History of male circumcision
Encyclopedia
The origination of male circumcision
is not known with certainty. It has been variously proposed that it began as a religious sacrifice, as a rite of passage
marking a boy's entrance into adulthood, as a form of sympathetic magic
to ensure virility or fertility, as a means of enhancing sexual pleasure, as an aid to hygiene where regular bathing was impractical, as a means of marking those of higher social status, as a means of humiliating enemies and slaves by symbolic castration
, as a means of differentiating a circumcising group from their non-circumcising neighbors, as a means of discouraging masturbation
or other socially proscribed sexual behaviors, as a means of removing "excess" pleasure, as a means of increasing a man's attractiveness to women, as a demonstration of one's ability to endure pain, or as a male counterpart to menstruation
or the breaking of the hymen
, or to copy the rare natural occurrence of a missing foreskin
of an important leader, and as a display of disgust of the smegma
produced by the foreskin
. It has been suggested that the custom of circumcision gave advantages to tribes that practiced it and thus led to its spread. Darby describes these theories as "conflicting", and states that "the only point of agreement among proponents of the various theories is that promoting good health had nothing to do with it." Immerman et al. suggest that circumcision causes lowered sexual arousal of pubescent males, and hypothesize that this was a competitive advantage to tribes practising circumcision, leading to its spread. Wilson suggests that circumcision reduces insemination efficiency, reducing a man's capacity for extra-pair fertilizations by impairing sperm competition. Thus, men who display this signal of sexual obedience, may gain social benefits, if married men are selected to offer social trust and
investment preferentially to peers who are less threatening to their paternity.
It is possible that circumcision arose independently in different cultures for different reasons.
The oldest documentary evidence for circumcision comes from ancient Egypt
. Circumcision was common, although not universal, among ancient Semitic
peoples. In the aftermath of the conquests of Alexander the Great, however, Greek dislike of circumcision (they regarded a man as truly "naked" only if his prepuce was retracted) led to a decline in its incidence among many peoples that had previously practiced it.
Circumcision has ancient roots among several ethnic groups in sub-equatorial Africa, and is still performed on adolescent boys to symbolize their transition to warrior status or adulthood.
Sixth Dynasty (2345–2181 BC) tomb artwork in Egypt
is thought to be the oldest documentary evidence of circumcision, the most ancient depiction being a bas-relief from the necropolis
at Saqqara
(ca. 2400 BC) with the inscriptions reading: "The ointment is to make it acceptable." and "Hold him so that he does not fall". In the oldest written account, by an Egyptian named Uha, in the 23rd century BC, he describes a mass circumcision and boasts of his ability to stoically endure the pain: "When I was circumcised, together with one hundred and twenty men...there was none thereof who hit out, there was none thereof who was hit, and there was none thereof who scratched and there was none thereof who was scratched."
Herodotus
, writing in the 5th century BC, wrote that the Egyptians "practise circumcision for the sake of cleanliness,
considering it better to be cleanly than comely." Gollaher (2000) considered circumcision in ancient Egypt to be a mark of passage from childhood to adulthood. He mentions that the alteration of the body and ritual of circumcision were supposed to give access to ancient mysteries reserved solely for the initiated. The content of those mysteries are unclear but are likely to be myths, prayers, and incantations central to Egyptian religion. The Egyptian Book of the Dead
, for example, tells of the sun god
Ra
cutting himself, the blood creating two minor guardian deities. The Egyptologist Emmanuel vicomte de Rougé interpreted this as an act of circumcision. Circumcisions were performed by priests in a public ceremony, using a stone blade. It is thought to have been more popular among the upper echelons of the society, although it was not universal and those lower down the social order are known to have had the procedure done. The Egyptian hieroglyph for "penis" depicts either a circumcised or an erect organ.
Circumcision was also adopted by some Semitic
peoples living in or around Egypt. Herodotus
reported that circumcision is only practiced by the Egyptians, Colchians
, Ethiopia
ns, Phoenicia
ns, the 'Syrians of Palestine', and "the Syrians who dwell about the rivers
Thermodon and Parthenius, as well as their neighbours the Macronians and Macrones". He also reports, however, that "the Phoenicians, when they come to have commerce with the Greeks, cease to follow the Egyptians in this custom, and allow their children to remain uncircumcised."
According to Genesis, God
told Abraham
to circumcise himself, his household and his slaves as an everlasting covenant in their flesh, see also Abrahamic Covenant. Those who were not circumcised were to be "cut off
might not have been circumcised; his sons were not, nor were some of his followers (Joshua 5: 4–7). Moses's wife Zipporah
may have circumcised their son
when God threatened to kill Moses (...kill Moses son - considering Gen 17:14) (Exodus 4: 24–26).
African cultural history is conveniently spoken of in terms of language group. The Niger–Congo
speakers of today extend from Senegal
to Kenya
to South Africa
and all points between. In the historic period, the Niger–Congo speaking peoples predominantly have and have had male circumcision which occurred in young warrior initiation schools, the schools of Senegal and Gambia being not so very different from those of the Kenyan Gikuyu and South African Zulu. Their common ancestor was a horticultural group five, perhaps seven, thousand years ago from an area of the Cross River in modern Nigeria
. From that area a horticultural frontier moved outward into West Africa and the Congo Basin
. Certainly the warrior schools with male circumcision were a part of the ancestral society's cultural repertoire.
Male circumcision in East Africa
is a rite of passage from childhood to adulthood, but is only practiced in some nations (tribes). Some peoples in East Africa do not practice male circumcision (for example the Luo
of western Kenya
).
Amongst the Gikuyu (Kikuyu) people of Kenya and the Maasai people of Kenya and Tanzania
, male circumcision has historically been the graduation element of an educational program which taught tribal beliefs, practices, culture, religion and history to youth who were on the verge of becoming full-fledged members of society. The circumcision ceremony was very public, and required a display of courage under the knife in order to maintain the honor and prestige of the young man and his family. The only form of anesthesia was a bath in the cold morning waters of a river, which tended to numb the senses to a minor degree. The youths being circumcised were required to maintain a stoic expression and not to flinch from the pain.
After circumcision, young men became members of the warrior class, and were free to date and marry. The graduants became a fraternity which served together, and continued to have mutual obligation to each other for life.
In the modern context in East Africa, the physical element of male circumcision remains (in the societies that have historically practiced it) but without most of the other accompanying rites, context and programs. For many, the operation is now performed in private on one individual, in a hospital or doctor's office. Anesthesia is often used in such settings. There are tribes however, that do not accept this modernized practice. They insist on circumcision in a group ceremony, and a test of courage at the banks of a river. This more traditional approach is common amongst the Meru and the Kisii
tribes of Kenya.
Despite the loss of the rites and ceremonies that accompanied male circumcision in the past, the physical operation remains crucial to personal identity and pride, and acceptance in society. Uncircumcised men in these communities risk being "outed", and subjected to ridicule as "boys". There have been many cases of forced circumcision
of men from such communities who are discovered to have escaped the ritual.
s, lechers, and barbarian
s. This dislike of the appearance of the circumcised penis led to a decline in the incidence of circumcision among many peoples that had previously practiced it throughout Hellenistic times. In Egypt, only the priestly caste retained circumcision, and by the 2nd century, the only circumcising groups in the Roman Empire
were Jews, Jewish Christians, Egyptian priests, and the Nabatean Arabs. Circumcision was sufficiently rare among non-Jews that being circumcised was considered conclusive evidence of Judaism
(or Early Christianity
and others derogatorily called Judaizers
) in Roman courts—Suetonius
in Domitian 12.2 described a court proceeding in which a ninety-year-old man was stripped naked before the court to determine whether he was evading the head tax placed on Jews and Judaizers. The 1st-century Alexandria
n Apion
denounced circumcision as a barbaric custom in his diatribe against the Jews, notwithstanding that it was still practiced among the Egyptian priestly caste.
Cultural pressures to circumcise operated throughout the Hellenistic world: when the Judean king John Hyrcanus
conquered the Idumeans, he forced them to become circumcised and convert to Judaism, but their ancestors the Edomites had practiced circumcision in pre-Hellenistic times.
Some Jews tried to hide their circumcision status, as told in 1 Maccabees
. This was mainly for social and economic benefits and also so that they could exercise in gymnasiums
and compete in sporting events. Techniques for restoring the appearance of an uncircumcised penis were known by the 2nd century BC. In one such technique, a copper weight (called the Judeum pondum) was hung from the remnants of the circumcised foreskin until, in time, they became sufficiently stretched to cover the glans. The 1st-century writer Celsus
described two surgical techniques for foreskin restoration
in his medical treatise De Medicina. In one of these, the skin of the penile shaft was loosened by cutting in around the base of the glans. The skin was then stretched over the glans and allowed to heal, giving the appearance of an uncircumcised penis. This was possible because the Abrahamic covenant of circumcision defined in the Bible was a relatively minor circumcision; named milah
, this involved cutting off the foreskin
that extended beyond the glans. Jewish religious writers denounced such practices as abrogating the covenant of Abraham in 1 Maccabees and the Talmud
. Because of these attempts, and for other reasons, a second more radical step was added to the circumcision procedure. This was added around 140 AD, and was named Brit Peri'ah. In this step, the foreskin was cut further back, to the ridge behind the glans penis
, called the coronal sulcus. The inner mucosal tissue was removed by use of a sharp finger nail or implement, including the excising and removal of the frenulum
from the underside of the glans. Later during the Talmudic period (500–625 AD) a third step began to be practiced by the more orthodox Jewish groups. This was known as Metzitzeh. In this step the mohel
would suck the blood from the circumcision wound with his mouth. Although initially thought to reduce the infections by sucking out any bacteria, it was actually found to introduce infection such as tuberculosis
and venereal diseases. More modern day mohels use a glass tube placed over the infant's penis for suction of the blood when performing metzitzah. In many Jewish ritual circumcisions this step of Metzitzah has been eliminated.
First Maccabees tells us that the Seleucids forbade the practice of brit milah, and punished those who performed it–as well as the infants who underwent it–with death.
