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Thursday, November 18,2010

The truth about genitals

By Dr. Jenni Skyler

Welcome back to Sophisticated Sex. This week we are changing the format of the column to incorporate your most juicy, burning or embarrassing questions about sex, intimacy and relationships. To submit your questions, see contact information at the bottom of the column.


Dear Dr. Jenni,

My husband and I are expecting a baby boy. It is our first child, and we are deliberating as to whether we should have him circumcised or not. My husband is circumcised and is eager to have the same procedure for our son. I am skeptical if this is needed. Is it cleaner to have him circumcised? Will it reduce his sexual pleasure in the future?

Concerned Mom-To-Be

Dear CMTB,

It’s fabulous that you are asking this question and having this important conversation with your husband. Circumcision is usually performed for religious, cosmetic and/or hygienic reasons; however there is no medical indication for the procedure. Removal of foreskin does make it easier to clean the penis, and research shows that those who are circumcised have a slightly lower risk of getting sexually transmitted infections (STIs). That said, a daily shower, including a good scrub-down of the foreskin and entire genital area, can handle the hygiene issue, and it goes without saying that condoms are enormously more safe and effective in preventing STIs than circumcision.

As for sexual sensation, the research differs. It’s safe to say that most adult men, circumcised or not, derive great pleasure from their penis and find their head to be highly sensitive. Yet, we know for sure that the foreskin is chock-full of nerve-endings. Because of this, some experts claim that circumcision shortchanges sexual sensation, as the penis skin has had to develop a tougher exterior in the absence of foreskin protection.

This may be evidenced in men who need harder thrusting during intercourse to obtain maximum physical sensation. On the other hand, studies of adult men who have lived part of their life with their foreskin and part of their life without it do not demonstrate considerable loss of sensation upon circumcision.

At the end of the day, you may want to defer this important decision to your soon-to-be son and empower him to make his own informed choice when he gets older.

Dear Dr. Jenni,

I have really uneven labia. One side is quite small and seems to have a normal appearance, while the other looks beefy and juts out. Is this weird to have such misshaped labia? I’ve only had sex with one person and did so in the dark because I was embarrassed.

Misshaped and Embarrassed

Dear M’n’E,

Don’t stress! The shape, size and color of the entire vulva — including the inner and outer labia, the clitoris, the clitoral hood and the vaginal opening — differ from woman to woman. Think of your vulva as a fingerprint. They are each unique and each normal. The inner lips may be beefier and bigger than the outer lips, or the other way around. One lip may be bigger than the other. Or all lips may be small and symmetrical or full and fabulous.

I highly suggest looking at the labia and anatomy sections on the site www.the-clitoris.com. There you will find a plethora of pictures with various vulvas. I encourage women to explore these pictures, as it normalizes the idea that vulvas really do come in many shapes, sizes and colors. Like a magazine cover, we rarely see more full-figured women or women with freckles or scars. If all women were to look like the flawless stick figures of Vogue, then there would be no room for other types of beauty. Same can be said for vulvas. We rarely get to see what other types of vulvas exist — beyond the small, shaved labias of Playboy. I encourage you to explore these pictures to see that there is a very varied world out there — and it’s all beautiful.

Then turn on the lights and get some mirror time to start looking at yourself and your vulva. Make friends with her so that you can feel more comfortable sharing her with a partner — with the lights on. Once you can accept and then love your labia, then so will the lucky partner who gets to be with you next.

Send questions for Jenni Skyler, PhD, to drjenni@theintimacyinstitute.org. Skyler is a sex therapist and board-certified sexologist who runs The Intimacy Institute in Boulder, www.theintimacyinstitute.org.

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Your advice about circumcision is almost fair, but PLEASE don't think your son has to 'scrub down' his foreskin! For a start, it shouldn't even be retracted until around the time of puberty! Just keep it clean.