Under the Skin

An anonymous writer tells of his personal experience with phimosis, a condition which in serious cases like his, requires full circumcision. He argues that the taboo around openly discussing our “private parts” can lead to confusion and distress about medical conditions which are ultimately a lot more common than we think.


Phimosis /fʌɪˈməʊsɪs/ is a condition in which a person’s foreskin sticks to the glans (or head) of the penis, preventing it from peeling back the way it’s supposed to. The issue is very common among young children and doesn’t cause any trouble if they grow out of it. Phimosis that continues past the age of 16, so-called “pathological” phimosis, can be a serious problem. While it is a common ailment – affecting 1 in 100 men – surprisingly few people know that it exists. I had never heard of phimosis, or that it caused so many problems until I realised that I had it.


Genitals are a mysterious part of the human body. As we grow up, they transform from a perfectly normal bit of us to a taboo that must be kept out of sight. We are slowly trained to cover ourselves up, to not let anyone – even close family members – see our “private parts”. We learn to be ashamed of our bodies for the first time, to keep that part of ourselves hidden away. Questions are a vital way of figuring out how the world works and how we work but we naturally stop asking the kinds of questions that make people uncomfortable. In those cases, we have to work it out for ourselves.


My general education on this part of my body began in private examinations, with research excursions in the few places where the privacy rules don’t apply: public urinals and communal changing rooms. In the locker room of Westwood swimming pool, men would inexplicably stand around with their penises proudly hanging out, each one scraggly and ugly in its own unique way. The standout piece of information I gathered from the first of these trips was the visual difference between circumcised and uncircumcised penises. I hadn’t realised that the foreskin was optional.


Pornography was another great educator. Although it was a starkly unrealistic introduction to human anatomy and sexuality, it was my first major hint that my penis might be especially different. While figuring out how it all worked, in that terrifying stage of pubescent sexual discovery and uncertainty, I noticed that all the men in these videos appeared circumcised while they were erect. After extensive analysis, I worked out that the foreskin was supposed to slide back really far and that the head was supposed to pop out entirely. My penis was having none of this, as some (regrettable) experimental tugs went on to prove.


Like most questions I had about my genitalia in this confusing time, I kept the subject of my mysterious foreskin to myself. It didn’t seem to really be an issue, and I wasn’t prepared to approach this graphic topic with anybody, especially not my parents. Again, the internet was my best resource. It was during a spur of the moment Google session that I first came across the term “phimosis”, as well as some advice and common remedies. I found some calming facts – most people grow out of it, sometimes it can be solved with simple stretching exercises – as well as some disconcerting ones. When left untreated, phimosis can lead to hygiene problems, difficulty urinating and during sex, and can even lead to tearing (yikes!). Scariest of all was the last resort solution, suggested at the bottom of every article I could find on the subject: full circumcision.


Here’s where I closed the window. My father first explained that term to me during a suddenly awkward drive home from the aforementioned swimming pool. I flinched with sympathetic pain and horror when he explained that it meant “cutting off the foreskin” and then explained which bit the “foreskin” was. To my tightly-wound, highly-private self, the concept seemed barbaric, sadistic and most of all unbearably humiliating. My conceptions hadn’t changed between that childhood drive home and this teenage google search. In my mind, at least if you got it done as a baby you’d have the luxury of forgetting the experience, of never knowing what life before it was like. The closest thing to surgery I’d ever experienced at this point was some minor stitches I got after cracking my head open on a skirting board. Actually having a part of my body removed, having to get mutilated, didn’t bear thinking about.

Illustration by Amy Regan
Illustration by Amy Regan

And besides, there wasn’t anything to worry about. At least, not until freshman year of college, when the prospect of sex went from a distant abstract to a very real possibility. (It was an optimistic time.) I recognised that, while masturbation was easy enough to accomplish without aggravating my tiny foreskin hole, sex was a great unknown. Phimosis forums, on which I had become a regular at this point, specified that sex could be an extremely difficult and painful ordeal, requiring patience and sensitivity from both participants. Images of what that strain might do to my dysfunctional penis haunted me. I got stressed out imagining how badly it might go, especially at this point in my life when opportunities for random, casual sexual encounters constantly seemed to lie just around the corner.


