). These receptors have the highest affinity for DHT, testosterone, and progesterone, in that order (Razel et al., 1985). Each one of them is thoroughly involved in the differentiating processes of cells and tissues, opposing the proliferative actions of hormones like estrogen (interestingly enough, the receptor affinity for estrogen in the foreskin is minimal). If androgen signaling promotes the development of various sexual characteristics in males, surely removing a site densely populated with them is bound to alter the organ’s natural development. This change isn’t localized either since touch and sensitivity are closely interrelated with mental capacity and perception. When the sensitivity of the male organ is reduced, behavioral patterns form following it. Below is a graph (n=619, self-reported questionnaire) attempting to link the emotional patterns of circumcised and uncircumcised males (Miani et al., 2020). The negative values indicate higher scores in the circumcised. I don’t necessarily find self-reporting very accurate, but I do find the cluster of seven personality “habits/patterns” in the end quite interesting. There does seem to be an increased occurrence of sensation-seeking, stress, and sexually-focused behaviors in adult circumcised males.
Mutilation of the various body parts is most common in more primitive cultures, in groups where speech as a faculty is seen or felt as inferior to brute force in earning compliance. Ray has spoken about the role of circumcision as a tool for control, implemented to imprint in the young the “fear of being cut”; a scar as a permanent reminder of your role. This doesn’t mean that sexual immorality or promiscuity is an appropriate response to an ever-increasing authoritarianism (an example of this you could argue was the sexual revolution of the 70s), but a healthy society cannot exist when its youngest members are mutilated by people who were themselves subjected to it, and who have no suitable understanding of biological life and what drives its maturation into complexity. I’ll leave you with an audio bit from one of Ray’s interviews.
References
Anders, T. F., & Chalemian, R. J. (1974). The Effects of Circumcision on Sleep-Wake States in Human Neonates. Psychosomatic Medicine, 36(2), 174–179. doi:10.1097/00006842-197403000-00009
Elhaik E. Neonatal circumcision and prematurity are associated with sudden infant death syndrome (SIDS). J Clin Transl Res. 2019 Jan 9;4(2):136-151. PMID: 30873502; PMCID: PMC6412606.
Frisch M, Simonsen J. Ritual circumcision and risk of autism spectrum disorder in 0- to 9-year-old boys: national cohort study in Denmark. J R Soc Med. 2015 Jul;108(7):266-79. doi: 10.1177/0141076814565942. Epub 2015 Jan 8. PMID: 25573114; PMCID: PMC4530408.
Gunnar, M. R., Fisch, R. O., Korsvik, S., & Donhowe, J. M. (1981). The effects of circumcision on serum cortisol and behavior. Psychoneuroendocrinology, 6(3), 269–275. doi:10.1016/0306-4530(81)90037-8
Miani A, Di Bernardo GA, Højgaard AD, Earp BD, Zak PJ, Landau AM, Hoppe J, Winterdahl M. Neonatal male circumcision is associated with altered adult socio-affective processing. Heliyon. 2020 Nov 26;6(11):e05566. doi: 10.1016/j.heliyon.2020.e05566. PMID: 33299934; PMCID: PMC7702013.
Razel, A. J., Svensson, J., Spelsberg, T. C., & Coulam, C. B. (1985). The androgen receptor in normal human foreskin. American Journal of Obstetrics and Gynecology, 153(4), 410–416. doi:10.1016/0002-9378(85)90079-1
Roehrborn CG, Lange JL, George FW, Wilson JD. Changes in amount and intracellular distribution of androgen receptor in human foreskin as a function of age. J Clin Invest. 1987 Jan;79(1):44-7. doi: 10.1172/JCI112805. PMID: 3491838; PMCID: PMC423982.
Talbert LM, Kraybill EN, Potter HD. Adrenal cortical response to circumcision in the neonate. Obstet Gynecol. 1976 Aug;48(2):208-10. PMID: 940653.