The 1st century Jewish author Philo Judaeus
(20 BC-50 AD) defended Jewish circumcision on several grounds, including health, cleanliness and fertility. He also thought that circumcision should be done as early as possible as it would not be as likely to be done by someone's own free will
. He claimed that the foreskin prevented semen
from reaching the vagina
and so should be done as a way to increase the nation's population. He also noted that circumcision should be performed as an effective means to reduce sexual pleasure: "The legislators thought good to dock the organ which ministers to such intercourse thus making circumcision the symbol of excision of excessive and superfluous pleasure."
The Jewish philosopher Maimonides
(1135–1204) insisted that faith should be the only reason for circumcision. He recognised that it was "a very hard thing" to have done to oneself but that it was done to "quell all the impulses of matter" and "perfect what is defective morally." Sages at the time had recognised that the foreskin heightened sexual pleasure. Maimonides reasoned that the bleeding and loss of protective covering rendered the penis weakened and in so doing had the effect of reducing a man's lustful thoughts
and making sex less pleasurable. He also warned that it is "hard for a woman with whom an uncircumcised man has had sexual intercourse to separate from him."
A 13th-century French Maimonides disciple, Isaac ben Yediah claimed that circumcision was an effective way of reducing a woman's sexual desire. With a non-circumcised man, he said, she always orgasms first and so her sexual appetite is never fulfilled, but with a circumcised man she receives no pleasure and hardly ever orgasms "because of the great heat and fire burning in her."
Flavius Josephus in Jewish Antiquities book 20, chapter 2 records the story of King Izates
who having been persuaded by a Jewish merchant named Ananias
(claimed by Robert Eisenman in James the Brother of Jesus to be Paul of Tarsus
) to embrace the Jewish religion, decided to get circumcised so as to follow Jewish law. Despite being reticent for fear of reprisals from his non-Jewish subjects he was eventually persuaded to do it by a Galilee
an Jew named Eleazar on the grounds that it was one thing to read the Law and another thing to practice it. Despite his mother Helen and Ananias's fear of the consequences, Josephus said that God looked after Izates and his reign was peaceful and blessed.
There was also division in Pharisaic Judaism
between Hillel the Elder
and Shammai
on the issue of circumcision of proselyte
s. See also Circumcision in the Bible#In rabbinic literature
The Council of Jerusalem
in Acts of the Apostles
15 addressed the issue of whether circumcision was required of new converts to Christianity
. Both Simon Peter and James the Just
spoke against requiring circumcision in Gentile converts and the Council ruled that circumcision was not necessary. However, Acts 16 and many references in the Letters of Paul
show that the practice was not immediately eliminated. Paul of Tarsus
, who was said to be directly responsible for one man's circumcision in Acts 16:1–3 and who appeared to praise Jewish circumcision in Romans
3:2, said that circumcision didn't matter in 1 Corinthians 7:19 and then increasingly turned against the practice, accusing those who promoted circumcision of wanting to make a good showing in the flesh and boasting or glorying in the flesh in Galatians
6:11–13. In a later letter, Philippians
3:2, he is reported as warning Christians to beware the "mutilation" (Strong's G2699). Circumcision was so closely associated with Jewish men that Jewish Christians
were referred to as "those of the circumcision" (e.g. Colossians 3:20) or conversely Christians who were circumcised were referred to as Jewish Christians or Judaizers
. These terms (circumcised/uncircumcised) are generally interpreted to mean Jews
and Greeks
, who were predominate, however it is an oversimplification as 1st century Iudaea Province
also had some Jews who no longer circumcised, and some Greeks (called Proselytes or Judaizers) and others such as Egyptians, Ethiopians, and Arabs who did.
According to the Gospel of Thomas
saying 53, Jesus
says:
Parallels to Thomas 53 are found in Paul's Romans
2:29, Philippians 3:3, 1 Corinthians 7:19, Galatians
6:15, Colossians 2:11–12.
In John's Gospel 7:23 Jesus is reported as giving this response to those who criticized him for healing on the Sabbath:
This passage has been seen as a comment on the Rabbinic belief that circumcision heals the penis (Jerusalem Bible, note to John 7:23) or as a criticism of circumcision.
The Catholic Church condemned the observance of circumcision as a mortal sin and ordered against its practice in the Council of Basel-Florence in 1442. According to UNAIDS, it stated that circumcision was unnecessary for Christians; El-Hout and Khauli, however, regard it as condemnation of the procedure.
In 1753 in London there was a proposal for Jewish emancipation. It was furiously opposed by the pamphleteers of the time, who spread the fear that Jewish emancipation meant universal circumcision. Men were urged to protect:
Until well into the 19th century, the same sentiments prevailed.
Then, a change of attitude began, something that was reflected in successive editions of the Encyclopædia Britannica:
Historically, neonatal circumcision was promoted during late Victorian times in the English-speaking parts of Canada
, Australia
, New Zealand
, the United States
and the United Kingdom
and was widely practiced during the first part of the 20th century in these countries. However, the practice declined sharply in the United Kingdom after the Second World War, and somewhat later in Canada, Australia and New Zealand. It has been argued (e.g., Goldman 1997) that the practice did not spread to other European countries because others considered the arguments for it fallacious. In South Korea
, circumcision was largely unknown before the establishment of the United States trusteeship in 1945. More than 90% of South Korean high school boys are now circumcised, but the average age of circumcision is 12 years, which makes South Korea a unique case.
Infant circumcision has been abandoned in New Zealand and Britain, and is now much less common in Australia and in Canada (see table 1). The decline in circumcision in the United Kingdom followed the decision by the National Health Service
(NHS) in 1948 not to cover the procedure following an influential article by Douglas Gairdner which claimed that circumcision resulted in the deaths of about 16 children under 5 each year in the United Kingdom.
"Self-abuse" was a term commonly used to describe masturbation in the 19th century. According to Paige, "treatments ranged from diet, moral exhortations, hydrotherapy, and marriage, to such drastic measures as surgery, physical restraints, frights, and punishment. Some doctors recommended covering the penis with plaster of Paris, leather, or rubber; cauterization; making boys wear chastity belt
s or spiked rings; and in extreme cases, castration
." Paige details how circumcision became popular as a masturbation remedy:
At the same time circumcisions were advocated on men, clitoridectomies (removal of the clitoris) were also performed for the same reason (to treat female masturbators). The US "Orificial Surgery Society" for female "circumcision" operated until 1925, and clitoridectomies and infibulation
s would continue to be advocated by some through the 1930s. As late as 1936, L. E. Holt, an author of pediatric textbooks, advocated male and female circumcision as a treatment for masturbation.
One of the leading advocates of circumcision was John Harvey Kellogg
. He advocated the consumption of Kellogg's corn flakes to prevent masturbation, and he believed that circumcision would be an effective way to eliminate masturbation in males.
Robert Darby, writing in the Australian Medical Journal, noted that some 19th century circumcision advocates—and their opponents—believed that the foreskin was sexually sensitive:
, balanitis
, and penile cancer. In that year, Lewis Sayre, a prominent New York
orthopedic surgeon
and vice president of the newly formed American Medical Association
, examined a five-year-old boy who was unable to straighten his legs, and whose condition had so far defied treatment. Upon noting that the boy's genitals were inflamed, Sayre hypothesized that chronic irritation of the boy's foreskin had paralyzed his knees via reflex neurosis. Sayre circumcised the boy, and within a few weeks, he recovered from his paralysis. After several additional incidents in which circumcision also appeared effective in treating paralyzed joints, Sayre began to promote circumcision as a powerful orthopedic remedy.
Sayre's prominence within the medical profession allowed him to reach a wide audience. He lectured widely in the United States and the United Kingdom, and his ideas influenced physicians throughout the English-speaking world. As more practitioners tried circumcision as a treatment for otherwise intractable medical conditions, sometimes achieving positive results, the list of ailments reputed to be treatable through circumcision grew. By the 1890s, hernia
, bladder
infections, kidney stone
s, insomnia
, chronic indigestion, rheumatism
, epilepsy
, asthma
, bedwetting
, Bright's disease
, erectile dysfunction
, syphilis
, insanity
, and skin cancer
had all been linked to the foreskin, and many physicians advocated universal circumcision as a preventive health measure. In 1855, the Quaker surgeon, Jonathan Hutchinson, observed that circumcision appeared to protect against syphilis
. Although this observation was challenged (the protection that Jews appear to have are more likely due to cultural factors), a 2006 systematic review concluded that the evidence "strongly indicates that circumcised men are at lower risk ... syphilis."
Specific medical arguments aside, several hypotheses have been raised in explaining the public's acceptance of infant circumcision as preventive medicine. The success of the germ theory of disease
had not only enabled physicians to combat many of the postoperative complications of surgery, but had made the wider public deeply suspicious of dirt and bodily secretions. Accordingly, the smegma that collects under the foreskin was viewed as unhealthy, and circumcision readily accepted as good penile hygiene. Secondly, moral sentiment of the day regarded masturbation
as not only sin
ful, but also physically and mentally unhealthy, stimulating the foreskin to produce the host of maladies of which it was suspected. In this climate, circumcision could be employed as a means of discouraging masturbation. All About the Baby, a popular parenting book of the 1890s, recommended infant circumcision for precisely this purpose. (However, a survey of 1410 men in the United States in 1992, Laumann found that circumcised men were more likely to report masturbating at least once a month.) As hospital
s proliferated in urban areas, childbirth
, at least among the upper and middle classes, was increasingly under the care of physicians in hospitals rather than with midwives in the home. It has been suggested that once a critical mass of infants were being circumcised in the hospital, circumcision became a class marker of those wealthy enough to afford a hospital birth.
During the same time period, circumcision was becoming easier to perform. William Halstead
's 1885 discovery of hypodermic cocaine
as a local anaesthetic made it easier for doctors without expertise in the use of chloroform
and other general anaesthetics to perform minor surgeries. Also, several mechanically aided circumcision techniques, forerunners of modern clamp-based circumcision methods, were first published in the medical literature of the 1890s, allowing surgeons to perform circumcisions more safely and successfully.
By the 1920s, advances in the understanding of disease had undermined much of the original medical basis for preventive circumcision. Doctors continued to promote it, however, as good penile hygiene and as a preventive for a handful of conditions local to the penis: balanitis, phimosis, and penile cancer.
