Rethinking male circumcision

There has long been a heated debate about the purported

health benefits of male circumcision.

Most Jewish people I know have strong feelings about male circumcision—-whether they have male children or not. I am sure my parents (who had two boys) felt as their parents did, and their parents before them, going back to the origins of the Jewish faith. They believed that male circumcision was essential.

Male Circumcision and Religion

Male circumcision is central to Jewish identity. It is a practice that has formed an unbroken chain for over 3,000 years. Deciding against male circumcision would mean breaking that chain, a cringe worthy possibility.

Male circumcision is a procedure that, by Jewish law, is performed on all male infants on the eighth day after birth. It involves the removal, by cutting, of all or part of the foreskin of the penis. In uncircumcised males, the sensitive glans (head of the penis), is fully or partially covered by the foreskin, which retracts for urination and sexual relations. In circumcised males the glans is permanently exposed.

In the Jewish faith, male circumcision is serious business. The Jewish bible makes that clear. In Genesis 17, God makes an everlasting covenant with Abraham and his progeny. Abraham will be the founder of a people who will grow until they give rise to a multitude of nations led by kings. As part of this covenant, God grants the Jewish people everlasting possession of the land of Canaan.

And what does God require of the Jewish people in return? As a token of the covenant between God and the Jews, every Jewish male must be circumcised. God’s gift also comes with a terrifying warning. Any Jewish male who is not circumcised has broken God’s covenant. He will be cut off from his people, a punishment that, in biblical times, was tantamount to death.

For Jews, the connection to circumcision is so strong that even many non-observant Jews feel the impulse to circumcise their male infants.

A Life and Death Matter

At times in our history, our practice of circumcision was indeed a life and death matter. For my parents, growing up in anti-Semitic Eastern Europe between the World Wars, male circumcision set Jews apart from their neighbors, who did not follow this practice. During the Nazi occupation of the Second World War, many Jewish boys and men survived by pretending to be gentiles. They had to take great pains to hide their circumcision, because once discovered, a male circumcision meant deportation and certain death.

When my aunt and uncle lived in Nazi-occupied Poland under an assumed gentile identity, my uncle had to remain in their apartment at all times. The Gestapo and German soldiers often stopped men on the street, pulled down their pants and checked for a circumcision. Had my uncle been discovered, not only he, but also my aunt and their two children, would have been deported to death camps.

My lot as a Jewish male has been much easier. I have never faced a murderous anti-Semitic occupation. And virtually all the boys at my school were circumcised, just like me, even those who were not Jewish.

Why Do It?

There has long been a heated debate about the purported health benefits of male circumcision.

In 2012, the American Academy of Pediatrics issued a policy statement on newborn male circumcision. The Academy’s position is that “the health benefits of newborn male circumcision outweigh the risks, but the benefits are not great enough to recommend universal newborn circumcision.” The Academy’s policy statement emphasizes the role of parents in making decisions about male circumcisions based not only on health benefits and risks, but also “their own religious, cultural and personal preferences.” This is a qualified and equivocal endorsement.

Other groups have strongly opposed male circumcision as unnecessary and harmful.

Pros

According to the Academy, male circumcision reduces the male’s risk of contracting HIV as well as other sexually transmitted diseases. It also can help prevent urinary tract infections and penile cancer (although the latter is rare). It reduces the risk of cervical cancer in the adult male’s female sex partners. Although studies on the effect of male circumcision on sexual pleasure have yielded mixed results, the Academy concluded that sexual function, satisfaction and sensitivity are not adversely affected.

In some instances, male circumcision is medically warranted in order to resolve a health problem such as phimosis, in which the foreskin fails to retract sufficiently for urination.

Many parents choose to circumcise their infant sons to satisfy their religious or cultural preferences. These parents may feel they have satisfied a moral obligation to their faith and religion. Because there is usually a group ritual surrounding the circumcision, parents feel part of a community. There is also the issue of the son’s appearance. The father may want his son to look the way he does and he may believe his son will be reassured in the knowledge that he is like his father. In communities in which male circumcision is widely practiced, a circumcised boy may fit in more easily with his peer group.

Male circumcision facilitates good genital hygiene.

Cons

Most of the benefits of male circumcision accrue after puberty. Yet, it is less risky to have the surgery as a child than as an adult. But at any age, the surgery is painful and carries a risk of infection. In rare cases, complications occur. For example, the surgeon may cut the foreskin too long or too short, the wound may bleed excessively or heal poorly. Parents may feel that the procedure is disfiguring because it alters the appearance of the child’s genitals.

The issue of male circumcision is so laden with strong feelings and myth that many people have idiosyncratic views they hold onto despite scientific evidence. Complicating the matter, scientific opinion itself changes from time to time as new research is published or old research challenged. Some men cannot be shaken from the belief that their circumcision has reduced their sexual pleasure; others hold firmly to the opposite view.

My Take

Had I a choice, I would choose to remain uncircumcised.

As a child and later an adolescent, I never thought about the issue and being circumcised didn’t bother me. I don’t think I understood what had been done to me. But as an adult I have had painful and frustrating episodes of irritation that are a direct result of circumcision.

I also wonder if the surgery has left me less able to enjoy sex. Because circumcision is done at such an early age, it is impossible to compare before and after experiences. I heard the experience of one man who was circumcised as an adult. He believed strongly that his sensitivity and sexual pleasure were diminished as a result of the surgery.

Like most Jewish people, I have felt attached to the idea of circumcision because it is a practice that stretches back many generations. There is something distressing about abandoning that link to the past. But in the end, I decided that it would be best to stop clinging to the past.

My view is that it makes sense to perform male circumcision when it is medically necessary or alleviates a medical problem. But I am no longer in favor of routine male circumcision. After all, there are lots of ancient practices that we have wisely abandoned, for example, the biblical injunction that a man marry his deceased brother’s widow (Deuteronomy 25:5).

And there are also lots of biblical traditions that we no longer follow. This has not led to loss of faith or morals. For example, at my father’s funeral the rabbi handed each mourner a small black ribbon and a safety pin to attach it to our clothes. He did this to help us satisfy the biblically-based tradition of “rending our clothes” at the funeral of a loved one. In this day and age we mourn, but we are not about to ruin a good piece of clothing.

I now think, “If I can modify a ritual to save me from tearing my shirt, surely I can modify the circumcision ritual to save my infant son from being cut.”  So, if I were to father a baby boy, I would host a brit milah (traditional circumcision ritual) but I would not allow anyone to cut my little boy.

Maybe I am right. Maybe wrong. But that is what I would do.