Circumcision Controversy

by Jeffrey R. Wood
  Founder of INTACT Educational Foundation*

Most Americans seem disinclined to think of routine neonatal circumcision as a controversial subject, if indeed they give it much thought at all. A typical response might be, “How could so widely and unquestioningly accepted a procedure be considered controversial?” Yet a growing number of people are beginning to regard the subject as non-controversial for an opposite reason. Once the thoroughly documented facts are known, the case against circumcision appears so strong that there can be little controversy over the advisability of performing the operation indiscriminately. Somewhere in the middle a controversy obviously exists. Let us, therefore, examine the issue more closely.

Despite the long-overdue publicity currently being given to the many advantages of natural childbirth and breastfeeding, there still appears to be little information circulated on the question of routine neonatal circumcision. People generally haven’t cared to discuss this issue and bring self-evident facts out into the open: yet in an age awakening to the value of personal liberties it is essential that we do so. Obviously any highly controversial procedure performed without the knowledge or consent of its victim is at least a flagrant violation of individual human rights. Parents claim and defend the right to do what they feel is best for their children, but lacking evidence that routine circumcision will ultimately prove to be in the best interests of the newborn infant, should not individual freedom of choice be preserved? The inconvenience of circumcision in later life for the few who would want (or seem to need) it is indeed a very small price to pay for the sacred privilege of making one’s own decision in so personal a matter.

INTACT was established in the year of our nation’s bicentennial as an effort to meet the sadly neglected need of expectant parents throughout North America for a source of reliable non-circumcision information. Our acronym reflects a fundamental conclusion we’ve arrived at – Infants Need To Avoid Circumcision Trauma. What we find ourselves dealing with is a uniquely American medico-cultural conspiracy of ignorance. With the exception of the United States and parts of Canada, non-religious circumcision is seldom practiced throughout the world. An outgrowth of Victorian anti-masturbation and ‘sex-is-dirty’ hysteria, it fell into general disfavor in England with the advent of socialized medicine there. Here, with the revelation that traditional medical arguments in favor of routinely performing the operation are at best inconclusive the situation as it now stands is beginning to take on the appearances of a cruel experiment with which no one in his right mind would want to be associated.

Fortunately where intuition has failed, experience and reason are succeeding. Now that routine circumcision in America has been given more than a fair chance to justify itself but has failed to do so, the procedure is being rapidly abandoned by thinking parents and physicians alike. As we begin to understand something of the complex psycho-sexual processes that underlie this barbaric assault against masculine integrity, we are discovering that emotionally as well as physically, the results of circumcision are unpredictable and often disastrous. Furthermore, there is a link being established between any violence inflicted upon helpless infants, and the unrest which they in turn may manifest when older. What people are consciously aware of is like the tip of an iceberg as far as mental activity is concerned, babies are much more than just highly organized biological mechanisms still waiting to become human beings. They are human beings already, and before conscious recall is functional, the unconscious mind remembers in its own way, which can profoundly affect emotional development. Consequently, psychologists are showing increased concern over the initial association of the penis with extreme pain in the neonatally circumcised male. Only in a religious context does there seem to be any less potential for psychological trauma throughout life, yet even progressive elements within the Jewish faith are calling for reform on this vital issue. What has been taken for centuries to symbolize the keeping of a religious covenant now increasingly appears to be symbolic of the same contempt for nature that has brought mankind to the very brink of self-destruction. Today’s trend toward more natural living isn’t merely another fad. It’s an expression of humanity’s concern for its ultimate survival.

