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| The idea that retraction is unnecessary could be 1) due to repression of actual experiences of pain and difficulty, 2) it may be learnt as the result of the approach of unpleasant and growing sensations of discomfort, or 3) it may be simply that retraction feels unnatural or is impossible. Experiences of this kind may take place semi-consciously even before puberty begins. In other words, this blindness is not due to stupidity on the part of the boy. Not only is there a severe lack of information to guide the family doctor and parents, but also an otherwise healthy boy accepts his body without worrying, and grows accustomed to his own condition, through erections and self play, possibly even previous to puberty. There is an area of his own sexual world which a boy with these conditions can't explore, even something he thinks he's not meant to explore. His knowledge is that the foreskin is designed to remain forward. He believes his condition to be normal and healthy, and he is unaware that he has any limitation which requires treatment. Ultra-sound pictures have shown that baby boys have erections in the womb. Reports from parents indicate that a boy may start innocently playing with his erect penis (with foreskin retraction), at the age of one and a half years old. It is therefore possible that the learning process may start even before puberty begins. At the beginning of puberty most boys begin to masturbate consciously. It is generally accepted that the most normal method of doing this, is by moving the foreskin. With these conditions a freely moveable foreskin at the same time as a full erection is impossible. A boy with these conditions develops a sexual relationship with himself, which is to some extent, restrained or restricted, (and he believes that this is normal). ADULT INITIATIONS With both phimosis and the frenulum breve, the final recognition of the condition often follows a conscious experience of pain or difficulty. |  | The complaints are often discovered when making love or attempting to, because at this time they are unavoidable. At this time, the erection, penetration and ejaculation are not exclusively controlled by one's own hands. A practising Urologist says, "it is not uncommon, . . that a phimosis is not at all consciously realised by the carrier until the first act of love" 14. With some degrees of phimosis, (during intercourse, when the vagina is unlubricated) the foreskin can ruffle up in a turtle neck making penetration difficult or impossible. It may not be obvious to the individual that something anatomical is not in working order, he may think that love making merely requires practice. Some men with the frenulum breve have the experience of the frenulum suddenly ripping while making love, others experience pain and tension, especially during ejaculation. It is clear that when the frenulum rips, this can save years of adult problems. There are inevitably a number of types of experience which have not come to my attention. THE TABOO CONTINUES Some men, like myself, do not consciously experience any pain or difficulty, they believe the foreskin is designed to remain forward, and have adapted to this. When a problem is conscious one can come to terms with it, and even turn it to some greater strength. Here, the basic problem and many of the symptoms are unconscious, or misinterpreted by the carrier himself, as being of a psychological nature. Two men who I spoke with had been in the situation of having an extreme phimosis without realising this. One of these never masturbated or had any interest in sex before his operation. The other, after describing how he washed under the foreskin with an extreme phimosis, (by flushing the area out with a squeezing action), told me he thought that "everyone's normal, we're all just a bit different". I can not prove anything about these men except that they had very few sexual experiences. |

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| T HE P ASSAGES T O M ANHOOD BEFORE PUBERTY Among young children, the main psychological difficulties which the congenital conditions present, is from phimosis resulting in a longer infection (often due to urinary problems) before having an operation. The nature of such disturbances appears to be a conscious one of early embarrassment with possibly a resultant lack of self esteem. Two men had intense memories of disturbing episodes in their childhood, which they thought had been caused by phimosis. The subject requires a deeper study, it is beyond the scope of this essay. PUBERTY RITUALS In Europe today, many operations occur once puberty has started. A number of cases have come to my attention. Most of the problems arise simply because boys masturbate, and the rubbing action of a phimosis repeatedly passing over the coronal ridge of the glans, causes soreness, which may subsequently develop into inflammations or infections. Two men described how due to this process, an infection became so obvious that they were forced to tell their parents. Two more reports without any infection, are of masturbating painfully for five and nine years. One adolescent with adhesions reported consciously avoiding pain, until he was eighteen. All these latter cases experienced pain, or the proximity of pain for several years before they felt confident enough to be able to approach a doctor, or to persuade him to operate. When it is left to the boy alone to discover