Circumcision controversies

Circumcision has been the subject of controversy for thousands of years. The Ancient Greeks and Romans valued the foreskin and were opposed to circumcision. Traditional Judaism and Islam have advocated male circumcision as a religious rite.

In modern times, from the mid 19th century, there has been advocacy on medical grounds while opponents to circumcision often question its effectiveness in preventing disease. Regarding infant circumcision, modern opponents also object to subjecting newborn boys without their consent to a procedure with what they consider to be questionable benefits and significant risks.

History

Main article: History of male circumcision

The Bible recounts Abraham and his undergoing circumcision as a radical break with the culture of his times. The Jewish and Islamic traditions both record circumcision used as a way to distinguish a group.. The bible records the concept of circumcised or un-circumcised as a derogatory reference from an opponent. From biblical and apocryphal texts it seems that circumcision was practiced only by the Jewish communities of the time and purely as a religious practice.

The Seleucid Empire made laws prohibiting circumcision, affecting the Jews living within the empire. In 167 B.C Antiochus (175–165 B.C.) gave a decree that punished any mother who circumcised their son with death (according to Tacitus, as quoted by Hodges, Antiochus "endeavoured to abolish Jewish superstition and to introduce Greek civilization."). See also Antinomianism in the Books of the Maccabees. In the Roman Empire, the consul Titus Flavius Clemens was condemned to death by the Roman Senate in 95 A.D. for converting to Judaism and becoming circumcised. Hadrian (117-138 A.D.) forbade circumcision. Antonine (138-161) initially forbade circumcision but later allowed Jews their religious practice (see also Fiscus Iudaicus). Marcus Aurelius (161-169) though revived the edict of Hadrian.

During the reign of Constantine all Jews were once again forbidden from practicing circumcision. Any Jew that circumcised his slave was punished by death. In the 6th century Justinian forbade Jews from practicing their faith. In the 7th century Jews were asked to renounce their faith including the practice of circumcision and be baptized. If they did not their property would be confiscated and they would be banished from the country. The Saracens persecuted the Jews of Spain and took away their children to be raised in the Christian religion. This was the case as well during the 15th century due to the Spanish Inquisition where the practicing of Judaism was abolished and Jews were forced to renounce their faith.

During these times resistance took two forms: circumcisions were secretly performed though - even on dead Jews - so that the law of their fathers could be carried out, or efforts were made by Jews to conceal their circumcision status. This first occurred during the reign of Antiochus. By the aid of appliances, the skin was forced to hang over the glans. Marcus described the instrument as a long copper tube which carried the penis, the weight of which forced the skin down over the glans. The apostle Paul refers to these practices in his epistle to the Corinthians "was anyone called being circumcised, let him not be uncircumcised." The instrument is not thought to have been effective.

Thomas Aquinas in his Summa Theologica questioned why, if under Jewish doctrine circumcision removed original sin, Jesus was circumcised - as Jesus had no original sin.

With the founding of Islam in 624 CE, Mohamed defined the Fitrah with one of the five principles being circumcision.

Countries that do not circumcise have often held antipathy for those that do. Often being circumcised was a sign of disgrace.

Until Victorian times, circumcision was widely regarded with repulsion. In 1650, English physician John Bulwer in his study of body modification, Anthropometamorphosis: Man Transform’d, or the Artificial Changeling, wrote of the loss in sexual pleasure resulting from circumcision: "the part which hangeth over the end of the foreskin, is moved up and down in coition, that in this attrition it might gather more heat, and increase the pleasure of the other sexe; a contentation of which they [the circumcised] are defrauded by this injurious invention. For, the shortnesse of the prepuce is reckoned among the organical defects of the yard, … yet circumcision detracts somewhat from the delight of women, by lessening their titillation." The English historian Edward Gibbon, author of The History of the Decline and Fall of the Roman Empire, referred to the practice as "a painful and often dangerous rite", "singular mutilation" practiced only by Jews and Turks.

The first formal objection to circumcision within Judaism occurred in 1843 in Frankfurt. The Society for the Friends of Reform, a group that attacked traditional Jewish practices, said that brit milah was not a mitzvah but an outworn legacy from Israel's earlier phases, an obsolete throwback to primitive religion. With the expanding role of medicine came further opposition; certain aspects of Jewish circumcision such as Preiah (Pre-ah) (removal of the foreskin & folding-back of the mucous membrane to expose the glans) and Metzitzah (drawing the blood from the circumcision wound through sucking or a cloth) were deemed unhygienic. Later evidence that syphilis and tuberculosis— two of the most feared infectious diseases in the nineteenth century — were spread by mohels, caused various rabbis to advocate metzitzah to be done using a sponge of a tube. (Today, the Rabbinical Council of America, the largest group of Modern Orthodox rabbis, endorses using a glass tube.)

Ephron reports that Gentiles and also some Jewish reformers in early 19th Century Germany had criticized ritual circumcision as "barbaric" and that Jewish doctors responded to these criticisms with defences of the ritual or proposals for modification or reform. By the late 19th century some German Jewish doctors defended circumcision by claiming it had health advantages.