Over the past several decades a number of well-researched articles, severely challenging the idea that circumcision should be routine, have appeared in various medical periodicals. The British Medical Journal in 1949 published a study by Dr. Douglas Gairdner which reminded physicians that it is perfectly normal for an infant’s prepuce to be non-retractile for a while after birth, and that therefore “tight skin” is not a legitimate excuse for circumcising a newborn. Another widely cited article, this one by Dr. Hawa Patel, appeared in a 1966 issue of The Canadian Medical Association Journal and reported a complication rate running as high as 55% for hospital-performed routine neonatal circumcisions. Admittedly, most of these complications were of a minor nature, but others were not. Dr. Robert L. Baker, writing in the November, 1979 issue of Sexual Medicine Today, was able to project a current annual U. S. death rate of at least 229 infants as a result of circumcision.

In 1970 the Journal of the American Medical Association published a lengthy and extensively documented study by E. Noel Preston, MD, entitled, Whither the Foreskin?”, which concluded: “Circumcision of the newborn is a procedure that should no longer be considered routine.” Since Dr. Preston’s article appeared, there has been a decline in the practice of routine circumcision from a national highthen estimated to be 95%, to less than 80% of newborn males today (*1976). With the recent publication of a study by a special task force of the American Academy of Pediatrics, the conclusions of which are likewise not at all favorable to the continuance of routine circumcision, percentages are expected to continue dropping. Already, about two-thirds of the male infants currently being born at home, as well as by the Leboyer method in hospitals, are not being circumcised. These facts, together with the observation that conscientious Americans are more outspoken than ever about a wide variety of social injustices, make it clear that the hypnotic influence of the circumcision mentality is finally on the wane.

Despite the encouraging trend away from routine circumcision, there is still a reluctance among health care professionals to admit that they could have been wrong about a subject which until recently has been given very little serious thought. Even when refuted by modern scientific evidence, the urge to meddle is an obsession that dies hard. An excellent article in the August, 1976 issue of Woman’s Day magazine reminds us: “Not being circumcised is not against the law, although hospital personnel often act as though it were.” Many well-meaning but grossly misinformed doctors still argue eloquently to sell a needless circumcision to trusting parents, while others continue to operate strictly out of mercenary motives. And as shocking as it may seem in view of the freedoms guaranteed us by the United States Constitution, unauthorized circumcision is not a rare occurrence in this country. We therefore advise prospective parents who do not want their sons circumcised to take a firm stand, resist coercion, and let everyone connected with the delivery know how you feel – before the baby arrives. (If the child turns out to be a girl, you will have at least given them something to think about, with the hope that others may benefit.) Occasionally, professionals are so accustomed to having their own way that the only effective deterrent may be an expressed intention to take appropriate legal action in the event that one’s directive goes unheeded. Beware especially of “blanket” consent forms, where circumcision may be included as part of a hospital’s standard neonatal care package or where reference to it is practically obscured in fine print such as few will take the time to read – particularly when the baby may not wait. Know what you and/or your spouse are signing. Today’s Health magazine reports (December, l975), “Some hospitals circumcise virtually all newborn males, some almost none…” We trust that no matter how you feel personally about circumcisions, certainly you would agree that chance should not be the deciding factor.

It should also be noted that many pediatricians are insistent that if a male infant remains intact (non-circumcised), foreskin retraction must be started very early in life. Of course retraction for cleanliness is very important as the child grows older and becomes able to wash himself, but according to the best current medical opinion, forcing back the foreskin of a tiny baby before the natural adhesions disappear (a process that may normally take up to four years or even longer), is not only unnecessary but dangerous. Presently the magnitude of routine circumcision’s emotional consequences can only be imagined. This is because intense penile trauma is not being confined to the circumcised infants. The non-circumcised males are commonly traumatized too, by having their foreskins painfully, unnecessarily and repeatedly forced back. As a result little meaningful psychological comparison can be made among American adult males. Furthermore, when an infant’s foreskin is torn away from the glans before the natural separation is complete, it may rejoin the glans in scar tissue, making full retraction impossible later on (thus running the risk of infection with recommendation for circumcision), whereas it would have become completely retractable on its own if simply left alone as nature intended.