Fortunately, I was incorrect and my first experience that was anything close to full intercourse didn’t happen for several years. It was an out-and-out disaster. I had phimosis and the girl I was with had vaginismus, a similar condition that makes the entrance to the vagina tight and sensitive. Vaginismus affects 10% of women and 2% of cases are extreme. At the time, neither of us realised this was a condition. She had a friend with the same problem and naturally assumed that that was just the way it was.


I had no luck until my final year of college, with one of my closest friends. Both of us were virgins and both of us had our own private reservations and trepidations. We were very open to communicating these things, which is probably the best situation I could have hoped for, especially following my painful and embarrassing earlier attempt. It didn’t happen on the first try, or the second and the first time we actually managed something close to “sex”, I did not enjoy myself a bit.


Thankfully, I was in a strong and supportive relationship and we were able to take our time and work through my problem, to an extent: different positions, new approaches to foreplay, figuring out whether condoms helped or exacerbated the problem (the latter) and whether lubricant might improve things (hell yes). The central issue was still there, though. My penis wasn’t functioning properly and in time the problem might even get worse. I realised that I had to bite the bullet and see a specialist.


After gently tugging at my foreskin a couple of times, the urologist concluded that the problem was severe and that full circumcision was the only solution. I felt validated. After years of wondering whether I really had a condition, or if I had just been self-diagnosing and overreacting to a perfectly normal situation, I had medical confirmation that my dick was faulty. I realised that this was partly why I was so scared of going through the process: the chance that it was all in my head and I’d just be exposing my most vulnerable self for no reason.


The circumcision part was still really scary, though. As the date of the operation grew closer, nightmare situations of what might go wrong on the table ran through my head. All were basic doctor’s appointment fears, magnified through the lens of genital awkwardness. Mercifully, I was knocked out for the whole thing, emerging into a state of morphine-induced bliss to realise that the worst was already over.


The drugs probably helped when I finally decided to take a peek downstairs and found myself laughing instead of crying at the bandaged, ridiculously swollen mess that was hanging from my crotch. It was bloody, it was unsightly, it was marred by a ring of large, pokey stitches. However, it was recognisably my own. The next couple of weeks sucked, lining my underpants with vaseline and taking each step with a great deal of care. Things gradually improved. It feels good to finally be out of the woods.


I don’t know how much longer I might have gone without saying anything or consulting a doctor if I hadn’t found someone understanding to help me through it. I might still be keeping this issue to myself, silently worrying that it would develop into something worse. I had a physical problem that was made much worse by how we talk – or don’t talk – about bodies and sex. Although Irish sex education has grown more progressive in recent years, our culture still places discussion of these sensitive matters behind a wall of shame and silence. As a result, children are forced to work out the complicated nature of sex organs for themselves, self-diagnosing their problems and telling no one.


Once I began telling other people about my phimosis, I was stunned to find out how many of them could relate. Two of my friends had siblings who went through the same thing and one of them had gone through it himself when he was a teenager. (Except he had the kind that’s easily cured with a topical cream, the prick.) One of my friends had vaginismus and had to apply pain-killing lubricant every time she wanted to have sex. Each of these mini-revelations was a weight off my chest, a recognition that behind the silence that shrouds genital issues and other unsavoury topics, there were people I knew who’d been in exactly the same position as me, who also didn’t feel comfortable discussing it openly. It was opening up to others that gave me the strength to face my problem and finally sort it out.


In order to take that first step, I had to pass through a socially constructed wall of silence. I had to defy the loud, anxious voice in my head that demanded I keep these things to myself. This is what happens when we suppress conversation about the body. We amplify personal miseries through shame and isolation. It took discovering that I had a problem and feeling like I couldn’t talk to anyone about it to realise how damaging and restrictive our discourse on sex and sexual health can be.

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