An intriguing debate is raging in Germany after a district court in the Rhineland city of Cologne (Köln) ruled in May that a doctor who performed a circumcision operation on a four-year-old boy, had committed an assault, despite the fact that the mother had given her consent. The court went on to acquit the doctor on the grounds that the legal situation vis-a-vis circumcision is somewhat unclear. Nevertheless, a local event escalated into an international storm involving German Chancellor Angela Merkel, Israeli President Shimon Peres and other high-level political leaders, with implications reaching far beyond the narrow boundaries of the original case. Most Jews and Muslims see circumcision as an important cultural rite of passage for their male offspring. With respect to Jews, Germany has a fair swag of historical guilt to live down, without aggravating matters by seeming to renew discrimination. Muslims are a significant and growing minority in the population, with Turks forming the largest group (four to five percent).
Political leaders like Merkel have a difficult row to hoe in Western Europe these days with the rise of popular fears focusing on immigration from poorer countries, Islamic fundamentalism and terrorism, public perception that their own culture and traditions are under threat, coupled with deteriorating economic conditions in the European Union. Voter interest in extreme right-wing parties appears to be growing at the same time as minority groups are expressing frustration with what they perceive as local resentment and intolerance.
Prejudice undoubtedly exists, fuelled by the usual problems associated with an influx of immigrants from different cultural backgrounds. The situation is, of course, not clear-cut. Far right politicians are playing to a significant sector of public opinion. A majority of Germans apparently favour a ban on the practice of circumcision for religious purposes. Their government rarely permits dual citizenship for immigrants from outside the EU. The Swiss have imposed a ban on the construction of minarets on mosques. At the same time, Muslims, Turks especially, are playing increasingly high-profile roles in their adopted homes – French, German and Swiss national football teams, for example, are happy to welcome players with Islamic roots.
In addition, the circumcision issue is further complicated by questions relating to the rights of children. When two apparently inalienable human rights conflict, resolution is not easy to find. In this case, we have the right of a group to continue a religious or cultural practice, versus the right of a child to retain its God-given bodily integrity without suffering physical harm. Drafting a law which will satisfy proponents of both positions is the problem currently facing German legislators.
But of course, it’s not just a German problem. On the microcosmic level, one of the most important decisions facing parents-to-be in many Western countries is what to do about the little chap’s foreskin, should they happen to produce a boy-child. Surgical removal is not common in European countries, but widely carried out in the USA – though statistics show a decline since the 1970s. In Jewish and Islamic communities, there’s not much to discuss. Societal pressure makes the decision, and the prepuce comes off.
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How does it come off? Well, in Jewish circles, I gather, there is a trained person (mohel) who stretches the foreskin of the eight-day-old baby and quickly slices off as much as he can without damaging the rest of the little fellow’s procreative equipment. Islamic tradition prefers waiting until the boy is older – somewhere between seven and ten years of age, and the method is similar. These days, there is a tendency towards hospital circumcision at birth, or performing the operation in a clinic with anaesthetic if done when the lad is older. In Western countries, the preference is for circumcising within a few days of birth, and involves a lengthier operation with more surgical tools. Generally, anaesthetic is used, but most sources I read suggest that parents should request this, because some doctors don’t bother.
It’s an interesting thing, isn’t it? Obvious questions arise here, in particular: why would you cut off a normal part of a healthy baby’s (or child’s, or man’s) anatomy? Especially in such a sensitive area of the body, crucial for the survival of the species. Where did the practice originate?
Well, it seems the origins of circumcision are lost in the mists of time, but most authorities agree that the earliest recorded foreskin removal ceremonies were conducted by the ancient Egyptians. Interestingly, the operation often seems to have been associated with some kind of religious ritual or initiation rite, and to have been fairly public. Egyptian paintings show grown men undergoing the procedure, and as far as can be surmised, the purpose was a test of manhood, demonstrating one’s ability to endure pain. OK, that’s one reason, then – and perhaps, in a primitive warrior society, there is a case to be made for such tests. However, there must be more to it than that, to have justified the continuation of circumcision down to the present day.