Women, we have found, play a most important role in determining the foreskin’s fate. It has been revealed that the vast majority of neonatal circumcisions are done at the request of the mother, or with her consent alone. One reason is that normally no mother wishes to handle her son’s penis every time she gives him a bath — as she may erroneously believe is necessary should he remain uncircumcised. Another is nothing more than a confusion and sexualization of the instinctive urge to sever her newborn child’s umbilical cord. A third reason is that if a woman’ husband is circumcised, rejection of the operation for her son may have unbearable implications concerning her marriage relationship. Ironically, however, many mothers do not know for sure whether their own husbands are circumcised! Too embarrassed to ask questions, the unknowledgeable mother can only assume that what the doctor wants to do is the right thing, and therefore must have been done to her husband when he was a baby.

INTACT would suggest that out of gratitude for the vast strides that women’s rights has made in recent times, women should, in turn, more actively seek to liberate their sons from the tyranny of routine circumcision. But such a motive should never eclipse the natural concern of a mother for the feelings of her baby. Some mothers who are not particularly attuned to the circumcision issue will still adamantly refuse consent for one very good reason – it hurts.

In an effort to understand the problem of circumcision trauma, we must first consider pain from a positive viewpoint For example, a child learning to walk falls down and bruises himself. This hurts, and in meeting the challenge presented by the pain of falling the child learns to walk. But were the pain of falling to prove excessive for the child, he would simply avoid its risk by not trying to walk. Pain which goes beyond serving any useful purpose to becoming detrimental is one definition of trauma. Significantly, a child’s ability to deal constructively with pain is acquired gradually, as vulnerability is outgrown. We believe that the sudden trauma of infant circumcision tends to have a negative “programming” effect on the baby’s brain. In many instances the operation is so traumatic that he will go into shock and be unable to even cry! Yet, an infant’s circumcision experience is often thought of as mild compared to the “trauma” of being born. Birth, however, is a natural process meant to be stimulating, not traumatic. Like a spectacular sunrise, it can be almost overwhelming in its beauty and simplicity. That birth is indeed sometimes (perhaps more often than not) a trauma is a sad commentary on the general lack of physical fitness among the population, as well as on the typical hospital’s environment and procedures. Whatever the case, though, birth is a natural and inevitable event, while neonatal circumcision is unnatural and preventable.

How do men feel about circumcision? Finding answers to this question gave us much insight into how myths concerning the practice perpetuate themselves from one generation to the next. Until quite recently, our society has not encouraged “bodily awareness” in men as it has in women. Consequently, a lot of men say they couldn’t care less whether they’d been circumcised or not. Probing deeper, however, we find that in nearly every instance, the strongest proponents of routine circumcision turn out to be men who have been circumcised since shortly after birth — yet these are the very ones unqualified to speak on the basis of comparative experiences On the other hand, certain men who have had themselves circumcised after marriage, on the advice that this would somehow make their wives less susceptible to cervical cancer, have become outraged upon later discovering that this argument has long been thoroughly discredited. Amputation of the foreskin, like that of any other part of the body, is much easier to accept when medically indicated as a result of deformity, disease or accident. In the case of circumcision these indications seldom exist, so there is a tendency to invent reasons after the fact. Those who still have their foreskins generally enjoy being “natural”, but may take their good fortune for granted and thus not be adequately prepared for defending the integrity of a newborn son.

