Andrew Gross
Published August 7, 2021
Updated December 21, 2022
Circumcision proponents typically refer to a penis with foreskin as uncircumcised. Opponents use the term intact - as in "intact man" or "intact genitals." Many people without a dog in the fight use either word. The terminology has become a contentious issue over the past two decades. Today I'll examine both terms and learn why uncircumcised is the appropriate term.
INTACT
In the introduction to his 2002 book "What your doctor may not tell you about circumcision," Paul Fleiss wrote,
"Notice that I write 'intact' instead of 'uncircumcised.' We would never call normal women 'unmastectomized' or 'unclitoridecomized.' We call them 'intact' because that is what they are. Therefore, we should call men who possess a complete penis what they are: 'intact.' 'Uncircumcised' is an unscientific, unhelpful, useless, and confusing term because it uses terminology normally reserved for abnormality to name a normal body part. Let us avoid confusion and stick to science." [1] [2]
Fleiss had it completely backwards. When referring to a male with foreskin, intact is the unscientific, unhelpful, useless, and confusing term.
Intact is unscientific because - as I'll document in the next section - scientists and medical professionals don't commonly use that term to describe a male with foreskin or a penis with foreskin.
(As an aside, for Paul Fleiss to attempt to define what is unscientific is the height of irony and hypocrisy. As late as 2005 he rejected a link between HIV and AIDS. He allowed a mother who tested positive for HIV to breastfeed her daughter, resulting in the daughter's tragic, needless death at age 3. [3] He promoted the consumption of raw, unpasteurized milk. [4] For his legacy to include an authority on science would be a travesty.)
Intact is unhelpful because it already has an established meaning related to sex organs. Few words in the English language have a specific definition with respect to genitals. Even fewer words have a specific meaning with respect to male genitals. Intact is one of those rare words. Intact means "not castrated." [5] Studies and articles about castration distinguish between castrated men and intact men. [6] [7]
Intact as a contrast to circumcised is useless - because both circumcised men and uncircumcised men have intact genitals. Fleiss wrote that an intact penis is a complete penis. A complete penis is one that can perform the three penile functions. Studies show that circumcision doesn’t adversely affect sexual pleasure. [8] I've seen no evidence that circumcision reduces procreation. And by removing an unnecessary bacteria trap, the procedure would actually improve the urinary function by reducing the risk of UTIs.
When referring to foreskin, intact is the confusing term. Intactivists instinctively know that intact is confusing. They know that when introducing the word, they must include an explanatory term in parentheses - typically "uncircumcised" or "not circumcised." [9][10] The "U" word almost never needs an explanation - because everyone knows what it means.
PUSHBACK #1 - The first definition - "untouched, entire, uninjured" - applies to a penis with foreskin.
The first definition refers to inanimate objects and non-corporeal relationships. It does not apply to a living body or its parts.
The house survived the war intact.
The vase remained intact despite rough handling.
Despite misfortune, his faith is still intact.
After 25 years, their friendship remained intact.
It's difficult to emerge from such a scandal with your reputation intact.
PUSHBACK #2 - The second definition - "of a living body or its parts: having no relevant component removed or destroyed" - applies to a penis with foreskin.
The key word is relevant, which is defined as "having significant and responsible bearing on the matter at hand." [11] That definition might apply to any part of the penis other than the foreskin. As stated above circumcision does not significantly affect the three functions of the penis. So the foreskin can hardly be considered significant.
PUSHBACK #3 - An intact penis is a normal penis. [2]
A penis with foreskin is normal. A penis without foreskin is also normal. Circumcised and uncircumcised are both normal.
PUSHBACK #4 - By that definition a penis in which part or all of the glans was removed is intact.
Unlike the foreskin the glans is an essential part of the penis, playing critical roles in the penile functions. At the end of the urinary process, urine is expelled through the meatus, the opening at the tip of the glans. During sexual intercourse the glans acts as a shock absorber to protect the internal penile structure and reduce vaginal pain for a female partner.