Infant circumcision was taken up in the United States
, Australia
, New Zealand
and the English-speaking parts of Canada
and to a lesser extent in the United Kingdom
. The British Royal Family had a long tradition requiring that all male children be circumcised” (Alfred J. Kolatach’s The Jewish Book of Why, Middle Village, New York; Jonathan David, 1981). Although it is difficult to determine historical circumcision rates, one estimate of infant circumcision rates in the United States holds that 30% of newborn American boys were being circumcised in 1900, 55% in 1925, and 72% in 1950.
to remove infant circumcision from its list of covered services. One reason may have been Douglas Gairdner’s famous study, The fate of the foreskin, which revealed that for the years 1942–1947, about 16 children per year in England and Wales had died because of circumcision, a rate of about 1 per 6000 circumcisions. Since then, circumcision has been an out-of-pocket cost
to parents, and the proportion of newborns circumcised in the hospital has fallen to less than one percent.
Similar trends have operated in Canada, (where public medical insurance is universal, and where private insurance does not replicate services already paid from the public purse) Individual provincial heath insurance plans began delisting non-therapeutic circumcision in the 1980s. Manitoba was the final province to delist non-therapeutic circumcision which occurred in 2005.
In South Korea
, circumcision was largely unknown before the establishment of the United States trusteeship in 1945 and the spread of American influence. More than 90% of South Korean high school boys are now circumcised, which makes South Korea a unique case. The average age of circumcision is 12 years.
In some South Africa
n ethnic groups, circumcision has roots in several belief systems, and is performed most of the time on teenage boys:
Prior to 1989, the American Academy of Pediatrics had a long-standing opinion that medical indications for routine circumcision were lacking. This stance, according to the AMA, was reversed in 1989, following new evidence of reduction in risk of urinary tract infection.
A study in 1987 found that the prominent reasons for parents choosing circumcision were "concerns about the attitudes of peers and their sons' self concept in the future," rather than medical concerns. A 1999 study reported that reasons for circumcision included "ease of hygiene (67 percent), ease of infant circumcision compared with adult circumcision (63 percent), medical benefit (41 percent), and father circumcised (37 percent)." The authors commented that "Medical benefits were cited more frequently in this study than in past studies, although medical issues remain secondary to hygience and convenience." A 2001 study reported that "The most important reason to circumcise or not circumcise the child was health reasons." A 2005 study speculated that increased recognition of the potential benefits may be responsible for an observed increase in the rate of neonatal circumcision in the USA between 1988 and 2000.
In a 2001 survey, 86.6% of parents felt respected by their medical provider, and parents who did not circumcise "felt less respected by their medical provider".
In the United States, statistics (1999) collected by the National Center for Health Statistics show that the overall rate of neonatal circumcision had remained near 65% since data collection began in 1979. However, strong regional differences in the circumcision rates have developed during this time. While more than 80% of newborn boys are circumcised in the Midwest and South, circumcision rates have declined to about 37% in the West in 1999. This has been attributed in part to increasing births among Latin Americans, who usually do not circumcise.
The AMA states that "virtually all current policy statements from specialty societies and medical organizations do not recommend routine neonatal circumcision, and support the provision of accurate and unbiased information to parents to inform their choice.". Specifically, major medical societies in the USA, Britain, Canada, Australia and New Zealand do not recommend routine non-therapeutic infant circumcision. The AAP advises that "Physicians counseling families concerning this decision should assist the parents by explaining the potential benefits and risks and by ensuring that they understand that circumcision is an elective procedure."
Some have voiced ethical concerns about the procedure. See Bioethics of neonatal circumcision
for more information.
Neonatal circumcision nonetheless still remains the most common pediatric operation carried out in the U.S. today.
The South African Children's Act (No. 38 of 2005) has made the circumcision of male children unlawful except for medical or religious reasons.
For current circumcision rates, please see prevalence of circumcision
.
Studies indicate that male circumcision can reduce the chance of HIV infection in heterosexual men. A criticism of encouraging the adoption of adult male circumcision in areas or populations heavily affected by HIV is that even in the best of studies the measure is merely reductive, not preventative, and may embolden the recipient of the operation to willfully undermine the demonstrably safe methods of serial monogamy and condom usage with new partners; for a more thorough look at the scientific research visit Circumcision and HIV
.
The AMA remarked that, in one study, physicians in "nearly half" of neonatal circumcisions "did not discuss the potential medical risks and benefits of elective circumcision prior to delivery of the infant son. Deferral of discussion until after birth, combined with the fact that many parents' decisions about circumcision are preconceived, contribute to the high rate of elective circumcision."
As of July 2011, eighteen state Medicaid programs had discontinued payment for non-therapeutic circumcision.
Circumcision
Male circumcision is the surgical removal of some or all of the foreskin from the penis. The word "circumcision" comes from Latin and ....
is not known with certainty. It has been variously proposed that it began as a religious sacrifice, as a rite of passage
Rite of passage
A rite of passage is a ritual event that marks a person's progress from one status to another. It is a universal phenomenon which can show anthropologists what social hierarchies, values and beliefs are important in specific cultures....
marking a boy's entrance into adulthood, as a form of sympathetic magic
Magical thinking
Magical thinking is causal reasoning that looks for correlation between acts or utterances and certain events. In religion, folk religion, and superstition, the correlation posited is between religious ritual, such as prayer, sacrifice, or the observance of a taboo, and an expected benefit or...
to ensure virility or fertility, as a means of enhancing sexual pleasure, as an aid to hygiene where regular bathing was impractical, as a means of marking those of higher social status, as a means of humiliating enemies and slaves by symbolic castration
Castration
Castration is any action, surgical, chemical, or otherwise, by which a male loses the functions of the testicles or a female loses the functions of the ovaries.-Humans:...
, as a means of differentiating a circumcising group from their non-circumcising neighbors, as a means of discouraging masturbation
Masturbation
Masturbation refers to sexual stimulation of a person's own genitals, usually to the point of orgasm. The stimulation can be performed manually, by use of objects or tools, or by some combination of these methods. Masturbation is a common form of autoeroticism...
or other socially proscribed sexual behaviors, as a means of removing "excess" pleasure, as a means of increasing a man's attractiveness to women, as a demonstration of one's ability to endure pain, or as a male counterpart to menstruation
Menstruation
Menstruation is the shedding of the uterine lining . It occurs on a regular basis in sexually reproductive-age females of certain mammal species. This article focuses on human menstruation.-Overview:...
or the breaking of the hymen
Hymen
The hymen is a membrane that surrounds or partially covers the external vaginal opening. It forms part of the vulva, or external genitalia. The size of the hymenal opening increases with age. Although an often practiced method, it is not possible to confirm with certainty that a girl or woman is a...
, or to copy the rare natural occurrence of a missing foreskin
Aposthia
Aposthia is a rare congenital condition in humans, in which the foreskin of the penis is missing.Toward the end of the nineteenth century, E. S. Talbot claimed in Medicine that aposthia among Jews was evidence for the now-discredited Lamarckian theory of evolution...
of an important leader, and as a display of disgust of the smegma
Smegma
Smegma is a combination of exfoliated epithelial cells, transudated skin oils, and moisture. It occurs in both female and male mammalian genitalia.-Human smegma:Both females and males produce smegma...
produced by the foreskin
Foreskin
In male human anatomy, the foreskin is a generally retractable double-layered fold of skin and mucous membrane that covers the glans penis and protects the urinary meatus when the penis is not erect...
. It has been suggested that the custom of circumcision gave advantages to tribes that practiced it and thus led to its spread. Darby describes these theories as "conflicting", and states that "the only point of agreement among proponents of the various theories is that promoting good health had nothing to do with it." Immerman et al. suggest that circumcision causes lowered sexual arousal of pubescent males, and hypothesize that this was a competitive advantage to tribes practising circumcision, leading to its spread. Wilson suggests that circumcision reduces insemination efficiency, reducing a man's capacity for extra-pair fertilizations by impairing sperm competition. Thus, men who display this signal of sexual obedience, may gain social benefits, if married men are selected to offer social trust and
investment preferentially to peers who are less threatening to their paternity.
It is possible that circumcision arose independently in different cultures for different reasons.
The oldest documentary evidence for circumcision comes from ancient Egypt
Ancient Egypt
Ancient Egypt was an ancient civilization of Northeastern Africa, concentrated along the lower reaches of the Nile River in what is now the modern country of Egypt. Egyptian civilization coalesced around 3150 BC with the political unification of Upper and Lower Egypt under the first pharaoh...
. Circumcision was common, although not universal, among ancient Semitic
Semitic
In linguistics and ethnology, Semitic was first used to refer to a language family of largely Middle Eastern origin, now called the Semitic languages...
peoples. In the aftermath of the conquests of Alexander the Great, however, Greek dislike of circumcision (they regarded a man as truly "naked" only if his prepuce was retracted) led to a decline in its incidence among many peoples that had previously practiced it.
Circumcision has ancient roots among several ethnic groups in sub-equatorial Africa, and is still performed on adolescent boys to symbolize their transition to warrior status or adulthood.
Circumcision in the Ancient world
Egypt
Egypt , officially the Arab Republic of Egypt, Arabic: , is a country mainly in North Africa, with the Sinai Peninsula forming a land bridge in Southwest Asia. Egypt is thus a transcontinental country, and a major power in Africa, the Mediterranean Basin, the Middle East and the Muslim world...
is thought to be the oldest documentary evidence of circumcision, the most ancient depiction being a bas-relief from the necropolis
Necropolis
A necropolis is a large cemetery or burial ground, usually including structural tombs. The word comes from the Greek νεκρόπολις - nekropolis, literally meaning "city of the dead"...
at Saqqara
Saqqara
Saqqara is a vast, ancient burial ground in Egypt, serving as the necropolis for the Ancient Egyptian capital, Memphis. Saqqara features numerous pyramids, including the world famous Step pyramid of Djoser, sometimes referred to as the Step Tomb due to its rectangular base, as well as a number of...
(ca. 2400 BC) with the inscriptions reading: "The ointment is to make it acceptable." and "Hold him so that he does not fall". In the oldest written account, by an Egyptian named Uha, in the 23rd century BC, he describes a mass circumcision and boasts of his ability to stoically endure the pain: "When I was circumcised, together with one hundred and twenty men...there was none thereof who hit out, there was none thereof who was hit, and there was none thereof who scratched and there was none thereof who was scratched."
