CHILDHOOD CIRCUMCISION:
James R. Robertson, Ed.D.
LONG-TERM EMOTIONAL CONSEQUENCESPresented at The First International Symposium on Circumcision, Anaheim, California, March 1-2, 1989.
In a study reported by Gocke Cansever (1965), a certain 12 Turkish boys, ages four to seven, were made ready for circumcision. Since Turkey is a Moslem country, they would expect to be circumcised. They should have regarded it as a part of growing up and a means of entrance into the community, both of which should have served to neutralize the pain and discomfort associated with the operation.
About a month before their circumcisions, the Goodenough Draw-a-Man Test and the Children's Apperception Test were administered to each child. Then, seven days after the operation, when its physical discomforts were over, the same tests were again administered to the children.
Cansever reported that the psychological effects of the circumcisions, as revealed by the results of the tests, "indicate that circumcision is perceived by the child as an aggressive attack upon his body, which damaged, mutilated and, in some cases, totally destroyed him. The feeling of `I am now castrated' seems to prevail in the psychic world of the child. As a result, he feels inadequate, helpless and functions less efficiently."
These results agree with psychoanalytic theory, which holds that circumcision performed during early childhood will be perceived as castration. Freud (1966) postulated that around the fourth or fifth years, the boy's interest in his sexual organs attains a dominant significance. At this stage of personality development, which Freud called the phallic phase, the sexual organs acquire a highly narcissistic value. The fear that damage may come to these valued organs is called castration anxiety. According to Freud, it is at this stage that the boy experiences strong genital strivings for his mother and a death wish for his father, which are conceptualized in the Oedipus complex. When the boy discovers the absence of a penis in girls, this discovery serves to confirm the danger of castration in himself as a retaliation for the forbidden sexual wishes toward his mother.
It is probably generally accepted that under castration anxiety, boys at the phallic stage are liable to experience irrational fears of damage to the penis. Indeed, Anna Freud (1968) has suggested that "any surgical interference with the child's body may serve as a focal point for the activation, reactivation, grouping and rationalization of ideas of being attacked, overwhelmed and castrated...If the operation is actually performed on the penis (circumcision, if not carried out shortly after birth), castration fears are aroused whatever the level of libidinal development." Moreover, psychoanalytic theory holds that if the defense mechanisms are not strong enough to master the anxiety, the child will react with neurotic manifestations in which, to some degree, personality development is arrested and a sense of loss and mutilation is carried through life (Rickman, 1957).
During recent years, a great deal of criticism has been directed at routine infant circumcision. Some critics regard it as medically unnecessary. Others believe it to be a barbaric relic and potentially dangerous. This increasing criticism of routine infant circumcision, however, and the psychoanalytic concern regarding circumcision performed during the phallic phase have not stimulated an investigation into the long-term emotional impact of circumcision. No one seems to have asked the circumcised men how they feel about their circumcised conditions.
The population of adult males who were circumcised as children is small. Wallerstein (1980) estimates the present rate of infant circumcision to be 85% of male births in the United States. He places post-infant circumcisions at less than 1% of the circumcised male population. If one accounts for a much lower rate of infant circumcision for men born during the first half of the century, the population of men who were circumcised as children must still be less than 5% of the circumcised male population.
In an attempt to locate such men (from a generally educated population), the following ad encouraging them to report on the long-term emotional impact of circumcision in their lives was placed in National Review, The Nation, and The New Republic:
Men, I'm conducting research on the long-term emotional impact of circumcision, particularly on men who experienced the operation as a child, but after infancy. Write Dr. J.R. Robertson... For purposes of the study, only those men who were circumcised between ages three to six (the approximate time of the phallic phase) were to be used in the investigation. A total of 36 letters were received. Of these, 19 were from men in the selected age group. Some writers described the long-term emotional impact in one letter. Others inquired into the nature of the study before responding in a second letter. All registered a concern for strict anonymity. Although occupational information was not requested, the letters revealed a computer programmer (B.S. in mathematics), an engineer, an architect, a professor, a physician and a mathematician.
In reviewing the letters, it was not expected that the reported negative effects, if any, would arise from the trauma of the operation nor from poor surgery. Emotional trauma is to be expected from any surgery performed on a child. The unique quality of feeling castrated, mutilated and incomplete should be expected from the condition of being one who is circumcised. The pain of surgery and its perceived poor quality serve to exacerbate the emotional impact, but they alone should not be expected to explain a long-term feeling of diminshed worth and a fixation on a lost foreskin predicted by psychoanalytic thought.