UNCIRCUMCISED
Uncircumcised is the medical and scientific term for a male with foreskin. Doctors, nurses, and scientists routinely refer to an uncircumcised penis, an uncircumcised boy, an uncircumcised man. The Technical Report for the 2012 American Academy of Pediatrics Circumcision Policy Statement contains 33 instances of uncircumcised (excluding footnotes.) [12] A 2018 document published by the U.S. Centers for Disease Control contains 18 instances of uncircumcised. [13]
The "U" term isn't limited to cultures where circumcision is popular. In its 2015 policy statement the Canadian Paediatric Society referred to the uncircumcised penis and uncircumcised males 10 times. [14] The Royal Australasian College of Physicians referred to uncircumcised males 10 times in its 2010 policy statement. [15] These medical organizations don't operate in pro circumcision cultures. The CPS reported a newborn circumcision rate of 32% in Canada, and the RACP estimated a circumcision rate in Australia and New Zealand at just 10-20%. The word intact does not appear anywhere in either statement. Even anti-circumcision researchers have used the "U" word. Morten Frisch, lead author of the European response to the AAP, referred to uncircumcised men 48 times in a 2011 study. [16] I've seen instances in which a circumcision opponent described himself as uncircumcised, and he objected when a fellow intactivist tried to "correct" him.
Fleiss didn't explain how uncircumcised is useless. The word is applied to the male organ far more often than intact. It appears three dozen times in the Bible. [17] It's even used in cultures in the Far East and Latin America - where circumcision has been considered rare. (Footnotes [18-21] include the names of all the authors, so that readers can see that each author is from a non-circumcising culture.) Far from useless, the "U" word is used overwhelmingly.
Fleiss noted that women are not called unmastectomized or unclitoridecomized. Of course they aren't! Mastectomy and clitoridectomy are typically therapeutic procedures used to treat a current medical condition. While some women have preventative mastectomies, a woman who has undergone a masectomy or clitoridectomy is generally the exception. Having her breasts and vulva is the normal, default state for a female. By contrast both penile statuses - circumcised and uncircumcised - are common and unremarkable.
Fleiss concluded by asserting that the prefix un- normally indicates an abnormality. In the year 2021 nothing could be further from the truth. The term unvaccinated is extremely relevant in the Coronavirus age. Many people cannot be vaccinated because of age or medical condition, and many others choose not to take the vaccine; the universally recognized term for these people is unvaccinated. [22] To follow Fleiss's logic, one would have to conclude that an unvaccinated status is abnormal.
PUSHBACK #5 - The prefix "un-" implies that a process was reversed. An uncircumcised penis would properly refer to a previously circumcised penis in which the foreskin was regrown or reattached.
The prefix un- can mean either "do the reverse of" or "not." Un- can mean "not" when added to a verb. For example: uncooked carrots, unaltered dress, uneducated bigot.
PUSHBACK #6 - Uncircumcised normalizes circumcision by implying that circumcised is the normal, default state; the term also implies that foreskin is abnormal.
Circumcision is already normal and has been for thousands of years. The "U" word in no way implies that foreskin is abnormal. Circumcised is normal, and uncircumcised is also normal.
As I noted above and documented in the footnotes, even cultures where circumcision is uncommon use the term uncircumcised. And as I explained above, the use of the term unvaccinated doesn't imply that being vaccinated is the default state. The use of the term uninjured in no way suggests that injured is the default state. Uninjured, unvaccinated, and uncircumcised are all normal. Vaccinated and circumcised are also normal.
CONCLUSION
Intactivists erroneously assume that uncircumcised carries the implication that foreskin is abnormal. The "U" word merely provides recognition of the reality that a circumcised penis is normal. Intactivists may prefer words like intact, normal, natural, and whole - words that imply that circumcised is sexually inferior or genitally incomplete. Their goal is to provoke in each man negative feelings about his own circumcision. That's why they call circumcised men - especially those who are happy or indifferent - mutilated or genitally deficient.
