Circumcision: The Unkindest Cut of All

Donald NorfolkThe human race has never been satisfied with its body image. In Burma, the women of the Kayan tribe once thought it desirable to have an elongated neck. To achieve this end they placed metal rings around the necks of their baby girls from the age of two years onwards. By the time they were of a marriageable age their heads might be  supported on an elegant stack of up to twenty gleaming hoops. (This didn’t lengthen their cervical spines, but merely deformed their collar bones and upper ribs.) In other cultures it was believed that a pointed skull was a sign of high birth. To acquire this coveted status symbol, boards were bandaged around babies’ heads so that their craniums grew upwards rather than outwards. A similar bodily deformation was practised in Victorian times, when women were willing to impair their health by undergoing tight lacing and wasp-waist corseting so that they acquired a fashionable hour-glass figure. (The singer Cher underwent cosmetic surgery a few years ago, having her lower ribs removed, to achieve the same, slenderising affect.)

Even since flint scalpels and metal knives were invented they’ve been employed to carry out male circumcisions, which stand as one of the oldest, and most widespread, of these acts of surgical remodelling. Murals discovered in Egyptian tombs, dating back four thousand years, depict young boys standing having their foreskins removed by priests, while assistants pinion their arms behind their backs. This male rite of passage was later adopted by the Jews, following the commandment God gave to Abraham that ‘everyman among you shall be circumcised’. This ceremony, traditionally performed by a mohel on the eighth day after birth, is part of the unique covenant between God and the Jewish people. Muslim boys are also frequently circumcised, for although it’s not mentioned in the Qur’an,  it’s regarded by many as a sunnah or practice approved by Muhammad. This is not the case among non-conformist Christians, some of whom regarded circumcision as an essentially pagan ritual. Just as they wouldn’t dock the tails of their dogs, on humanitarian grounds, so they wouldn’t unsheathe the penises of their sons and run the risk of causing haemorrhage and infection, complications which arise in less than ten per cent of cases. For Catholics the situation is even clearer, since the Vatican regards circumcision as a mortal sin and has forbidden its practice since 1442.

The one clear medical indication for male circumcision is phimosis, a relatively rare condition in which a congenitally tight foreskin makes urination and erections painful. At one time doctors advocated it as cure, or even a threatened punishment, for masturbation. Others suggested that it could help overcome premature ejaculation, by removing the thousands of highly erogenous nerve endings situated in the foreskin. This application was questioned by Masters and Johnson, the famous sex researchers, who found no difference in the sexual sensitivity of men whether circumcised or not. At present, the World Health Organisation estimates that about thirty per cent of the world’s males are circumcised either in infancy or during adolescence. This they believe can help reduce the transmission of AIDS and other sexually transmitted diseases (STDs), particularly in third world countries where water is short and standards of personal hygiene low.

In the past it was thought that women who coupled with circumcised men reduced their risk of developing cervical cancer. This was only true when the comparison was made with men who failed to keep their tackle clean. The under surface of the foreskin contains glands that secrete a waxy substance called smegma, which serves the useful function of lubricating the tip of the penis during sexual intercourse. Unless this substance is regularly washed away it’s liable to trap dirt particles and germs, act as a breeding ground for STDs, and cause a painful inflammation of the tip of the penis known as balinitis. Surveys have shown that women are less likely to develop cancer of the cervix if they’re married either to circumcised men, or men who are  fastidious about their personal hygiene. So, from a health perspective, men can safely hold on to their foreskins providing they’re prepared to give them a daily soap and water wash. This was the recommendation of a paediatrician writing in the Journal of the American Medical Association who said: ‘If a child can be taught to tie his shoes, or brush his teeth or wash behind his ears, he can also be taught to wash beneath his foreskin.’

The medical mores and ethics on this issue are clearly changing, but they still vary widely from country to country. Circumcision has always been more popular in America than in Europe. At the start of the twentieth century the US neonatal circumcision rate was 68 per cent. In Britain it was just six per cent among men who were neither Jews nor Muslims. This was partly because the intervention was no longer offered free under the National Health Service, and also because it was held that it could have a negative impact on an infant’s trust and maternal bonding. In Sweden, since 2001, circumcision has been permissible only when it’s carried out in the presence of a doctor using an anaesthetic provided by either a pain relieving ointment or a dorsal penile nerve block. The Dutch Medical Association takes an even tougher stand, claiming that unless there’s a valid medical reason, the circumcision of underage boys violates children’s human rights under the Dutch constitution and article 8 of the European Convention on Human Rights. This is also the view of Dr David Shaw, a lecturer in ethics at Glasgow University, who declares that any doctor who performed circumcision without a medical reason could be held guilty of negligence and found in breach of the Human Rights Act because the child could not consent to the operation, which could be argued was not in his best interests. In his view, the removal of a boy’s foreskin was no

different than pulling out his finger nails, except that the nails would re-grow.

It seems today that even the American Medical Association is coming round to this way of thinking, having said that unless it was carried out for religious reasons: ‘Virtually all current policy statements from speciality societies and medical organizations do not recommend routine neonatal circumcision.’ Can it be that in future it will be impossible to distinguish Jews from non-Jews in a men’s locker room in America?  If so I’ll lose the chance of telling one of my favourite Jewish jokes. ‘Why do Jewish women like circumcised men?’ ‘Because they can’t resist anything with ten per cent off.’

© Donald Norfolk 2010

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