A Discussion of Circumcision

Sounds like a rousing subject, no?  I thought so too.

Believe it or not, this has been a major topic of conversation at my place of employment this week due to a protest that took place a few days ago.  The hospital I work at has been doing research on the merits of different circumcision devices, and an anti-circumcision group called Intact America staged a protest outside the hospital.

OMG, right? 

In discussing this situation with various co-workers, it struck me that there are a lot of misconceptions about circumcision, its use, its purpose, and its history.  So, naturally, I decided a blog post was in order to provide a little education on the subject.

Though circumcision today is most commonly associated with Jews and Muslims, it has been practiced among humans for thousands of years.  The ancient Egyptians were practicing it, to one degree or another, as far back as 4,500 years ago.

This is a diagram of a carving in a tomb at Saqqara, Egypt, dating from around the time of the pyramids.

It's likely that the ancient Jews picked up the practice from their Egyptian cousins.  In the book of Genesis, when God establishes his "everlasting covenant" with Abraham, he establishes the practice of Jewish circumcision as a requirement for all Jewish males on the 8th day after their birth.  Circumcision, in fact, is not just "a thing" Jews are to do, but it is actually established as the very outward, physical mark of what it means to be a Jew: "it shall be a sign of the covenant between me and you" (Genesis 17:11), and "any male who is not circumcised shall be cut off from his people; he has broken my covenant" (v. 14).

In Luke 2:21, the infant son of Mary and Joseph is circumcised on the 8th day and given the name Jesus, in keeping with Jewish law and custom.

In his teaching life, Jesus is never depicted speaking or teaching about circumcision.  Like other Jews of his time, Jesus would have accepted the practice as the social and religious norm, required by God as a sign of his everlasting covenant with the Jewish people.

It was not until after Jesus's death that circumcision became an issue for his followers.  Like Jesus himself, the earliest Christians were all practicing Jews.  They followed all the Jewish rules and customs, ate only kosher foods, practiced all the sacrificial rites, and celebrated the traditional Jewish holidays, including the weekly Sabbath.  Like all Jews, they circumcised their sons.  However, when Christianity began to spread outward from Palestine into the larger Greco-Roman world, many Greeks and Romans were receptive to the message of Jesus, but not at all keen on "becoming Jewish" - that is, on following Jewish dietary laws or, especially, getting circumcised.  The Jewish leaders of Christianity at that time, namely Peter and James, insisted that new Greek and Roman converts must also get circumcised and become Jewish.

This soon became the source of a major rift among the early Christians, with the apostle Paul leading the charge against circumcision (in the book of Philippians, Paul calls Jewish Christians "dogs" and "evil workers" who "mutilate the flesh.")  According to the book of Acts, James and Peter eventually changed their minds and decided to allow new non-Jewish converts to forgo circumcision, as long as they followed certain dietary laws (Acts chapter 15).

Although conversion to Judaism, along with its required circumcision, continued to exist in small circles of Christianity for the next few hundred years, mainline Christianity after the time of Paul gave up the rite and began regarding it as part of the "old covenant" through Abraham, superseded by the "new covenant" through Christ.  Around A.D. 150 (roughly 100 years after Paul's arguments against circumcision) Justin Martyr wrote that circumcision had become a sign not of the covenant between God and the Jews, but a sign that Jews are "separate" from Christians and the rest of the world, and so that Jews, alone, would receive their "just punishments" from God, which Justin equated to the Roman destruction of Jerusalem and other Jewish towns.  These circumcised Jews, according to Justin, deserved to have their towns and cities destroyed because they crucified Jesus.

This vicious anti-Semite is one of the most beloved of the early Church fathers

A papal bull issued in the 1400's by Pope Eugene IV specifically outlawed the practice among Christians and established that it was a mortal sin which would cause "the loss of eternal salvation."
        
Like Christianity before it, Islam also has roots in Judaism, arising in Arabia in the 7th century A.D. (about 600 years after Jesus).  Islam reveres Abraham, Moses, and Jesus as prophets, but not Paul.  As a result, unlike Christianity, Islam never rejected circumcision.  Muslims, from that time to now, circumcise their sons as part of a religious rite.