Members of the organized anti-circumcision movement are free to use the terms intactivist and intactivism - or make up other words to label themselves and their movement. They do not get to demand that the rest of society reject long-established definitions, nor redefine words they find inconvenient.
UPDATE - December 12, 2022
In a 2017 paper critical of the American Academy of Pediatrics, Brian Earp and David Shaw wrote that the AAP's use of "the term 'uncircumcised' frames circumcision as the default status, and recasts the natural penis as the linguistically marked category." Earp and Shaw determined that "the choice of terminology employed by the AAP Task Force appears to reflect the prevailing cultural assumption(s) under which it was operating: namely, that the normative status for males is to be circumcised, rather than genitally intact." [23]
As I've demonstrated in this article, Earp and Shaw's assertions are flawed. The AAP's choice of words reflects the same terminology that Danish anti-circumcision physician Morten Frisch used 48 times in a paper published just one year earlier. [16] The AAP's choice reflects the same terminology used by scientists and scholars in Canada, Argentina, Australia, China, Hong Kong, and Japan - none of which can reasonably be considered a pro circumcision culture. [18-21]
For a point of comparison, I will assume that the authors have no problem with a similar term for another preventative medical treatment. Unvaccinated refers to healthy people who have not been injected with a foreign substance for preventative medical reasons. All normally developing children are born without artificial vaccines in their bodies. When Earp and Shaw's article was published in 2017, there was no Covid-19. When this article was published in August 2021, most children around the world had not been "forcibly" injected with a Covid-19 vaccine. By their reasoning, the term unvaccinated frames vaccination as the default status and recasts the natural body as the "linguistically marked category."
To be clear, I do not oppose the use of vaccinations to protect the general population from Covid-19. With this exercise I'm merely showing that Earp and Shaw's objection to one particular "U" word constitutes a double-standard.
PUSHBACK #7 - Unlike circumcision, the Covid-19 vaccination and other immunizations are performed in nearly every country on earth.
That's just Arguentum ad Populum, also known as Appeal to the Majority or the Bandwagon Fallacy. Circumcision is popular in several cultures beyond the United States border. As of 2021 almost 28 million males in Africa have been circumcised under a U.S. government program. [25] Hospitals in Beijing are training university doctors to perform circumcision. [26] About 20% of the world's population live in China. If circumcision becomes popular there, then at some point in this century, circumcised men will be in the majority. Then circumcised would overtake uncircumcised as the global "normative male status."
[1] Paul M. Fleiss, M.D.; "What Your Doctor May Not Tell You About Circumcision" Warner Books; 2002
[2] See also: Danelle Day; "INTACT: Let's use correct terminology"; Dr. Momma; August 31, 2009. Ronald Goldman; "Why Not Say Uncircumcised?"; Circumcision Resource Center
[3] Carla Hall, “Fleiss (the father) is put on probation”; Los Angeles Times; October 9, 2007
[4] William M London; “Medical Renegage Paul M Fleiss, M.D. Dead at 80”; Healthy Skepticism; August 12, 2014
[5] "Intact"; Merriam-Webster Dictionary
[6] Sandra G. Bookman; "Does castration stop sex crimes?"; Washington Post; March 17, 1992. "The most common misconception about castration is that it involves amputating the penis. In fact, surgical castration usually involves removal of the testicles that produce the male hormone testosterone. The penis is left intact." [7] Robert W. Martin, PhD; "Unmanned: An Unnatural History of Human Castration"; Psychology Today; July 14, 2016. "But in 1993 Eberhard Nieschlag and colleagues reported finding no difference in lifespan between castrati and intact men. 50 castrati with outstanding reputations as singers born between 1581 and 1858 were compared to a control group of 50 intact male singers who had achieved comparable fame and were closely matched by year of birth. The average lifespan of the castrati was 65.5 years, not significantly different from the 64.3 years for intact singers."