Herodotus
Herodotus
Herodotus was an ancient Greek historian who was born in Halicarnassus, Caria and lived in the 5th century BC . He has been called the "Father of History", and was the first historian known to collect his materials systematically, test their accuracy to a certain extent and arrange them in a...
, writing in the 5th century BC, wrote that the Egyptians "practise circumcision for the sake of cleanliness,
considering it better to be cleanly than comely." Gollaher (2000) considered circumcision in ancient Egypt to be a mark of passage from childhood to adulthood. He mentions that the alteration of the body and ritual of circumcision were supposed to give access to ancient mysteries reserved solely for the initiated. The content of those mysteries are unclear but are likely to be myths, prayers, and incantations central to Egyptian religion. The Egyptian Book of the Dead
Book of the Dead
The Book of the Dead is the modern name of an ancient Egyptian funerary text, used from the beginning of the New Kingdom to around 50 BC. The original Egyptian name for the text, transliterated rw nw prt m hrw is translated as "Book of Coming Forth by Day". Another translation would be "Book of...
, for example, tells of the sun god
Solar deity
A solar deity is a sky deity who represents the Sun, or an aspect of it, usually by its perceived power and strength. Solar deities and sun worship can be found throughout most of recorded history in various forms...
Ra
Ra
Ra is the ancient Egyptian sun god. By the Fifth Dynasty he had become a major deity in ancient Egyptian religion, identified primarily with the mid-day sun...
cutting himself, the blood creating two minor guardian deities. The Egyptologist Emmanuel vicomte de Rougé interpreted this as an act of circumcision. Circumcisions were performed by priests in a public ceremony, using a stone blade. It is thought to have been more popular among the upper echelons of the society, although it was not universal and those lower down the social order are known to have had the procedure done. The Egyptian hieroglyph for "penis" depicts either a circumcised or an erect organ.
Circumcision was also adopted by some Semitic
Semitic
In linguistics and ethnology, Semitic was first used to refer to a language family of largely Middle Eastern origin, now called the Semitic languages...
peoples living in or around Egypt. Herodotus
Herodotus
Herodotus was an ancient Greek historian who was born in Halicarnassus, Caria and lived in the 5th century BC . He has been called the "Father of History", and was the first historian known to collect his materials systematically, test their accuracy to a certain extent and arrange them in a...
reported that circumcision is only practiced by the Egyptians, Colchians
Colchis
In ancient geography, Colchis or Kolkhis was an ancient Georgian state kingdom and region in Western Georgia, which played an important role in the ethnic and cultural formation of the Georgian nation.The Kingdom of Colchis contributed significantly to the development of medieval Georgian...
, Ethiopia
Ethiopia
Ethiopia , officially known as the Federal Democratic Republic of Ethiopia, is a country located in the Horn of Africa. It is the second-most populous nation in Africa, with over 82 million inhabitants, and the tenth-largest by area, occupying 1,100,000 km2...
ns, Phoenicia
Phoenicia
Phoenicia , was an ancient civilization in Canaan which covered most of the western, coastal part of the Fertile Crescent. Several major Phoenician cities were built on the coastline of the Mediterranean. It was an enterprising maritime trading culture that spread across the Mediterranean from 1550...
ns, the 'Syrians of Palestine', and "the Syrians who dwell about the rivers
Thermodon and Parthenius, as well as their neighbours the Macronians and Macrones". He also reports, however, that "the Phoenicians, when they come to have commerce with the Greeks, cease to follow the Egyptians in this custom, and allow their children to remain uncircumcised."
According to Genesis, God
God
God is the English name given to a singular being in theistic and deistic religions who is either the sole deity in monotheism, or a single deity in polytheism....
told Abraham
Abraham
Abraham , whose birth name was Abram, is the eponym of the Abrahamic religions, among which are Judaism, Christianity and Islam...
to circumcise himself, his household and his slaves as an everlasting covenant in their flesh, see also Abrahamic Covenant. Those who were not circumcised were to be "cut off
Moses
Moses was, according to the Hebrew Bible and Qur'an, a religious leader, lawgiver and prophet, to whom the authorship of the Torah is traditionally attributed...
might not have been circumcised; his sons were not, nor were some of his followers (Joshua 5: 4–7). Moses's wife Zipporah
Zipporah
Zipporah or Tzipora is mentioned in the Book of Exodus as the wife of Moses, and the daughter of Reuel/Jethro, the priest or prince of Midian...
may have circumcised their son
Zipporah at the inn
Zipporah at the inn is the name given to an episode alluded to in three verses of Exodus. It is one of the more unusual, curious, and much-debated passages of the Pentateuch....
when God threatened to kill Moses (...kill Moses son - considering Gen 17:14) (Exodus 4: 24–26).
Male circumcision in Africa
"The distribution of circumcision and initiation rites throughout Africa, and the frequent resemblance between details of ceremonial procedure in areas thousands of miles apart, indicate that the circumcision ritual has an old tradition behind it and in its present form is the result of a long process of development." Wagner, G. 1949. The Bantu of North Kavirondo. London: International African Institute.African cultural history is conveniently spoken of in terms of language group. The Niger–Congo
Niger–Congo languages
The Niger–Congo languages constitute one of the world's major language families, and Africa's largest in terms of geographical area, number of speakers, and number of distinct languages. They may constitute the world's largest language family in terms of distinct languages, although this question...
speakers of today extend from Senegal
Senegal
Senegal , officially the Republic of Senegal , is a country in western Africa. It owes its name to the Sénégal River that borders it to the east and north...
to Kenya
Kenya
Kenya , officially known as the Republic of Kenya, is a country in East Africa that lies on the equator, with the Indian Ocean to its south-east...
to South Africa
South Africa
The Republic of South Africa is a country in southern Africa. Located at the southern tip of Africa, it is divided into nine provinces, with of coastline on the Atlantic and Indian oceans...
and all points between. In the historic period, the Niger–Congo speaking peoples predominantly have and have had male circumcision which occurred in young warrior initiation schools, the schools of Senegal and Gambia being not so very different from those of the Kenyan Gikuyu and South African Zulu. Their common ancestor was a horticultural group five, perhaps seven, thousand years ago from an area of the Cross River in modern Nigeria
Nigeria
Nigeria , officially the Federal Republic of Nigeria, is a federal constitutional republic comprising 36 states and its Federal Capital Territory, Abuja. The country is located in West Africa and shares land borders with the Republic of Benin in the west, Chad and Cameroon in the east, and Niger in...
. From that area a horticultural frontier moved outward into West Africa and the Congo Basin
Congo Basin
The Congo Basin is the sedimentary basin that is the drainage of the Congo River of west equatorial Africa. The basin begins in the highlands of the East African Rift system with input from the Chambeshi River, the Uele and Ubangi Rivers in the upper reaches and the Lualaba River draining wetlands...
. Certainly the warrior schools with male circumcision were a part of the ancestral society's cultural repertoire.
Male circumcision in East Africa
East Africa
East Africa or Eastern Africa is the easterly region of the African continent, variably defined by geography or geopolitics. In the UN scheme of geographic regions, 19 territories constitute Eastern Africa:...
is a rite of passage from childhood to adulthood, but is only practiced in some nations (tribes). Some peoples in East Africa do not practice male circumcision (for example the Luo
Luo (Kenya and Tanzania)
The Luo are an ethnic group in Kenya, eastern Uganda, and northern Tanzania. They are part of a larger group of ethnolinguistically related Luo peoples who inhabit an area including southern Sudan, northern and eastern Uganda, western Kenya, and northern Tanzania.The Luo are the third largest...
of western Kenya
Kenya
Kenya , officially known as the Republic of Kenya, is a country in East Africa that lies on the equator, with the Indian Ocean to its south-east...
).
Amongst the Gikuyu (Kikuyu) people of Kenya and the Maasai people of Kenya and Tanzania
Tanzania
The United Republic of Tanzania is a country in East Africa bordered by Kenya and Uganda to the north, Rwanda, Burundi, and the Democratic Republic of the Congo to the west, and Zambia, Malawi, and Mozambique to the south. The country's eastern borders lie on the Indian Ocean.Tanzania is a state...
, male circumcision has historically been the graduation element of an educational program which taught tribal beliefs, practices, culture, religion and history to youth who were on the verge of becoming full-fledged members of society. The circumcision ceremony was very public, and required a display of courage under the knife in order to maintain the honor and prestige of the young man and his family. The only form of anesthesia was a bath in the cold morning waters of a river, which tended to numb the senses to a minor degree. The youths being circumcised were required to maintain a stoic expression and not to flinch from the pain.
After circumcision, young men became members of the warrior class, and were free to date and marry. The graduants became a fraternity which served together, and continued to have mutual obligation to each other for life.
In the modern context in East Africa, the physical element of male circumcision remains (in the societies that have historically practiced it) but without most of the other accompanying rites, context and programs. For many, the operation is now performed in private on one individual, in a hospital or doctor's office. Anesthesia is often used in such settings. There are tribes however, that do not accept this modernized practice. They insist on circumcision in a group ceremony, and a test of courage at the banks of a river. This more traditional approach is common amongst the Meru and the Kisii
Kisii people
The Kisii is a community of Bantu speakers who inhabit the two counties in Nyanza Province, Western Kenya...
tribes of Kenya.
Despite the loss of the rites and ceremonies that accompanied male circumcision in the past, the physical operation remains crucial to personal identity and pride, and acceptance in society. Uncircumcised men in these communities risk being "outed", and subjected to ridicule as "boys". There have been many cases of forced circumcision
Forced circumcision
Forced circumcision most commonly refers to the circumcision of a male who has not given his consent. In a biblical context the term is used especially in relation to Paul the Apostle and his polemics against the forced circumcision of gentile Christians...
of men from such communities who are discovered to have escaped the ritual.
