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Lauren Myers

Professor Dylan Colvin

English 1201 Online

18 March 2019

Circumcision in America

In 2015, within a month of graduating from college with my BFA, I became pregnant

with my son. Within the swirl of suddenly having to find a house, buy the necessities, find a

good doctor, take the classes, pick a name, etc. that comes with one’s first child, some things

were overlooked; most notably our decision to circumcise our little boy. It had always been my

assumption that circumcision was natural, healthy, and no cause for concern. I never had an

opinion either way that was for or against circumcision because I always thought it was the

choice of the parent. Three years later I stumbled upon a documentary on Netflix called

American Circumcision​, which explored the effects of botched circumcisions on the children of

the parents, the science supporting intactness, female genital mutilation, and the origins of

circumcision. After watching the documentary I began to feel strongly about this topic, therefore

the aim of this paper is to explore the history of circumcision, the rise of its widespread, routine

practice across the United States, the practice of other countries in regards to circumcision, the

risks and benefits of circumcision, the difference between male circumcision and female genital

mutilation in terms of why one is considered acceptable while the other is not, and the lasting

psychological effects on both the parents and the child. During my research on this topic, I have

found statistics showing at least half of the male population in America is circumcised when

there has been no medical or religious reason for the removal of the foreskin by a doctor, as well
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as a surprising infant mortality figure in correlation with botched circumcision, and many states

are proposing laws or have passed a law that female circumcision be illegal because it is

considered mutilation, thus, circumcision is a human rights issue.

In order to better understand circumcision and the perception Americans have of it today,

we first need to discuss the history and origin of this practice. While there is not much evidence,

it is presumed that circumcision dates back in humans thousands of years ago. According to ​Rites

of Circumcision​, written by Robert D. Martin Ph. D, “A penis is present in all living mammals,

so the beginnings of the foreskin may date back to the origin of mammals, around 200 million

years ago… All living placental mammals have a well-developed foreskin, this feature was

established before 100 million years ago. In all placental mammals, the foreskin (prepuce) is a

retractable, double-layered membrane covering the head of the flaccid penis, providing

protection and lubrication” (Martin). It is interesting when considering all mammals have

foreskins because this notion explains that all mammals are born intact, with the foreskin serving

an essential purpose of protecting the genitals. Over time, the foreskin has evolved to better serve

mammals in reproduction through the development of “touch-sensitive nerve-endings” (Martin).

So, why then, if mammals are born with an existing foreskin, do the majority of Americans feel

the need to cut away the foreskin of infant boys? To best answer this question, it is important to

examine the ritual of human circumcision.

Some examples of circumcision are thought to predate history, with supposed evidence

appearing in cave paintings. However, “The oldest known evidence clearly showing

circumcision comes from Ancient Egypt, with documentation from around 4,500 years ago both

in a tomb mural and in a written account. In these and subsequent cases, circumcision was
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performed not soon after birth, but on adolescent boys” (Martin). It is not until referencing the

Bible, that one begins to see the religious context for this procedure which is predominantly

associated to Jewish, Christian, and Islamic religions. The very first reference to circumcision in

the Bible occurs in Exodus, where Moses’ infant boy is circumcised by Zipporah, his mother

(Warren). The next mention of circumcision is found in The Book of Genesis where God

presents Himself to Abraham, telling Abraham that if he circumcises himself, as well as all of his

sons on their eighth day of life, that God will make Abraham the father of many nations

(Warren). Three religions of the world are claim Abraham as their patriarch, they are Judaism,

Islam, and Christianity (Warren). In the beginning of ritual circumcision, it was a fairly simple

excision of the front part of the foreskin, it was not until later during the Hellenistic period that

the removal of the foreskin became a more radical procedure (Marotta, Warren). In both Islamic

and Jewish faiths, circumcision is still routinely practiced, while Christianity has moved away

from this routine. The main difference between circumcision in Jewish faith compared to Islamic

faith, is that in Judaism the circumcision is done in the presence of a rabbi, the parents and the

grandparents of the infant boy in a custom called “brit milah,” while in the Islamic faith this

procedure can be conducted at any point during the boy’s youth without religious ceremony

(Warren).

If circumcision was intended for religious sacrifice, how did it come to be so widely

practiced non-secularly? In 19th century England, the thought that the removal of the foreskin

would keep men from masturbating is where the concept of non-secular cricumcision began.

