Illustration by Jackie Rodriguez

 

Hours after he is born, usually within 48 hours, a baby boy is strapped to a table by his arms and legs so he cannot move, and a doctor inserts forceps between his foreskin and penis and begins to separate the two. The newborn’s cries of agony pierce the air as the doctor begins to cut away at the skin surrounding the penis.

This may sound like a torture method that those who have lost touch with their humanity perform on infants, however, the circumcision procedure is a common practice in hospitals and doctors’ offices throughout the United States and much of the world. According to the Center for Disease Control CDC, thousands of newborn boys are circumcised before they are released from the hospital after birth.

Although circumcision is still the norm in many parts of the United States, the Anti-Circumcision Movement, a movement in which its activists call themselves “intactivists,” encourage others not to circumcise their sons. The movement is beginning to gain traction and many parents are deciding not to circumcise their baby boys. According to the American Pediatrics Group, the newborn circumcision rate has been at roughly 77 percent overall since 2010, down 13 percent from the 1960s.

So, Where Did Circumcision Come From, Anyway?

According to Cirp.org, a circumcision information website, hieroglyphs depicting circumcision date back to 2400 B.C. Therefore, it is probable that circumcision took place long before biblical times, but it is unknown exactly where it originated.

In the Jewish religion, circumcision has been around for over 3,000 years. In the Torah, the sacred book of worship in the Jewish religion, Abraham was commanded by God to circumcise himself, all male members of his family, his descendants, and his slaves. In Genesis 16:14, the Torah also states that any uncircumcised male will be cut off from his people for he has broken God’s covenant.

It is written many places in the Bible, such as Luke 2:21, that Jesus Christ, who was Jewish by birth, was circumcised when he was just eight days old in order to be accepted into the kingdom of heaven. The circumcision of Jesus is depicted in a number of paintings, such as Venetian painter Giovanni Bellini’s work, “The Circumcision,” portraying Jesus Christ circumcised as an infant. Even God’s son was not exempt from having his foreskin removed.

For this reason, it is traditional for Jewish people to circumcise newborn boys at a ceremony known as a Bris. The ceremony is usually held in the family’s home, but can be held in a synagogue and the circumcision itself is traditionally performed by a rabbi.

Historyofcircumcision.net reports that circumcision became popular in America during the early, to mid 1900s —around the same time as the two world wars. During this period in history, there was a hostility towards masturbation. Physicians believed that removing the foreskin would discourage men from masturbating. It was also believed that men who were uncircumcised were at a higher risk of developing cancer and contracting sexually transmitted diseases.

Before this time period, babies were born in the home. Mothers sometimes had the assistance of a midwife, but otherwise there was no medical care present when a woman gave birth. Around the time of the second world war, childbirth transitioned from the home to the hospital. The end of World War II created thousands of new jobs, and employers began offering employees lavish benefit packages, including medical insurance. For the first time in United States history, all economic classes of women could receive prenatal care and medical attention when giving birth. Circumcisions were usually covered under each medical plan, and doctors were able to advise mothers of the perceived benefits of the procedure. The rate of circumcision skyrocketed from about 50 percent to nearly 90 percent during this time period.

Circumcision Today in the USA

On Dec. 2, the CDC released a draft of the updated federal guidelines for circumcision. In this document, the CDC states that the medical benefits of circumcisions outweigh the risks. “The benefits of male circumcision have become more and more clear over the last 10 years,” said Dr. Aaron Tobian, a Johns Hopkin’s University researcher.

According to the CDC’s new guidelines male circumcision can:

—Reduce the risk of getting HIV from an infected partner by 50 to 60 percent.

—Reduce the risk of genital herpes by 30 percent or more.

—Lower the odds of contracting a urinary tract infection in infancy and penile cancer in adulthood.

The accuracy of these guidelines —specifically the guideline claiming that circumcision reduces the risk of contracting HIV— were proven true by a study conducted in Uganda. The study found that human foreskin contains cells that make it highly susceptible to HIV and HPV.

However, according to George C. Denniston, MD, founder of Doctors Opposing Circumcision, a nonprofit Seattle-based corporation with an international set of members from six continents, despite their medical accuracy, these new guidelines fail to recognize that human genitals have been designed correctly by millions of years of evolution. The organization “acknowledges the right of each individual to decide for herself or himself whether or not to go through life with incomplete genitalia.” In addition, the website states that the organization does not oppose adult circumcision of either gender, providing that the adult requests it only after fully informed consent.

