If the decision to bring new life into the world is deemed one of life's toughest challenges, so too is the decision parents make about whether or not to circumcise their son.
"To cut or not to cut" has fast become one of America's most hotly debated parenting issues. Over the last fifteen years, hundreds of groups opposed to routine infant circumcision have sprung up around the country. Intent on educating parents and challenging medical and religious institutions, these concerned adults have gone so far as to sue doctors for inflicting harm against newborns. They have also effectively lobbied such health insurance companies as Blue Shield to delete circumcision from the "medically necessary" category.
This new movement to protect infants from the knife is clearly an outgrowth of similar initiatives to return to more natural birthing and childrearing experiences. Unlike past women-run campaigns dedicated to reclaiming breastfeeding and vaginal births, the pro and anti-circumcision movements are led by women and men, and most importantly, by the medical establishment itself.
Perhaps the most astonishing blow to pro-circumcision advocates was the 1999 statement by the American Academy of Pediatrics (AAP), reversing its former endorsement of circumcision for medical reasons. In a press release dated March 1999, Dr. Carole Lannon, chairwoman of the AAP's Task Force on Circumcision, stated, "Circumcision is not essential to a (boy's) well-being at birth, even though it does have some potential medical benefits."
As powerful an institution as the AAP is, it was not the first to make this determination about a procedure that is performed on more than one million male newborns annually. In the last few years, the American Medical Association, the American Cancer Society, the Centers for Disease Control and Prevention and the National Institutes of Health have deemed circumcision an unnecessary medical procedure.
There is no doubt these official proclamations have influenced the multibillion dollar health insurance industry. A 1990 article in the New England Journal of Medicine claims that routine infant circumcision earns the health insurance system an estimated $140 to $160 million annually. The cutting procedure has become an automatic response after birth the article said, and is routinely practiced in thousands of hospitals around the country.
Dr. Mark Fleiss, a pediatrician at the University of Southern California Medical Center, says the AAP's announcement fortified a fairly new trend among insurance companies not to cover the procedure. He points to Blue Shield of Pennsylvania and Prudential Insurance Company, along with some welfare programs, that now refuse to pay for the operation.
Despite modern medicine's rejection of what in America is a century-old tradition, millions of parents continue to circumcise their newborn sons. For many, this decision stems from tradition, particularly among Jewish parents whose faith guides the father to circumcise his eight day-old son as a way of forming a covenant with God. For others, the decision is based on the desire for cosmetic conformity, and belief that a cut penis is a cleaner and healthier penis.
Page Two: Find out the history of circumcision
Page Three: Learn the myths (and realities) of this common procedure
Page Four: See what the procedure entails
Page Five: Discover the medical facts about the male foreskin
Page Six: Read the American Academy of Pediatrics' 1999 Press Release on circumcision
The Evolution of Routine Infant Circumcision
The routine infant circumcision practiced in America today is quite different from the circumcision practiced by society thousands of years ago, says Miriam Pollack, author of "Circumcision: A Jewish Feminist Perspective."
Prior to the time of Hellenic and later Roman influence, Pollack says Jewish circumcision consisted of cutting off that part of the foreskin, which extended beyond the glans, leaving much of the foreskin intact. When Jewish men competed nude in Greek-style athletic competitions, however, they were routinely ridiculed for their mutilated genitalia.
"To the Greeks, exposing the glans was a sign of vulgarity, and cutting the body in order to please God was unthinkable," Pollack writes. "Hadrian outlawed circumcision as well as castration, and circumcision became a signal for persecution. Many Jews tried to hide their circumcisions in order to assimilate into Greek culture or later, to elude persecution by the Romans."
As a result, Jewish men became intent on hiding their circumcisions through various methods of stretching or tying their remaining foreskins. But in 140 AD, Pollack says, the rabbis demanded that in order for a circumcision to meet the standard of Jewish law, radical circumcision, or periah must be performed. Periah consists of the complete stripping and shearing of the foreskin.
In the 20th century, during World War II and the onset of the Cold War, circumcision occurred more often among non-Jewish families in America, according Dr. Fleiss of the University of Southern California Medical Center. Due to the unsanitary conditions of war, uncircumcised soldiers often developed serious infections around the foreskin. More often than not, American soldiers sent into battle uncircumcised returned home without foreskins. New recruits were also expected to be circumcised.
Joseph Zoske is an independent health care consultant in Albany, New York, who says routine medical circumcision is rooted in neither science nor medicine. Zoske claims the practice grew out of the mid-19th century hysteria and superstition about masturbation.
"Given the sexual mores of that time, child-rearing practices, and the lack of understanding of disease etiology, masturbation was blamed for a litany of ills," he wrote in article in the Journal of Men's Studies. "Insanity, epilepsy, blindness, and even death were its feared results." Circumcision was viewed as a "treatment" for these ailments and was performed as a way to control young boys' masturbating habits. The popularity of the procedure peaked between 1850 and 1879, he said.
Zoske says it took about 100 years for a different viewpoint to emerge; one that largely stemmed from British physician Douglas Gairdner who in 1949 published an article entitled "The Fate of the Foreskin."
"For the first time, a direct challenge was made to the practice of routine circumcision," Zoske explained. "Physicians were encouraged to delay circumcision for two to three years, until its 'minor advantages' could be better assessed."
Gairdner's cautionary message was recognized within the British National Health Service, and circumcision rates dropped dramatically in England. In the United States, however, it would take another generation before alternative ideas took root in the psyches of the medical establishment and parents.
Page Three: Learn the myths (and realities) of this common procedure
Page Four: See what the procedure entails
Page Five: Discover the medical facts about the male foreskin
Page Six: Read the American Academy of Pediatrics' 1999 Press Release on circumcision
The Myths and Realities of Circumcision