Masturbation was believed to cause weak sperm; weak sperm was attributed to any and all

ailments during this time period, therefore if the removal of the foreskin were to prevent men
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from masturbation, then all disease might be eradicated. During this time, things like clubfoot,

impotence, sexual dysfunction, blindness, etc. were thought to be prevented through

circumcision; as the years wore on, however, it became clear that circumcision was the

end-all-be-all of whatever disease or serious illness afflicted the people of that decade (Marotta).

Presently, circumcision is believed to prevent HIV/AIDS, HPV, penile cancer in men, cervical

cancer in women, and UTIs in infants (Denniston et al.). Studies have reported that in African

countries, the incidences of HIV/AIDs and other STDS in circumcised men is about 50% less

likely than in uncircumcised men, however, one needs to view this study with caution because

when the numbers are broken down we see that only about 1.5% of circumcised men were HIV

negative, while about 3.8% of uncircumcised men tested positive for HIV/AIDS; therefore, the

accuracy of that statement is not as valid as it could be, especially when one considers that​ ​the

study combined the percentages of their findings against each other to suggest a much larger

percentage​ ​(Marotta). Also, when one considers that such things as the Gardasil vaccine for

women can prevent instances of cervical cancer by protecting against the spread of HPV, or that

UTIs can easily be cured through the use of antibiotics, or that penile cancer is seemingly rare

and most notably seen in men practicing poor hygiene (such as homeless men), or that the spread

of STDS like HIV/AIDs can be prevented through safe-sex practices and is more prevalent in

drug users (Denniston et al.), then one begins to see that there is not much hygienic benefit to

circumcision, which is the reason it routinely began outside of religious context. There is concern

in the medical community that neglecting to circumcise one’s infant boy can lead to phimosis,

which is a medical condition where the foreskin chokes the penis, but phimosis is exceedingly

rare and by adolescence the foreskin becomes completely retractable; up until adolescence there
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is no functional reason for the foreskin to be retracted, as the foreskin aids in arousal and

reproduction (Martin). Many people, healthcare professionals included, believe that the foreskin

needs to be retracted in infancy for cleaning, but the parent does not need to clean what they can

not see, much like in female infants (Marotta). ​Fortunately, in about the past 40 years the rate of

circumcision in America has steadily decreased from 80% in 1980 to about 55% in 2010

(Shmerling, Fig. 1).

Fig. 1 The percentage of men with circumcisions around the globe (Zavala-Offman).

In continuing the discussion of circumcision, it is important to think about how

circumcision might affect the delicate psyche of a child’s brain. In the past, physicians and

surgeons believed that infants could not feel pain, so they would not anesthetize children under

any circumstance - this includes instances of abdominal surgery and open heart surgery

(Marotta). What is most curious about this information is how, when the human body has been

studied for generations, does someone ignore that all human beings are born with a central

nervous system? If we are born with nerves in our bodies, then we can most definitely feel pain

at the very beginning stages of life. Between 1846 to 1986 (a span of 140 years), pediatric
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surgeons operated on infants without first anesthetizing them due to their belief that it was unsafe

(Denniston et al.). However, it has become more and more routine within the past 10-20 years

for doctors to begin using a local anesthetic on the foreskin; this anesthetic needs at least 5

minutes before the procedure can begin, otherwise the infant will feel everything (Marotta).

According to a 2006 study found in ​Circumcision and Human Rights​ by Denniston et al., it was

explored how the medical community continued to miss the seriousness of infant pain with the

use of brain-scanning equipment, focusing primarily on premature babies before, during, and

after they were subjected to regular blood testing with blood being removed from the heel of the

foot. Maria Fitzgerald and colleagues used a type of technology to determine the blood supply

and available oxygen in the brain of babies from 25-45 weeks of conceptual age. They results

determined that flows of blood and oxygen were entering a region of the brain that had been

connected to pain in adults, thus these infants were experiencing real pain, not reflexes