“If physicians would just simply leave the newborn’s penis intact, the foreskin would be left to fulfill its several functions,” said Denniston.

In infancy, the foreskin protects the penis from irritation and fecal matter. In adulthood, the foreskin aids in sexual pleasure because it has more nerve endings than the shaft and head of the penis alone.

“If there is any possibility that the foreskin can contribute significantly to sexual enjoyment, is that not a cogent reason for rethinking our motives for this procedure?” said Denniston

Doctors Opposing Circumcision is just one of many anti-circumcision groups that have been formed in the wake of the decline in circumcision rates nationwide. Activist groups such as the National Organization of Circumcision Information Resource Center NOCIRC, and Intact America, discourage circumcision by citing a lack of medical necessity for the procedure, calling the procedure itself inhumane because it is usually performed without anesthesia. Such groups draw a comparison to the ritualistic mutilation of female genitalia as a reason for parents to reconsider circumcising their newborns.

According to the CDC, circumcision rates in the U.S. are on the decline. The rate has dropped from 64.9 percent in 1979 to 58.3 percent in 2010, with the lowest percentage being 55.4 percent in 2007.

Denniston maintains that male or female genital mutilation performed on a child who cannot consent is a violation of that child’s human rights.

John Baptist, a 57-year-old intact male, said that circumcision is no different than female genital mutilation.

“If this was happening to baby girls, the entire world would go nuts,” said Baptist.

Baptist said he blames the stigma men face if they talk about their genitals for the world’s indifference towards circumcision.

“Men who even speak of their penis are thought to be pervs,” said Baptist. “Who wants to take that risk?”

Howard Smith, now in his 60s, was circumcised shortly after his birth. He feels as though his rights as a human being were violated when his parents made the choice to have him circumcised.

“As I entered my teens my feelings about being circumcised expanded to include jealousy and resentment towards my intact friends. Later I grew angry and felt shame and an unshakeable sense of violation. I have to say I have never really felt whole,” said Smith.

Smith never confronted his parents with his feelings, but he resolved that if he ever had a son, he would remain as nature had made him. As an adult, Smith did have a son, and he was not circumcised at birth. However, at the age of 11 his son contracted what was possibly a urinary tract infection, or UTI. Smith and his wife were told by a urologist that their son’s foreskin was not retractable and had to be removed despite the fact that the infection quickly cleared up with antibiotics.

Smith said that he was advised by NOCIRC’s director to avoid surgery at all costs. He was advised by another well known intactivist to try balloon dilation, a procedure in which a specially designed balloon catheter is placed underneath the foreskin and slowly inflated thereby stretching the foreskin and allowing it to retract fully to prevent further infection. When he suggested this procedure to his son’s urologist, the doctor dismissed the procedure without much of an explanation. Out of concern for their son, Smith’s wife gave the doctor permission to circumcise the boy. His son was circumcised shortly thereafter.

“There is no other part of the human body that is amputated for prophylactic reasons,” Smith said. “Breast cancer is a thousand times more prevalent than foreskin problems, but nobody advocates for the removal of breast buds in little girls.”

Marietta Ruiz, a 28-year-old UCLA graduate, has two young sons, 3 and 1. She decided after much thought and research to not circumcise her boys because she said in the end, she did not see any reason to.

“My husband is not circumcised and after asking family and friends, and researching, it seemed wrong to do this to boys who can’t make the decision for themselves,” she said.

And then there are the cosmetic reasons. Some women admit that they find uncircumcised men less attractive. This idea was even joked about on the popular HBO series Sex and the City. Character Charlotte York dates an uncircumcised man and discusses how she can’t sleep with him because of the way his penis looks. York says to her friends, “There was so much skin, it was like a shar pei!” She convinces her date to get a circumcision, who later decides it’s “too pretty” to not share with other women.

Stephanie Bond, 29, who has two circumcised boys, 7 and 9, and made the decision to circumcise her boys for this reason. “I didn’t want them to be different, or to have to deal with women finding them unattractive in the bedroom, so I circumcised them. Plus, it’s better and safer for them in the long run,” she said.

Joanne Ducelli, a 58-year-old corporate executive from Los Angeles, said that things were different when she gave birth to her boys, now 25 and 27.

“The medical field makes you believe that circumcision is standard and necessary, but the underlying reasons are cosmetic,” she said. She added that she begrudgingly circumcised her boys because her then husband convinced her that they would be teased by women.

