A new art exhibit is making its Philadelphia debut at Open Space Studio this week. Titled “HUFO, The Missing Piece,” this unique installation lies at the intersection of human experience, medical science, and, according to its Italian creator, human rights. Its aim is to raise awareness about a procedure that many take for granted, but that others find hugely concerning.

HUFO stands for human foreskin. The artist, Vincenzo Aiello, is an opponent of infant male circumcision.

“Newborn circumcision is a trauma, and it’s ingrained in our psychology,” said Aiello, whose nine artworks with silicone replicas of human foreskin draw inspiration from Leonardo da Vinci’s Vitruvian Man. “There are obvious concerns and dangers to the infant. And remember, anything that is a danger to an infant is a danger to society.”

Aiello is not alone in his opinions.

One of Vincenzo Aiello's replica foreskins made from silicon resin.
Courtesy of Vincenzo Aiello
One of Vincenzo Aiello's replica foreskins made from silicon resin.

“It is a very heated topic,” said Gregory E. Dean, chief of pediatric urology at St. Christopher’s Hospital for Children. “Very heated.”

Parents advocating for their children, medical ethicists, men who feel violated — these are some of the voices in an impassioned controversy, particularly on secular circumcision.

“I consider circumcision an epidemic of great harm that will stop when doctors stop performing this atrocity,” said George Denniston, the Philadelphia-born, Penn medical school-educated founder of Doctors Opposing Circumcision (DOC), a national group against foreskin removal done for nonmedical reasons.

Blood-Stained Men & Their Friends is an activist — or, members might say, intactivist — group that has engaged in protests across the United States, including in Atlantic City. Wearing white painter’s coveralls with red-splattered crotches, the group’s members equate male infant circumcision with genital mutilation and argue that it impacts men’s sexuality and even traumatizes children.

“This issue affects people on the most personal level possible,” said Brendon Marotta, director of the award-winning 2018 documentary American Circumcision, which is now playing on Netflix.

The opposition to a once-standard procedure is no outlier phenomenon.

Mainstream pediatric urologists also point out that circumcision is more common in the United States than other places, including the United Kingdom, Scandinavia, and Australia, as well as South America and parts of Asia. Yet even in the U.S., there is evidence that support of routine circumcision not based on religious or cultural practice — such as by Jews and Muslims — has declined.

The most recent study by the U.S. Centers for Disease Control and Prevention found that while rates have fluctuated with changes in medical advice, male newborn circumcision declined overall from 1979 to 2010 from about 65 percent to 58 percent. Regional rates vary, with the highest rates in the Midwest, followed by the Northeast, the South, and the West.

The American Academy of Pediatrics’ position, last updated in 2012, is that scientific literature shows potential health benefits to circumcision but that the decision should be left up to parents and doctors.

Among the benefits cited were lower risks of acquiring HIV, genital herpes, the human papilloma virus (HPV), and syphilis. The group also said research indicated that circumcision can lessen the risk of urinary tract infection in the first year of life and penile cancer over a male’s lifetime. It can also reduce the risk of cervical cancer for sexual partners.

Still, many parents decide against circumcision for their sons. One of them is Jennifer Holland, 40, of Williamstown, Gloucester County.

As a Christian, Holland said, “the whole idea that God made us broken and we need to fix it — that didn’t sound right to me.”

Holland, an engineer, said she looked into some of the research and didn’t find it compelling enough to perform a procedure on her infant, which she worried might cause him pain. Her son, now 7, has never had a urinary infection and hasn’t been teased by other boys for having a penis that looks different from theirs.

“Just for reference, I think people make an assumption that the people who choose not to [circumcise] are granola-eating hippies. My child is fully vaccinated,” Holland said. “I let him eat Fruit Roll-Ups.”

Two of the Philadelphia region’s leading pediatric urologists agree that while research does show potential health benefits to circumcision, most of those risks can be reduced or even eliminated through steps like practicing safe sex, good hygiene, and vaccinations against HPV.

“Neonatal circumcision does not need to be done to be healthy,” said T. Ernesto Figueroa, pediatric urology division chief for Nemours/Alfred I. duPont Hospital for Children. “Men can live perfectly healthy lives if they’re not circumcised as long as the foreskin is managed and they follow precautions.”

Figueroa said he tries to give parents balanced information and respect their beliefs and preferences.

One concern about circumcision Figueroa said he often needs to address is pain. Measures like local numbing or pain-blocking medication, the presence of a parent, sugar water, and a quiet room are used to make the experience more comfortable.

“When we do that, at least in our experience, three out of four boys sleep through the procedure,” Figueroa said.

Comfort measures have also been adopted by Abington Hospital, one of the region’s busiest birthing sites, in its Newborn Circumcision Quality Initiative, according to St. Christopher’s Dean, who has been involved in the program’s implementation with his private practice group, Urologists for Children.

Another part of that effort is having newborn circumcisions done only by urologists, he said, to avoid improperly performed procedures.

Dean didn’t discount opponents’ contention that the tissue removed in circumcision can mean the loss of some sexual sensation. However, he added, there is no scientific evidence of widespread sexual dysfunction or sexual dissatisfaction due to circumcisions.

“I think the biggest thing is to give families as much education as they want,” Dean said, “and then make sure, if [circumcision] does get done, that it gets done well.”

Meanwhile, at Open Space Studio in Northern Liberties (1014 N. Marshall St.), opposition to nonconsensual circumcision will be on display through the works of Aiello until June 14.

Aiello, 55, said he was circumcised as an adult to deal with a health need.

“Through my experience, I have realized this is a surgery that can only be done to adults who consent and only for medical reasons,” said Aiello, who considers neonatal circumcision a human-rights violation.

The artist interviewed 50 men to help him inform and create his installation. That experience also inspired him to found Foregen, a medical nonprofit exploring the possibility of regenerating foreskin. That work is still in the early stages, but this month, the outrage of the men he interviewed will be given a voice through art.

Said Aiello: “These men are not alone anymore.”