THE CIRCUMCISION REFERENCE LIBRARY
[A submission in December 1996 to the Law Commission for England and Wales in response to Consultation Paper Number 139 - Consent in the Criminal Law]
Copyright © Christopher Price 1996
CONTENTS
The function of the criminal law "is to preserve public order and decency, to protect the citizen from what is offensive or injurious, and to provide sufficient safeguards against exploitation and corruption of others, particularly those who are specially vulnerable because they are young, weak in body or mind, inexperienced, or in a state of special physical, official or economic dependence" 1.
`Circumcision is not an operation to be undertaken lightly and if it is to be performed in Great Britain it is probably best performed in a hospital environment, in an older child as a general anaesthetic day-case' 2.
This paper intends to examine the issue of nontherapeutic male circumcision, in the light of the Law Commission's Consultation Paper No 139 (`The Consultation Paper'), and its lawfulness for ritual and nontherapeutic reasons. By `non-therapeutic' is meant any circumcision which is not to treat an existing disease process or bodily abnormality; a circumcision is a form of proper procedure only where there is a disease process or abnormality and treatment by other conservative methods is, or on genuine medical grounds is considered to be, medically inappropriate and/or less invasive treatments have been tried but have failed. [See also in Secretary, Dept. of Health and Community Services v. JWB and SMB per Brennan J 2A]
This paper does not seek to comment on the Consultation Paper generally; nor does the paper seek to comment on Appendix C of the Consultation Paper, which discusses certain philosophical issues, except that the continuing lack of a rigorously thought-through philosophical position is a clear defect in the Consultation Paper.
Further, it would be inappropriate for this paper to rehearse in any great detail the reasons why male circumcision medically cannot properly be regarded as harmless; that is dealt with fully by others elsewhere. This paper will simply and briefly describe the 3 areas where medical studies have demonstrated harm, give some sample references to medical papers by way of illustration only and will proceed on the basis that the contention in the paper that it is `generally accepted that the removal of the foreskin of the penis has little, if any, effect on a man's ability to enjoy sexual intercourse, and this act is not, therefore, regarded as mutilation' is wholly false: and from that position, to examine the legal consequences that flow therefrom.
It has been thought right to touch on the burden of proof which, it is suggested, lies on those who would continue this procedure; and, in view of dispute as to whether or not circumcision is a mutilation to give some illustrative definitions of that word. Equally, because of the antiquity of the practice, the religious and tribal overtones to it, and the myths that have grown up around it-not least from the `masturbation-phobia' of the 19th century to the pseudo-science of more recent years - it seems right to devote some space in this paper to an examination of this history of this procedure.
The general rule is that he who avers, proves.
Circumcision involves the amputation of a body part; when done for ritual, cultural or social reasons, the part amputated is healthy flesh from the healthy organ of a healthy male and those who say that it is proper to do it, and would do it to another without that other's consent, are required to justify the alleged propriety and to justify this interference with the bodily integrity and functioning of that other.
The specific assertions usually made are that:
It is not for those who would have children left intact and uncircumcised to demonstrate that circumcision is damaging (and unless required for clear therapeutic reasons, unjustifiable); although, were it to be wrongly suggested that the burden were so laid on them, it is suggested that this paper has discharged that burden.
Rather it is clearly for the circumcisers, not least in the light of mainstream medical knowledge and current legal concepts, to make good their general and specific assertions, by careful and rigorous evidence, arguments and refutation of the medical and legal position. Mere repetition of these assertions, as in the Consultation Paper, particularly in paragraphs 9.1 and 9.2, are valueless. Mere assertion that ritual circumcision is seen as a religious duty is equally valueless in discharging the burden of proof: it may provide a reason but does not provide a justification, or in other words it may explain but does not excuse.
The use of the word `mutilate' or `mutilation' to describe circumcision is hotly opposed by those who circumcise for non-therapeutic reasons; hence also the defensive, medically-refuted and incorrect assertion (`incorrect' since it takes no account of the facts nor of the definition of the word `mutilate') at the end of the second sentence of paragraph 9.2 of the Consultation Paper.
"Language often reveals more about ourselves than we intend and our choice of words can show the way we humans idealise things that we might otherwise see in a different light. The stunted deformed feet that resulted from foot-binding of Chinese girls were called `Golden Lotuses' and were considered highly attractive and desirable. Their counterpart --normal feet -- were seen as gross and ugly. Similarly, The Layman's Guide to the Covenant of Circumcision [by Rabbi Jacob Schechet] calls circumcision the `Golden Circle'" and "...a rabbi writing of his own struggle between protective parental instinct and the cultural mandate to circumcise his newborn son refers to the intact penis with its foreskin as a `stopped-up dullness'" quoted by Boyd 3.
The use of the concept of mutilate/mutilation in connection with circumcision is resisted both by those who wish to continue the practice; and by many circumcised men, for whom the process of denial of their own damage is fragile, so as to cope with the destabilising effect on themselves and others of a description of such accuracy and directness. The resulting contortions to avoid such uncomfortable words and/or to re-define them in an attempt to exclude circumcision are worthy of Humpty Dumpty.
Yet the word `mutilation' as defined in its ordinary sense, as well as by medical dictionaries, is wholly apt to describe the result of this procedure. Thus:
Mutilate
`1. To deprive (a person or animal) of a limb or some principal organ of the body; to cut off or otherwise destroy the use of (a limb or organ)
`2. To render (a thing, esp. a record , book etc.) imperfect by cutting off or destroying a part.' Oxford English Dictionary OUP 1971.
`Injure, make imperfect or inefficient, by depriving of a part.' The Pocket Oxford Dictionary (4th Edition 1942, revised 1946)
`Implies the cutting off or removal of a part essential to completeness, not only of a person but also of a thing, and to his or its perfection, beauty, entirety or fulfilment of function.' Webster's New Dictionary of Synonyms: a Dictionary of Discriminated Synonyms and Analogous and Contrasted Words (1968)
Mutilation
`1. The action of depriving (a person or animal ) of a limb or of the use of a limb; the excision or maiming (of a limb or bodily organ).
`2. The action of rendering (a thing) imperfect by excision or destruction of one or more of its parts.' Oxford English Dictionary OUP 1971.
`Disfigurement or injury by removal or destruction of any conspicuous or essential part of the body.' Stedman's Medical Dictionary (26th Edition) 1995
`The act of depriving an individual of a limb, member, or any other important part; deprival of an organ; severe disfigurement.' Dorland's Illustrated Medical Dictionary (28th Edition) 1994
`Maiming; the act of removing or destroying a conspicuous or essential part or organ.' Taber's Cyclopedic Medical Dictionary (17th Edition) 1993
Given that many circumcisions are performed by doctors and also given that, even though the Oath may not now be formally administered, its priciples are as applicable today as ever, both to doctors and all others performing surgery or medical treatment on another, it is appropriate to cite an extract from the Hippocratic Oath4:
"The regimen I adopt shall be for the benefit of my patients according to my ability and judgement, and not for their hurt or for any wrong....Whatsoever house I enter, there will I go for the benefit of the sick, refraining from all wrongdoing or corruption."
Typically and incorrectly, male circumcision has been seen in the past by the lay public, as `a minor snip', and so described by many especially in popular magazines; the foreskin is variously described as `a vestigial piece of skin' or `redundant'.
Whilst circumcision is not now routinely carried out in Britain for non-religious reasons, as it used to be from the 19th century until circa 1950, there are still those who wish to perform it on their children for non-ritual reasons and from time to time there are calls for its wider use: thus, Beth Raleigh in Your Sex Organs, 40 Fascinating Facts (August 1994 SHE) when she wrote that neonatal circumcision "can have health benefits."
Or it is seen a procedure conducted by Jews on the 8th day after birth or by Muslims and members of some other religions/ethnic groups as a slightly odd but essentially harmless ritual.
It is difficult to obtain exact figures for the number of circumcisions performed each year in Britain.
Gordon and Collin5 say that nearly 7% of boys in Britain will be circumcised by age 15, and they suggest that this number is well in excess of those for whom medical reasons demand circumcision (they suggest that the proper number will be between 1% and 2%). By contrast, Finland manages to circumcise only 6 per 100,000 males (a figure of 0.006%).
According to the NHS Executive6, the figures for operations on the prepuce are:
1991/92: 36,644
1992/93: 37,586
1993/94: 36,403
These figures will however only include procedures carried out in hospital, and will exclude those performed outside hospital either privately and/or by General Practitioners; they will however include a number of circumcisions done for purely ritual reasons.
According to a discussion, earlier this year, on BBC2's Newsnight some 30,000 ritual circumcisions are done each year; whilst some of these will be included in the NHS figures, some will represent additional circumcisions. What one can say, with confidence, is that the vast bulk of the circumcisions will be for non-therapeutic reasons (as defined) and will be well in excess of 36,000 and may approach 67,000 each year.
Whatever the reason for its being done, it is popularly seen (vide the populist and unsupported remark in paragraph 9.2 of the Consultation Paper) as having few risks or ill-effects for the male and, by some, as offering a range of medical benefits, the breadth of whose claims and whose persistence in the face of medical refutation is a demonstration that strong and hidden forces are at work. That in the neonate it is usually performed without anaesthesia raises no eyebrows, since the traditional thinking was, and still is, that the neonate does not feel pain.
Circumcision, as is now well recognised by doctors, has three main areas of physical harm, which, in brief are:
Circumcision is very painful and increasingly, despite the inherent risks of any anaesthesia, doctors performing neonatal circumcision now give some form of anaesthesia; however, the Jewish Bris Milah and, in many cases, Muslim circumcisions are carried out without anaesthesia.