Male circumcision in the Greco-Roman world
According to Hodges, ancient Greek aesthetics of the human form considered circumcision a mutilation of a previously perfectly shaped organ. Greek artwork of the period portrayed penises as covered by the foreskin (sometimes in exquisite detail), except in the portrayal of satyrSatyr
In Greek mythology, satyrs are a troop of male companions of Pan and Dionysus — "satyresses" were a late invention of poets — that roamed the woods and mountains. In myths they are often associated with pipe-playing....
s, lechers, and barbarian
Barbarian
Barbarian and savage are terms used to refer to a person who is perceived to be uncivilized. The word is often used either in a general reference to a member of a nation or ethnos, typically a tribal society as seen by an urban civilization either viewed as inferior, or admired as a noble savage...
s. This dislike of the appearance of the circumcised penis led to a decline in the incidence of circumcision among many peoples that had previously practiced it throughout Hellenistic times. In Egypt, only the priestly caste retained circumcision, and by the 2nd century, the only circumcising groups in the Roman Empire
Roman Empire
The Roman Empire was the post-Republican period of the ancient Roman civilization, characterised by an autocratic form of government and large territorial holdings in Europe and around the Mediterranean....
were Jews, Jewish Christians, Egyptian priests, and the Nabatean Arabs. Circumcision was sufficiently rare among non-Jews that being circumcised was considered conclusive evidence of Judaism
Judaism
Judaism ) is the "religion, philosophy, and way of life" of the Jewish people...
(or Early Christianity
Early Christianity
Early Christianity is generally considered as Christianity before 325. The New Testament's Book of Acts and Epistle to the Galatians records that the first Christian community was centered in Jerusalem and its leaders included James, Peter and John....
and others derogatorily called Judaizers
Judaizers
Judaizers is predominantly a Christian term, derived from the Greek verb ioudaïzō . This term is most widely known from the single use in the New Testament where Paul publicly challenges Peter for compelling Gentile believers to "judaize", also known as the Incident at Antioch.According to the...
) in Roman courts—Suetonius
Lives of the Twelve Caesars
De vita Caesarum commonly known as The Twelve Caesars, is a set of twelve biographies of Julius Caesar and the first 11 emperors of the Roman Empire written by Gaius Suetonius Tranquillus.The work, written in AD 121 during the reign of the emperor Hadrian, was the most popular work of Suetonius,...
in Domitian 12.2 described a court proceeding in which a ninety-year-old man was stripped naked before the court to determine whether he was evading the head tax placed on Jews and Judaizers. The 1st-century Alexandria
Alexandria
Alexandria is the second-largest city of Egypt, with a population of 4.1 million, extending about along the coast of the Mediterranean Sea in the north central part of the country; it is also the largest city lying directly on the Mediterranean coast. It is Egypt's largest seaport, serving...
n Apion
Apion
Apion , Graeco-Egyptian grammarian, sophist and commentator on Homer, was born at the Siwa Oasis, and flourished in the first half of the 1st century AD....
denounced circumcision as a barbaric custom in his diatribe against the Jews, notwithstanding that it was still practiced among the Egyptian priestly caste.
Cultural pressures to circumcise operated throughout the Hellenistic world: when the Judean king John Hyrcanus
John Hyrcanus
John Hyrcanus was a Hasmonean leader of the 2nd century BC.-Name:...
conquered the Idumeans, he forced them to become circumcised and convert to Judaism, but their ancestors the Edomites had practiced circumcision in pre-Hellenistic times.
Some Jews tried to hide their circumcision status, as told in 1 Maccabees
1 Maccabees
The First book of Maccabees is a book written in Hebrew by a Jewish author after the restoration of an independent Jewish kingdom, about the latter part of the 2nd century BC. The original Hebrew is lost and the most important surviving version is the Greek translation contained in the Septuagint...
. This was mainly for social and economic benefits and also so that they could exercise in gymnasiums
Gymnasium (ancient Greece)
The gymnasium in ancient Greece functioned as a training facility for competitors in public games. It was also a place for socializing and engaging in intellectual pursuits. The name comes from the Ancient Greek term gymnós meaning "naked". Athletes competed in the nude, a practice said to...
and compete in sporting events. Techniques for restoring the appearance of an uncircumcised penis were known by the 2nd century BC. In one such technique, a copper weight (called the Judeum pondum) was hung from the remnants of the circumcised foreskin until, in time, they became sufficiently stretched to cover the glans. The 1st-century writer Celsus
Aulus Cornelius Celsus
Aulus Cornelius Celsus was a Roman encyclopedist, known for his extant medical work, De Medicina, which is believed to be the only surviving section of a much larger encyclopedia. The De Medicina is a primary source on diet, pharmacy, surgery and related fields, and it is one of the best sources...
described two surgical techniques for foreskin restoration
Foreskin restoration
Foreskin restoration is the process of expanding the residual skin on the penis, via surgical or non-surgical methods. It can be performed for several reasons, among them being a desire to create the appearance of a natural foreskin covering the glans penis, or to increase sexual sensitivity of...
in his medical treatise De Medicina. In one of these, the skin of the penile shaft was loosened by cutting in around the base of the glans. The skin was then stretched over the glans and allowed to heal, giving the appearance of an uncircumcised penis. This was possible because the Abrahamic covenant of circumcision defined in the Bible was a relatively minor circumcision; named milah
Brit milah
The brit milah is a Jewish religious circumcision ceremony performed on 8-day old male infants by a mohel. The brit milah is followed by a celebratory meal .-Biblical references:...
, this involved cutting off the foreskin
Foreskin
In male human anatomy, the foreskin is a generally retractable double-layered fold of skin and mucous membrane that covers the glans penis and protects the urinary meatus when the penis is not erect...
that extended beyond the glans. Jewish religious writers denounced such practices as abrogating the covenant of Abraham in 1 Maccabees and the Talmud
Talmud
The Talmud is a central text of mainstream Judaism. It takes the form of a record of rabbinic discussions pertaining to Jewish law, ethics, philosophy, customs and history....
. Because of these attempts, and for other reasons, a second more radical step was added to the circumcision procedure. This was added around 140 AD, and was named Brit Peri'ah. In this step, the foreskin was cut further back, to the ridge behind the glans penis
Glans penis
The glans penis is the sensitive bulbous structure at the distal end of the penis. The glans penis is anatomically homologous to the clitoral glans of the female...
, called the coronal sulcus. The inner mucosal tissue was removed by use of a sharp finger nail or implement, including the excising and removal of the frenulum
Frenulum of prepuce of penis
The word frenulum on its own is often used for the frenulum of prepuce of penis, which is an elastic band of tissue under the glans penis that connects to the prepuce, or foreskin to the vernal mucosa, and helps contract the prepuce over the glans. This is sometimes colloquially known as the "banjo...
from the underside of the glans. Later during the Talmudic period (500–625 AD) a third step began to be practiced by the more orthodox Jewish groups. This was known as Metzitzeh. In this step the mohel
Mohel
A mohel is a Jewish person trained in the practice of brit milah "covenant of circumcision."-Etymology of the Hebrew and Aramaic term:...
would suck the blood from the circumcision wound with his mouth. Although initially thought to reduce the infections by sucking out any bacteria, it was actually found to introduce infection such as tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
and venereal diseases. More modern day mohels use a glass tube placed over the infant's penis for suction of the blood when performing metzitzah. In many Jewish ritual circumcisions this step of Metzitzah has been eliminated.
First Maccabees tells us that the Seleucids forbade the practice of brit milah, and punished those who performed it–as well as the infants who underwent it–with death.
The 1st century Jewish author Philo Judaeus
Philo
Philo , known also as Philo of Alexandria , Philo Judaeus, Philo Judaeus of Alexandria, Yedidia, "Philon", and Philo the Jew, was a Hellenistic Jewish Biblical philosopher born in Alexandria....
(20 BC-50 AD) defended Jewish circumcision on several grounds, including health, cleanliness and fertility. He also thought that circumcision should be done as early as possible as it would not be as likely to be done by someone's own free will
Free will
"To make my own decisions whether I am successful or not due to uncontrollable forces" -Troy MorrisonA pragmatic definition of free willFree will is the ability of agents to make choices free from certain kinds of constraints. The existence of free will and its exact nature and definition have long...
. He claimed that the foreskin prevented semen
Semen
Semen is an organic fluid, also known as seminal fluid, that may contain spermatozoa. It is secreted by the gonads and other sexual organs of male or hermaphroditic animals and can fertilize female ova...
from reaching the vagina
Vagina
The vagina is a fibromuscular tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. Female insects and other invertebrates also have a vagina, which is the terminal part of the...
and so should be done as a way to increase the nation's population. He also noted that circumcision should be performed as an effective means to reduce sexual pleasure: "The legislators thought good to dock the organ which ministers to such intercourse thus making circumcision the symbol of excision of excessive and superfluous pleasure."
The Jewish philosopher Maimonides
Maimonides
Moses ben-Maimon, called Maimonides and also known as Mūsā ibn Maymūn in Arabic, or Rambam , was a preeminent medieval Jewish philosopher and one of the greatest Torah scholars and physicians of the Middle Ages...
(1135–1204) insisted that faith should be the only reason for circumcision. He recognised that it was "a very hard thing" to have done to oneself but that it was done to "quell all the impulses of matter" and "perfect what is defective morally." Sages at the time had recognised that the foreskin heightened sexual pleasure. Maimonides reasoned that the bleeding and loss of protective covering rendered the penis weakened and in so doing had the effect of reducing a man's lustful thoughts
Concupiscence
Concupiscence is often defined as an ardent, usually sensual, longing or lust. The concept is most commonly encountered in Christian theology, as the selfish human desire for an object, person, or experience...
and making sex less pleasurable. He also warned that it is "hard for a woman with whom an uncircumcised man has had sexual intercourse to separate from him."
A 13th-century French Maimonides disciple, Isaac ben Yediah claimed that circumcision was an effective way of reducing a woman's sexual desire. With a non-circumcised man, he said, she always orgasms first and so her sexual appetite is never fulfilled, but with a circumcised man she receives no pleasure and hardly ever orgasms "because of the great heat and fire burning in her."
Flavius Josephus in Jewish Antiquities book 20, chapter 2 records the story of King Izates
Izates bar Monobaz
Izates II or Izates bar Monobaz was a proselyte to Judaism who became King of the Parthian client kingdom of Adiabene. He was the son of Queen Helena of Adiabene and Monobaz I. During his youth he was sent by his father to the court of King Abinergaos I of Characene in Charax Spasinu...
who having been persuaded by a Jewish merchant named Ananias
Ananias of Adiabene
Ananias of Adiabene was a Jewish merchant and mendicant proselytizer, probably of Hellenistic origin, who, in the opening years of the common era, was prominent at the court of Abinergaos I, king of Characene. He was instrumental in the conversion to Judaism of numerous native and foreign...