(Denniston et al.). Circumcision can affect human psychology even further, especially when one

considers the horrific complications that can arise from circumcision. While complications vary

between 0.2% and 10%, “depending on the quality of the reporting and how a complication is

defined,” there are still at least 200 cases of infant death in the U.S. due to complications from

circumcision (Denniston et al.). Some of the complications of circumcision include infection,

and painful erections, with the worst of these complications including necrosis (death of the

tissue) and death due to hemorrhage (Denniston et al.). Most of these complications can be quite

traumatic for men in adulthood, while the complications including necrosis, death, infection,

hemorrhage, and gangrene are more likely to be traumatic for the parent whose sole reason, in

many situations, for circumcising their child is because of their belief that it is healthier.
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In other countries, such as Turkey, circumcision can occur at any time before seven years

of age in boys, with the procedure being performed most commonly between the ages of two and

four years old (Yavuz et al.). Freud’s idea of psychoanalysis of young boys was that during the

fourth and fifth years of life, boys enter a stage called the phallic-oedipal stage, which is

important in distinguishing the differences of boys from girls, and in creating the foundation for

identifying one’s gender (Yavuz et al.). During this period in young boys’ lives, Freud believed

that there was a fear and anxiety of castration. ​American Circumcision​ interviewed several adult

men and one 16 year old boy about their attitudes toward their own circumcision, and every

single one of these men harbor negative feelings toward their parents, specifically toward the

mother. These men all agreed that circumcision should only be performed on a person of

consenting age. One study found men were unhappy with their circumcision, experiencing

feelings of outrage, resentment, despair, and shame (Yavuz et al.). Some of these men have

expressed feeling as if their human rights were violated, believing they were tortured and

mutilated, and expressing that their circumcision in infancy was sexual assault (Yavuz et al.).

Another study stated that circumcision was associated with aggression, weak ego, and bad

dreams or nightmares (Yavuz et al.). A third study tested 12 children between the ages of four

and seven using brain scanning technology and psychological testing a month before the

procedure and three days after circumcision, the results suggested that children identify

circumcision as assault, and that coping mechanisms decreased (Yavuz et al.). However, there

are studies that exist in which men and children who were circumcised do not feel bad about the

procedure and overall effect. One study stated none of the men interviewed felt negatively about

their circumcision and did not experience any notable body image issues (Yavuz et al.). A
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second study from Turkey reported that if a parent explains the procedure of the circumcision to

the child in the days leading up to the procedure, that the child does not experience any negative

or traumatic feelings after the procedure has been performed; it is worthy of noting, though, that

these children were around the age of seven and ten years, therefore they had a better

understanding of the procedure itself, as well as of the culture implications involved (Yavuz et

al.).

Circumcision is not just limited to men; some countries practice female circumcision, but

it more often referred to as female genital mutilation, or FGM. The instances of Obstetricians

and Gynecologists and midwives caring for women who have experienced some sort of genital

mutilation is increasing due to immigration into the States, Europe, and Australia - this is

important because the degree of care, compassion, and empathy needs to be higher when treating

these women. A common reason for this procedure in women is that it is a coming of age

ceremony associated with a woman’s sexuality, and thought to prepare a woman for her union to

a male partner (​Ogunsiji). FGM is frequently seen in Africa (Fig. 2).

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Fig. 2 A map of where female genital mutilation occurs in Africa (Rex).

According to World Health Organization, FGM is a widespread practice where hundreds of

millions of women and girls experiencing genital cutting in some form, with 28 countries in

Africa practicing this procedure (Ogunsiji). There are approximately four types of genital cutting

in women which is based on the intensity of the injury: Type one is clitoridectomy, defined as

the limited or complete removal of the clitoris; type two is excision, which is defined as the

limited or complete removal of the clitoris and labia minora with or without removal of the labia

majora; type three is infibulation, or the narrowing of the vaginal opening; type four includes all

other damaging procedures to the female genitals that are not for medical reasons (Ogunsiji).

Due to the extreme nature of this procedure, there are a variety of negative effects associated

with the practice, such as physical, sexual, and psychological; some of these complications
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include UTIs, hemorrhage, anemia, and deadly infections like sepsis (Ogunsiji). In a report found

in ​Circumcision and Human Rights,​ risks of FGM gradually increase with more substantial

mutilation, the loss of a baby is considerably higher in women who have experienced this form

of mutilation (Denniston et al). Another study found in ​Circumcision and Human Rights​ was

conducted in Egypt in 2007, and explored the impact of FGM on newly married women; it

concluded that women experienced a more problems with menstrual cramps, problems with

marriage and sex, complications with childbirth, and more incidences of anxiety (Denniston et

al). The authors of this particular study surmised that circumcision in women was troublesome

during consummation and childbirth, which had an opposite effect that the families had expected

(Denniston et al). A final study examined ten African women who gave birth in Australia,

reporting that these survivors of FGM experience feeling self-conscious and ashamed of their

genitals due to the disfigurement caused by their mutilation (Ogunsiji).