For most of this century, the bulk of medical literature stated that newborn boys were insensitive to pain and would not, therefore, need risky anaesthesia for circumcision. "This myth was based on the fact that much of the peripheral nervous system has still to develop the myelin that insulates the nerve fibres, hence the inability of newborns to co-ordinate muscle movement etc. Without myelin, the fibres concerned are unable to pass integrated or high level messages. It is extraordinary that medically trained professionals could not recall that all pain messages are carried by thin unmyelinated fibres of the pain and temperature tracts that are unrelated to the myelinated motor and discriminatory sensation pathways. Far from being incomplete in their development at birth, the pain pathways are probably the most developed peripheral neural tracts."7
Remarks such as: `He slept through the whole thing' are often used. What is seen as `sleeping through' the procedure is however a form of shock or semi-coma from the trauma. Dr Justin Coll, infant psychologist and Professor in Chief of Child and Adolescent Psychology at the University of California, is quoted in Romberg Circumcision: The Painful Dilemma, as saying: that infants being circumcised `can lapse into a semi-coma' which is an `abnormal state in the newborn'.
Dalens 8 writes: "Pain in paediatrics has long been underestimated. The numerous scientific studies carried out during the last decade show that its existence can no longer be doubted: in fact, pain already exists during the neonatal period, and probably throughout the last trimester of gestation as well. Pain pathways mature during the embryonic period and peripheral receptors develop between the 7th and 20th week [of gestation]. Spinal roots and nerves are completely differentiated before the second month [of gestation]. Assessing pain, already a difficult task in the adult, is all the more so in children because of lesser verbal communicative capabilities, difficulty in handling abstract concepts, lack of experience of painful stimuli to make comparisons, and ignorance of their body image. [In diagnosing pain] behavioural tests remain the mainstay until the prepubertal period."
Because of the danger of administering general anaesthesia to babies under 6 months of age, and the pain and risks of tissue damage of administering local anaesthetics to the penis, circumcisions in this age group are still mostly performed without any anaesthesia to this day. Parents are not usually told that their sons will go through this agony.
"There is no doubt that circumcisions are painful for the baby. Indeed, circumcision has become a model for the analysis of pain and stress responses in the newborn. Not only does the unanesthetized newborn cry vigorously, tremble, and, in some cases, become mildly cyanotic because of prolonged crying, but other stress-related physiological reactions have also been demonstrated, including dramatic changes in heart and respiratory rates and in transcutaneous oxygen and plasma cortisol levels.": H.J. Stang et al9.
Taddio et al.10 studied the effects of neonatal circumcision pain on later sensitivity to pain. They found that the effects of this pain were detectable in later childhood; but then arrived at the incorrect conclusion that, instead of not circumcising, there should be pain-relief given for circumcisions.
Dr R Van Howe writes:11
"The work of Gunnar,12 Marshall13, and others,14 show that the behaviour and physiologic responses to neonatal circumcision have been well established. Although a few physicians such as Weiss15 claim the newborn does not experience pain, most informed physicians now agree that neonatal circumcision is painful and recommend local anesthetic for the procedure. Performing this extremely painful procedure without anesthetic has allowed researchers to study the parameters of extreme pain in experiments that would not have been allowed on laboratory animals.
"Using routine, unanesthetized circumcision as a model of stress, Porter et al. were able to examine the relation between cry acoustics and vagal tone in 49 (32 experimental; 17 control) 1 to 2-day-old, full-term normal, healthy newborns during the preoperative, surgical, and postoperative periods. Vagal tone was significantly reduced during the severe stress of circumcision. These reductions were paralleled by significant increases in the pitch of the infants' cries.
In addition, individual differences in vagal tone measured prior to circumcision surgery were predictive of the physiological and acoustic reactivity to subsequent stress.16
"Two studies by Marchette's group looked at non-medical nursing interventions to alleviate the pain associated with circumcision. In the first, neonates were randomly assigned to one of three intervention groups: 18 infants received routine care, 15 infants had music played, and 15 infants had a tape of intrauterine sounds played. During circumcision, monitors measured cardiac rate, rhythm, blood pressure, and transcutaneous oxygen. Pain was measured by analysis of videotaped facial expressions. The mean heart rate was above normal limits during all steps of the circumcision for the control group and during some of the steps for the other two groups. Analysis of the facial expressions showed that all three groups expressed pain much more than any other emotion during the procedure. Unfortunately, the two interventions were unable to offset the effects of circumcision pain.17
"The second study assessed the effectiveness of some noninvasive pain reduction interventions in 121 neonates undergoing unanesthetized circumcision. Subjects were randomly assigned to one of six groups: classical music, intrauterine sounds, pacifier, music and pacifier, intrauterine sounds and pacifier, or no interventions used while heart rate, rhythm, dysrhythmias, blood pressure, transcutaneous oxygen, rate pressure product, and behavioral state were measured during 14 circumcision steps. Over the 14 steps, 42% of the heart rates, 78% of the systolic blood pressures, 30% of the diastolic blood pressures, and 81% of the transcutaneous pO2 pressures were abnormal. Again, few significant differences were found among any of the steps."18
Circumcision has been described as "among the most painful [procedures] performed in neonatal medicine"19 and the pain therefrom as "severe and persistent"20 and of a level which "would not be tolerated by older patients"21
Walco et al. write22:
"Many myths about pain in children have been discredited. One myth was the belief that very young infants do not have the neurologic capacity to experience pain. Neuroanatomical studies, however, have shown that by 29 weeks of gestation, pain pathways and the cortical and subcortical centers involved in the perception of pain are well developed, as are the neurologic systems for the transmission and modulation of painful sensations 23. Behavioral24 25 and physiologic26 studies have shown that even very young infants respond to painful stimuli. Premature infants undergoing surgery with minimal anesthesia, which was once standard practice, have significantly higher stress responses (by hormonal and metabolic measures) and significantly higher rates of complications and mortality than those given deeper anesthesia.27 28
"A related misunderstanding is the belief that even if very young children experience pain, they have no memory of it, and therefore it has no lasting effect. However, recent studies have concluded that pain and distress, such as those associated with circumcision, can endure in memory, resulting, for example, in disturbances of feeding, sleeping, and the stability of the state of arousal 29. Preliminary data even suggest that early experiences of pain may produce permanent structural and functional reorganization of developing nociceptive neural pathways, which in turn may affect future experiences of pain 30.
"Another belief that has been dispelled is that children's pain cannot be measured accurately. Pain in children can be assessed through physiologic indicators, systematic observation of behavior, and reports by the children themselves 31."
Circumcision is a procedure which carries risks which have been described as high as some 50%; of course, if the inevitable diminution of sexual function is counted as a complication (as would seem to be wholly sensible a course), then the complication rate is 100%. It is far from easy to obtain definitive figures for the rate of complications as conventionally defined.
When the United Kingdom medical profession and the NHS decided to abolish routine circumcision after the publication of Gairdner's landmark paper in 1949 [op. cit. at n 78], one of the reasons cited was the high death rate: this ranged from 10-19 per annum nationally in circumcised boys under 5 years of age in a country that did not perform wholesale circumcision (e.g. during the same period as these death rate figures, one representative city had a circumcision rate of only 5-8%). Because most of the deaths following circumcision result from conditions secondary to the surgery (e.g. infection or haemorrhage) the records kept have usually shown the actual mortal condition rather than the primary medical event that induced it. So it is not surprising that a number of reviews of the procedure have remarked on the difficulty in obtaining realistic mortality rates.
As Gellis32 has more recently observed:
"It is an incontestable fact at this point that there are more deaths each year from complications of circumcision than from cancer of the penis."
Illingworth in his standard textbook has noted:33
"Most practising paediatricians have seen unfortunate consequences from the operation of circumcision, and seen or personally heard of death directly resulting from it."
The Journal of Urology (Baltimore) puts the figure for the risk of complications at 1.5% to 15%.34
Williams and Kapila35 offer a `realistic figure of 2% to 10%'. However, they also comment that the incidence of meatal ulceration following circumcision is from 8% to 20% which would seem to suggest that their rate of complications is on the low side. They write: "Meatal stenosis is generally a direct consequence of circumcision that is seldom encountered in uncircumcised men; meatal calibre is known to be greater in uncircumcised individuals. The incidence of meatal ulceration is from 8 to 20 per cent....Meatal stenosis following circumcision has been advanced as a cause of recurrent pyelonephritis and obstructive uropathy, for which meatotomy is curative."36.
Patel's37 is the only longitudinal study beyond the first few months which studied the true extent of complications; as many of the complications arise in later years, his are the most reliable as shown by the high figures he obtained. He reported a rate of 24% of serious complications.
Apart from the problems of differing and varying diagnostic criteria employed, there are indications that complications and mishaps are being misreported or not reported at all. The Editorial comment38 in 1996 British Journal of Urology, commenting on a case report by Neulander and others, which describes an amputation of the distal penile glans following ritual circumcision as a `rare complication', observes: "The authors report what they describe as a rare complication....Fistula formation, lymphoedema and iatrogenic hypospadias have all been reported. Most amputations are almost certainly not reported. I have seen half a penis amputated in a 4-year-old boy during a ritual Muslim circumcision. The penis was left by the General Practitioner surgeon in the waste-paper basket of his surgery."
