Selling Circumcision in America
By David Chamberlain Ph.D
Circumcision originated at least 6,000 years ago as a tribal and religious identity symbol in African and Semitic cultures. The ballooning of the practice in 20th century America, however, was the work of pediatricians and obstetricians who gave it new status as a "medical" procedure. Circumcision received a big lift from a nationally prominent physician, John Harvey Kellogg of Battle Creek, Michigan (later a founder of the famous cereal company) who was obsessed with the evils of sex in general and masturbation in particular; he saw the painful ritual of circumcision as a discouragement. Kellogg's book, Plain Facts for Old and Young (1877) urged parents to have their boys circumcised without anesthesia--because the pain would have a "salutary effect upon the mind." Before long, the book was as common as his corn flakes in American homes.
Expressing a sharply opposing view, psychohistorian Lloyd DeMause (1991) finds circumcision one of the numerous acts of genital mutilation and violence perpetrated on infants and children in virtually every culture since the earliest times. Because it involves sexual mutilation in the family circle, DeMause claims it falls into the category of "incest" and should be seen as "an adult perversion." Other modern critics have labeled it a "betrayal of the innocent" and a "breech of trust" (Grimes, 1978; Janov, 1983). Anesthesiologist John Scanlon (1985) simply calls it "barbarism." Nevertheless, a century ago, under medical leadership, circum- cision swept through the male population.
Medical circumcision became a uniquely American phenomenon. About 80% of the world's population never adopted the practice: This includes most of Europe, and populous countries like Japan, China, and Russia. Researcher Edward Wallerstein (1995) refers to circumcision as an American medical "enigma." A urologist estimates that 90% of American males currently living were initiated into life in this violent way. Significantly, for men, circumcision is where sex and violence first meet. Swiss psychoanalyst Alice Miller (1983) sees in this kind of cruelty the roots of social violence.
Leading the crusade for circumcision over a century ago, the physician P. C. Remondino (1891) called the prepuce "a malign influence causing all manner of ills, unfitting a man for marriage or business and likely to land him in jail or a lunatic asylum." According to him, "circumcision is like a substantial and well-secured life annuity; every year of life you draw the benefit....Parents cannot make a better investment for their little boys, as it assures them better health, greater capacity for labor, longer life, less nervousness, sickness, loss of time, and less doctor bills" (Cited in Speert 1953:165). Dr. Remondino claimed that circumcision would cure about a hundred ailments, among them asthma, alcoholism, enuresis, and rheumatism (Wallerstein 1985). People were afraid and gullible.
Another physician of the day (Clifford 1893) enumerated the alleged dangers of the intact foreskin. These included penile irritation, interference with urination, nocturnal incontinence, hernia or prolapse of the rectum (from a tight foreskin!), syphilis, cancer, hysteria, epilepsy, chorea, erotic stimulation, and masterbation. This was the flimsy basis for selling circumcision to America--although none of it turned out to be true. In modern times, dire warnings are still dressed in medical language pointing to the normal foreskin as the source of sexual diseases, cancer, urinary infections, and even AIDS. Yet circumcision neither causes nor cures any of these conditions. The medical compulsion to perform the operation--usually without anesthesia--continues this long legacy of pain as many physicians are still turning a deaf ear to rational arguments from within their own profession (e.g. Grimes, 1978; Wallerstein 1985; Winberg et al. 1989; and Ritter 1992). The American record is unique.
Meanwhile, as the trade flourishes, a humane trend is clearly visible in journal publications. Numerous articles have reported empirical measures of stress during circumcision, and compare procedures and anesthetics for pain (e.g., Kirya and Werthmann 1978; Yeoman, Cooke and Hain, 1983; Pelosi and Apuzzio, 1985; Masciello, 1990). In this professional literature, one can see a growing empathy for infants, full acceptance of their pain, serious doubts about performing circumcisions, and strong recommendations for anesthetics which effectively reduce pain (Williamson and Williamson 1983; Holve et al. 1983; Dixon et al. 1984; Stang et al. 1988; and Rabinowitz and Hulbert 1995). Perhaps this is a harbinger of what is to come, and a sign that the century of denial may be ending.
A mix of cultural forces blur the future. In exploring the extent of physician influence on parental choice for circumcision, one study showed that when the doctor was opposed to circumcision, the rate fell to 20%, but when he was in favor, the rate was 100% (Patel 1966). In contrast, when four pediatricians in Baltimore did an educational experiment with pregnant mothers (Herrera et al. 1982), they were surprised at the results. While half had been taught the medical "risks and benefits" of circumcision and half received no information, virtually all the mothers opted for circumcision. The doctors concluded that deep cultural and traditional issues were working against a change in attitude in their group. Surveys examining parental motives for requesting circumcision have revealed these forces at work.
Parents typically care about "appearances," yield to pressure from relatives to continue circumcising, and believe the propaganda about medical "benefits." They hold a variety of false notions that circumcision is mandated by hospitals, by public health law, or is required for admission into the Armed Forces (Patel 1966; Grimes 1978). And parents are not warned that their infants will endure severe pain and be robbed of a functional part of their sexual anatomy for life! In the United States, while circumcision has fallen below 60% it still touches the lives of over one million baby boys each year.
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