For the man deprived of his foreskin since infancy, enforced ignorance may cause him to misapprehend even rudimentary preputial anatomy. Hygiene is thought to be a major obstacle, when in fact it is far simpler than cleaning the teeth, fingernails or numerous other parts of the body that require specific attention for the sake of cleanliness. The human foreskin is not a separate, sheathlike appendage, but rather is simply an abundance of penile skin that is normally folded over on top of itself, as when the organ is in its flaccid state. Observe what happens when a turtle withdraws its head into its shell and you will readily get the idea. But unlike the skin of the turtle’s neck, the foreskin has a contractile part which is supposed to prevent it from automatically retracting whenever the man has an erection. During precoital excitement, a small quantity of lubricating fluid is passed out of the urethra and is distributed over the glans by the elongated foreskin. Then, penetration pushes the foreskin back and in effect it disappears for the duration of actual intercourse. Thus the foreskin is more than merely protective. It aids in lubrication as well. Now if the foreskin is too short, too loose or partially cut away, so that it retracts simultaneously with erection or at some time before penetration is achieved, the lubricating secretion is no longer effectively distributed and a film of it, upon exposure to the atmosphere, will quickly dry out. Conversely, if the foreskin is so tight that retraction is painful or impossible, this condition, known as phimosis, can be cured (depending on its severity) by either stretching or minor surgery. Phimosis that prevents normal hygienic measures can, in turn, give rise to an inflammation called balanitis.

Men circumcised in adulthood because of a legitimate medical problem such as we have just described invariably tend to believe that most other men are prone to the same difficulty. Nothing could be further from the truth, Although up to about 2% of males in an uncircumcised population can derive a reasonable degree of benefit from the procedure (hardly enough to justify universal circumcision and well below the serious complication rate for the operation itself), most of these men can achieve equal or greater benefit from either nonsurgical treatment or less drastic surgery. However, doctors are commonly trained to think of a radical (complete) circumcision as the only available alternative to any problem involving the foreskin.

Here in America the dramatic increase in the practice of infant circumcision right after World War II has been followed by a corresponding increase in sexually transmitted disease statistics about a generation later. Could this be because as a psychological defense mechanism against feelings of sexual inadequacy that may arise from his unnatural state, the circumcised male tends to blame his partner rather than his “equipment” for any sexual shortcomings which are in fact brought about by circumcision? Hence a resulting rise in promiscuity (caused by sexual dissatisfaction) has caused an epidemic in sexually transmitted disease. (Yet at one time circumcision was purported to prevent STD’s!)

Circumcision has also been advocated as a deterrent to masturbation, obviously in that circumcision makes masturbation less pleasurable. However, this fails to take into consideration the fact that boys will masturbate out of frustration at least as much as they do for pleasure. Circumcision simply increases the element of frustration by taking away some or most of the pleasure from masturbation. The net difference in the incidence of masturbation, if any, would probably be an increase as the pleasurable aspect becomes more elusive. Masturbation is usually not harmful, but it fails to provide the spiritual fulfillment of an interpersonal love relationship. Therefore, in the normal individual, masturbation does not prove to be an acceptable substitute for such a relationship.

Parents are sometimes concerned that at adolescent son may feel self-conscious about being “different” if he is part of a non-circumcised minority among his peers. A problem such as this can exist only as a monument to the lack of proper sex education in the home. Leaving a son non-circumcised is not enough. He must be taught to appreciate his wholeness. Children instinctively turn first to their parents for advice in sexual matters, but if such information is not forthcoming, they will get it in some other way– usually together with misinformation which, coming at an impressionable age, may never be entirely unlearned.

In presenting the case against routine circumcision, we fully concede that it’s possible for a man to adjust to having been circumcised as an infant. Countless men have been forced to make such an adjustment, and succeeding in this, have enjoyed satisfactory marriages and sex lives. But it is unfortunate that so many men have gone beyond the point of mere adjustment, to concluding that they are really better off minus the foreskin. Told the usual “old wives’ tales” about circumcision at an impressionable age, they have matured to advocate the operation for their sons as well. For to do otherwise would seemingly constitute a confession of sexual inferiority such as few men would be willing to make. Yet in reality it’s entirely an individual matter. Regardless of how favorably a man may evaluate his own circumcision, the fact remains that there is absolutely no guarantee his sons will do likewise. Even today a significant portion of neonatally circumcised men find themselves unable or unwilling to fully accept their unnatural state. The consequences range from occasional wishing to severe depression. And we can only conclude on the basis of current trends that such discontent will increase dramatically within the time it takes today’s newborn male to reach full sexual maturity.