Dr Van Howe39 summarises the following complications as having been reported in the medical literature: acute obstructive uropathy40 and acute renal failure,41 penile ischemia,42 necrosis,43 buried penis,44 penile and glans amputation,45 iatrogenic hypospadias,46 severe hemorrhage,47 total denudation of the penis,48 infections including Staphylococcus aureus,49 Escherichia coli,50 meningitis,51 staphylococcal scalded skin syndrome,52 Group B hemolytic Streptococcus sepsis,53 erysipelas,54 impetigo,55 neonatal septicemia,56 tuberculosis,57 scrotal abscess,58 death,59 meatal stenosis,60 abdominal distension,61 adhesions and preputial skin-bridging,62 penile tourniquet syndrome,63 methemoglobinemia,64 gangrene of the penis65 and scrotum (Fournier's syndrome), pneumothorax, Plastibell retention, urethral fistula, meatal ulceration, keloid formation, ruptured bladder, gastric rupture, urethral strictures and stenosis, tachycardia and heart failure, myocardial injury, acute urinary retention, iatrogenic burns, pulmonary embolism, impotence (in adult men), chilling, phimosis, unilateral leg cyanosis, and cosmetic result not achieved and re-circumcision requested..
The victim (to use the Commission's own word, which here seems wholly apposite) will suffer from inevitable deficits, viz:
Removal of the prepuce removes specialised tissue and nerves designed for sexual pleasure. Taylor et al.66 write:
"clearly, the penis is a complex organ with many different parts, each specialized for a specific role. The prepuce provides a large and important platform for several nerves and nerve endings. The innervation of the outer skin of the prepuce is impressive 67; its sensitivity to light touch and pain are similar to that of the skin of the penis as a whole. The glans. by contrast, is insensitive to light touch, heat, cold 68 and, as far as the authors are aware, to pin-prick. Le Gros Clark 69 noted that the glans penis is one of the few areas on the body that enjoys nothing beyond primitive sensory modalities."
This insensitivity elicited the comment70 "that the glans penis has been documented to have unusually low (emphasis added) sensitivity (high threshold) to mechanical stimulation. Von Frey71 found that the only the portion of human skin less sensitive to mechanical stimulation was a callus on the sole of the foot.
The loss of some one-third (or an area in the adult of some 15 square inches) of penile skin, removes the skin within which the penis should move during intercourse and masturbation, producing a feeling of `tightness' during an erection.
"Like many boys of my generation in Britain, I was circumcised in infancy by a doctor. I grew up knowing that something had been removed from my penis as my older brother was intact, but was told that this did not matter. The glans was always uncomfortable when rubbed by clothing throughout childhood and on into adult life, so that I always looked for tight supportive underwear to minimise friction. The discomfort was poorly localised, and it is only recently that I have realised that my intolerance of boxer shorts was the direct result of circumcision.
"The shaft skin was very tight during erection, though I never thought of this as abnormal as I had nothing to compare with. Masturbation was often accompanied by laceration of the skin, so that I learnt to masturbate wearing a condom. I married 25 years ago and at first there were problems of dyspareunia from time to time which we attributed to vaginal dryness, as I considered myself normal. We overcame this by use of artificial lubricants. As time went on we explored ways of maximising our sexual enjoyment. I observed that there was remarkably little sensitivity in the glans, the skin of which seemed to thicken with advancing years. I remarked on this to my wife, who thought it strange. It was when I observed that the most sensitive part of my penis was the skin between the circumcision scar and the glans, that I began to realise for the first time how much I had been harmed by circumcision. This skin was the remnant of the inner lining of the foreskin, the remainder of which had of course been amputated. I assumed there was nothing whatever to be done about this tragedy, and I resolved to make the most of what was left"72.
All too often, however, considerably more skin than that is removed; and losses of 60%+ of the total penile skin are far from uncommon.
The glans is exposed to daily assaults and trauma from infections, urine and faeces in the nappies and to life-long abrasion from clothing; and becomes dry, wrinkled and covered with a layer of keratin (or, as some have described it, becomes `cornified')and insensitive and able to tolerate touch which an intact man cannot. As such it is wholly unlike the glans of an intact man whose glans is smooth, glistening and sensitive to touch. Warren and Bigelow73 write:
"Bigelow The Joy of Uncircumcising74 reports that the prepuce has four functions. Firstly, it is itself sensitive due to the nerve endings on its inner surface, which become exposed during sexual arousal. Secondly, it protects the glans.
"The protected glans remains soft, moist and sensitive throughout life, but the exposed glans of the circumcised male becomes increasingly thickened and desensitised. Were this not so it would be impossible for a circumcised man to tolerate the abrasion of clothing on the exposed glans. Thirdly, the mobile sheath of skin on the intact penis allows the prepuce to slide back and forth over the glans during foreplay and intercourse. Ritter calls this action `the pleasure dynamic'. Fourthly, it provides slack skin on the shaft of the erect penis allowing it to glide within its own sheath of skin during intercourse. This provides for more enjoyable intercourse for both partners and avoids problems with vaginal dryness."
Others too have earlier described the prepuce as one of the most sensitive parts of the penis and its potential for enhancing sensation during sexual intercourse; and the development on the exposed glans of dermal layers up to 12 times the skin thickness, which has been described as the formation of a cornified layer-an additional outer covering of compressed dead cells which as a result of this `scarification' process may render the penis less sensitive.75
All too often, one hears supporters of circumcision claiming that they have not been harmed, that their sexual life is unimpaired and, even, that they `could not cope with any more sensitivity'. No one would claim that circumcision renders the man incapable of procreation. Rather the analogy is of a person blinded at birth in one eye: he can still see and in most respects lead, with his remaining vision, a useful and functional life; but what he cannot know, and can never experience, is the function and quality of life with binocular vision —those of us with full vision can only feel pity, and sorrow, for his loss even whilst we might commend his ability to cope with his disability. Further, that some circumcised men, being unaware of the diminution of sexual pleasure which they have suffered, are content with the what remains of their sexual pleasure is neither convincing as to there being no losses, nor an argument for imposing those on another.
Douglas Gairdner76 wrote of the function of the prepuce:
"It is often stated that the prepuce is a vestigial structure devoid of function. However, it seems to be no accident that during the years when the child is incontinent the glans is completely clothed by the prepuce, for, deprived of this protection, the glans becomes susceptible to injury from contact with sodden clothes or napkin. Meatal ulcer is almost confined to circumcised male infants, and is only occasionally seen in the uncircumcised child when the prepuce happens to be unusually lax and the glans consequently exposed (Freud, 1947).
"There remain a number of more or less trivial factors which are sometimes mentioned as reasons why infant circumcision is desirable: difficulties in keeping the uncircumcised parts clean, or the supposed aesthetic or erotic superiority of the shorn member. In order to fulfil the intention of this paper an inquiry on these points should have been made amongst a group of uncircumcised men. This was not attempted, although with regard to the last two of the factors mentioned it should be stated that whenever the subject has been broached in male company those still in possession of their foreskin have been forward in their insistence that any differences which may exist in such matters operate emphatically to their own advantage.
"Moreover, if there were sensible disadvantages in being uncircumcised, one would expect that the fathers of candidates for circumcision would sometimes register their feelings in the matter. Yet in interviewing the parents of several hundred infants referred for circumcision I have met but one father who wished his son circumcised because of his disagreeable experience of the uncircumcised state. The rest of the fathers were equally indifferent about the matter whether they themselves had been circumcised or not. Indeed, so little did the father's personal experience seem important that onequarter of the mothers did not even know whether their husbands were or were not circumcised. These facts provide some evidence that few uncircumcised men have cause to regret their state."
See also, for another view from this period, Daniel Whiddon77:
"The glans belongs to the group of special sense organs. It is almost insensitive to light touch, has no appreciation of heat and cold, and interprets painful stimuli (such as a pinprick) only as a vaguely unpleasant contact; ..... The preservation, undulled and undiminished, of this special sense that the glans can receive some sexual sensations], and the guarding of the mucous membrane in which it resides from constant exposure and a dulling of its sensibility, is of paramount importance ..... A second less important function is in the act of coitus itself. The erect uncircumcised penis enters the vagina without effort or at any rate without friction, the prepuce unfolding as the penis advances and each part of it remaining in contact with successive areas of the vaginal walls, till finally the uncovered glans lies at the cervix. The circumcised penis, deprived of this self-tracking mechanism, is introduced to the accompaniment of friction between penile skin and vaginal mucous membrane. it is the difference between slipping the foot into a sock that has been rolled up and one that is held open by the top. The human foreskin, then, is neither vestigial nor useless. It is part of the normal mechanism of reproduction, and without it sexual desire is to some extent blunted, and the performance of the sexual act -at any rate the first act of coitus between the virgin male and the virgin female — made more difficult. ..... Apart from those evil results which are due to imperfect workmanship, there are the fairly common minor troubles that follow because a stupid and unnecessary operation has been done, a normal mechanism has been destroyed, and a delicate surface has been exposed to the air and to friction 4 or 5 years before it should be exposed. Eczema of the glans and meatus is not rare in the newly circumcised infant; it needs careful treatment with ointment and sometimes leads to scarring and narrowing of the meatus. These are the facts....the medicine of the jungle and the witch-doctor, the teaching of the Bible and the Koran, the traditional science of the midwife, the health visitor, and the Home Medical Dictionary, are all against us....Nonetheless, let us keep our own sanity. When we meet those who advocate this mutilation, let us ask them why they do it and again why: they have seldom asked themselves. When we meet a young mother whose mind is her own and not someone else's gramophone record, let us ask her if she thinks it likely that Nature would bring 1000 English children into the world every day, well formed in all respects except this one; if it is not more likely that Nature is right and the folk-medicine that tries to improve on her is wrong......let us not commit the sin against the Holy Ghost by concealing from ourselves that it is foolish..Daniel Whiddon."
Even discounting the `anti-masturbatory' reason, discussed below, for circumcision (and the so-called hygiene grounds, which for the Victorians carried the message of moral cleanliness) and which became disproved by circumcised boys who still masturbated, the claims for benefits for circumcision other than as a religious or ritual observance are as myriad as they are discredited. Thus, for example, the claim of hygiene in the sense that the word is understood to-day as referring to bodily cleanliness and cited by the Commission, is disproved even by the pro-circumcision biased Task Force on circumcision of the American Academy of Pediatrics in 1989.78
The claims still often (indeed, one might almost say invariably) made by circumcisers as benefit(s) flowing from circumcision include the following:
- Hygiene.
