“In the equation, the value of the actual foreskin is often put at zero.
Put a value on it. It is a structure in its own right.”
John R. Taylor, M.D., pathologist

“As a medical student, we don’t learn anything about foreskins. In my anatomy textbook, there are two lines about the foreskin: ‘It’s the skin that folds back upon itself and reattaches around the glans penis,’ and the second line is: ‘It’s the skin that’s usually removed during circumcision.’ And that’s it, in the entire textbook.”
Stewart Blandon, M.D.

“Nature is a possessive mistress, and whatever mistakes she makes about the structure of the less essential organs, such as the brain and stomach, in which she has not much interest, you can be sure that she knows best about the genital organs.”
Sir James Spence, M.D.

The Prepuce

Because circumcision has been practiced so routinely in the United States for at least several generations, few Americans today are familiar with the natural penis. In the United States, even health professionals often receive little training about and have little clinical experience with the normal intact male genitalia.[1]

Ignorance of the normal anatomy of the intact penis on the part of health professionals all too often leads to harmful care practices such as premature, forcible foreskin retraction (PFFR). Ignorance of the functions of the foreskin translates to a devaluing of the foreskin, accompanied by a complacent willingness to promote circumcision.

To provide informed, respectful care to males with intact genitals, and to fully understand the harms of circumcision, health professionals must have a thorough grasp of the anatomy, development, and functions of the foreskin (also known as the prepuce).

The following articles and videos are excellent sources of information on these topics, presented here in the interest of demystifying, normalizing, and ascribing value to this unique, specialized, sexually important body part.

For further information on the sexual functions of the foreskin, please see: Sexual Impact of Circumcision. For further information on the development and care of the foreskin, including the harms of PFFR, please see: Care of the Intact Penis. For more information on PFFR, please see also: Wrongful Foreskin Retraction.

1. A 2004 survey of ninety U.S. medical textbooks found that 71% of the primary depictions of the human penis were anatomically incorrect (i.e. no foreskin), and that “the penis [was] routinely defined and depicted in a partially amputated condition, as if this were its natural state, without explanation or caveat.” The survey concluded that “American medical students are being misinformed about fundamental anatomy.” [Harryman GL. An analysis of the accuracy of the presentation of the human penis in anatomical source materials. In: Denniston GC, et al., editors. Flesh and blood: perspectives on the problem of circumcision in contemporary society. New York: Kluwer Academic/Plenum Publishers; 2004. p. 17-25.]

Anatomy and Functions of the Foreskin

Fahmy MAB. Normal and Abnormal Prepuce. Cham, Switzerland: Springer International Publishing; 2020.

The penis and foreskin: preputial anatomy and sexual function. Circumcision Information and Resource Pages review article.

Anatomy of the penis, mechanics of intercourse. Circumcision Information and Resource Pages review article.

Foreskin sexual function and circumcision sexual dysfunction. Circumcision Information and Resource Pages review article.

Taylor JR, Lockwood AP, Taylor AJ. The prepuce: specialized mucosa of the penis and its loss to circumcision. BJU Int. 1996;77:291-5. Ground-breaking anatomical study on this specialized tissue, and the implications of its loss to circumcision.

Cold CJ, Taylor JR. The prepuce. BJU Int. 1999;83(Suppl 1):34-44. In-depth review article on the anatomy, physiology, and histology of the foreskin, from two North American pathologists.

Fleiss P, Hodges F, Van Howe RS. Immunological functions of the human prepuce. Sex Trans Inf. 1998;74(5):364-7. Summary of the evidence on the immunological functionality of the foreskin.

Scott S. The anatomy and physiology of the human prepuce. In: Denniston GC, et al., editors. Male and female circumcision. New York: Kluwer Academic/Plenum Publishers; 1999. p. 9-18. Summary of the scientific literature on the anatomy, development, and functions of the foreskin.

Northrup C. How circumcision may be affecting your love life. Men’s Health Magazine; 2004. Highlights the sexual functions of the foreskin, particularly the impact of circumcision on women’s sexual experience.

Sorrells ML, et al. Fine-touch pressure thresholds in the adult penis. BJU Int. 2007;99:864-9. Touch testing study concludes, “Circumcision ablates the most sensitive parts of the penis.”

Development and Care of the Intact Penis

Normal development of the prepuce: birth through age 18. Circumcision Information and Resource Pages review article.

The development of retractile foreskin in the child and adolescent. From Doctors Opposing Circumcision.

Fleiss P. Protect your uncircumcised son: expert medical advice for parents. Mothering Magazine, 1999. What parents (and health professionals) need to know about minor problems and normal variations with the foreskin, showing that circumcision is rarely medically necessary.

Geisheker JV. What is the greatest danger for an uncircumcised boy? Psychology Today. 2011 Oct 23. Discusses the widespread problem of forcible foreskin retraction.

Geisheker JV. Doctor ignorance of male anatomy harms boys. Psychology Today. 2011 Oct 30. How inadequate medical training contributes to improper foreskin care and advice.

Videos

NOTE: The following visual resources may contain pictures of adult or infant male genitals, for educational purposes only.

Published July 2016, updated December 2020