Late 19th Century to Present

A protest against non-therapeutic infant circumcision in connection with the annual meeting of the American Academy of Pediatrics at Washington Convention Center

Circumcision spread in several English-speaking nations from the late nineteenth century. One reason for this was promotion by doctors such as Sir Jonathan Hutchinson in England. Peter Charles Remondino, of San Diego, wrote a History of Circumcision from the Earliest Times to the Present: Moral and Physical Reasons for Its Performance (1891), to promote circumcision. Lewis Sayre, a prominent American Orthopedic surgeon at the time, was another early American advocate. Dr. John Harvey Kellogg recommended circumcision of boys, writing: "A remedy for masturbation which is almost always successful in small boys is circumcision.... The operation should be performed by a surgeon without administering anaesthetic, as the pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment." An early opponent of circumcision was Herbert Snow, who wrote a short book called The barbarity of circumcision as a remedy for congenital abnormality in 1890.

In the late nineteenth century, doctors and others advocated circumcision to prevent masturbation, which was then considered sinful and harmful. As late as 1936, L. E. Holt, an author of pediatric textbooks, advocated male and female circumcision as a treatment for masturbation.

The first serious questioning of the practice did not occur until late 1949 when Gairdner published The Fate of the Foreskin in the British Medical Journal; according to Wallerstein this began to affect the practice of circumcision in Britain.

Some men are unhappy about being circumcised, including A E Houseman, W.H. Auden, Geoffrey Keynes and his brother John Maynard Keynes, the famous economist. In 1996 the British Medical Journal published a letter by 20 men saying that "we have been harmed by circumcision in childhood" ; they argued that "it cannot be ethical for a doctor to amputate normal tissue from a normal child". According to Darby and Cox, the persistence of circumcision in the USA has led to more vigorous protest movements. One such organization distributed questionnaires to circumcised men. The complaints included prominent scarring (33%), insufficient penile skin for comfortable erection (27%), erectile curvature from uneven skin loss (16%), and pain and bleeding upon erection/manipulation (17%). Psychological complaints included feelings of mutilation (60%), low self esteem/inferiority to intact men (50%), genital dysmorphia (55%), rage (52%), resentment/depression (59%), violation (46%), or parental betrayal (30%). Many respondents reported that their physical/emotional suffering impeded emotional intimacy with their partner(s), resulting in sexual dysfunction.

According to Marilyn Milos and Donna Macris, "The need to defend the baby's right to a peaceful beginning was brought to light by Dr. Frederick Leboyer in his landmark work, Birth Without Violence". Those opposed to circumcision began creating websites in the mid-1990s, and this process has continued. This period also saw the formation of Genital Integrity organizations in Australia, Canada, the United Kingdom and South Africa. In response to consumer demand for accurate information on circumcision, The National Organization of Circumcision Information Resource Centers (NOCIRC), was formed by Marilyn Milos, R.N., in 1985. The organization's stated objective is to secure the birthright of male, female, and intersex children and babies to keep their sex organs intact. Protest rallies have been held in the USA and other areas. NOCIRC have consistently criticised the American medical community's circumcision guidelines.

NOCIRC, the International Coalition for Genital Integrity, and Stop Infant Circumcision Society launched the First Genital Integrity Awareness Week in Washington, D.C. during the first week of April, Child Abuse Prevention Month. The 12th Annual Demonstration/March Against Infant Circumcision took place during March 29 - April 3, 2005.. From 2004 to 2007, the organization MGMbill.org sent a proposed bill to the US Congress and 15 state legislatures to extend the prohibition on genital modification and mutilation of minors to include male and intersex children. The proposed bill has not been endorsed by any member of Congress.

The Bay Area iNtactivists Group (BANG) in the San Francisco region takes part in baby fairs, the Solano Stroll, Gay Pride marches and other events. An interview broadcast on Outlook TV in April 2006 emphasises genital integrity for boy, girl, and intersexed babies.

Dr. Benjamin Spock (d. 1998), who originally supported circumcision, changed his mind near the end of his life. Dr. Thomas Wiswell, who was originally opposed to circumcision, later changed his mind after his research revealed a protective effect against urinary tract infections. Dr. Edgar Schoen, (b. 1925) former chair of the American Academy of Pediatrics' Task Force on Circumcision, maintains a web site promoting circumcision and claims physical benefits in sexual performance in addition to medical arguments. Aaron J. Fink, M.D. (d. 1990), another late 20th century circumcision advocate, self-published Circumcision: A Parent's Decision for Life to promote his ideas.

In Australia, Professor Brian Morris, author of "In Favour of Circumcision" said, "It was never my intention to be the biggest campaigner for circumcision in Australia. Really, I’m a campaigner for science." Morris writes that circumcision confers many medical benefits including reduced risk of UTIs, penile cancer, HIV, balanitis, posthitis, phimosis, and prostate cancer and argues that circumcision has sexual benefits.

Boyle et al. suggest that "As we enter the 21st Century, appropriate legal action must be taken to safeguard the physical genital integrity of male children."