As far as Jews are concerned, the practice goes back to Father Abraham’s covenant with God, way back when. God pretty much promised Abraham the Earth, but for his side of the bargain, Abraham had to have his foreskin removed – harsh treatment for a 99-year-old guy! Anyway, you can find it all there (the story, not the foreskin), in the Old Testament Book of Genesis, Chapter 17, Verses 10-14: ‘he that is eight days old shall be circumcised among you’, your own kids, relatives, servants, slaves, the lot; ‘and the uncircumcised man child whose flesh of his foreskin is not circumcised, that soul shall be cut off from his people.’
The Islamic position is a little less clear, since there is, apparently, no instruction about it in the Quran. However, Muslims tend to accept most of the Old Testament teachings, and certainly regard Abraham as a Prophet of God, so by and large they go along with it. From a societal point of view, such practices tend to forge a sense of belonging to a group, and also serve to distinguish members from non-members, so again, you can see the rationale. By extension, that probably explains a reason sometimes put forward by modern-day parents: all the other male members of the family had their male members trimmed, and we don’t want the little fellow feeling that there’s something wrong with him. Islamic scholars, however, seem to be of the opinion that conversion to the faith does not absolutely require surgical modification of the male sex organ.
Anyway, let’s move on to consider other justifications offered in more recent times for the continued practice, especially in the absence of religious or long-standing cultural tradition. Towards the end of the 19th century, a time when sex had acquired something of a negative reputation, particularly in Britain and the United States, members of the medical profession were recommending circumcision as a cure for ‘masturbatory insanity’. Individuals so cured, it was said, would be healthier, live longer and be more energetic and productive. Interestingly, proponents of this argument also favoured female circumcision (clitoridectomy) for much the same reasons. As an example of this line of thinking, I have to share this quotation with you. The speaker is Dr John Harvey Kellogg (of Corn Flakes fame), who considered his commercial breakfast cereal effective in preventing masturbation. In addition:
"Covering the organs with a cage has been practiced with entire success. A remedy which is almost always successful in small boys is circumcision . . . The operation should be performed by a surgeon without administering an anesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. The soreness which continues for several weeks interrupts the practice, and if it had not previously become too firmly fixed, it may be forgotten and not resumed.”
I have an early memory of being bathed by my mother – I must have been around three years old – and I guess I was experimentally examining my little doodle. ‘Don’t touch it,’ warned my mum, and she told me the cautionary tale of a young lad in the neighbourhood who played with his appendage and it had to be cut off. The lesson was effective, at least for a while, and it was some years before I summoned the courage for further experimentation. In mum’s favour, I have to thank her that she refrained from having me punitively circumcised – though perhaps my father must share the gratitude, since he had also retained his manhood intact.
Hygiene is often cited as a reason for male circumcision, and there is some evidence that infections can occur in uncircumcised males. There is also a condition known as phimosis (the inability to retract the foreskin over the head of the penis) which is sometimes treated by circumcision. Some doctors argue that urinary tract infections occur less in circumcised babies, and also that there is a reduced risk of penile cancer in later life. Perhaps the most powerful argument in favour of circumcision these days is the claim that removal of the foreskin reduces the risk of sexually transmitted diseases, especially HIV, at least in countries where the rate of infection is high – so for many proponents, no further justification is necessary.
If you are the prospective parent of a new boy child, clearly there is no shortage of arguments in favour of having the little man’s foreskin removed. What about the other side of the debate? Undoubtedly there are many uncircumcised grown men in the world leading relatively normal, well-adjusted, productive lives, as yet untouched by AIDS or cancer of the penis. What of them? Are they just lucky, or is there a case to be made for leaving your male child whole and uncut? In my roamings on the internet, I came across the website of an organisation calling itself the Circumcision Resource Center, and I really recommend you to take a look. One of the first things I noticed on their home page was the claim that most of their directors are Jewish. Another item that caught my eye was a quotation on the banner by Michael de Montaigne: “Nothing is so firmly believed as what we least know.”