- Prevention of phimosis and paraphimosis
- Prevention of balanoposthitis and balanitis).
- Prevention of cervical and penile cancers.
- `Better done at birth than later'
This is still the most persistent of the myths that surround circumcision; indeed it is the prime reason why Muslims feel compelled to circumcise. Yet the American Academy of Pediatrics' own Task Force on circumcision (op. cit.) has, notwithstanding a pro-circumcision bias, concluded that ordinary and regular washing serves just as well as circumcision. Thus: "It is particularly important that uncircumcised boys be taught careful penile cleansing. As the boy grows, cleansing of the distal portion of the penis is facilitated by gently, never forcibly, retracting the foreskin only to the point where resistance is met. Full retraction may not be achieved until age 3 years or older."
Dr Terry Russell79, an Australian general practitioner, is typical of the muddled, emotive, un-researched and wholly unthought-out advocate of circumcision for `hygiene' reasons: "What man after a night of passion is going to perform penile hygiene before rolling over and snoring the night away (with pathogenic organisms multiplying in the warm moist environment under the prepuce)": to which one can only say that there is no evidence educed of `pathogenic organisms' and that the woman, who is just as likely to `roll over and snore the night away' will have her, much more convoluted, internal and thus retentive, genitals bathed in her and her partner's fluids. Further, the argument for the ease of cleaning claimed for male circumcision has not lead to demands in any civilised country for excision of the clitoral hood and the labia in infant girls (who, despite also producing smegma) are relied upon to wash.
Van Howe (op. cit. at n8) observes:
"If left alone, the micro-environment of the preputial space maintains a delicate pH and bacterial balance. If disturbed through retraction or `cleaning', friendly bacteria are killed, and more aggressive pathogens are free to colonize mucosal tears and, potentially, the urinary tract itself. It has also been established that soap will dry out the preputial mucosa leading to inflammation and infections such as balanoposthitis and recurrent balanitis80." He also observes: "The importance of this advice [against forcible retraction by parents and doctors] cannot be over-emphasized. The experience of the author has been the same as Watson's,81 namely, every intact boy that I have seen with complications (i.e. phimosis, urinary tract infection, balantitis) have all had their foreskins prematurely and forcibly retracted by a physician or had the parents forcibly retract the child's foreskin at the physician's insistence."
Kayaba et al.82 found the same: infection of or under the prepuce was not a function of unretractability of the prepuce, but rather of poor hygiene. They found in a study of 608 boys that none were type V under the age of 1 and that the numbers of a Type V prepuce increased with age; the incidence of balanoposthitis was only 1.5% and 7 boys were aged 1 to 5 years (and the infection, they suggested, owed more to poor penile hygiene than a foreskin).
Of course, without a foreskin the chances of phimosis (a narrowing or stenosis of the foreskin which prevents full retraction of the foreskin) are either reduced (van Howe has described finding phimosis in circumcised boys) or eliminated: one might equally say that amputation of the toes will eliminate the chances of athlete's foot — yet no one seriously would propose that as a method of prevention and treatment is by less invasive means when and as needed. Yet what is clear is that, particularly in the United States but also in Britain, phimosis is `diagnosed' when it is simply not present: The penis develops with the glans `fused' to the foreskin and few boys will have a free and retractile foreskin at birth: separation occurs over the following years, but whilst many will have achieved this by age 5, some will not until as late as age 17. It is a misdiagnosis, suggestive of a fundamental ignorance of the basic anatomy, and development. of the boy's penis to diagnose phimosis in a young child; yet the usual `justification' in the United States for, and the reason given for a claim on health insurers, routine neonatal circumcision is phimosis (usually coupled with the comment `redundant foreskin'). Øster's observations83 for older boys in a Danish population, where circumcision is rarely practised, showed that non-retractability is found in 8% of 6-7 year-olds, in 6% between 8 and 11 years, 3% at 12-13, and only 1% at age 14-17. He also showed that preputial adhesions decreased with advancing age in the boys in the study, so that these were present in 63% of 6-7 year-olds, but only 3% of 16-17 year-olds. More recently Kayaba et al. (op. cit.) have found the same; and they conclude that: "We agree with Wallerstein that in the absence of emergency medical problems the prepuce of infants should remain uncircumcised. CONCLUSIONS In most male individuals preputial separation continues until adolescence, presumably to protect the immature glans penis. Physicians as well as parents should be familiar with the biological role and natural development of the prepuce. Whilst surgery must be considered in the presence of paraphimosis or dysuria associated with phimosis, few boys require circumcision until adolescence when the only reason for this procedure is poor preputial retractability."
Where there is genuine phimosis or paraphimosis, then recent work has indicated that treatment with steroid creams or preputioplasty can treat the problem in the bulk of cases, thus saving the foreskin with its nerves and other functions84; apart from boys suffering from the rare condition of balanitis xerotica obliterans, the prepuce is usually saveable.
The claims of a reduction, or even hints of the elimination, of cancers of the cervix and penis (a disease of a tiny number of elderly men) have been discredited; Denmark and Japan, mainly uncircumcised countries, have a lower rate than the United States and, to put the disease in perspective, some 9,600 men die annually in Britain of cancer of the prostate. In view of the continuation, despite clear refutation in the medical literature, as to these claims, it is worth quoting from a letter to Dr Peter Rappo, of the American Academy of Pediatrics, dated 16 Feb 1996 and from Drs Hugh Singleton and Clark Heath, the National Vice President and Vice President, of the American Cancer Society:
"...we would like to discourage the American Academy of Pediatrics from promoting routine circumcision as a preventative measure for penile and cervical cancer. Research suggesting a pattern in the circumcision status of partners of women with cervical cancer is methodologically flawed, outdated, and has not been taken seriously in the medical community for decades. Penile cancer rates in countries which do not practice circumcision are lower than those found in the United States. Fatalities caused by circumcision accidents may approximate the mortality rate from penile cancer."
The incidence of problems involving the prepuce is low: as has been discussed, the incidence of true phimosis is
low, and certainly under 2% —- and probably of the order of 1% or less: Finland circumcises at the rate of 6 per 100,000 (or 0.00006%)85. An adult, or even an older boy will be able to understand why, assuming that more conservative and less invasively mutilating treatments have not worked, it is necessary to suffer this; he will be old enough (in his adolescence or older) to have anaesthesia and post-operative analgesia; his synechia will be wholly or largely dissolved (thus avoiding the stripping of them with trauma and subsequent scarring of the glans and resulting further loss of sensitivity); and his penis will be grown enough for a careful and calculated amputation to be made thus avoiding extra disfigurement, rather than the guess-work for an infant penis; and healing is usually uneventful. The claims that circumcision "hurts more in later life" are made, usually, by those circumcised ritually at birth or early childhood who therefore do not know from personal experience what they are talking about and who offer, as usual, not one scrap of evidence in support of their claims.
To the `traditional' and well-debunked claims, the following `new', and equally unscientific, candidates have recently emerged:--
Now, perhaps as a measure of the desperation of circumcision's supporters to find a reason to continue, it is suggested as a preventive against UTIs, AIDS and other sexually transmitted diseases (on the basis, according to some US doctors,86 that the keratinised layer on the glans acted as a form of condom!). If that were indeed so then one would not expect to find rates of HIV infection in the USA, a mainly circumcised population, some 8 times that of Britain and the rest of mainly uncircumcised Europe, and on a level with Sub-Saharan Africa.87
The `best' that the American Academy of Pediatrics could come up with in their Task Force report (op. cit.) was:
"Evidence regarding the relationship of circumcision to sexually transmitted diseases is conflicting. Early series indicated a higher risk of gonococcal and nonspecific urethritis in uncircumcised men, whereas one recent study shows no difference in the incidence of gonorrhoea and a higher incidence of nonspecific urethritis in circumcised men. Although published reports suggest that chancroid, syphilis, human papillomavirus, and herpes simplex virus type 2 infection are more frequent in uncircumcised men, methodologic problems render these reports inconclusive."
Van Howe (op.cit. at n8) concludes, after an exhaustive review of the literature:
"There is no compelling evidence that circumcision protects an individual from sexually transmitted diseases, especially in a developed nation setting, and to depend on circumcision to protect an individual from contracting these illnesses would be naive and foolhardy. The non-medical factors that are used to reach a decision concerning neonatal circumcision are probably more important a factor in developing sexually transmitted diseases than the presence of the foreskin. At this point, until studies prove otherwise, circumcision cannot be recommended as a preventative measure against sexually transmitted diseases."
Indeed, it has been suggested by some that the circumcised male, lacking the natural mobility of skin afforded by the foreskin and lacking the sensitivity both of which makes intercourse such a labour for the circumcised, might be more vulnerable to tears in the penile skin than the uncircumcised; thus giving a readier access to the HIV virus and other pathogens; but no real research seems to have been conducted to test this theory.
The work relied upon for this latest `scare-tactic' by circumcisers is that of Wiswell, a US Army doctor. Yet the American Academy of Pediatrics' Task Force concluded:88
"In another army hospital study, infants were examined in the first month of life and it was concluded that the high incidence of urinary tract infection in uncircumcised boys was accompanied by a similarly increased incidence of other significant infection, including bacteremia and meningitis; however, the authors of that study did not distinguish between bacteriuria secondary to septicemia and primary urinary tract infection. Still another recent army hospital study lends support to a 1986 hypothesis that circumcision prevents preputial bacterial colonization and thus protects male infants against urinary tract infection. It should be noted that these studies in army hospitals are retrospective in design and may have methodologic flaws. For example, they do not include all boys born in any single cohort or those treated as outpatients, so the study population may have been influenced by selection bias." [emphasis added].