(claimed by Robert Eisenman in James the Brother of Jesus to be Paul of Tarsus
Paul of Tarsus
Paul the Apostle , also known as Saul of Tarsus, is described in the Christian New Testament as one of the most influential early Christian missionaries, with the writings ascribed to him by the church forming a considerable portion of the New Testament...
) to embrace the Jewish religion, decided to get circumcised so as to follow Jewish law. Despite being reticent for fear of reprisals from his non-Jewish subjects he was eventually persuaded to do it by a Galilee
Galilee
Galilee , is a large region in northern Israel which overlaps with much of the administrative North District of the country. Traditionally divided into Upper Galilee , Lower Galilee , and Western Galilee , extending from Dan to the north, at the base of Mount Hermon, along Mount Lebanon to the...
an Jew named Eleazar on the grounds that it was one thing to read the Law and another thing to practice it. Despite his mother Helen and Ananias's fear of the consequences, Josephus said that God looked after Izates and his reign was peaceful and blessed.
There was also division in Pharisaic Judaism
Pharisees
The Pharisees were at various times a political party, a social movement, and a school of thought among Jews during the Second Temple period beginning under the Hasmonean dynasty in the wake of...
between Hillel the Elder
Hillel the Elder
Hillel was a famous Jewish religious leader, one of the most important figures in Jewish history. He is associated with the development of the Mishnah and the Talmud...
and Shammai
Shammai
Shammai was a Jewish scholar of the 1st century, and an important figure in Judaism's core work of rabbinic literature, the Mishnah....
on the issue of circumcision of proselyte
Proselyte
The biblical term "Proselyte", derives from the Koine Greek προσήλυτος/proselytos, as used in the Septuagint for "stranger", i.e. a "newcomer to Israel"; a "sojourner in the land", and in the New Testament for a convert to Judaism from Paganism...
s. See also Circumcision in the Bible#In rabbinic literature
The Council of Jerusalem
Council of Jerusalem
The Council of Jerusalem is a name applied by historians and theologians to an Early Christian council that was held in Jerusalem and dated to around the year 50. It is considered by Catholics and Orthodox to be a prototype and forerunner of the later Ecumenical Councils...
in Acts of the Apostles
Acts of the Apostles
The Acts of the Apostles , usually referred to simply as Acts, is the fifth book of the New Testament; Acts outlines the history of the Apostolic Age...
15 addressed the issue of whether circumcision was required of new converts to Christianity
Christianity
Christianity is a monotheistic religion based on the life and teachings of Jesus as presented in canonical gospels and other New Testament writings...
. Both Simon Peter and James the Just
James the Just
James , first Bishop of Jerusalem, who died in 62 AD, was an important figure in Early Christianity...
spoke against requiring circumcision in Gentile converts and the Council ruled that circumcision was not necessary. However, Acts 16 and many references in the Letters of Paul
Pauline epistles
The Pauline epistles, Epistles of Paul, or Letters of Paul, are the thirteen New Testament books which have the name Paul as the first word, hence claiming authorship by Paul the Apostle. Among these letters are some of the earliest extant Christian documents...
show that the practice was not immediately eliminated. Paul of Tarsus
Paul of Tarsus
Paul the Apostle , also known as Saul of Tarsus, is described in the Christian New Testament as one of the most influential early Christian missionaries, with the writings ascribed to him by the church forming a considerable portion of the New Testament...
, who was said to be directly responsible for one man's circumcision in Acts 16:1–3 and who appeared to praise Jewish circumcision in Romans
Epistle to the Romans
The Epistle of Paul to the Romans, often shortened to Romans, is the sixth book in the New Testament. Biblical scholars agree that it was composed by the Apostle Paul to explain that Salvation is offered through the Gospel of Jesus Christ...
3:2, said that circumcision didn't matter in 1 Corinthians 7:19 and then increasingly turned against the practice, accusing those who promoted circumcision of wanting to make a good showing in the flesh and boasting or glorying in the flesh in Galatians
Epistle to the Galatians
The Epistle of Paul to the Galatians, often shortened to Galatians, is the ninth book of the New Testament. It is a letter from Paul of Tarsus to a number of Early Christian communities in the Roman province of Galatia in central Anatolia...
6:11–13. In a later letter, Philippians
Epistle to the Philippians
The Epistle of Paul to the Philippians, usually referred to simply as Philippians, is the eleventh book in the New Testament. Biblical scholars agree that it was written by St. Paul to the church of Philippi, an early center of Christianity in Greece around 62 A.D. Other scholars argue for an...
3:2, he is reported as warning Christians to beware the "mutilation" (Strong's G2699). Circumcision was so closely associated with Jewish men that Jewish Christians
Jewish Christians
Jewish Christians is a term which appears in historical texts contrasting Christians of Jewish origin with Gentile Christians, both in discussion of the New Testament church and the second and following centuries....
were referred to as "those of the circumcision" (e.g. Colossians 3:20) or conversely Christians who were circumcised were referred to as Jewish Christians or Judaizers
Judaizers
Judaizers is predominantly a Christian term, derived from the Greek verb ioudaïzō . This term is most widely known from the single use in the New Testament where Paul publicly challenges Peter for compelling Gentile believers to "judaize", also known as the Incident at Antioch.According to the...
. These terms (circumcised/uncircumcised) are generally interpreted to mean Jews
Jews
The Jews , also known as the Jewish people, are a nation and ethnoreligious group originating in the Israelites or Hebrews of the Ancient Near East. The Jewish ethnicity, nationality, and religion are strongly interrelated, as Judaism is the traditional faith of the Jewish nation...
and Greeks
Greeks
The Greeks, also known as the Hellenes , are a nation and ethnic group native to Greece, Cyprus and neighboring regions. They also form a significant diaspora, with Greek communities established around the world....
, who were predominate, however it is an oversimplification as 1st century Iudaea Province
Iudaea Province
Judaea or Iudaea are terms used by historians to refer to the Roman province that extended over parts of the former regions of the Hasmonean and Herodian kingdoms of Israel...
also had some Jews who no longer circumcised, and some Greeks (called Proselytes or Judaizers) and others such as Egyptians, Ethiopians, and Arabs who did.
According to the Gospel of Thomas
Gospel of Thomas
The Gospel According to Thomas, commonly shortened to the Gospel of Thomas, is a well preserved early Christian, non-canonical sayings-gospel discovered near Nag Hammadi, Egypt, in December 1945, in one of a group of books known as the Nag Hammadi library...
saying 53, Jesus
Jesus
Jesus of Nazareth , commonly referred to as Jesus Christ or simply as Jesus or Christ, is the central figure of Christianity...
says:
- "His disciples said to him, "is circumcision useful or not?" He said to them, "If it were useful, their father would produce children already circumcised from their mother. Rather, the true circumcision in spirit has become profitable in every respect."" SV
Parallels to Thomas 53 are found in Paul's Romans
Epistle to the Romans
The Epistle of Paul to the Romans, often shortened to Romans, is the sixth book in the New Testament. Biblical scholars agree that it was composed by the Apostle Paul to explain that Salvation is offered through the Gospel of Jesus Christ...
2:29, Philippians 3:3, 1 Corinthians 7:19, Galatians
Epistle to the Galatians
The Epistle of Paul to the Galatians, often shortened to Galatians, is the ninth book of the New Testament. It is a letter from Paul of Tarsus to a number of Early Christian communities in the Roman province of Galatia in central Anatolia...
6:15, Colossians 2:11–12.
In John's Gospel 7:23 Jesus is reported as giving this response to those who criticized him for healing on the Sabbath:
- Now if a man can be circumcised on the sabbath so that the Law of Moses is not broken, why are you angry with me for making a man whole and complete on a sabbath? ( Jerusalem Bible)
This passage has been seen as a comment on the Rabbinic belief that circumcision heals the penis (Jerusalem Bible, note to John 7:23) or as a criticism of circumcision.
Male circumcision in the Renaissance
Europeans, with the exception of the Jews, did not practice male circumcision.The Catholic Church condemned the observance of circumcision as a mortal sin and ordered against its practice in the Council of Basel-Florence in 1442. According to UNAIDS, it stated that circumcision was unnecessary for Christians; El-Hout and Khauli, however, regard it as condemnation of the procedure.
Male circumcision in the 18th century
Circumcision was not practiced amongst Christians in Europe in the 18th century.- Edward GibbonEdward GibbonEdward Gibbon was an English historian and Member of Parliament...
had referred to it as a "singular mutilation" practised only by Jews and Turks and as "a painful and often dangerous rite" ... (R. Darby)
In 1753 in London there was a proposal for Jewish emancipation. It was furiously opposed by the pamphleteers of the time, who spread the fear that Jewish emancipation meant universal circumcision. Men were urged to protect:
- "the best of Your property" and guard their threatened foreskins. It was an extraordinary outpouring of popular beliefs about sex, fears about masculinity and misconceptions about Jews, but also a striking indication of how central to their sexual identity men considered their foreskins at that time. (R.Darby)
Male circumcision in the 19th century and beyond
- The English explorer Sir Richard BurtonRichard Francis BurtonCaptain Sir Richard Francis Burton KCMG FRGS was a British geographer, explorer, translator, writer, soldier, orientalist, cartographer, ethnologist, spy, linguist, poet, fencer and diplomat. He was known for his travels and explorations within Asia, Africa and the Americas as well as his...
observed that "Christendom practically holds circumcision in horror". This attitude is reflected in the ninth edition of the Encyclopaedia Britannica (1876) which discusses the practice as a religious rite among Jews, Moslems, the ancient Egyptians and tribal peoples in various parts of the world. The author of the entry rejected sanitary explanations of the procedure in favour of a religious one: "like other body mutilations ... [it is] of the nature of a representative sacrifice". (R. Darby)
Then, a change of attitude began, something that was reflected in successive editions of the Encyclopædia Britannica:
- By 1910 the entry had been turned on its head: "This surgical operation, which is commonly prescribed for purely medical reasons, is also an initiation or religious ceremony among Jews and Muslims": now it was primarily a medical procedure and only after that a religious ritual. The entry explained that "in recent years the medical profession has been responsible for its considerable extension among other than Jewish children ... for reasons of health" (11th edition, Vol. 6). By 1929 the entry is much reduced in size and consists merely of a brief description of the operation, which is "done as a preventive measure in the infant" and "performed chiefly for purposes of cleanliness". Ironically, readers are then referred to the entries for "Mutilation" and "Deformation" for a discussion of circumcision in its religious context (14th edition, 1929, Vol. 5). (R. Darby)
Historically, neonatal circumcision was promoted during late Victorian times in the English-speaking parts of Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...
, Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
, New Zealand
New Zealand
New Zealand is an island country in the south-western Pacific Ocean comprising two main landmasses and numerous smaller islands. The country is situated some east of Australia across the Tasman Sea, and roughly south of the Pacific island nations of New Caledonia, Fiji, and Tonga...
, the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
and the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
and was widely practiced during the first part of the 20th century in these countries. However, the practice declined sharply in the United Kingdom after the Second World War, and somewhat later in Canada, Australia and New Zealand. It has been argued (e.g., Goldman 1997) that the practice did not spread to other European countries because others considered the arguments for it fallacious. In South Korea
South Korea
The Republic of Korea , , is a sovereign state in East Asia, located on the southern portion of the Korean Peninsula. It is neighbored by the People's Republic of China to the west, Japan to the east, North Korea to the north, and the East China Sea and Republic of China to the south...
, circumcision was largely unknown before the establishment of the United States trusteeship in 1945. More than 90% of South Korean high school boys are now circumcised, but the average age of circumcision is 12 years, which makes South Korea a unique case.
Infant circumcision has been abandoned in New Zealand and Britain, and is now much less common in Australia and in Canada (see table 1). The decline in circumcision in the United Kingdom followed the decision by the National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
(NHS) in 1948 not to cover the procedure following an influential article by Douglas Gairdner which claimed that circumcision resulted in the deaths of about 16 children under 5 each year in the United Kingdom.
Male circumcision to prevent masturbation
Non-religious circumcision in English-speaking countries arose in a climate of negative attitudes towards sex, especially concerning masturbation. In her 1978 article The Ritual of Circumcision, Karen Erickson Paige writes: "In the United States, the current medical rationale for circumcision developed after the operation was in wide practice. The original reason for the surgical removal of the foreskin, or prepuce, was to control 'masturbatory insanity' – the range of mental disorders that people believed were caused by the 'polluting' practice of 'self-abuse.'""Self-abuse" was a term commonly used to describe masturbation in the 19th century. According to Paige, "treatments ranged from diet, moral exhortations, hydrotherapy, and marriage, to such drastic measures as surgery, physical restraints, frights, and punishment. Some doctors recommended covering the penis with plaster of Paris, leather, or rubber; cauterization; making boys wear chastity belt
Chastity belt
A chastity belt is a locking item of clothing designed to prevent sexual intercourse. They may be used to protect the wearer from rape or temptation. Some devices have been designed with additional features to prevent masturbation...
s or spiked rings; and in extreme cases, castration
Castration
Castration is any action, surgical, chemical, or otherwise, by which a male loses the functions of the testicles or a female loses the functions of the ovaries.-Humans:...
." Paige details how circumcision became popular as a masturbation remedy:
- "In the 1890s, it became a popular technique to prevent, or cure, masturbatory insanity. In 1891 the president of the Royal College of Surgeons of England published On Circumcision as Preventive of Masturbation, and two years later another British doctor wrote Circumcision: Its Advantages and How to Perform It, which listed the reasons for removing the 'vestigial' prepuce. Evidently the foreskin could cause 'nocturnal incontinence,' hysteria, epilepsy, and irritation that might 'give rise to erotic stimulation and, consequently, masturbation.' Another physician, P.C. Remondino, added that 'circumcision is like a substantial and well-secured life annuityLife annuityA life annuity is a financial contract in the form of an insurance product according to which a seller — typically a financial institution such as a life insurance company — makes a series of future payments to a buyer in exchange for the immediate payment of a lump sum or a series...
...it insures better health, greater capacity for labor, longer life, less nervousness, sickness, loss of time, and less doctor bills.' No wonder it became a popular remedy."
At the same time circumcisions were advocated on men, clitoridectomies (removal of the clitoris) were also performed for the same reason (to treat female masturbators). The US "Orificial Surgery Society" for female "circumcision" operated until 1925, and clitoridectomies and infibulation
Infibulation
Infibulation is the surgical modification or mutilation of the genitals in males and females, particularly the foreskin, labia minora and labia majora...
s would continue to be advocated by some through the 1930s. As late as 1936, L. E. Holt, an author of pediatric textbooks, advocated male and female circumcision as a treatment for masturbation.
One of the leading advocates of circumcision was John Harvey Kellogg
John Harvey Kellogg
John Harvey Kellogg was an American medical doctor in Battle Creek, Michigan, who ran a sanitarium using holistic methods, with a particular focus on nutrition, enemas and exercise. Kellogg was an advocate of vegetarianism and is best known for the invention of the corn flakes breakfast cereal...
. He advocated the consumption of Kellogg's corn flakes to prevent masturbation, and he believed that circumcision would be an effective way to eliminate masturbation in males.
- "Covering the organs with a cage has been practiced with entire success. A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of phimosis. 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. If any attempt is made to watch the child, he should be so carefully surrounded by vigilance that he cannot possibly transgress without detection. If he is only partially watched, he soon learns to elude observation, and thus the effect is only to make him cunning in his vice."
Robert Darby, writing in the Australian Medical Journal, noted that some 19th century circumcision advocates—and their opponents—believed that the foreskin was sexually sensitive:
- In the 19th century the role of the foreskin in erotic sensation was well understood by physicians who wanted to cut it off precisely because they considered it the major factor leading boys to masturbation. The Victorian physician and venereologist William Acton (1814–1875) damned it as "a source of serious mischief", and most of his contemporaries concurred. Both opponents and supporters of circumcision agreed that the significant role the foreskin played in sexual response was the main reason why it should be either left in place or removed. William Hammond, a Professor of Mind in New York in the late 19th century, commented that "circumcision, when performed in early life, generally lessens the voluptuous sensations of sexual intercourse", and both he and Acton considered the foreskin necessary for optimal sexual function, especially in old age. Jonathan Hutchinson, English surgeon and pathologist (1828–1913), and many others, thought this was the main reason why it should be excised.
Medical circumcision from 1870 to 1950 in English-speaking countries
Until 1870, medical circumcisions were performed to treat conditions local to the penis: phimosisPhimosis
Phimosis , from the Greek phimos ), is a condition where, in men, the foreskin cannot be fully retracted over the glans penis...
, balanitis
Balanitis
Balanitis is inflammation of the glans penis . When the foreskin is also affected, it is termed balanoposthitis....
, and penile cancer. In that year, Lewis Sayre, a prominent New York
New York City
New York is the most populous city in the United States and the center of the New York Metropolitan Area, one of the most populous metropolitan areas in the world. New York exerts a significant impact upon global commerce, finance, media, art, fashion, research, technology, education, and...
orthopedic surgeon
Orthopedic surgery
Orthopedic surgery or orthopedics is the branch of surgery concerned with conditions involving the musculoskeletal system...
and vice president of the newly formed American Medical Association
American Medical Association
The American Medical Association , founded in 1847 and incorporated in 1897, is the largest association of medical doctors and medical students in the United States.-Scope and operations:...
, examined a five-year-old boy who was unable to straighten his legs, and whose condition had so far defied treatment. Upon noting that the boy's genitals were inflamed, Sayre hypothesized that chronic irritation of the boy's foreskin had paralyzed his knees via reflex neurosis. Sayre circumcised the boy, and within a few weeks, he recovered from his paralysis. After several additional incidents in which circumcision also appeared effective in treating paralyzed joints, Sayre began to promote circumcision as a powerful orthopedic remedy.
Sayre's prominence within the medical profession allowed him to reach a wide audience. He lectured widely in the United States and the United Kingdom, and his ideas influenced physicians throughout the English-speaking world. As more practitioners tried circumcision as a treatment for otherwise intractable medical conditions, sometimes achieving positive results, the list of ailments reputed to be treatable through circumcision grew. By the 1890s, hernia
Hernia
A hernia is the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it. A hiatal hernia occurs when the stomach protrudes into the mediastinum through the esophageal opening in the diaphragm....
, bladder
Urinary bladder
The urinary bladder is the organ that collects urine excreted by the kidneys before disposal by urination. A hollow muscular, and distensible organ, the bladder sits on the pelvic floor...
infections, kidney stone
Kidney stone
A kidney stone, also known as a renal calculus is a solid concretion or crystal aggregation formed in the kidneys from dietary minerals in the urine...
s, insomnia
Insomnia
Insomnia is most often defined by an individual's report of sleeping difficulties. While the term is sometimes used in sleep literature to describe a disorder demonstrated by polysomnographic evidence of disturbed sleep, insomnia is often defined as a positive response to either of two questions:...
, chronic indigestion, rheumatism
Rheumatism
Rheumatism or rheumatic disorder is a non-specific term for medical problems affecting the joints and connective tissue. The study of, and therapeutic interventions in, such disorders is called rheumatology.-Terminology:...
, epilepsy
Epilepsy
Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain.About 50 million people worldwide have epilepsy, and nearly two out of every three new cases...
, asthma
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
, bedwetting
Bedwetting
Nocturnal enuresis, commonly called bedwetting, is involuntary urination while asleep after the age at which bladder control usually occurs. Nocturnal enuresis is considered primary when a child has not yet had a prolonged period of being dry...
, Bright's disease
Bright's disease
Bright's disease is a historical classification of kidney diseases that would be described in modern medicine as acute or chronic nephritis. The term is no longer used, as diseases are now classified according to their more fully understood causes....
, erectile dysfunction
Erectile dysfunction
Erectile dysfunction is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance....
, syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...
, insanity
Insanity
Insanity, craziness or madness is a spectrum of behaviors characterized by certain abnormal mental or behavioral patterns. Insanity may manifest as violations of societal norms, including becoming a danger to themselves and others, though not all such acts are considered insanity...