Well, let me say loudly and clearly that I am not going to go criticising anyone’s religion or strongly held cultural beliefs. Biblical scholars and historians of ancient Israel apparently harbour doubts about the historical validity of events and personages featuring in the Book of Genesis but if Abraham’s covenant with God is important for you, then nothing much remains to be said. That will be the crucial factor in determining your parental responsibilities in this matter.
I don’t know how much pain tolerance remains an unspoken but important element in some people’s view of a child’s passage to manhood. Call me a wimp, but I freely admit that I would not willingly submit to the removal of any part of my anatomy, let alone in that nether region, without a very convincing life-or-death medical argument, and certainly not without serious pain relief. However, in defence of my virility, I would like to offer the words of my childhood dentist, in the days when teeth were excavated by slowly spinning drills, sometimes even treadle-powered, without the benefit of local anaesthetic. Through mists of pain and watering eyes, I recall his gruff Scottish voice remarking, “Well, laddie, those Germans widnae hae got much out o’ you!” I understood he was comparing his dental ministrations to Gestapo techniques of interrogation, well known to my post-war generation. Later, at the replica English grammar school I attended, I took my canings, as did most of my peers, without a fuss. More recently, a Turkish orthopaedic doctor, realigning my dislocated elbow, observed that my pain tolerance was quite high, so I don’t feel the need for more intimate proof.
The question of belonging is undoubtedly an important one, especially in all-male environments such as boarding schools, military barracks and prisons. Such communities can be unforgiving of anyone seen as different. I’m not so sure about the family argument though. Little boys may ask, ‘Why is daddy’s hair black and mine is orange?’ They may ask about different eye colour and so on. As a parent, you give the child an answer. Perhaps circumcising the kid might save the father’s embarrassment, though, if he felt obliged to explain that ‘Grandpa and grandma had mine cut off.’
As for other claims for the benefits of circumcision, genital health and hygiene, most sources I checked agreed that the evidence is not powerfully persuasive. It seems that a little boy’s foreskin rarely retracts in early childhood, and there is no cause for treatment unless it becomes a problem in teenage years. In modern societies, with readily available bathrooms, running hot water and soap, personal cleanliness is less of a difficulty than it may have been in waterless Middle Eastern deserts or medieval cities. The incidence of urinary tract infections is not high in babies, and when it occurs, may be attributable to other factors besides the existence of a foreskin. The same appears to be true for penile cancer in adults, and it is questionable whether the slight reduction in risk justifies the removal of a part of the body which the Creator, in His (or Her) infinite wisdom, saw fit to attach to His (or Her) highest creation. There is evidence that circumcision provides some reduced risk from sexually transmitted diseases, especially AIDS, but most of this evidence comes from poorer countries where the rate of infection is high, and again, seems to be a less convincing argument in more advanced societies. Also, other factors can be said to play an important role, in particular the practice (or not) of promiscuous unprotected sex.
Finally, there is the question, implied above, of why the male sex organ comes with a foreskin attached. First, there is the obvious function of protecting the sensitive head of the penis. One source I came across compared it to the eyelid’s role in protecting the eye. Second, there is the medical fact that the foreskin contains nerves and blood vessels which make it also highly sensitive, increasing the pleasure of sexual contact. Admittedly, though, this may be a reason for Dr Kellogg’s recommendations (see above). Finally, it has been suggested that the existence of the foreskin increases pleasure for the woman also in the sex act because it reduces friction and dryness. Of course, reducing such pleasure for the woman is, as far as I am aware, the major argument for female circumcision, or genital mutilation, as is the preferred term these days. Interestingly, use of the latter term is not extended to males, though the ancient Greeks apparently considered it so, finding the practice abhorrent.
Well, I will continue to follow the progress of German law-makers in finding a solution acceptable to all sides in this debate. In the end, I suspect, in the interests of peace and social harmony, they will be obliged to leave the decision to snip or not to snip to the families concerned, while legislating to ensure that the procedure is carried out in authorised hospitals or clinics by qualified medical practitioners using some form of anaesthetic. That’s probably as much as we can hope for in this less-than-perfect world.