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Foreskin restorers: insights into motivations, successes, challenges, and experiences with medical and mental health professionals – An abridged summary of key findings

International Journal of Impotence Research volume 35, pages 309–322 (2023)Cite this article

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A Correction to this article was published on 27 July 2023

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Abstract

Demographically diverse surveys in the United States suggest that 10–15% of non-voluntarily circumcised American males wish that they had not been circumcised [1, 2]. Similar data are unavailable in other countries. An unknown proportion of circumcised males experience acute circumcision-related distress; some attempt to regain a sense of bodily integrity through non-surgical foreskin restoration. Their concerns are often ignored by health professionals. We conducted an in-depth investigation into foreskin restorers’ lived experiences. An online survey containing 49 qualitative and 10 demographic questions was developed to identify restorers’ motivations, successes, challenges, and experiences with health professionals. Targeted sampling was employed to reach this distinctive population. Invitations were disseminated to customers of commercial restoration devices, online restoration forums, device manufacturer websites, and via genital autonomy organizations. Over 2100 surveys were submitted by respondents from 60 countries. We report results from 1790 fully completed surveys. Adverse physical, sexual, emotional/psychological and self-esteem impacts attributed to circumcision had motivated participants to seek foreskin restoration. Most sought no professional help due to hopelessness, fear, or mistrust. Those who sought help encountered trivialization, dismissal, or ridicule. Most participants recommended restoration. Many professionals are unprepared to assist this population. Circumcision sufferers/foreskin restorers have largely been ill-served by medical and mental health professionals.

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Fig. 1: Foreskin restoration devices.
Fig. 2: Types of Circumcision Damage.
Fig. 3: One respondent’s restoration.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Change history

Notes

  1. A peer reviewer has asked us to elaborate, and we do so briefly here. While heterosexual males may be visually familiar with penile aesthetics through partially-mediated experiences (e.g., watching pornography; seeing male genitalia in changing rooms at some distance), gay/bi men likely have broader and/or less-mediated experiences with circumcised and intact penises in the context of intimate interpersonal encounters, allowing for multi-modal comparisons (i.e., via sight, touch, smell, taste and even sound). In addition, concerns around bodily autonomy may be of heightened significance for gay/bi men in relation to such matters as what may be done to one’s body–vis-à-vis threats of medical or psychological “conversion therapies”, arrest or imprisonment under sodomy laws, hate-motivated violence, and so on. As such, long-standing LGBTQ + concepts of body ownership and bodily autonomy may foster a deeper awareness, understanding, and/or sensitivity to issues that lie at the intersection of sexuality and human rights [20]. For further analysis, see Unabridged Supplementary Section “Gay/Bisexual men”.

  2. Although numerous immediate and short-term complications have been documented [26, 27], there is no universally accepted definition among professionals of what constitutes a circumcision “complication”, especially in the un(der)-investigated long-term. Nevertheless, a systematic review concluded that neonatal penile circumcision complications are likely more common than is typically surmised [28]. Many complications are never recorded because they become evident only as the penis develops. An analysis of medicalized MGC found a complication rate of 4% and that adult complications are not greater than infant complications [29].

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Acknowledgements

TH wishes to acknowledge the late R. Wayne Griffiths, who guided TH on his own restoration journey, assisted him with the co-founding of the National Organization of Restoring Men (NORM), conducted the first organized survey of 240 foreskin restorers in 1995, and whose early efforts inspired TH to undertake this current larger-scale survey. The authors also express their gratitude to the more than 2100 respondents who courageously stepped forward to share their lived experiences on this intensely private matter by submitting completed or partially completed surveys.

Author information

Authors and Affiliations

  1. Independent Researcher, Your Sexual Medicine Journal https://www.nature.com/ijir/

    Tim Hammond & Ryan McAllister

  2. Quinnipiac University, Hamden, CT, USA

    Lauren M. Sardi & William A. Jellison

  3. Certified Sex Therapist, Minneapolis, MN, USA

    Ben Snyder

  4. Al-Azhar University, Cairo, Egypt

    Mohamed A. B. Fahmy

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  1. Tim Hammond
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  6. Mohamed A. B. Fahmy
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Contributions

This investigation was conceived by TH who developed the survey questionnaire based on decades of listening to the lived experiences of circumcision sufferers and foreskin restorers. He assembled and managed the team of co-authors and contributed significantly to the overall manuscript. LS acted as Principal Investigator, obtained IRB approval from Quinnipiac University, authored the Methods and Result sections, and contributed significantly to the Discussion section. WJ, as statistician, contributed his skills to analyze survey findings, and along with LS authored the Methods and Results sections. RM contributed conceptual knowledge and data analysis and organized the overall presentation flow. BS, as a certified sex therapist, authored the Discussion section relative to sexual impacts. MAB as a physician and author of medical textbooks on male genitalia and the complications of circumcision, provided medical review of the section on penile anatomy, physiology, and circumcision complications. All authors were responsible for the review and editing of the final manuscript prior to submission.

Corresponding author

Correspondence to Tim Hammond.

Ethics declarations

Competing interests

TH is the author of two related surveys of circumcision sufferers and is co-founder of the nonprofit charity the National Organization of Restoring Men. TH knew the owners of two restoration device companies and asked for assistance to promote this survey to past customers. Anonymized email lists were supplied to TH at no charge and no promotional promises were made to the companies. LMS has written numerous articles about ethical and human rights implications of circumcision; WAJ has performed statistical analyses and published papers about circumcision; RM appeared in documentaries and videos and has written about the ethics and effects of circumcision; BS appeared in a circumcision documentary for US parents; MABF has published medical textbooks on normal and abnormal prepuce and the short- and long-term physical effects of penile circumcision. The non-profit organization Doctors Opposing Circumcision underwrote the subscription cost (<$300) of the online survey software used in this research.

Ethical approval

This study received Institutional Review Board approval (Protocol #04421) from Quinnipiac University in Hamden, CT, USA, and followed all ethical standards to ensure proper protection of participants and their data.

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41443_2023_686_MOESM1_ESM.pdf

Unabridged Supplement to Foreskin Restorers: Insights into Motivations, Successes, Challenges and Experiences with Medical and Mental Health Professionals

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Hammond, T., Sardi, L.M., Jellison, W.A. et al. Foreskin restorers: insights into motivations, successes, challenges, and experiences with medical and mental health professionals – An abridged summary of key findings. Int J Impot Res 35, 309–322 (2023). https://doi.org/10.1038/s41443-023-00686-5

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