[8] "15 square inches of errogenous tissue?"; Circumcision Choice; March 21, 2020
[9] IntactAmerica.com home page - accessed July 22, 2021. "Four out of ten intact (not circumcised) boys will experience having their foreskin forcibly torn from its foundation by misguided adults."
[10] "Care of the Intact (Not Circumcised) Penis in the Young Child"; Doctors Opposing Circumcision; July 2016. "Today, more and more boys in the United States and Canada are growing up with their natural genitals intact (not circumcised)."
[11] "Relevant"; Merriam-Webster Dictionary
[12] Susan Blank M.D. et al; "Male Circumcision Technical Report"; Pediatrics; September 2012. The AAP Technical report does include two instances of the word "intact," but they are used to describe the attached foreskin, not the entire penis.
[13] "Information for providers counseling male patients and parents regarding male circumcision and the prevention of HIV infection, STIs, and other health outcomes"; U.S. Centers for Disease Contro and Prevention; August 22, 2018. The document doesn't contain any instances of "intact."
[14] "Newborn male circumcision position statement"; Canadian Paediatric Society; September 8, 2015. The CPS reaffirmed its policy statement in 2021.
[15] "Circumcision of infant males"; The Royal Australasian College of Physicians; September 2010 [16] Morten Frisch et al; "Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark"; International Journal of Epidemiology; June 14, 2011. "We used chi-squared tests to evaluate possible differences in background variables between participants and non-participants and differences in background variables and general sexual experiences between circumcised men and men with an intact foreskin (referred to hereafter as uncircumcised), and between women with circumcised and uncircumcised spouses."
[17] The word appears 39 times in the King James Version and 36 times in the New International Version.
[18] Lianjun Pan, Aixia Zhang, Rong Shen, and Zhong Wang; "Acceptability of early infant male circumcision among Chinese parents: strategy implications of HIV prevention for China"; BMC Public Health; September 4, 2012. "Boys circumcised during the first month of life have significantly lower frequencies of urinary tract infections and bacteremia compared with uncircumcised boys, and serious complications are rare." (1 uncircumcised, 0 intact)
[19] Michael WY Leung 梁偉業; Paula MY Tang 鄧敏兒; Nicholas SY Chao 趙式言; Kelvin KW Liu 廖鑑榮; "Hong Kong Chinese parents’ attitudes towards circumcision"; Hong Kong Medical Journal; December 2012. "Regarding parents of uncircumcised boys at the time of study, 28.9% of them thought that their sons had phimosis; 15.6% of them thought their boys would need circumcision later, and 37.6% did not know." (4 uncircumcised, 0 intact)
[20] Tomomi Shibuya; “Japan’s uncircumcised penises: a 200-year history of men’s bodies”; Chikumashobo; February 2021
[21] María A Pando, Ivan C Balan, Curtis Dolezar, Ruben Marone, Victoria Barrenda, Alex Carballo-Dieguez, María M Avila; "Low frequency of male circumcision and unwillingness to be circumcised among MSM in Buenos Aires, Argentina: association with sexually transmitted infections"; Journal of the International AIDS Society; June 6, 2013. "Objective: The aims of this study were to investigate the frequency of male circumcision among men who have sex with men (MSM) in Buenos Aires, Argentina; the association between circumcision and sexually transmitted infections (STIs); and, among those uncircumcised, the willingness to be circumcised." (17 uncircumcised, 0 intact)
[22] For example: Dennis Pillion; "‘I’m sorry, but it’s too late’: Alabama doctor on treating unvaccinated, dying COVID patients"; Alabama Media Group; July 21, 2021
[23] Brian D. Earp and David M. Shaw; "Cultural Bias in American Medicine: The Case of Infant Male Circumcision"; Journal of Pediatric Ethics; 2017
[24] Zack Smith; "Appeal to the Majority"; Firmitas; 2019
[25] "Latest Global Program Results"; U.S. President's Emergency Plan for AIDS Relief (PEPFAR); December 2021
[26] Yang Wanli; "Circumcision to be promoted at Beijing universities"; China Daily; April 26, 2019