The Journal of Sex Research
Vol. 28,
No.1,
pp. 145-156 February,
1991
Clinical Notes
SEXOLOGY, BODY IMAGE, FORESKIN RESTORATION,AND BISEXUAL STATUS
JOHN
MONEY,
Ph.D.
Johns Hopkins University and Hospital
Foreskin restoration, far from being a modem fad, has ancient origins. Thehistory of this practice traces back to Roman times. During the reign of theEmperor Tiberius
(A.D.14-37),
in Book
III
of
De Medicina
(Trans.,
1938),
Aulus Cornelius Celsus described two surgical methods of foreskin restoration. Both are illustrated diagrammatically in Schneider
(1976)
and Rubin
(1980).
The more radical operation was for those who had been circumcised and hada completely exposed glans penis. The less radical was for those whose ownforeskin was too short to cover the glans completely. The latter required acircular cut
at
the base of the penis so as
to
free the skin of the penis
to
bestretched forward, until there was enough foreskin to cover the entire glansand
to
be held there, tied with a string. The former required a circular cutaround the head of
the
penis
at
the corona. The skin of the shaft of the peniswas then degloved from
its
underlying tissue. Thus freed,
it
could then bepulled forward to cover the glans penis in the manner of a foreskin. The rawtissue over which
it
was pulled forward was packed with plaster to preventadhesions while healing, and
the
reconstruction was held in place with abandage.The fact
that
Celsus described
an
operation to lengthen a natural foreskin
that
was too short is itself proof
that
the function
of
the operation wascosmetic.
It
enabled a young athlete to conform to the Hellenistic ideal ofgymnastic nudity, namely
that
competitors should have a foreskin
that
com
pletely covered the glans penis. The same applied also to the operation devisedfor young athletes who had formerly been circumcised. They were sons of thecircumcising peoples of North Africa and the eastern Mediterranean. So
that
they could compete in the games, they also needed
to
conform to the Hellenistic ideal.As the ideal of the Hellenistic athlete faded with the fall of Rome, so also didthe practice of foreskin restoration become neglected, if one judges by thesilence
of
the historical record.
That
silence was broken only in the recent
past
when the cosmetics of the foreskin and
its
restoration underwent a revival.
In
the United States, this revival coincided with the genesis of a healthreform movement
that
repudiates routine neonatal circumcision as an unnecessary surgical mutilation (Wallerstein,
1980).
Neonatal circumcision had
Supported by USPHS Grant HD 00325. Requests for reprints should be sent
to
Dr.
John
Money, Suite LL20, Old Town Office Center, 1235 E. Monument Street, Baltimore, MD 21202.145
146
CLINICAL NOTES
become a routine practice in the 19th century on the basis of the faulty belief
that it
would prevent masturbation in later years (Kellogg, 1888; 1906). Thisbelief was derived from Tissot's 18th-century revival of the ancient Ayurvedictheory
that
loss of the sukra (semen) caused degeneracy, disease, and death(Money, 1985; Prakasam
et
aI., 1991).The revival of foreskin restoration more or less coincided also with
the
rise ofthe sexual liberation movement, including
the
gay
liberation movement, whichgave men the freedom to be explicit about the foreskin as an erotic organ.
In
response to
an
invitation in the Newsletter of the Uncircumcised Society ofAmerica (USA), volunteers and their partners, both male and female, providedwritten comments on the foreskin
as
a visual and tactile erotic organ (Berkeley
&
Tiffenbach, 1983).Some seekers of foreskin restoration
attempted
on their own initiative toregain a foreskin by means of taping, tying,
and
progressive stretching.Others underwent plastic surgery (Greer
et
aI., 1982; Mohl
et
aI.,
1981) or selfsurgery (Walter
&
Streimer, 1990). Establishing a kinship of purpose, some ofthem formed BUFF, a small network of Brothers United for Future Foreskins.Independently of this network, in the six years after 1977, four men appliedto
Johns
Hopkins Psychohormonal Research Unit (PRU) to request adviceand
to
give information regarding their fixation on foreskin restoration. Afifth man volunteered
an
account of his personal experience of foreskinrestoration by stretching. These are the people whose cases are here reported.The purpose of the report is documentary.
It
is also comparative, insofar aseach case differs from the other four in the degree and pervasiveness of thefixation on foreskin restoration.Sample and ProcedureThe five cases constitute a self-selected, availability or opportunity sample,assembled over a six-year period. The size of
the
foreskin restoration population from which they are self-selected is not known, nor is the range of
its
phenomenological variability. Table 1 summarizes various pertinent characteristics of
the
five cases.The
data
in this report were collected according
to
the Systematic Scheduleof Inquiry regularly used in the PRU. Interviews were recorded and transcribed. They were then indexed so
that
data
could be categorized for use in
the
tables
and
in biographies of the Findings section.FindingsThe findings listed in Table 2 provide chronological and other
data
pertinentto the circumstances regarding circumcision and the
quest
for foreskinrestoration and
its
outcome. Table 3 provides
data
on various sexuoeroticpractices and fantasies relative to the development of sexuoerotic experience
as
homosexual (Kinsey
rating
6)
or heterosexual (Kinsey
rating
0)
ratedseverally for prepuberty, adolescence, and adulthood.The sample lacks homogeneity to a degree sufficient to require documentation of individual differences. Hence the brief biographies of circumcision andforeskin restoration
that
follow. Their sequence is chronological, according
to
the order in which they were obtained.
CLINICAL NOTES
147
Table 1
Sample Characteristics: Foreskin Restoration Cases (N
=
5)
Biography Biography Biography Biography Biography1 234
5
Age referred
20
years
48
years 49 years
43
years 33 yearsReferral bySelf
(mail)
Psycho-Self
(mail)
Invitation InvitationtherapistEducation College Trade College College Collegecourses
training
graduategraduate graduateReligionEvangelicalProtestantFunda-RomanJewishProtestant mentalistl CatholiclProtestant AtheistOffspring None Seven None None NoneErect penislength 7 inches 6 inches
51t~
inches 6 inches
6Y2
inchesPsycho-therapyhistory YesYes Yes
No No
Self-diagnosed YesYes Yes
Yes
YesSuicidalideation Yes
Yes No No No
Table 2
Circumcision and Foreskin Restoration Data (N
=
5)
Biography Biography BiographyBiography Biography1 2 34
5
Age circum-cised
10
years2 years BirthBirth BirthReason cir-cumcised PaternalMaternal Routine Routine Brisdecision decisionFather cir-cumcised YesNo?
No
No YesOnset feltmutilated10 years 7 years 8 years
22
years 30 yearsGlans defect
No
No
No
Insensitive, Sensitive,too
dry
painfulOnset restora-tion fixa-tion
10
years
42
years
24
years
27
years 30 yearsRestorationmethodSurgery None None SurgeryStretchingRestorationoutcome FailureNone None DefectiveExcellentOutcomeResignation Unascer-Acceptance Try again Satisfiedresponse tained
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Sexology, Body Image, Foreskin Restoration, And Bisexual Status
Sexology, Body Image, Foreskin Restoration, and Bisexual Status, by John Money, in The Journal of Sex Research, Vol. 28, No. 1 (Feb., 1991), pp. 145-156
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