About NORM-UK

Dr John Warren MB DCH FRCP

As a medical student in the 1960s I was fortunate enough to hear Dr Douglas Gairdner, a Cambridge paediatrician, lecture. He had published a paper in the BMJ in 1949 which showed that routine neonatal circumcision that had been practised in the UK up to then was not necessary or advisable. I had myself been circumcised in infancy and realised that I had had an unnecessary operation.

A few years later as a house surgeon I found myself in an operating theatre, performing a circumcision on a small, anaesthetised boy whose foreskin was too tight to retract. This was the first time I really had a close look at the foreskin, and discovered what I had lost. I was surprised how much skin there was, and started to wonder what it was there for. Medical textbooks were silent on this point. However, I refused to believe that it had no function, since all other body parts seem to be there for a reason. Soon after this, I was studying for an exam in paediatrics in 1968, and read an article in a journal by a Danish paediatrician, showing that boys with tight foreskins develop normally if they are left to mature through puberty, without being circumcised. I assumed that this spelt the death knell of circumcision of children for medical reasons. My career took a turn to adult medicine, and I gave the subject little further thought for many years.

From time to time I would check the medical literature to see if further work had been done on the function of the foreskin, but nothing of significance appeared. Then in 1992, a book by Dr Jim Bigelow, a Californian psychologist was published. It was called The Joy of Uncircumcising! At last this book explained the function of the foreskin and the effects of its removal. In 1994 I travelled to California to meet Dr Bigelow, and his associates who had developed techniques of non-surgical foreskin restoration. In California there were groups of men meeting to exchange ideas on how to improve the techniques, and help one another. There was also NOCIRC, an organisation led by a nurse, Marilyn Milos, campaigning to stop routine neonatal circumcision, which was still common practice in USA.

I realised there might be a need for a voluntary group in Britain as there must be large numbers of circumcised males. Others did indeed hear of what was happening in USA, and the first group of men in Britain to meet to discuss foreskin restoration met in London in November 1994. We decided to continue meeting from time to time, and adopted the name NORM-UK after one of the American groups called NORM. At first we were mainly interested in foreskin restoration, but almost at once members were aware that the numbers of children being circumcised in Britain could be reduced, and that prevention of circumcision was preferable to trying to correct it later. In fact, Lewis Spitz, Nuffield Professor of Paediatric Surgery, Institute of Child Health, writing in Archives of Diseases in Childhood, July 1998, estimates that in England alone, 21,000 unnecessary circumcisions are performed annually. Quite apart from the risks of complications and the physical and psychological effects of mutilation, this imposes a heavy financial burden on the NHS.

NORM-UK is a voluntary organisation which runs support groups that meet regularly in England, produces a quarterly magazine, and has dealt with thousands of enquiries, both about foreskin restoration and about avoidance of circumcision. NORM-UK from the start was mainly concerned about medical rather than religious circumcision. However, we have been joined by members who were circumcised on religious grounds, and our view is that we cannot support the mutilation of children for any reason, unless there is serious disease not treatable by conservative measures. We do not oppose ritual circumcision of fully informed adults, who, after due consideration of the facts, have given their consent without coercion. Genital mutilation of children (who are naturally incapable of giving informed consent) regardless of their race, religion or sex, violates their human rights, and exposes them to pain, risks to physical and psychological health, and to permanent bodily mutilation. We believe that the skin or mucosa covering the sexual organs of the human is a unique and highly specialised part of the body, richly endowed with tactile sensory receptors, and that it plays an important role in conveying sexual pleasure.

• Dr John Warren is a consultant physician at the Princess Alexandra Hospital in Harlow,Essex