SEXUAL HEALTH: Cut or uncut: does it matter?


A week to their wedding, Tom and Elsie were facing a serious crisis. Being staunch Christians, they had abstained from sex waiting for marriage and as D-day drew closer, their excitement grew.

“I fantasise about our first night together,” Tom said when they came to the sexology clinic, “and this has kept me awake for hours for the last few nights.”

The source of Tom’s stress was cultural. Tom came from a community that does not culturally circumcise their men while Elsie’s community does.

In their one-and-a-half-year courtship they had not talked about the implication of this. When a team from Tom’s family went to conclude the bride price rites a week to their wedding, they got the shock of their lives.

Elsie’s family would not receive the bride price and would not allow the wedding to proceed unless there was proof that Tom was circumcised.

“Our emissaries must check and confirm that our daughter is not marrying a child,” the elders said.

In Elsie’s community, you only become a man after the foreskin of your penis is cut. Otherwise you are considered to be still a boy. You cannot sit at the table of men.


And so, frustrated and confused, Tom and Elsie came to the sexology clinic for ‘emergency circumcision’.

“The wedding has to go on, but I cannot marry without the blessings of my father as much as I don’t care whether Tom is cut or not,” Elsie said.

My role was to provide medical facts to help Tom make an informed choice.

Incidentally, only 25 per cent of men in the world are circumcised. That does not stop the brains of the majority who are uncircumcised from maturing into adulthood, neither does it stop them from playing manly roles or performing optimally in bed.

The cultural reasons for circumcision can therefore be ignored with little consequence. In fact cultural reasons for circumcision may even be dangerous given that in some cultures part of the teaching is for men to subjugate women following the chopping off of the foreskin.

Culture aside, there are definite medical benefits of circumcision. Circumcised men have a lesser risk of getting infected when they have sex with a HIV-positive woman. Although this risk is not absolute and infection still does happen, circumcision has saved a few men from HIV infection.

A circumcised penis is also easier to keep clean. It takes more effort for an uncircumcised man to remain clean. Poor hygiene has consequences that include harbouring of bacteria and viruses that can flare up into infections.

Tom remained quiet and thoughtful as I explained all this.

An interesting scientific finding is that it is unusual to find cancer of the penis in a circumcised man. Although the cancer is rare, whenever it occurs, it is the uncircumcised men who are affected. Researchers have therefore concluded that circumcision, especially in the first month of life, protects against cancer of the penis.

“Eh, what do you do when cancer of the penis happens, chop the organ off?” Tom asked, showing anxiety for the first time.

Yes, treatment may include surgery to remove part of or the whole organ.

“Doctor, I want the circumcision now!” Tom exclaimed as Elsie burst out laughing.

Circumcision may be painful and takes time to heal. In most cases the healing happens in two weeks. In rare occasions there may be too much bleeding during surgery or infection may complicate the healing process, especially if hygienic conditions are not observed.

Doing the surgery on Tom therefore meant that he would have his wedding but no sex during honeymoon as they had anticipated.

“Well, we have waited for more than a year, a few more days will not kill us,” Tom said.

Tom ended up with a wounded penis at his wedding. The couple however lived happily thereafter, basking in the blessings of all of their parents.