The American Academy of Pediatrics (AAP) circumcision policy has been criticised, both by those who believe that it is too negative about the practice, and those who believe that it is too positive. Hill has also criticised the Academy's circumcision information brochure for parents, arguing that the brochure is inadequate to persuade parents to avoid circumcision.

The WHO and UNAIDS advocate male circumcision as a means of reducing the rate of HIV infection.

Opposition to circumcision exists among Jews in Israel. Even though there is often pressure from family to circumcise their sons, a small but growing number of Jews are choosing to forgo the procedure.

The Association for Genital Integrity (AGI) advocates genital integrity in Canada.

NORM-UK is a major opponent of circumcision based in the United Kingdom.[1]

The National Organisation of Circumcision Information Resource Centers (NOCIRC) has organised a series of International Symposia in cooperation with circumcision opposition organisations since 1989. They were

1. 1989 Anaheim, California (on Circumcision)
2. 1991 San Francisco, California (on Circumcision)
3. 1994 Maryland (on Circumcision)
4. 1996 Lausanne, Switzerland (on Sexual Mutilations)
5. 1998 Oxford, England (on Genital Mutilation)
6. 2000 Sydney, Australia (on Genital Integrity)
7. 2002 Washington, DC (on Genital Integrity)
8. 2004 Padova, Italy (on Human Rights and Modern Society: Advancing Human Dignity and the Legal Right to Bodily Integrity in the 21st Century)
9. 2006 Seattle, Washington (on Circumcision, Genital Integrity, and Human Rights)
10. 2008 Keele, UK (on Circumcision, Genital Integrity and Human Rights)

The proceedings of several of these symposia have been published in book form.

Many opponents of circumcision see infant circumcision as unnecessary, harmful and unethical; some want the procedures prohibited.

Hammond asserts that every person has a right to a whole and intact body and that, where minors are concerned, "the unnecessary removal of a functioning body organ in the name of tradition, custom or any other non-disease related cause should never be acceptable to the health profession." He says that such interventions are violations of individual bodily rights and "a breach of fundamental medical ethics principles". Others also see the genital cutting of children as a human rights issue, opposing the genital modification and mutilation of children, including circumcision and female genital cutting. Several anti-circumcision organizations also oppose the sexual-reassignment surgery of infants with ambiguous genitalia.

Current laws in many countries, and laws in several U.S. states, prohibit the genital modification and mutilation of female minors, with some exceptions based on medical need. Opponents of male circumcision assert that laws against genital modification and mutilation of minors should apply equally to males and females, and several organizations have also objected to involuntary sex reassignment. Opposition to circumcision does not imply bias against those who have been circumcised, and those who agree with Genital Integrity accept the right of individuals to make informed choices about their bodies.

The Genital Integrity Ribbon was created by the "National Organization to Halt the Abuse and Routine Mutilation of Males" (NOHARMM). The pink ribbon symbolizes girls and blue symbolizes boys. The ribbon as a whole can symbolize intersexed people.

See also

• Ethics of circumcision
• Human rights
• Reproductive rights
• Ridged band
• Female genital cutting
• Gliding action
• Foreskin
• Medical analysis of circumcision
• Penis

References

Further reading

• Robert Darby, "A Surgical Temptation: The Demonization of the Foreskin and the Rise of Circumcision in Britain, Chicago, University of Chicago Press, 2005. (ISBN 0-226-13645-0)
• Leonard B. Glick, "Marked in Your Flesh: Circumcision from Ancient Judea to Modern America", New York, Oxford University Press, 2005
• David A. Gollaher, Circumcision: A History of the World's Most Controversial Surgery. New York: Basic Books, 2000. 253 pages. (ISBN 0-465-04397-6)
• Peter Charles Remondino. History of Circumcision from the Earliest Times to the Present. Philadelphia and London; F. A. Davis; 1891.
• Edward Wallerstein, Circumcision: An American Health Fallacy. New York: Springer Publishing Co. 1980.
• Ritual Circumcisionist's Kit, 1950s URL: http://americanhistory.si.edu/toolbox/ritual.html
• David L. Gollaher, Circumcision: A history of the world's most controversial surgery, New York, Basic Books, 2000, ISBN 0-465-04397-6, hardback
• Dunsmuir WD, Gordon EM. The history of circumcision. BJU Int 1999;83 Suppl. 1:1-12. URL: http://www.cirp.org/library/history/dunsmuir1/

External links

Opposition to circumcision

• The Circumcision Information and Resource Pages
• National Organization of Circumcision Information Resource Centers (NOCIRC)
• MGMbill.org
• Doctors Opposing Circumcision

Criticism of opposition to circumcision

• "Anti-Circumcision Lobby Groups"
• "Myths, Lies and Half-Truths About Male Circumcision

Circumcision advocates

• The Benefits of Male Circumcision by Dr David Hawker, General Practitioner, UK
• Medical Benefits of Circumcision by Professor Brian Morris, Australia
• Circumcision: a lifetime of medical benefits by Dr. Edgar J. Schoen, USA

Critics of circumcision advocacy

• Myths about circumcision
• Circumcision Positions of Advocates and Critics
• Circumcision: The Step to Becoming a REAL Man