In reading the selected letters, it is clear that no one likes his circumcised condition. The common theme that runs through all the letters is mutilation. One man reports, "I cannot stress (too heavily) the psychological damage which has haunted me for years to come." Another writes, I have felt incomplete and troubled that I was thus mutilated...and worry that the same could be inflicted on my male children...I don't seem to be able to forget about it." Remembering the surgery a man wrote, "When I woke up, I remember the awful pain and looking down at the bandage, I thought they had removed it. I screamed and screamed. In following years, I suffered from a recurring nightmare in which my penis was always cut off."
Feeling mutilated, the writers often feared exposure of their penises.
"During adolescence, I never showed my penis to anyone.""I didn't go out for sports for the sole reason that I didn't want to undress and shower with others."
"I never participated in school athletics or skinny dipping."
"I thought the scar was the ugliest thing I had ever seen."
"I perceived my penis as hideous and would only have sex in the dark."
"I felt more naked than they were."
"I have always been self-conscious and felt that I was offering an unattractive penis to a sexual partner."
Anger is a frequent emotional response. A man aged 72 writes that he has felt mutilated and deformed and "mad about being circumcised...today I am absolutely furious!" Another reports that he believes circumcision to be "barbaric" and that he is "resentful and hateful" towards his parents. "I am now 50 years old," another writes, "not a day has passed since my circumcision that I have not suffered from pain and rage."
One is impressed that the writers have not felt free to discuss their feelings except to an occasional close friend. "I have never said these things before," one of them writes, "it helps to be able to tell someone." Another writer said, "The one time I spoke of my circumcision in therapy, I cried for a full hour and could have cried longer."
Fear of rejection and ridicule might explain a hesitancy to reveal their feelings. One man spoke of his feelings of mutilation to a doctor who told him, "Don't be ridiculous! Be glad with what you've got." "When I tried to tell my mother," another writes, "she ridiculed me by saying, `What do you care if you've lost a little skin?'"
For three of the men, the sense of mutilation and loss were severe enough to ponder the possibility of seeking a surgical foreskin restoration.
Although the ad sought men who were circumcised in childhood; nevertheless, letters were received from men who were much older at the time of the operation - 13, 17, 28, 30 and 40. The difference in their attitudes is remarkable. They like their circumcised condition. It was their choice. In all cases, they regard it as an improvement. They wish it had been done in infancy. Two of them wondered why there would be interest in a study on the long-term emotional impact of circumcision since it is so obviously a better condition.
There were, of course, letters from men who were older than the selected ages, three to six, but still children when they were circumcised. There were seven of these letters representing ages 7, 9, 10 and 11. In all cases, like the men from the selected group, they were, to some degree, tricked or forced into the operation. Their mothers told them it wouldn't hurt as bad as it did; they believed they were going to the doctor for a tonsillectomy and were circumcised as well; and/or they were forcibly packed off to the doctor and circumcised. The difference between them and the men of the selected group is that they seem to be able to understand what happened to them. One man wrote that his mother told him a "white lie" about the amount of pain, but he suggests that his "lack of terror or pain over the affair had to do with the calm way in which it was described and carried out." While they resent being forced or tricked into circumcision, they tend to be forgiving: "I suppose they thought they were doing what was best for me." Or philosophical: "Most men are circumcised anyway." "I guess it is healthier this way." There are no such attitudes expressed among the selected group.
In summary, the 19 letters from men circumcised between ages three and six reveal emotional results in conformity with predicted psychoanalytic consequences for circumcision performed during the phallic stage. These 19 men characteristically feel mutilated, diminished and incomplete. They are preoccupied, if not fixated, with their lost foreskins. They show anger at having been denied the right to choose. When they have attempted to discuss their feelings, they tend to have been met with ridicule, rejection and amusement.
References
Cansever, G. (1965). Psychological effects of circumcision.
Brit. J. Med. Psychol. 38: 321-331.Freud, A. (1968). The role of bodily illness in the mental life of children.
In: The Writings of Anna Freud, Vol. IV. International Universities Press, Inc. New York. 269-270.Freud, S. (1966). The Complete Introductory Lectures on Psychoanalysis.
W. W. Norton & Company. New York 545-575.Rickman, J. (1957). Selected Contributions to Psycho-Analysis. Basic Books, Inc. New York. 270.
Wallerstein, E. (1980). Circumcision: An American Health Fallacy.
Springer Publishing Company. New York. 131.
James R. Robertson earned his Bachelor and Master of Science degrees at the University of Utah and his Ed.D. at Utah State University. He was a high school social science teacher, a high school counselor, and counselor at San Joaquin Delta College. He is now retired.
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