With all this history in mind, why then do so many modern Americans, who are neither Jewish nor Muslim, circumcise their sons?

From the time of Paul, up through the end of the 19th century, circumcision was virtually unheard of outside of Muslim nations, Jewish communities, and Coptic Christian communities (a form of Christianity practiced in north Africa).  Folks like George Washington, Thomas Jefferson, and Abraham Lincoln, not to mention their millions of fellow countrymen, were virtually universally uncircumcised.  The Encyclopedia Britannica of 1876 described it as a "bodily mutilation" practiced by Jews and Muslims and generally abhorred by Christian nations.

You know you're picturing it.

However, beginning in the late 19th century, doctors in mainly English-speaking nations began promoting circumcision for a variety of health reasons, claiming it could cure or prevent everything from kidney stones to joint disease.  By the first few decades of the 20th century, the practice had become widespread in places like the U.S., Canada, England, and Australia (it did not ever spread in any significant fashion to mainland Europe, Asia, or South America).

As time passed, however, and medical science progressed, it became apparent that the earlier claims for the health benefits of circumcision were not just untrue, many were patently absurd (one very prominent physician claimed the practice could cure childhood paralysis; another popular theory was that it somehow prevented masturbation).  As a result, circumcision began to decline rapidly in England after World War II, and eventually Canada and, to a lesser degree, Australia, followed suit.

In the U.S., however, circumcision has remained common.  Circumcision is practiced more widely in the U.S. than in any country on earth outside of the Middle East and northern Africa.  The practice is very rare (with rates less than 20%) across Europe, Asia, South America, southern Africa, and Central America.  The World Health Organization estimates that roughly 70% of the world's male population is uncircumcised.  Among those who are circumcised throughout the world, roughly 70% are Muslim.  Among non-Muslims and non-Jews, the U.S. has almost as many circumcised men as the entire rest of the world combined.

Even within the U.S., the practice is not geographically equal: it is far more common in the Midwest and Northeast, and less common in the South and (especially) the West (in the last decade, rates have been has high as 80% in the Midwest, and as low as 35% in the West).

Midwesterner, Rick Santorum.  Probably circumcised.

Westerner, Nancy Pelosi.  Probably not circumcised.

Advocates generally argue that circumcision prevents the spread of STD's and is a form of good hygiene.  Both of these claims are controversial.  According to various studies done in recent decades, STD infection is more likely among uncircumcised men.  However, opponents of the practice argue this is not a good enough reason to remove a portion of the penis, since simple safe sex practices can virtually eliminate the risk of STD's.

As for hygiene, though most acknowledge a need for increased care for uncircumcised people, opponents again argue that this is not a good enough reason for removing part of the penis.  The simple fact is that most human males throughout human history, up through the present day, have not been circumcised, and they've managed their personal hygiene just fine.

Despite how supporters of circumcision point to hygiene and STD prevention as reasons for circumcising boys, a WHO study in 2007 found that, in the United States, social conformity is the most commonly cited reason for parents choosing to circumcise their sons.  The same study showed a strong correlation with the father's circumcision status: 90% of circumcised fathers chose to circumcise their sons, compared with just 23% for uncircumcised fathers.

CONCLUSION

I have two daughters, so I never had to make this decision for my own children.  However, if I had had sons, I would have had them circumcised, and I would have made that choice primarily for social conformity.

Despite that, I am with the opponents of circumcision in spirit.  There simply doesn't seem to be any legitimate reason, in a First World nation, for widespread circumcision of male babies.  Safe sex practices and good personal hygiene eliminate the primary biological arguments for circumcision, and if we stopped circumcising, then the social conformity issue would quickly disappear too.

The simple fact is, the very thought of "female circumcision" is shuddered at and referred to as "ritual genital mutilation" (see this fact page from the WHO), yet the same standard is not held for mutilating the genitals of boys.  The foreskin is not an evolutionary accident; it's there for a reason.

In my opinion, there really doesn't seem to be any good argument for continuing its practice on a widespread basis, especially in developed countries where safe sex practices and good hygiene are the norm.