Wiswell's work has been the subject of trenchant criticism by others, such as Altschul89 and by van Howe (op. cit. at n8). Kayaba et al. (op. cit.) found not a single case of urinary tract infection and conclude that reduction of urinary tract infection (and there is doubt as to the efficacy of circumcision to achieve this anyway) "is not a decisive reason for justifying indiscriminate neonatal circumcision"; Dr van Howe comments on this in a private communication: "The fact that no urinary tract infections were seen is extremely important. When compared to Wiswell's studies there is a significantly lower incidence of UTI in this study (Fisher's exact test ranges between 0.001 to 0.000000031 depending on which Wiswell study is looked at). This study is another in a long line that has failed to confirm Wiswell's dramatic and unreproducible finding. Adding to the importance of this finding is that this study was prospective which is much more powerful than Wiswell's cursory chart reviews ..... actually Wiswell couldn't even reproduce his own results. The rate of UTI's in his first two reports differed significantly with the first study having a higher rate (odds ratio = 2.34, 95% confidence interval = 1.04 - 5.26)."
It is unnecessary here, given that the Commission do not offer it as a reason for proposing that ritual circumcision be regularised and given that the medical consensus in Britain and the rest of the non-circumcising world (some 85% of the world's men are blissfully uncircumcised) is that there are no real benefits to routine neonatal circumcision, to refute those claims at any great length: those who require further detail are directed, as a start-point, to the work of Dr R Van Howe (op.cit. at n8) and to the paper by Williams and Kapila (op.cit. at n32) and the papers there cited.
Initiation rites, usually involving the infliction of pain and the scarifying of the body, or the deformation of body parts or the excision of flesh were, and remain, not uncommon in primitive societies. It would not be unreasonable to see them as a mark, and a test, both of the victim's ability to withstand pain (and thus prove himself as a staunch warrior) and/or as a method whereby the tribe asserted itself and its powers over the individual. It is inappropriate here to examine in detail the motivation for such practices; but it is wholly appropriate to bear the nature and history of such mutilations in mind when considering the legality of circumcision, especially in the last years of the 20th century.
J. Henry C. Simes90 wrote in 1890:
"The mutilation of the genitals among the various savage tribes of the world presents a strange and unaccountable practice of human ideas, which one is not able to reconcile with any reasoning power. Why such customs should be in vogue none can tell at the present time; but we must suppose that at some period they had their significance, which in the course of ages has been lost, and the practice has been handed down from generation to generation."
Warren and Bigelow write91 today:
"The origins of circumcision are lost in antiquity. Male circumcision is depicted in Egyptian tombs 5,000 years ago, while Gairdner (op. cit. at n 78) refers to evidence that it has its origins long before this in prehistory up to 15,000 years ago.
"We do not know with certainty why this procedure was carried out, but many writers have suggested that it was a sacrificial rite. No doubt human sacrifice was widespread, and it seems likely that substitutes for this practice included the sacrifice of domestic animals and mutilations of the human body, of which circumcision is just one example. Circumcision would usually have been carried out as an initiation ordeal at about the time of puberty, but there was a tendency for the age at which it was performed to shift earlier, so that Jewish ritual circumcision has been carried out on the eighth day of life since biblical times.
"Ritual circumcision is particularly popular and widespread geographically. An important aspect of sacrifice is the shedding of blood, and circumcision is a notoriously bloody operation, and even in modern surgical conditions haemorrhage can be a problem. A rate of up to 2% is reported by Denton92, sometimes requiring blood transfusion. Gellis93 reported that there were more deaths in the USA from the complications of circumcision than from carcinoma of the penis. One can only guess what the mortality from haemorrhage and infections might be in primitive or ancient communities.
"Another aspect of sacrifice is that the object which is forfeited should be valuable. The greater the value of the object sacrificed, the more worthy the sacrifice. This should make us wonder what are the value and function of the prepuce. If it were just a useless flap of skin, it would not be much of a sacrifice, and one might just as well shave off one's beard or cut one's toenails. The prepuce plays a major role in ensuring the sensitivity of the penis during sexual acts and circumcision greatly reduces the possibilities of pleasurable sensations. This makes it an ideal sacrificial object, as the circumcised male is able to function normally in society and to procreate, but suffers permanent impairment of sexual enjoyment and bears a visible, life-long reminder of his sacrifice."
According to Philo circumcision was for
"the excision of passions, which bind the mind. For since among all passions that of intercourse between man and woman is the greatest, the lawgivers have commended [sic] that the instrument, which serves this intercourse be mutilated, pointing out, that these powerful passions must be bridled, and thinking not only this, but all passions would be controlled through this one."
Indeed, after the passage in Genesis Chapter 17 as to circumcision, there is then the passage in Genesis Chapter 22 of the sacrifice demanded by God, even though then stayed, of Isaac; the connection between these two requests, and the value of that which was required to be sacrificed, is clear.
Hosken94 writes:
"Some anthropologists also speculate how or if the tradition of male circumcision, the removal of the prepuce, is related to the cutting off the entire penis which was offered as a sacrifice to the gods...Circumcision of both boys and girls came into fashion long before Islam, and was practised in many different areas in Africa....The Copts in Egypt and the Abyssians (Ethiopians) have practised circumcision of boys and girls (at a much younger age than the typical puberty rites of Sub-Saharan Africans) from pre-historic times....It is stated that both the Jews and the Arabs learned circumcision in Egypt, rather than vice versa. The rule in the Middle East, as well as in Sub-Saharan Africa, is that a boy cannot get married unless he is ...circumcised...excision [in females]...is practised to affirm the sex of the individual because it is believed that the clitoris represents a male element in a female, and that the prepuce of the penis represents femininity in a boy. Hence, the girls are excised and the boys circumcised in order to establish their sex in society."
In Genesis Chapter 17, verses 10 to 14, God is said to have commanded Abraham to circumcise himself and all males in his household as a sign of the covenant between him and God. In Leviticus Chapter 12 verse 3, it is written:
See also I Sam 18:25 for another, undeniably primitive, reason for circumcision, quoted by Szasz95."And in the eighth day the flesh of his foreskin shall be circumcised."
Szasz also (op.cit.) observes:
"The roots of both RNC [`Routine Neonatal Circumcision'] and anti-masturbatory measures lie in Jewish law, which recognises the legitimacy of erotic pleasure associated with sexual intercourse, provided that the act is marital-genital congress between a Jewish man and a Jewish woman. Every other sexual act is strictly prohibited. Masturbation is condemned unequivocally both in the Talmud and in extraTalmudic literature. The Zohar (an authoritative commentary on the Pentateuch) calls masturbation `a sin more serious than all the sins of the Torah' (Feldman D M: 1968: Birth Control in Jewish Law: Marital Relations, Contraception, and Abortion as Set Forth in the Classical Texts of Jewish Law p114)....Recognising the obvious connections between touching the penis and sexual arousal, Jewish law `definitely prohibits touching one's genitals --the unmarried man never, and the married man only in connection with urination' (Epstein L M: 1967 Sex Laws and Customs in Judaism p137) When an Orthodox Jewish father bladder trains his son, he admonishes him: `Without hands! Better a bad aim than a bad habit.'"
The form of the circumcision originally practised by Jews was a much less invasive procedure than the Bris (or Brit) Milah of to-day, which (in its radical excision of the penile skin) is the form also adopted by circumcisions performed by doctors: only the very tip of the prepuce was removed, thus preserving the frenulum and most of the prepuce with its nerves and its coverage of much of the glans; indeed it seems possible that in some instances only a token `cut' or drawing of blood was deemed necessary. With such `minor' excision it was not difficult for a man circumcised in this way to pull and retain the remnants of his prepuce over the glans so as to appear to be uncircumcised. Since the ancient Greeks (who were naked for sporting activities and exercise) found the sight of the uncovered glans to be offensive and obscene during exercise, Jews who wanted to take part in sports with uncircumcised Greeks adopted this method of `un-circumcision' and this method could be used in any situation where the Jewish man wished to conceal the physical mark of his Jewishness. It is a method adopted by Jews whenever they have wished to conceal their Jewishness, as for example during the Holocaust (powerfully demonstrated in the film Europa Europa) and broadly speaking it is the foundation of the non-surgical method of foreskin restoration described by Bigelow in his book, The Joy of Uncircumcising (op. cit.). The need for many men to-day, some of whom are circumcised Jews, to follow the lengthy and often uncomfortable technique to restore just a tiny bit of the function of the foreskin lost in circumcision is evidence of their realisation of the damage caused by their circumcision.
In or about 140 AD, the more radical form of circumcision, the pariah (or periah) was introduced: its radical tearing off the lining of the prepuce of the glans and, with a sharpened fingernail or thumbnail, the removal of all the mucous tissue that comprises the inner lining of the prepuce and amputation of the whole prepuce made it impossible for a man thus circumcised to re-cover his glans, since there was insufficient penile skin left. It is this form which has been used since then by Jews and is the model for the modern non-ritual circumcision which also involves radical amputation after the forcible breaking-down of the synechia between prepuce and glans penis.
The loss of sexual pleasure of the circumcised man and the measure of the sacrifice imposed on the ritually circumcised boy has been well-known for many centuries (albeit that the recent trend is for circumcisers to feel impelled to deny that loss in order to defend their behaviour).