by the conscious pain of his first active erections, it means that a considerable percentage of boys who are not routinely circumcised or checked, are going to have a fully distorted first impression of sex and manhood. An absurdly mismanaged and senseless puberty ritual. |  | THE BLIND SPOT This anatomical inhibition functions in a similar manner to the generally understood emotional inhibition. Anyone with any sort of inhibition does not experiment as freely in that area, he does not discover, he is not as aware of, and, he probably does not have as much interest in the area. If a boy with these conditions did admire himself, any recognition of, or belief he establishes in his sexual identity would be based on a misunderstanding and misinterpretation of reality, (i.e. it would be based on the misconception that the foreskin is designed to remain forward). He is not as aware of himself, and to remain unaware he could never have compared himself, therefore he is probably not as aware of the male phallus in general. (On seeing pictures of the phallus with a retracted foreskin, I automatically thought that such men must be circumcised). CONSEQUENCES While I maintain that my entire post-puberty emotional development was influenced by this hidden anxiety in my own body, to give individual examples is pointless because any effects on the basic character, emotions, responses etc., are dependant on, and relative to an individual's other experiences (upbringing etc.). There is nothing absolute which can be stated, only that these conditions are compatible with shyness, anxiety, frustration and privacy, and they are incompatible with a relaxed sexuality, openness and leading a simple life. These phenomena have an irrational and disturbing influence on the sexual behaviour, at the very least they would hinder any re-education over sexual inhibitions learnt in childhood. In an adolescent whose basic character was inhibited by upbringing etc., the lack of awareness of his condition may merely allow him less chance of breaking free. Other men may go for years, before the collective experiences resulting from this unconscious anatomical influence have any serious behavioural effects. |

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| B ACKGROUND LACK OF INFORMATION For over thirty sexually active years, I was unaware that the movement of my foreskin was restricted by a combination of a frenulum breve and a mild phimosis. The phimosis was impossible to check for when flaccid. The frenulum could have been checked in five seconds and operated in twenty minutes, had the correct information been available to the medical profession or my parents. Any man or child today with similar problems to mine may end up as oblivious to their condition as I was. The first point to understand is that the frenulum is underneath and behind the foreskin. When the penis is erect, if the frenulum is too short it pulls the foreskin forward, therefore to a man with this condition it is hidden. To visually identify this physiological spring mechanism, involves the carrier in what are to him unnatural contortions. The second point is that in public literature there is only occasionally any mention of the frenulum breve. I have never come across an accurate way of checking for it, even in medical texts, (one is given under Prevention). Unfortunately the explanations in publicly available books, relating to all three conditions, are often fully inadequate for parents or any individual who has them. (see Appendix b). Only occasionally is the medical definition given, that the foreskin cannot be retracted, or this can only be done with pain or difficulty. Very rarely mentioned, are pain or difficulty by intercourse or masturbation, and there is never an indication about what these difficulties may be. Urological One reason for the lack of information is shown by a surgeon who comments "The request for circumcision to allieviate painful erections and intercourse and frenular tears is not widely appreciated in the urological literature. Being unpublished, these complaints can easily be ignored . . . " 12. |  |
I NDIVIDUAL EXPERIENCES
SYMPTOMS The problem with presenting any individual experience, is that they are relative to an individuals upbringing, character etc. Anatomical (erect) One example which seems significant as evidence of an unconscious anatomical disturbance : When half waking up with a full erection, my reaction was to hold this firmly to suppress it. As the erection subsided, I'd return to sleep. I had been consciously aware of this process approximately once a month since the age of eleven. The lack of wet dreams. Behavioural One example is particularly clear. When a woman touched my phallus I lost my erection. There was one exception to this where she used to pull the foreskin forward (i.e, away from the problem area). I would argue that regardless of the love and trust in a relationship, with such a disposition, there is bound to be a degree of anxiety about one's phallus being held, (or this would develop with experience). The problems encountered by love making is an area which is difficult to summarise. It seems generally true, for all men with these conditions, that penetration is impossible without an amount of lubrication. Personally speaking, it's not that the necessary foreplay was unpleasant, but I would argue that making love does not come as naturally as it otherwise would. One thing is clear, and it must be common to all men with these conditions, using a condom while holding the foreskin forward, requires considerable practice. |