Among many recent breaks in the self-consciously rooted silence which has traditionally enshrouded the circumcision controversy is a report published in the January 24, 1979 issue of The New York Times which states: “Parents have both a right and an obligation to know all the facts, pro and con, before they consent to the surgical removal of the foreskin of a child who can have no say in the matter but who must live with the consequences.” Whenever the pros and cons of circumcising a child seems inconclusive, the freedom-of-choice aspect of the issue should surge to the forefront as the one decisive consideration against the operation. Sometimes when a maturing son fails to meet reasonable expectations, his parents will lament, “We gave him everything– what did we do wrong?” Meanwhile, child psychologists denounce “too much permissiveness” as the basis for moral decay in our society. Perhaps the problems is not in “too much”, but rather a distorted sense of permissiveness. As an example, little boys who are permitted to eat “junk” food and watch unwholesome TV programs, but who are not allowed to keep a body part that is rightfully theirs.

We who oppose routine circumcision are often criticized for needlessly sending parents who have already had sons circumcised on a “guilt trip” over an issue which supposedly has little importance. Let us philosophize. In order to make continued progress, we must all advance from where we are right now, unimpeded by wishful thinking about the past. Guilt not used constructively would only compel us to repeat our mistakes, rather than admit to having erred in judgment. Securing more advanced motives in thought overcomes guilt, enabling us to rejoice that truth is discerned and inspiring us to share our insights with others.

INTACT firmly believes that there are millions of receptive parents in this great country of ours who would never submit their sons to circumcision if only they knew the pertinent facts. We therefore urge you, the reader, to share freely the information that has come to you on this topic. Though it may seem difficult at first, there is probably no other cause where so little effort can prevent so much suffering.

Today the world is at the threshold of what progressive young adults are calling the New Age. It’s an age characterized by a greater overall degree of spiritual understanding than mankind has ever known before. But in order to enter the New Age, we must first abandon erroneous ways of thinking about a great many subjects, however ancient or cherished our prejudices may be. The non-circumcision movement is but one outward symbol of a tremendous upheaval presently taking place in human consciousness. It is with this all-encompassing process of spiritual enlightenment that INTACT seeks to identify.

SOME JEWISH POINTS OF VIEW

“Circumcision is the sign of the covenant concluded between God and Abraham, and his descendants… and its seal on the body of every Israelite. As long as such a covenant had significance for the religious consciousness of the Jews, as long as the idea of a close covenant of love excluding other nations was deeply rooted in the people’s thought,… circumcision was the characteristic symbol of this covenant, and was therefore clung to with particular zeal in Israel. But after this idea of the particular covenant which underlies circumcision has ceased to be a religious truth and an object of faith, protest must be lodged against circumcision as the expression of an outlived idea.”

—from David Philipson, The Reform Movement in Judaism, p. 280

“…It is important to remember that Jews circumcise their sons solely for religious reasons. There as a vast difference between a surgical circumcision and the Brith Milah that is required of us by Judaism. Brith Milah is a most sacred religious ceremony. Its whole purpose is not medical and there is a vast difference between the normal medical approach and the requirements of Brith Milah. Thus, the Jewish religious requirements are not met by mere surgical circumcision. ”

—by Rabbi Norris Shoulson, author of Circumcision in Jewish Law and Modern Medical Practice

“…It is important to remember that Jews circumcise their sons solely for religious reasons. There as a vast difference between a surgical circumcision and the Brith Milah that is required of us by Judaism. Brith Milah is a most sacred religious ceremony. Its whole purpose is not medical and there is a vast difference between the normal medical approach and the requirements of Brith Milah. Thus, the Jewish religious requirements are not met by mere surgical circumcision. “

—by Rabbi Norris Shoulson, author of Circumcision in Jewish Law and Modern Medical Practice

   In July of 1966 FACT magazine published a vigorous denunciation of routine circumcision in the form of an article by John M. Foley, M.D., entitled, “The Unkindest Cut of All.” Subsequent issues of the periodical contained numerous reader responses, one of which is reproduced below. )

Dear Sirs:

Dr. Foley’s article on circumcision was devastating.