Thus, Moses Maimonides (1135-1204 AD.), a noted Jewish rabbi, sage and doctor of his time, wrote:96
"As regards circumcision, I think that one of its objects is to limit sexual intercourse, and to weaken the organ of generation as far as possible, and thus cause man to be moderate. Some people believe that circumcision is to remove a defect in man's formation; but every one can easily reply: How can products of nature be deficient so as to require external completion, especially as the use of the fore-skin to that organ is evident? This commandment has not been enjoined as a complement to a deficient physical creation, but as a means for perfecting man's moral shortcomings. The bodily injury caused to that organ is exactly that which is desired; it does not interrupt any vital function, nor does it destroy the power of generation. Circumcision simply counteracts excessive lust; for there is no doubt that circumcision weakens the power of sexual excitement, and sometimes lessens the natural enjoyment; the organ necessarily becomes weak when it loses blood and is deprived of its covering from the beginning. Our Sages (Beresh. Rabba, c. 80) say distinctly: It is hard for a woman, with whom an uncircumcised had sexual intercourse, to separate from him. This is, as I believe, the best reason for the commandment concerning circumcision. And who was the first to perform this commandment? Abraham, our father! of whom it is well known how he feared sin; it is described by our Sages in reference to the words, `Behold, now I know that thou art a fair woman to look upon' (Gen. xii.II).
"This law can only be kept and perpetuated in its perfection, if circumcision is performed when the child is very young, and this for three good reasons. First, if the operation were postponed till the boy had grown up, he would perhaps not submit to it. Secondly, the young child has not much pain, because the skin is tender, and the imagination weak; for grown-up persons are in dread and fear of things which they imagine as coming, some time before these actually occur. Thirdly, when a child is very young, the parents do not think much of him; because the image of the child, that leads the parents to love him, has not yet taken a firm root in their minds. That image becomes stronger by the continual sight; it grows with the development of the child, and later on the image begins again to decrease and to vanish. The parents' love for a new-born child is not as great as it is when the child is one year old. The feeling and love of the father for the child would have led him to neglect the law if he were allowed to wait two or three years, whilst shortly after birth the image is very weak in the mind of the parent, especially of the father who is responsible for the execution of this commandment. The circumcision must take place on the eighth day (Lev. xii. 3), because all living beings are after birth, within the first seven days, very weak and exceedingly tender, as if they were still in the womb of their mother; not until the eighth day can they be counted among those that enjoy the light of the world. That this is also the case with beasts may be inferred from the words of Scripture: `Seven days shall it be under the dam' (Lev. xxii. 27), as if it had no vitality before the end of that period. In the same manner man is circumcised after the completion of seven days. The period has been fixed, and has not been left to everybody's judgement.
"The precepts of this class include also the lesson that we must not injure in any way the organs of generation in living beings (ibid. xxii. 24). The lesson is based on the principle of "righteous statutes and judgements" (Deut. iv. 8); we must keep in everything the golden mean; we must not be excessive in love, but must not suppress it entirely; for the Law commands, `Be fruitful, and multiply' (Gen. i. 22). The organ is weakened by circumcision, but not destroyed by the operation. The natural faculty is left in full force, but is guarded against excess. It is prohibited for an Israelite `that is wounded in the stones, or hath his privy member cut off' (Deut. xxiii. 2), to marry an Israelitish woman; because the sexual intercourse is of no use and of no purpose; and that marriage would be a source of ruin to her, and to him who would claim her. This is very clear."
But one must realise that, according to Jewish belief, one is Jewish if, and only if, one's mother is herself Jewish: the retention or otherwise of a prepuce has nothing to do with being Jewish. Thus, a Jewish man writing in the Guardian97 says:
"My wife is not Jewish. Our child -- regardless of the condition of his penis --is not Jewish, if you pay attention to the Orthodox authorities. All the same, it was important to me to have Julius circumcised....`You know, it still won't make him Jewish,' said Dr Cohen....I held Julius's legs down and apart. Whenever I felt a tremor from him, I pushed down slightly harder on the knees. The action seemed to comfort him. He stopped crying. He became calm. It was almost as if he trusted us....Dr Cohen gathered Julius's foreskin between his fingers, pulled it away, and his sad little glans was exposed....I heard the sound of Dr Cohen's breathing, and then I heard the sound of scissors tearing through skin. And then, a moment later, the horrible scream that Julius made of utter, excruciating pain....Supposedly, circumcised penises have 30 per cent less sensitivity than uncircumcised ones....God is perfect, man cannot be, so let us blemish our synagogue floors and mutilate our sons to prove it. I still don't believe in God. And if I have another son I am sure that he will be circumcised too."
One can only ask why? Why this mutilation, of his son, by a man who does not believe in God, and thus for whom the `religious duty' can have no meaning; when the child cannot become Jewish by so doing it (or less Jewish by not doing it) and thus `cultural identity' seems meaningless; when he does not claim any medical benefits for doing it; and he accepts that it is painful, and damaging to penile sensitivity?
By way of contrast, there are Jews for whom the Bris Milah is unacceptable:
"According to Jewish law, it is forbidden to cause tsa'ar ba'alei chaim, or pain of living things. Even the necessary causing of pain is considered cruel in Judaism. Jewish law even prohibits the pairing up of a small and a large animal for plowing in case the asymmetry causes the littler one discomfort. Clearly, concern over the pain of others has strong Judaic roots.
"What about the concern that circumcision involves the surgical alteration of a perfectly natural God-given part of the body? This concern, too, stems from Jewish thought. Westerners generally find the bodily mutilation practised in other cultures to be deeply distasteful. This distaste is based on the Hebrew Bible's denouncement of pagan practices such as tattooing and cutting the flesh.
"There is also the risk of serious complications, and even death, from circumcision. No matter how small these risks are, they must be considered. Now, even this concern is an echo of Jewish law. Judaism regards life as infinitely sacred and gives it precedence over all else.
"Accordingly, Jewish law tells us that any medical procedure involving even the possibility of risk to life must be viewed as dangerous and is, therefore, strictly forbidden. Thus, the risk of circumcision is not just a medical concern, but a Jewish one.
"Thousands of Jews today are questioning circumcision. Some are deciding not to circumcise their infant sons. By my estimates, American Rabbis are getting at least 3,000 calls each year from parents who are in conflict with the rite."98
"Judaism is a tremendously rich pro-survival religion that, through persistent mistreatment and misinformation, is still widely misunderstood. However, the mistakes that it carries within it, such as the ritual of circumcision, called Brit Milah, should not be considered any differently than in society in general, no matter how essentially important to the Jewish culture it is seen. Circumcision is child abuse. It is medically unnecessary. It is nothing short of a traumatic way to introduce a newborn male into the world and into the Jewish community. The centuries of a covenant with God has produced great denial in viewing the very real pain of the newborn. From the start it relegates females as being less important than males as historically there has been no equivalent ceremony to welcome the newborn Jewish female baby.
"Make no mistake about it, young people do not ask for and react sharply to the imposition of adult values on them and their bodies. Expecting nothing short of a complete and exuberant welcome into their world, the pain of the tools used by the Mohel, or the doctor, is a rude shock not readily forgotten by the newborn with an already developed nervous system and a brilliant mind."99
A Jewish mother, in the Channel 4 TV programme War Cries: It's a Boy:
"I'm a Jewish mother. My son Max is five months old and I refuse to have him circumcised. [I told my mother] "I would do anything not to hurt you, my parents, except hurt my child."
For Muslims, it is by no means clear that, as often asserted and cited by the Commission in footnote 3 to Part IX of the Consultation Paper, circumcision is regarded as a fundamental and required rite.
The reason for its performance seems to be that Abraham was revered and that if he circumcised himself then that was a reason for its performance by Muslims; it also seems that the requirement for cleanliness before prayer was a factor (though no reason seems to have been advanced for not using water, as with other body parts; and seemingly no difficulty is seen with the propriety of prayers from boys uncircumcised until late childhood/teenage years).
Dr S N Kahn states in The Islamic Viewpoint:100
"Circumcision, encouraged in Islam and widely practised by Muslims, is a tradition of the Prophet and an important ritual" (emphasis added).
Ritual circumcision has also been discussed by Dr Sami Aldeeb Abu-Sahlieh.101 Although he deals rather more with female circumcision, his analysis of the mind-process behind both forms (i.e. male and female circumcision) is illuminating. He writes:
"Circumcision as a sign of alliance can only be found in two other passages of the Bible. Elsewhere, it is more narrative: King Saul demanded one hundred Philistine foreskins from David, before he gave his consent to David marrying his daughter Mikal: "David.... thought it was a good deal in order to become the king's son in law... He went to war...He killed 200 Philistine men, brought back their foreskins, counted them in front of the king....So Saul...had to admit that Jehovah was on David's side." This interpretation of the Koranic verses with reference to the Bible is considered abusive by Imam Mahmud Shaltut (israf fil-istidlal). What is more, this textual argument based on Jewish law concerns male circumcision only, not female circumcision that the Bible does not mention and that the Jews do not practice (Falachas excepted). Al-Sukkari answers that, according to Ibn Hagar, the Jews used to circumcise both sexes, which is why he rejects male and female circumcision on the 7th [sic] day, so as not to look like them. Even the authentic Bible - today's one is considered falsified does not contain any text related to female circumcision. Nonetheless, the Muslims must practice it, if the Muslim law makes provision for it.