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| (Extra Notes) In Advanced Years In a certain percentage of men, the conditions reoccur in old age as the skin becomes less flexible. This is also considered as a congenital complaint. In comparison to the free movement of yesteryear the difference is easy to notice and if operated on promptly the situation causes minimal psychological complications. Secondary Phimosis A congenital primary phimosis can often lead to infections, and be cured for reasons of this secondary symptom. On the other hand, circumcision is a treatment often needed for a variety of ailments (skin diseases and infections, penile cancer, diabetes, injuries), and as a result of some of these, the secondary phimosis which may develop. This development is noticable to the individual and therefore (if treated without hesitation), bears little comparison to a congenital primary phimosis. FRENULUM BREVE (Latin Frenulum: a small bridle. Breve: short). The frenulum is like the joining ridge under the tongue, this membrane joins the underside of the glans to the foreskin. There are various degrees of brevity. Occasionally the frenulum is so short that there is actually no frenulum, the foreskin being attatched directly to the glans. With the frenulum breve, when erect the foreskin often pulls back partially, and then simply slides forward again. Minor degrees allow retraction behind the glans, apparently causing few problems. However sufferers feel a tension which therefore limits optimal enjoyment. The frenulum is the most sensitive area on the phallus. If the area is sensitive to pain at present, this turns to pleasure after being operated. |  | Once some form of these ideas is acknowledged and becomes practiced, it appears that in many countries and cultures one boy in ten would have a healthier and happier start to life. Books on child-care must mention the subject and a check is also necessary as normal practice in the school entry medical examination. Every boy with one of these conditions must be discovered and treated before puberty. ADULT CHECK Adult books which discuss circumcision must include adequate information. Every adolescent and adult male should have the opportunity of educating himself. When erect, the foreskin is normally movable, with the possibility of pulling it back inside out so that it sheathes the shaft. In doing this, the frenulum should not be so tight that it pulls the glans downward or the foreskin forward. A word of caution is necessary about late operations and after effects. In two cases these after effects were diagnosed as psychosomatic. The third was offered no alleviative for the burning sensations. Even if such after effects are psychosomatic, they could be prevented by corrective treatment before puberty. METHOD OF TREATMENT Careful consideration should be given to the treatment. Some methods of modernising the ancient technique of circumcision are indicated on internet. A few words about some of the ancient alternatives are given in appendix a. |

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| T HE CONDITIONS The following detailed anatomical descriptions, may tire some readers, if so please turn to the central discussion. ADHESIONS The foreskin may stick to the glans, it may stick partially, it may also restick after being released. This condition is normal and healthy in babies. Generally it resolves of its own accord by the age of three, however sometimes the condition continues up until puberty. There are different degrees of adhesion. Some boys release the foreskin themselves at the beginning of puberty, others experience intense pain when they attempt to do this. (Bettelheim reports a case4 where during masturbation adhesions "had been partly painful"5. ) Note: I believe that when adhesions release at a later age (e.g. at ten years old) the foreskin develops less elasticity, and this results in a tight foreskin. PHIMOSIS (Greek phimos : a muzzle, nose band of a bridle). A thin white ring of connective tissue around the end of the foreskin, about a third of an inch from the end, narrows the opening of the foreskin and restricts its elasticity. This hinders the retraction of the foreskin over the coronal ridge and behind the glans. Any difficulty when flaccid is magnified when erect. A Matter of Degree The ring varies in narrowness. Very extreme degrees often cause urinary complications or infections, and are discovered in childhood. |  | People with experience I am interested to hear any personal experience which agrees, or disagrees with any of the ideas which are presented. Initially, any reports from wives, girl friends, mothers and fathers, would all be interesting. I need information. If this concerns you please contact me. Men with personal experience Maybe what I've written is enough to show the importance of routinely checking every male child, previous to any difficulties occurring. It would be much easier, if other men with similar experiences would contact me, and share their experiences. Please help me to stop this ignorance around us, so that other boys / men don't have these initiation problems. Robin Stuart, |

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| This essay was first published on Internet 22nd. February 1996. Booklet from June 21st. 1996 Please review updates on Internet https://www.male-initiation.net/welcome.html |  | Appendix a