You may be interested to know that at a recent meeting of Reform rabbis the subject was discussed from the standpoint of Jewish religious practice. All of us were troubled about the ritual practice of circumcision in the light of considerations very much like those adduced by Dr. Foley. We have been offended by the scatological atmosphere which almost always attends the ceremony, at least as we see it practiced nowadays. We recognize that its origins, even religiously speaking, are primitive and barbaric. We have seen instances — isolated, it is true — of operative “slips”, injuries and infections. We are not at all certain about the “painlessness” of the operation even in the young infants. We are well aware that many medical authorities question any hygienic value in the practice and that some feel it may be deleterious.

Nevertheless, we all finally agreed that it would be practically impossible to get even Liberal (Reform) Jews to abandon circumcision. It is too deeply entwined with conscious and unconscious feelings of Jewish identification, Jewish loyalties, and a stubborn resistance to doing voluntarily that which millennia of persecution have not succeeded in getting us to do (or not to do).

Rabbi Samuel Glasner, Ed . D.
Board of Jewish Education
Baltimore, MD

COMMENT

The exclusively religious nature of circumcision in the Jewish faith cannot be overstated. It is true that many Jewish doctors have sought to make the ritual less a source of embarrassment by claiming certain medical advantages, but in so doing they have always acted independently without the official blessing and encouragement of their faith. One can hardly blame them, considering the persecutions that the Jews have suffered throughout the centuries. INTACT maintains that its educational program can be (and is being) conducted without the slightest trace of anti-Semitism. To this end, we stress the importance of preserving freedom of religion here in the United States. We have been reminded by those who would like to see routine circumcision outlawed, that religious freedom an this country means freedom to believe, not necessarily freedom to practice one’s beliefs where there is a conflict of interests — particularly in cases involving parents and children. It has been stressed that Jewish babies, after all, have the same rights as do others. While these points may be well taken, we need to examine in proper perspective what is probably the most controversial aspect of the whole issue. Religious circumcision is clearly a well-established, time-honored practice. Although it seems reasonable to assume (or hope!) that the Jewish male infant has gradually evolved a tolerance for the operation quite unmatched by descendants of those who have practiced non-ritual circumcision for only a generation or two (if even that), observers have assured us that he is by no means exempt from the sheer anguish that is the gentile infant’s typical response. Nevertheless, government intervention in religious matters has consistently failed to accomplish its ultimate objective, as indeed history teaches us. A far better approach than legislation (or anything else that could be interpreted as oppression) would be for us to simply set an example with regard to our own children, and highly rejoice whenever others feel inspired to follow it. Parents naturally want what is best for their offspring, so it is basically a matter of communicating right ideas in the least offensive manner.

INTACT Educational Foundation*
Eighth edition (12/80),
Reprinted by Peaceful Beginnings (10/89),
(Updated for website – 2000), (re- updated – 2013)

 (* INTACT Educational Foundation was established in 1976 by Jeffrey R. Wood of Massachusetts, USA , and was expanded by the efforts of Rosemary Romberg [then residing in Washington state, during the late 1970’s and early 80’s]. Mr. Wood retired from his activism in 1983, at which time his contributions and efforts were taken over by Peaceful Beginnings [founded by Ms. Romberg] and NOCIRC [founded by Marilyn Milos, RN.] I am well aware that the above treatise is (understandably) distinctly “seventies” in perspective. However, the message remains timelessly insightful. Mr. Wood’s work, and those of others continue to have great historical value in awakening the thoughts and energies of so many others who have continued their work in the ever increasing concern against routine infant circumcision. – R.R.)


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