Tout savoir sur la circoncision

Everything you need to know about circumcision

Circumcision, the surgical removal of the foreskin of the penis, is an ancient practice performed for cultural, religious, and medical reasons . This article explores the origins of circumcision, the reasons why it is performed in different countries, and the arguments for and against the procedure. We will also focus on the practice of circumcision in France, examining current studies and medical opinions.

History and origins of circumcision

Circumcision is one of the oldest surgical procedures, having been practiced for thousands of years. It has its origins in the religious and cultural traditions of certain societies.

Religious circumcision

- Judaism : In Jewish tradition, circumcision (Brit Milah) is a religious ceremony performed on male infants on the eighth day after birth. This practice is a sign of the covenant between God and Abraham.

- Islam : Circumcision (Khitan) is also a common practice in Islam, although the timing of circumcision may vary. It is usually performed on boys before puberty and is considered a Sunnah (practice recommended by the Prophet).

Cultural circumcision

In some African and Australian cultures, circumcision is part of the rites of passage into adulthood. It is often performed during ceremonies that mark the transition from childhood to adulthood.

Circumcision in the world

UNITED STATES

In the United States, circumcision is a common practice for medical and cultural reasons. Approximately 58% of newborn males are circumcised, although this figure varies by region and socioeconomic group. The practice was popularized in the early 20th century for reasons of hygiene and disease prevention.

Sub-Saharan Africa

In many countries in sub-Saharan Africa, circumcision is practiced for cultural and public health reasons. For example, in South Africa, circumcision is part of traditional Xhosa rituals and is also promoted as part of HIV/AIDS programmes. Studies have shown that circumcision reduces the risk of HIV infection in heterosexual men by 60%.

Europe

In Europe, circumcision is not as common as in the United States. In France, about 14% of men are circumcised, mainly for religious (Judaism and Islam) or medical reasons. Medical guidelines in France do not advocate routine circumcision, but it may be performed in cases of phimosis or other medical conditions.

Benefits and risks of circumcision

Arguments in favor of circumcision

  1. Reduced risk of infections : Circumcision reduces the risk of urinary tract infections (UTIs) in infants and young boys. One study showed that circumcised boys have a 10 times lower risk of UTIs than uncircumcised boys.

  2. HIV and STI prevention : Circumcision can reduce the risk of HIV infection and some other sexually transmitted infections (STIs) such as human papillomavirus (HPV) and genital herpes. A meta-analysis published in *The Lancet* found that circumcision reduces the risk of HIV infection by 60% in heterosexual men. Another study published in the *New England Journal of Medicine* showed that circumcision reduces the risk of HPV infection and genital herpes.

  3. Hygiene : Circumcision facilitates personal hygiene by making cleaning the penis easier and reducing the buildup of smegma, a substance that can promote bacterial infections.

Arguments against circumcision

  1. Surgical risks : Like any surgical procedure, circumcision carries risks, including infections, bleeding, and surgical complications. Serious complications are rare but possible.

  2. Pain and trauma : Circumcision can be painful, especially if performed without adequate anesthesia. Studies show that pain related to circumcision can have long-term effects on pain sensitivity and perception.

  3. Ethical issue : Some believe that circumcision on infants and children, who cannot give consent, is a violation of their bodily rights and physical integrity.

Effects of circumcision on sexuality

Circumcision may have effects on sexuality, although opinions and experiences vary widely.

Sensations during penetration

Some circumcised men report decreased sensitivity of the glans because the foreskin, which is rich in nerve endings, is removed. However, this decreased sensitivity can also prolong the duration of intercourse by delaying ejaculation. A study published in the *Journal of Sexual Medicine* found that circumcised and uncircumcised men report similar levels of sexual satisfaction, although the specific sensations may differ.
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Approval for oral reports

From a partner's perspective, some people find oral sex more enjoyable with a circumcised partner because of the increased feeling of smoothness and cleanliness. Others prefer the look and feel of the uncircumcised penis. Preferences are highly subjective and vary from person to person.

Circumcision in France

In France, circumcision is not a routine practice and is generally performed for religious or medical reasons. The recommendations of the High Authority of Health (HAS) do not encourage systematic circumcision. However, it may be indicated in cases of phimosis (narrowing of the foreskin) or other medical conditions that prevent the proper functioning of the penis.

Medical studies and opinions in France

A study in France found that circumcision may be beneficial in reducing recurrent urinary tract infections in young boys and in treating phimosis. However, the National Academy of Medicine emphasizes that the medical benefits of routine circumcision in newborns are limited and that the decision to circumcise should be made after an informed discussion between parents and the physician.

International comparison of circumcision practices

An international comparison shows that the prevalence of circumcision varies considerably across regions and cultures. In the United States, circumcision is common and often performed at birth for hygiene and disease prevention reasons. In Europe, circumcision rates are much lower and the procedure is usually reserved for medical cases or religious observances. In Africa, circumcision is often performed as part of public health programs aimed at reducing HIV transmission.

What can we conclude?

Circumcision is a complex practice with deep roots in religious, cultural, and medical traditions. Arguments in favor of circumcision include reduced risks of urinary tract infections, some STIs, and improved personal hygiene. However, surgical risks, pain, and ethical considerations must also be considered.

In France, circumcision is not systematic and is generally reserved for specific medical cases or religious practices. The decision to perform circumcision should be made after an informed discussion between the parents and the doctor, taking into account the potential benefits and associated risks.

Sources:

Auvert, B., Taljaard, D., Lagarde, E., Sobngwi-Tambekou, J., Sitta, R., & Puren, A. (2005). "Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial". *PLoS Medicine*.

Bailey, R.C., Moses, S., Parker, CB, Agot, K., Maclean, I., Krieger, JN, & Ndinya-Achola, JO (2007). "Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomized controlled trial". *The Lancet*.