"The Sunnah: We will try here to glean, from the works of contemporary Arab authors, the different sayings of Mohammed related to male and female circumcision. The most often mentioned narration reports a debate between Mohammed and Um Habibah (or Um Tatiyyah). This woman, known as an exciser of female slaves, was one of a group of women who had immigrated with Mohammed. Having seen her, Mohammed asked her if she kept practising her profession. She answered affirmatively adding: "unless it is forbidden and you order me to stop doing it." Mohammed replied: "Yes, it is allowed. Come closer so I can teach you: if you cut, do not overdo it (la tanhaki), because it brings more radiance to the face (ashraq) and it is more pleasant (ahza) for the husband." According to others, he said: "Cut slightly and do not overdo it (ashimmi wa-la tanhaki), because it is more pleasant (ahza) for the woman and better (ahab, from other sources abha) for the husband." We shall hereinafter refer to this narration as the exciser's narration. - Mohammed said: "Circumcision is a sunnah for the men and makrumah for the women." The term sunnah here means that it is conform to the tradition of Mohammed himself, or simply a custom at the time of Mohammed. The term makrumah is far from clear but we can translate it into a honorable deed. - Speaking to the Ansars' wives, Mohammed said: "Cut slightly without exaggeration (ikhtafidna wa-la tanhikna), because it is more pleasant(ahza) for your husbands." - Someone came to Mohammed and became a convert before him. Mohammed told him: "Shave off your unbeliever's hair and be circumcised." - Mohammed said: "Let him who becomes a Muslim be circumcised, even if he is old." - One asked Mohammed if an uncircumcised man could go to pilgrimage. He answered: "Not as long as he is not circumcised." - Mohammed said: "Five norms define fitrah: shaving of the pubis, circumcision, moustache trimming, armpit depilation and nail clipping." Other narrations name ten norms amongst which circumcision is always mentioned. The norms of fitrah are believed to be those taught by God to His creation. The man in pursuit of perfection must conform to those norms. They are not compulsory, but simply advisable (mandubah), except for circumcision which is mandatory. Based on these premises, Al-Sukkari believes Adam to have been the first circumcised man. His descendants having neglected their obligation, it was reconfirmed to Abraham and his descendants. Thus circumcision would be the sign which would differentiate the believer from the non-believer."
Whilst the Jews circumcise, in accordance with their beliefs, on the 8th day of life, Muslims often delay circumcision until later in childhood: sometimes as late as the onset of puberty or even mid-teens or before marriage. The effect on such a boy of this amputation, without anaesthesia, particularly after the onset of puberty requires little imagination. Further, given that there is not a need, as with Judaism, to circumcise on a set day, there is no reason why the decision cannot be left to the boy himself when he is old enough to form his own independent view as to his belief-systems and his own body, when the procedure can be performed under suitable conditions and on an adult organ when the amount to be amputated can be the more accurately assessed. It is hard to resist the thought that the reason that it is typically performed in early childhood is because the child is at that age very much in the power of the parents and unable to resist this mutilation.
The form of Muslim circumcision has been described by Wilfred Thesiger in his book Arabian Sands, first published by Longmans in 1959, and describing his travels in Arabia from 1945 onwards. He writes of meeting a Salim bin Turkia whose 15 year-old had `a curious cockscomb of hair, a sign that he was still uncircumcised'. Later, he writes of one his companions, bin Kabina aged about 16: although Thesiger says that circumcision is `usually performed on a child about the age of seven', he describes the haggard appearance of bin Kabina who tells him of his recent circumcision 3 months earlier. Thesiger also describes some of the features of this procedure: often the flayed member was then `kippered' for several days thereafter by being held in the smoke from a fire and sometimes mutilations such as `the flaying circumcision' were carried out, in which the skin was removed from the navel down to the inside of the thighs.
Although the flaying circumcision in the sense described by Thesiger has been banned in Arab countries, very radical circumcision, involving the removal of much of the penile skin was practised in the southern parts of Oman as late as the 1970s.
In an article The Knife-edge of Manhood, the circumcision of 7 year-olds in Istambul is described and photographed102 The circumciser, Kemal Ozkan, claims to have done as many as 2000 circumcisions in a day, and is reported as being a local celebrity and featuring in tourist guidebooks to the city of Istanbul; according to him the ideal age is between 5 and 9 but that age is, see for example Cansever103, the age when procedures on the boy's genitals is likely to cause great mental trauma. As Anna Freud observed:
"Ever since the discovery of the castration complex analysts have had ample opportunity in their therapeutic work to study the impact of surgical operations, on normal and abnormal development. By now it is common knowledge that surgical interference with the child's body may serve as the focal point for the activation, reactivation, grouping and rationalization of ideas of being attacked, overwhelmed and (or) castrated. The surgeon's action, from minor surgery to major operations, is interpreted by the child in terms of his level of instinct development, or in regressive terms. What the experience means in his life, therefore does not depend on the type or seriousness of the operation but on the type and depth of the fantasies aroused by it. If, for example, the child's fantasies are concerned with his aggression against the mother projected on to her person, the operation is experienced as a retaliatory attack made by the mother on the inside of the child's body (Melanie Klein); or the operation may be used to represent the child's sadistic conception of what takes place between the parents in intercourse, with the child in the role of the passive sexual partner; or the operation is experienced as a mutilation, i. e., as punishment for exhibitionistic desires, for aggressive penis envy, above all for masturbatory practices and oedipal jealousies."104
The boys sit on a merry-go-round and are spun around; Ozkan stops the wheel to select the next boy for circumcision. One 7 year-old is quoted as saying "If you don't cut, I'll give you double the money that my father is paying you": his plea is ignored, his penis is grabbed and, after the circumcision, he is handed to his mother and the wheel spins again whilst Ozkan sharpens his knife for the next victim.
Money et al105 describe circumcision (or `dhapi') at age 8 or 9:
"One of [the ceremonial initiates among the elders] lies on his back on the ground, the boy lying upward upon him and pinioned in a locked embrace. Another holds down the boy's legs. A third does the actual cutting. In ancient times a stone knife was used. Today the instrument is a razor blade. The cutting is more likely to be a series of dissection movements. The boy may cry out with the pain. Immediately the foreskin is removed, the men in charge carry the boy into the bush nearby where he is passed through the smoke of a fire for spiritual cleansing. The bleeding of his penis is stopped by cauterising with a piece of hot charcoal and the application of hot, wet leaves....The meaning of the ceremony is, like the origin of circumcision itself, lost in the unrecorded annals of prehistory. My own theoretical guess is that it represents a substitute for, and an attenuation of, human sacrifice."
Meggit106 writes of the circumcision, performed between the age of 11 and 13:
"The rite of circumcision and its attendant ceremonies firmly and unequivocally establish a youth's status in Walbiri society. Should he fail to pass through these rites, he may not enter into his father's lodge, he may not participate in religious ceremonies, he cannot acquire a marriage line, he cannot legitimately obtain a wife; in short, he cannot become a social person."
He notes, at page 253, that "The Walbiri explicitly equate circumcision with ritual killing"; and at page 261 describes the procedure as follows:
"A brother seizes the novice and places him face upward on the table, with his feet toward the fire. Another brother straddles him and presses his pubes against the lad's face to silent his cries, while a third grips his legs. a brother holds the shaft of the boy's penis, in order to protect `the inside bone' from injury; one of the circumcisers stretches the foreskin several inches, and another cuts it off with two or three quick slices."
Subincision, although abandoned in a number of communities, is performed by the Walbiri at age 17 and is described by Meggit at page 265 as follows:
"To the accompaniment of loud chanting by the company, the man deftly slices open the youth's penis from the meatus to a point about an inch along the urethra."
Cawte,107 in a remark which seems unacceptably insensitive, writes that "Subincision is another matter; this is going a little too far for European tastes; a subincised man makes a mess by spraying rather than squirting in toilets and urinals" (emphasis added). That this brutal further mutilation is described merely as "going a little too far for European tastes" and that the only disbenefit seemingly is that the victim makes a mess during urination is a telling demonstration of the mind-set towards genital mutilation as a whole and male circumcision and other male genital mutilations.
It is important, in considering the whole issue of circumcision and its legality, to have firmly at the front of one's mind the primitive tribal origins and barbarity of the ritual and the abuse from it of the victim; despite attempts to sanitise the ritual, to divorce it from its origins in human sacrifice and to cloak it in `acceptably' religious demands.
It is commonly accepted that Victorian Britain was deeply troubled by sexual matters; and that the paterfamilias was seen as an all-powerful figure. Further, women and children were seen as the property of the man: to do what the man deemed right for himself and/or to serve the man's desires and purposes. The treatment of women and children in Victorian Britain was barbarous, cruel and beyond the comprehension of modern society; child labour and child prostitution were commonplace. Sexual hypocrisy was rife.
In particular, the unwillingness to face sexuality in women was seen in the denial/refusal to admit that women were capable of feeling sexual pleasure (or at least that one's wife was so `unrefined' so to feel) or to experience orgasm; equally, the sexual pleasure from masturbation by boys was also seen as deeply unhealthy, unclean in the moral sense, and impure; it was often called the `solitary vice'. Masturbation was seen as a cause of a wide variety of illnesses from mental illhealth, epilepsy, alcoholism and a host of other ailments; and if that were right then it seemed desirable to take any steps to curb this `vice'. Thus, in the mid-1800s it was thought that circumcision would help stop boys masturbating.
Whether it was thought that the deprivation of sensation and also of the skin comfortably to erect into, and masturbate with, was the cure for masturbation, or that that it was that the mere act and intense pain of circumcision would be a sign of the `inherent dangers' of sex and sexual pleasure (certainly the dangers of such expression outside the sanctity of marriage) is not clear.
It seems that Money, writing in 1887 in Treatment of Disease in Children, considered that the pain, on-going if possible, was desirable:
"Whether masturbation is a cause of epilepsy is doubted. But there can be no doubt of its injurious effect ..... Circumcision should always be practised. It may be necessary to make the genital area so sore by blistering fluids that pain results from attempts to rub the part."
Probably, both strands of thinking were present at the same time. What does seem clear is that the effect of circumcision on the ability to enjoy sexual activities was recognised by the Victorians, as it had been by Maimonides.