A NCIENT M ETHODS OF O PERATION
Full marks for creativity goes to New Guinea, "Long pendulous foreskins are apparently a thing of beauty for some tribes in New Guinea who deliberately stretch them by suspending weights from the penis"36 . There is the possibility of "removing some of the foreskin and leaving the remainder as a flap, as practiced by the Maasai and Kikuyu of East Africa, or cutting the foreskin away but retaining it as two flaps, as practiced by the Tikopia of Polynesia"37 . "The most rudimentary form of male circumcision is a simple gash of the prepuce", "the simple process of tearing the prepuce with the fingers", or "a wedge-shaped piece is excised"38 . It is worth noting that "In some Turkish families the foreskin is retracted straight away after birth, and this is done periodically, in order to prevent adhesions"39 . In addition at least two cultures perform an incision of the frenulum, "the inhabitants of the Loyalty Islands . . and, . . on Tahiti"s40 . |

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| S UMMARY The human male can be affected by three congenital conditions of the penis: adhesions, phimosis and the frenulum breve, these occur singly or in any combination. These conditions anatomically inhibit the relationship between the foreskin and the glans, particularly on the erect penis, and this functionally restricts the erection. If these conditions continue until after puberty they influence a boy's sexual development. The Encyclopedia Judaica says over circumcision that "10% of boys eventually need it, because of non-retractibility of the foreskin" 3. (Two medical studies arguably support this figure - see page 2). When the penis is erect, these conditions have the following effects: Adhesions: The foreskin may stick to the glans restricting any movement. Phimosis: A thin ring of connective tissue, narrows the opening of the foreskin, and hinders its retraction behind the glans. Frenulum Breve: A fold of skin underneath the glans joins it to the foreskin, if this is too short it causes the foreskin to slide forward. These conditions are usually only treated as the result of a conscious experience of pain, difficulty, tension, (or any other problem for example diseases in the area). Such treatment is usually required during puberty or after the first attempts at love-making. The conscious experience of pain and difficulty usually has a disturbing influence on the sexuality, however the unconscious avoidance of such uncomfortable sensations can lead to far greater problems. |  |
REFERENCES
1) Kenneth PURVIS "The Male Sexual Machine: An Owner's Manual" St. Martin's Press New York. (1992) p.30 : (Original Title "En Guide til Mannes Underliv" Gyldendal Norsk Forlag (1991),). 2) Desmond MORRIS "Babywatching" Jonathon Cape Ltd. London. (1991) p.157 3) Encyclopaedia JUDAICA Book 5 pages 567-576 Editor Cecil Roth. Keter Publishing House Ltd. (1971) p.575 4) Bruno BETTELHEIM "Symbolic Wounds" Revised Edition, Collier Books, New York. (1968) p.32-33, 50, 53 5) Bruno BETTELHEIM (ibid) p.33 6) Dr, med. Werner SCHÖBERLEIN "Bedeutung und Häufigkeit von Phimose und Smegma." Münchener Medizinische Wochenschrift 7. pages 373-377 (1966) p.373 7) Dr. med. F. SAITMACHER "Sozialhygienische Betrachtung zu einer routinemässigen Zirkumzision männlicher Säuglinge" Das Deutsche Gesundheitswesen Jahrgang 15 Heft 23 Pages 1217-1220 (1960) p.1218 8) Horst DANNER "Zirkumzision bei Dermatologischer Indikation" Hamburg University. (1986) p.59-60 9) Dr. for Urology Dieter BEHLING in conversation. Quoted with permission. 10) Prof. Dr. Med. Hartmut PORST "Was jedermann über Sexualität und Potenz wissen sollte" Georg Thieme Verlag Stuttgart, Trias (1991) p.60 11) The KINSEY Institute New Report on Sex. June Reinisch. Penguin (1990) p.39 12) LTC Edward J. PIENKOS, MC USAR "Circumcision at the 121st Evacuation Hospital : Report of a Questionaire with Cross-Cultural Observations" Military Medicine Vol 154, 4:169 (April 1989) p.170 13) Dr. Carl Graf HALLER "Hydrokortisonsalbe in der Nachbehandlung der Phimoseoperationen" 27 Zeitschrift für Urologie Heft 7 pages 385-387 (1957) p.385 14) Prof. Dr. Med. H. PORST (ibid) p.59-60 15) Felix BRYK "Die Beschneidung bei Mann und Weib" Gustav Feller. New Brandenburg .(1931) p.174 16) Dr. for Urology Dieter BEHLING confirms this 17) The KINSEY report "Sexual Behavior in the Human Male" 9th. printing W. B. Saunders Company (1949) 18) The KINSEY Institute New Report on Sex (ibid) p.339 19) Desmond MORRIS "Bodywatching A Field guide to the Human Species" Jonathon Cape Ltd. (1985) Book Club Association Edition (1986) p.218 20) Dr. B. SPOCK and Dr. Michael B. Rothenberg "Dr. Spock's Baby and Child Care for the Nineties" Simon and Schuster Inc. (1992) p.225-226 21) Alex COMFORT: "The New Joy of Sex" Mitchell Beazley International Ltd. (1991) p.59 35) Felix BRYK (ibid.) p.77 36) Kenneth PURVIS (ibid.) p.28 37) The Encyclopedia of RELIGION Book 3 pages 511-514 Editor Mircea Eliade. Macmillan Publishing Company. (1987) p.511 38) Encyclopaedia of RELIGION and ETHICS. Volume 3 pages 659-680 main Author : Louis H. Gray. Edited by James Hastings. Published T. & T. Clark. (1932 Reprint 1971) p.660 39) Felix BRYK (ibid.) p.176 40) Felix BRYK (ibid.) p.169 : (Quoting RISA (Nuri Bey) "Studien über die rituale Beschneidung im osmanischen Reiche" in Sammlung klinischer Vorträge Nr. 438 (serie 15) Chirurgie 123, Leipzig (1906),). |