Most notably, when learning about female genital mutilation, one finds that there is a

greater degree of acceptance towards male circumcision than there is to FGM. Male circumcision

is more widely accepted because it is viewed as a commandment of God, while female

circumcision is not thought to be the will of God, therefore it is believed to be abuse (Yavuz et

al.). Male circumcision is associated with perfection in Muslims and Jews (Yavuz et al.). The

foreskin of the penis is considered a flaw, in order for the male body to be perfected in God’s

image it must be removed, while the removal of the female foreskin is believed to be more

negative and traumatic to the female body (Yavuz et al.). However, when discussing bodily

integrity as a human rights issue, it is important to evaluate the discrimination involved between
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male and female circumcision; male circumcision is viewed as normal when routinely practiced

on boys, while when carried out on girls it is perceived as a crime (Yavuz et al.).

Overall, it appears that there is still a large amount of ignorance concerning the procedure

of circumcision. Doctors and OB-GYNs are not informing parents of the risks of circumcision, in

fact, the conversation is rarely taking place between expecting parents and healthcare

professionals. While circumcision can certainly be beneficial to boys if an underlying medical

condition exists, there really is no point in performing a circumcision for nonmedical reasons as

the risks are too great and the benefits are easily refuted. Circumcision for religious purposes

remains important to a number of different faiths but should be practiced with discretion because

parents have the right to refuse as cultural norms should not dictate the masculinity of a boy

based on whether or not he has a foreskin. While female circumcision is considered a crime, both

legally (in the U.S.) and perspectively, male circumcision is viewed with high regard due to its

roots in religion. It is important that this topic remain relevant because it is a human rights issue

simply do to the fact that infants, babies, and toddlers are not old enough to understand the

procedure or what is being done to them, they cannot give consent.

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Works Cited

Denniston, George C., et al. ​Circumcision and Human Rights.​ Springer, 2009. Accessed 04

March 2019.

Marotta, Brendon, director. ​American Circumcision.​ 2017. Accessed December 2019.

Martin Ph.D., Robert D. “Rites of Circumcision.” ​Psychology Today,​ Sussex Publishers, LLC.,

10 Oct. 2018, ​www.psychologytoday.com/us/blog/how-we-do-it/201810/rites-circumcision​.

Accessed 03 March 2019.

Ogunsiji, Olayide. “ Female Genital Mutilation (FGM): Australian Midwives’ Knowledge and

Attitudes.” ​Health Care for Women International,​ Nov. 2015, pp. 1179–1193, doi:

http://dx.doi.org.sinclair.ohionet.org/10.1080/07399332.2014.992521​. Accessed 05 March

2019.

Rex. “Medical Corner... Female Genital Mutilation.” Doctor Rex, 14 June 2013,

http://hrexach.wordpress.com/2013/06/14/medical-corner-female-genital-mutilation/​.

Accessed 01 April 2019.

Shmerling, Rob. "Circumspection For Circumcision." ​Harvard Medical School Commentaries

on Health,​ edited by Harvard Health Publications, 1st edition, 2019. ​Credo Reference​,

https://search-credoreference-com.sinclair.ohionet.org/content/entry/hhphoh/circumspection_

for_circumcision/0#​? Accessed 02 March 2019.

Warren, John. “The Foreskin and the Origins of Circumcision.” ​Church and State​, 27 Nov. 2012,

​http://churchandstate.org.uk/2012/11/the-foreskin-and-the-origins-of-circumcision/​.

Accessed 05 March 2019.

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Yavuz, Mesut, et al. “The Effect of Circumcision on the Mental Health of Children: A Review.”

Turkish Journal of Psychiatry, Mar. 2012, pp. 3–8., DOI: 10.5080/u6508, Source: PubMed

https://www.researchgate.net/profile/Turkay_Demir/publication/221870605_The_Effect_of_

Circumcision_on_the_Mental_Health_of_Children_A_Review/links/54404de20cf21227a11b

a965/The-Effect-of-Circumcision-on-the-Mental-Health-of-Children-A-Review.pdf​.

Accessed 02 March 2019.

Zavala-Offman, Alysa. “The Great Foreskin Debate: Why the Midwest Leads the World in

Infant Circumcision and What the Hell That Says about Us .” ​Detroit Metro Times,​ 1 Oct.

2014,

www.metrotimes.com/detroit/the-great-foreskin-debate-why-the-midwest-leads-the-world-in

-infant-circumcision-and-what-the-hell-that-says-about-us/Content?oid=2251571​. Accessed

01 April 2019.