The Victorians were well aware of the Jewish circumcision, (indeed, in the Christian calendar, there is the Feast of the Circumcision of Christ), as well as Muslim circumcision and circumcision carried out in other parts of the world such as Africa and the Australian aboriginals. Clearly, circumcision did not prevent these men from being able to procreate and it would appear that it was but a small step to conclude that circumcision would have no harmful effects if done on British boys. Thus, they espoused an amputation which whilst curbing sexual pleasure would not prevent procreation and would, it was thought, stop what was seen as the deeply damaging `self-abuse' of masturbation and would thereby prevent the onset of dreadful illnesses.
The same masturbation-phobia also drove the introduction of routine neonatal circumcision in 19th century United States of America (a country where such circumcisions were some 85% in the 1970s and which, although the rates are now declining especially in the western states, still account for more than 50% of boys).
As Frederick Hodges, the medical historian, has written, involuntary circumcision was introduced and enforced in America as a way of surgically desensitizing and denuding the penis in order to make masturbation theoretically impossible. The vast majority of original circumcisionists were, as they were in Victorian Britain, Christians who had of course never themselves, been circumcised. They knew exactly what the effects of circumcision would be. They could well imagine the destruction circumcision would cause to sexual sensation and function when it was forced on boys and men who had been caught masturbating. Adults who had been convicted of masturbation were regularly incarcerated in lunatic asylums and subjected to castration, circumcision and electric shock.
The medical history of circumcision in the United states is discussed by David L. Gollaher108 who writes:
"The medical history of circumcision in the United States properly begins in 1870. Dr. Lewis A. Sayre published a paper in which he sought to show that a range of wellnigh miraculous cures were effected by circumcision."
Other important US doctors who promoted circumcision as an anti-masturbatory procedure in the 1870s were Abraham Jacobi and M.J. Moses. Dr Jacobi (1830-1919) was the president and founder of the American Pediatric Society, the first Chairman of the Section on Diseases of Children of the American Medical Association, President of the New York State Medical Society, President of the New York Academy of Medicine, and President of the Association of American Physicians. Both Jacobi and Moses claimed that Jews were immune to masturbation solely because they were circumcised. They were cited as authorities by medical writers for the next few decades. Both claimed that nonJews were especially prone to masturbation and to the horrible diseases that resulted from masturbation solely because they had foreskins. Jacobi produced many "studies" to prove this, and to "prove" that the male foreskin caused epilepsy, paralysis, malnutrition, hysteria, and other nervous disorders.109
In 1871, Dr. Moses wrote110:
"As an Israelite, I desire to ventilate the subject, and, as a physician, have chosen the medium of a medical journal, that I may not be trammelled in my expressions, as I necessarily would be were I confined to the pages of an ordinary paper...I refer to masturbation as one of the effects of a long prepuce; not that this vice is entirely absent in those who have undergone circumcision, though I never saw an instance in a Jewish child of very tender years, except as the result of association with children whose covered glans have naturally impelled them to the habit."
It is quite clear from context that the title word `Hygienic' had, in the United States of that time as with Victorian Britain, a different meaning than it does today. At this time, circumcisers used words such as hygiene to denote moral hygiene, not personal hygiene. Circumcisers likewise used the term sanitary to denote moral purity, and not absence of germs or dirt. By manipulating the meaning of words in a fashion presaging the "New-Speak" of Orwell's classic, 1984, circumcisers pathologized normal functions: erotic sensitivity was redefined as "irritation."; orgasm was redefined as "convulsions."
Jonathan Hutchinson, who was President of the Royal College of Surgeons of England in 1889, wrote in 1891 a paper on circumcision as a preventive of masturbation, in which he not only advocated circumcision for the treatment and prevention of this "shameful habit", but also proposed that
"—if public opinion permitted their adoption — measures more radical than circumcision would be a true kindness."
In 1914, Dr. Abraham Wolbarst111 wrote:
"It is generally accepted that irritation derived from a tight prepuce may be followed by nervous phenomena, among these being convulsions and outbreaks resembling epilepsy. It is therefore not at all improbable that in many infants who die in convulsions the real cause of death is a long or tight prepuce. In a case reported by A.H. Baker of Elmira, N.Y., repeated attacks of epileptiform convulsions occurred in a boy aged 5. It was found that there was an adherent prepuce with marked adhesions. After the child was circumcised the convulsions ceased and have not since recurred... We safely conclude that circumcision is to be regarded as a powerful prophylactic against masturbation and other reflex neuroses that result from preputial irritation."
That circumcision was of no effect in preventing masturbation became self-evident: circumcised boys have the same urge to masturbate as their intact brothers and will do so, notwithstanding that for them it will be, as with sexual intercourse, a pale shadow of the pleasure that should have been theirs by birthright. But the motivations to continue to circumcise required the invention by circumcisers of a variety of pseudo-medical `rationales' for continuing to circumcise: first by claims of cleanliness, then the reduction/prevention of diseases such as cancers of the cervix and penis to claims that circumcision will reduce the incidence of UTIs, AIDS and other sexually transmitted diseases. These false claims have been discussed above; but the increasingly desperate efforts by circumcisers to find a benefit and/or a medical rationale for their mutilation of others, as each claimed `benefit' is refuted, leads one to ponder at the psycho-pathology of these people involved and certainly to wonder at their efforts to read/read with an open-mind the range of medical literature which gives the lie to their claims.
Although, except for ritual circumcisions, neonatal circumcisions have been largely abandoned in Britain, in America, where neonatal circumcisions are a lucrative source of medical income and where from a peak of nearly 90% of all neonate boys to a current figure of some 59%, routine neonatal circumcisions are still, in the teeth of medical studies, a societal commonplace encouraged by those doctors who profit from the fees (typically $200 per neonatal circumcision). Marilyn Fayre Milos, an American Registered Nurse, whose experiences of witnessing neonatal circumcision impelled her to abandon her nursing career and courageously to speak out against this barbarity, has written movingly112. Apart from minor differences of technique (the mohel does not employ a probe but uses a sharpened finger-nail to rip asunder and then to strip fully the glans-preputial adhesions and does not use a clamp to crush the foreskin so as to control bleeding before amputation) the result is much the same as at a Bris Milah.
"We students filed into the newborn nursery to find a baby strapped spread-eagle to a plastic board on a counter top across the room. he was struggling against his restraints -- tugging, whimpering, and then crying helplessly. no one was tending the infant, but when I asked my instructor if I could comfort him, she said `Wait until the doctor gets here'. I wondered how a teacher of the healing arts could watch someone suffer and not offer assistance. I wondered about the doctor's power which could intimidate others from following protective instincts. When he did arrive, I immediately asked the doctor if I could help the baby. he told me to put my finger into the baby's mouth; I did, and the baby sucked. I stoked his little head and spoke softly to him. he began to relax, and was momentarily quiet.
"The silence was soon broken by a piercing scream — the baby's reaction to having his penis pinched and crushed as the doctor attached the clamp to his penis. The shriek intensified when the doctor inserted an instrument between the foreskin and the glans, tearing the two structures apart.....The baby started shaking his head back and forth -- the only part of his body free to move -- as the doctor used another clamp to crush the foreskin length-wise, where he then cut. This made the opening of the foreskin large enough to insert a circumcision instrument, the device used to protect the glans from being severed during the surgery.
"The baby began to gasp and choke, breathless from his shrill, continuous screams. How could anyone say that circumcision is painless when the suffering is so obvious? My bottom lip began to quiver, tears filled my eyes and spilled over, I found my own sobs difficult to contain. How much longer could this go on?
"During the next stage of surgery, the doctor crushed the foreskin against the circumcision instrument and finally amputated it. The baby was limp, exhausted, spent.
"I had not been prepared, nothing could have prepared me. for this experience. To see a part of this baby's penis being cut off -- without an anesthetic -- was devastating. But even more shocking was the doctor's comment, barely audible several octaves below the piercing screams of the baby: `There's no medical reason for doing this.' I couldn't believe my own ears, my knees became weak, and I felt sick to my stomach. I couldn't believe that medical professionals, dedicated to helping and healing, could inflict such unnecessary pain and anguish on innocent babies."
In the autumn 1995, Channel 4 TV transmitted a film, War Cries: It's a Boy, by Victor Schonfeld, which dealt with ritual circumcision. Some quotes from this film are illuminating:
Rabbi David Singer:
"The last but one [circumcision] that I did, the parents were telling me that before the circumcision the baby was very fractious and was always crying at night and very unsettled, and the night after the brit was done, the baby spent a quiet night, he's sticking to a three-, three-and-a-half, four-hour feeding routine, so they were quite delighted it could be done."
Jewish woman on street:
"There's no pain. It's a baby, a week old."
Another Jewish women on street:
"I've been at many and not one child has suffered."
Dr. Adrian Lloyd Thomas, Pediatrician (in response to being asked about circumcision without anesthesia):
"You can see there a very definite response from the baby as soon the forceps are applied to the foreskin. The baby is holding his breath, shivering. Infants having an operation may actually experience more pain than adults do having the same procedure, and the reason for this is that the control mechanisms, particularly in the spinal cord, which are highly developed to damp down and suppress pain in a mature adult nervous system, are not so well developed in the small baby. So, the pain signals travel through uncontrolled, unsuppressed....I think it would be unwise to draw that conclusion [that the baby stopped crying because the pain was over]. I'd more prefer to think that the experience had been so overwhelming that the baby can't...put up a fight anymore....My personal feeling as a pediatric anesthetist is that it is not ethical to perform circumcisions without some form of topical anesthesia."
Narrator:
"...the British medical consensus is that newborn circumcision is not medically w