According to intaction.org, this common misconception that their children will be teased or that women will not want to have sex with them upon discovering that they are intact often leads parents to circumcise their sons. However, since circumcision rates are now declining, a boy with an intact penis will no longer be the odd man out in a locker room; and women will become more used to seeing the penis in its natural state.

“If I could do it over, I would not circumcise them,” Ducelli said. “If a child is born with a very large nose or ears, should we immediately fix those things because we don’t like the way it looks?” she asked.

She added that so much of this stigma could be avoided if sex education that includes the topic of circumcision and safe sex was taught in schools. As for the cosmetic aspect, Ducelli said it has never made a difference to her.

“I’ve had a handful of lovers that were not circumcised and trust me, there is no difference,” Ducelli said.

Jordan Ashley, a middle school teacher in her 20s, agreed. She said that if she found out a potential partner was uncircumcised, it would have no bearing on whether or not she has sex with him.

“I don’t think it would change my mind,” Ashley said. “Honestly, knowing myself I’d probably be extremely curious and ask him a lot of questions.”

Asking questions is the best way to combat fear of the unknown. According to Doctors Opposing Circumcision, doctors do not receive enough information in medical school about caring for an intact penis. In consequence, the general American public has not been educated on how to care for an intact penis, or why the foreskin should not be removed.

Dr. Michael Albertson, a gastroentrologist and professor of clinical medicine at UCLA, and graduate of USC Keck School of Medicine, disagreed with that statement and endorses circumcision for medical reasons.

“Anyone attending medical school is taught how to deal with the male anatomy, circumcised or not,” Albertson said.

He added that he has seen many cases of uncircumcised men coming in as adults with medical issues related to being uncircumcised.

“I had a rotation in urology as a medical student, and we saw a fair number of guys with phimosis, where the foreskin becomes inflamed and you can’t retract it over the penis,” Albertson said. “We had to do adult circumcisions on these guys and it’s a much more painful and difficult procedure to do as an adult because there is more tissue to remove and the pain pathways are more developed.”

He also said that he saw a fair number of adult uncircumcised men who came in with penile cancer. The American Cancer Society reports that uncircumcised men are at a higher risk for penile cancer: Circumcision seems to protect against penile cancer when it is done during childhood. “Men who were circumcised as children have a lower chance of getting penile cancer than those who were not, but studies looking at this issue have not found the same protective effect if the foreskin is removed as an adult. Some studies even suggested a higher risk of penile cancer in men who were circumcised as adults.”

Whether or not to circumcise newborns is a highly personal decision, but accurate information is key.

Circumcision In Other Countries and Cultures

Circumcision is something that takes place worldwide. It holds a different meaning and is sometimes done as a rite of passage in other cultures.

In the Philippines, circumcision is known as pagtutuli. Pagtutuli marks a boy’s ceremonial passage into manhood. An amateur performs the operation on local boys while they sit astride a banana log into which a wooden plug is inserted.

Pagtutuli usually consists of a dorsal slit made in the foreskin, rather than complete removal of the prepuce. It is traditionally performed on boys between 7 and 12 years of age. The ceremony itself is a very public affair, with the whole village in attendance to watch and photograph the event.

In Asian countries, young men are circumcised if they experience problems with foreskin. Because the scar is more visible on Asian skin than on Caucasian skin, doctors make the cut around the base of the penis, rather than the foreskin itself. The skin is pulled back to expose the glans, and then stitched into place.

The Maasai tribe of Africa regards their circumcision ceremony as one of the most vital rites of passage. Interestingly, this ceremony is eagerly undergone by both men and women as an initiation into adulthood. The ceremony usually takes place shortly after the onset of puberty.

The ritual begins before sunrise and is performed by a man considered to be qualified by the tribe. After the operation, boys receive gifts of livestock from family and friends. Boys also gain a substantial amount of respect within the tribe for their bravery.

Despite being considered a rite of passage in many countries, Americans continue to question the tradition of circumcising their sons. Whether it is due to the lack of proof that circumcision is a medical necessity, or the many anti-circumcision groups disseminating information online, public opinion on circumcision is changing from a personal decision made by each individual family, to a topic that is widely discussed publicly. If circumcision continues its decline in the United States, the next generation of boys may be the first in many generations to experience life fully intact.

Substance is a publication of the Mt. San Antonio College Journalism Program. The program recently moved its newsroom over to Medium as part of a one-year experiment. Read about it here.