, and skin cancer
Skin cancer
Skin neoplasms are skin growths with differing causes and varying degrees of malignancy. The three most common malignant skin cancers are basal cell cancer, squamous cell cancer, and melanoma, each of which is named after the type of skin cell from which it arises...
had all been linked to the foreskin, and many physicians advocated universal circumcision as a preventive health measure. In 1855, the Quaker surgeon, Jonathan Hutchinson, observed that circumcision appeared to protect against syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...
. Although this observation was challenged (the protection that Jews appear to have are more likely due to cultural factors), a 2006 systematic review concluded that the evidence "strongly indicates that circumcised men are at lower risk ... syphilis."
Specific medical arguments aside, several hypotheses have been raised in explaining the public's acceptance of infant circumcision as preventive medicine. The success of the germ theory of disease
Germ theory of disease
The germ theory of disease, also called the pathogenic theory of medicine, is a theory that proposes that microorganisms are the cause of many diseases...
had not only enabled physicians to combat many of the postoperative complications of surgery, but had made the wider public deeply suspicious of dirt and bodily secretions. Accordingly, the smegma that collects under the foreskin was viewed as unhealthy, and circumcision readily accepted as good penile hygiene. Secondly, moral sentiment of the day regarded masturbation
Masturbation
Masturbation refers to sexual stimulation of a person's own genitals, usually to the point of orgasm. The stimulation can be performed manually, by use of objects or tools, or by some combination of these methods. Masturbation is a common form of autoeroticism...
as not only sin
Sin
In religion, sin is the violation or deviation of an eternal divine law or standard. The term sin may also refer to the state of having committed such a violation. Christians believe the moral code of conduct is decreed by God In religion, sin (also called peccancy) is the violation or deviation...
ful, but also physically and mentally unhealthy, stimulating the foreskin to produce the host of maladies of which it was suspected. In this climate, circumcision could be employed as a means of discouraging masturbation. All About the Baby, a popular parenting book of the 1890s, recommended infant circumcision for precisely this purpose. (However, a survey of 1410 men in the United States in 1992, Laumann found that circumcised men were more likely to report masturbating at least once a month.) As hospital
Hospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....
s proliferated in urban areas, childbirth
Childbirth
Childbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...
, at least among the upper and middle classes, was increasingly under the care of physicians in hospitals rather than with midwives in the home. It has been suggested that once a critical mass of infants were being circumcised in the hospital, circumcision became a class marker of those wealthy enough to afford a hospital birth.
During the same time period, circumcision was becoming easier to perform. William Halstead
William Halstead
William Halstead was an American Whig Party politician who represented New Jersey at large in the United States House of Representatives from 1837–1839, and again from 1841 to 1843....
's 1885 discovery of hypodermic cocaine
Cocaine
Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine. It is a stimulant of the central nervous system, an appetite suppressant, and a topical anesthetic...
as a local anaesthetic made it easier for doctors without expertise in the use of chloroform
Chloroform
Chloroform is an organic compound with formula CHCl3. It is one of the four chloromethanes. The colorless, sweet-smelling, dense liquid is a trihalomethane, and is considered somewhat hazardous...
and other general anaesthetics to perform minor surgeries. Also, several mechanically aided circumcision techniques, forerunners of modern clamp-based circumcision methods, were first published in the medical literature of the 1890s, allowing surgeons to perform circumcisions more safely and successfully.
By the 1920s, advances in the understanding of disease had undermined much of the original medical basis for preventive circumcision. Doctors continued to promote it, however, as good penile hygiene and as a preventive for a handful of conditions local to the penis: balanitis, phimosis, and penile cancer.
Infant circumcision was taken up in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
, Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
, New Zealand
New Zealand
New Zealand is an island country in the south-western Pacific Ocean comprising two main landmasses and numerous smaller islands. The country is situated some east of Australia across the Tasman Sea, and roughly south of the Pacific island nations of New Caledonia, Fiji, and Tonga...
and the English-speaking parts of Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...
and to a lesser extent in the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
. The British Royal Family had a long tradition requiring that all male children be circumcised” (Alfred J. Kolatach’s The Jewish Book of Why, Middle Village, New York; Jonathan David, 1981). Although it is difficult to determine historical circumcision rates, one estimate of infant circumcision rates in the United States holds that 30% of newborn American boys were being circumcised in 1900, 55% in 1925, and 72% in 1950.
Circumcision since 1950
In 1949, a lack of consensus in the medical community as to whether circumcision carried with it any notable health benefit motivated the United Kingdom's newly formed National Health ServiceNational Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
to remove infant circumcision from its list of covered services. One reason may have been Douglas Gairdner’s famous study, The fate of the foreskin, which revealed that for the years 1942–1947, about 16 children per year in England and Wales had died because of circumcision, a rate of about 1 per 6000 circumcisions. Since then, circumcision has been an out-of-pocket cost
Out-of-pocket expenses
Out-of-pocket expenses are direct outlays of cash which may or may not be later reimbursed.In operating a vehicle, gasoline, parking fees and tolls are considered out-of-pocket expenses for the trip...
to parents, and the proportion of newborns circumcised in the hospital has fallen to less than one percent.
Similar trends have operated in Canada, (where public medical insurance is universal, and where private insurance does not replicate services already paid from the public purse) Individual provincial heath insurance plans began delisting non-therapeutic circumcision in the 1980s. Manitoba was the final province to delist non-therapeutic circumcision which occurred in 2005.
In South Korea
South Korea
The Republic of Korea , , is a sovereign state in East Asia, located on the southern portion of the Korean Peninsula. It is neighbored by the People's Republic of China to the west, Japan to the east, North Korea to the north, and the East China Sea and Republic of China to the south...
, circumcision was largely unknown before the establishment of the United States trusteeship in 1945 and the spread of American influence. More than 90% of South Korean high school boys are now circumcised, which makes South Korea a unique case. The average age of circumcision is 12 years.
In some South Africa
South Africa
The Republic of South Africa is a country in southern Africa. Located at the southern tip of Africa, it is divided into nine provinces, with of coastline on the Atlantic and Indian oceans...
n ethnic groups, circumcision has roots in several belief systems, and is performed most of the time on teenage boys:
- "...The young men in the eastern Cape belong to the Xhosa ethnic group for whom circumcision is considered part of the passage into manhood... A law was recently introduced requiring initiation schools to be licensed and only allowing circumcisions to be performed on youths aged 18 and older. But Eastern Cape provincial Health Department spokesman Sizwe Kupelo told Reuters news agency that boys as young as 11 had died. Each year thousands of young men go into the bush alone, without water, to attend initiation schools. Many do not survive the ordeal..." [].
Prior to 1989, the American Academy of Pediatrics had a long-standing opinion that medical indications for routine circumcision were lacking. This stance, according to the AMA, was reversed in 1989, following new evidence of reduction in risk of urinary tract infection.
A study in 1987 found that the prominent reasons for parents choosing circumcision were "concerns about the attitudes of peers and their sons' self concept in the future," rather than medical concerns. A 1999 study reported that reasons for circumcision included "ease of hygiene (67 percent), ease of infant circumcision compared with adult circumcision (63 percent), medical benefit (41 percent), and father circumcised (37 percent)." The authors commented that "Medical benefits were cited more frequently in this study than in past studies, although medical issues remain secondary to hygience and convenience." A 2001 study reported that "The most important reason to circumcise or not circumcise the child was health reasons." A 2005 study speculated that increased recognition of the potential benefits may be responsible for an observed increase in the rate of neonatal circumcision in the USA between 1988 and 2000.
In a 2001 survey, 86.6% of parents felt respected by their medical provider, and parents who did not circumcise "felt less respected by their medical provider".
In the United States, statistics (1999) collected by the National Center for Health Statistics show that the overall rate of neonatal circumcision had remained near 65% since data collection began in 1979. However, strong regional differences in the circumcision rates have developed during this time. While more than 80% of newborn boys are circumcised in the Midwest and South, circumcision rates have declined to about 37% in the West in 1999. This has been attributed in part to increasing births among Latin Americans, who usually do not circumcise.
Circumcision in the 21st century
Some have voiced ethical concerns about the procedure. See Bioethics of neonatal circumcision
Bioethics of neonatal circumcision
Male circumcision involves the excision of genital tissue from the human body, so the ethics of circumcision are sometimes controversial.Some studies indicate that the foreskin and frenulum perform certain physiological functions among the men tested, which would be destroyed by excision...
for more information.
Neonatal circumcision nonetheless still remains the most common pediatric operation carried out in the U.S. today.
The South African Children's Act (No. 38 of 2005) has made the circumcision of male children unlawful except for medical or religious reasons.
For current circumcision rates, please see prevalence of circumcision
Prevalence of circumcision
The prevalence of circumcision refers to the proportion of males that are circumcised in a given population. It may also refer to the proportion of newborn males that are circumcised. Estimates of the proportion of males that are circumcised worldwide vary from to...
.
Studies indicate that male circumcision can reduce the chance of HIV infection in heterosexual men. A criticism of encouraging the adoption of adult male circumcision in areas or populations heavily affected by HIV is that even in the best of studies the measure is merely reductive, not preventative, and may embolden the recipient of the operation to willfully undermine the demonstrably safe methods of serial monogamy and condom usage with new partners; for a more thorough look at the scientific research visit Circumcision and HIV
Circumcision and HIV
Over forty epidemiological studies have been conducted to investigate the relationship between male circumcision and HIV infection. Reviews of these studies have reached differing conclusions about whether circumcision could be used as a prevention method against HIV.Experimental evidence was...
.
The AMA remarked that, in one study, physicians in "nearly half" of neonatal circumcisions "did not discuss the potential medical risks and benefits of elective circumcision prior to delivery of the infant son. Deferral of discussion until after birth, combined with the fact that many parents' decisions about circumcision are preconceived, contribute to the high rate of elective circumcision."
As of July 2011, eighteen state Medicaid programs had discontinued payment for non-therapeutic circumcision.
External links
- VIDEO – Male Circumcision: History, Ethics and Surgical Considerations Dr. Benjamin Mandel speaks at the University of Wisconsin School of Medicine and Public Health, December 2007.
- Peter Charles Remondino. History of Circumcision from the Earliest Times to the Present. Philadelphia and London; F. A. Davis; 1891.
- Jewish Encyclopedia: Circumcision
- The History of Circumcision website