To cut or not to cut. The choice loomed the moment New Yorkers Rob and Deanna Morea found out, three months into Deanna’s pregnancy, that their first child was going to be a boy. Both had grown up with the view of circumcision as something automatic, like severing the umbilical cord. To Rob—white, Catholic, and circumcised—an intact foreskin seemed vaguely un-American. Deanna, African-American and also Catholic, dismissed the parents who don’t circumcise their children as a “granola-eating, Birkenstock-wearing type of crowd.” But that was before they knew they were having a son.
Circumcision is still, as it has been for decades, one of the most routinely performed surgical procedures in the United States—a million of the operations are performed every year. Yet more Americans are beginning to ask themselves the same question the Moreas did: Why, exactly, are we doing this? Having peaked at a staggering 85 percent in the sixties and seventies, the U.S. newborn-circumcision rate dropped to 65 percent in 1999 and to 56 percent in 2006. Give or take a hiccup here and there, the trend is remarkably clear: Over the past 30 years, the circumcision rate has fallen 30 percent. All evidence suggests that we are nearing the moment (2014?) when the year’s crop of circumcised newborns will be in the minority.
Opposition to circumcision isn’t new, of course. What is new are the opponents. What was once mostly a fringe movement has been flowing steadily into the mainstream. Today’s anti-circumcision crowd are people like the Moreas—people whose religious and ideological passions don’t run high either way and who arrive at their decision through a kind of personal cost-benefit analysis involving health concerns, pain, and other factors. At the same time, new evidence that circumcision can help prevent the spread of AIDS, coupled with centuries-old sentiments supporting the practice, are touching off a backlash to the backlash. Lately, arguments pro and con have grown fierce, flaring with the contentious intensity of our time.
The idea of separating the prepuce from the penis is older than the Old Testament. The first depiction of the procedure exists on the walls of an Egyptian tomb built in 2400 B.C.—a relief complete with hieroglyphics that read, “Hold him and do not allow him to faint.” The notion appears to have occurred to several disparate cultures, for reasons unknown. “It is far easier to imagine the impulse behind Neolithic cave painting than to guess what inspired the ancients to cut their genitals,” writes David L. Gollaher in his definitive tome Circumcision: A History of the World’s Most Controversial Surgery. One theory suggests that the ritual’s original goal was to simply draw blood from the sexual organ—to serve as the male equivalent of menstruation, in other words, and thus a rite of passage into adulthood. The Jews took their enslavers’ practice and turned it into a sign of their own covenant with God; 2,000 years later, Muslims followed suit.
Medical concerns didn’t enter the picture until the late-nineteenth century, when science began competing with religious belief. America took its first step toward universal secular circumcision, writes Gollaher, on “the rainy morning of February 9, 1870.” Lewis Sayre, a leading Manhattan surgeon, was treating an anemic 5-year-old boy with partially paralyzed leg muscles when he noticed that the boy’s penis was encased in an unusually tight foreskin, causing chronic pain. Going on intuition, Sayre drove the boy to Bellevue and circumcised him, improvising on the spot with scissors and his fingernails. The boy felt better almost immediately and fully recovered the use of his legs within weeks. Sayre began to perform circumcisions to treat paralysis—and, in at least five cases, his strange inspiration worked. When Sayre published the results in the Transactions of the American Medical Association, the floodgates swung open. Before long, surgeons were using circumcision to treat all manner of ailments.
There was another, half-hidden appeal to the procedure. Ever since the twelfth-century Jewish scholar and physician Maimonides, doctors realized that circumcision dulls the sensation in the glans, supposedly discouraging promiscuity. The idea was especially attractive to the Victorians, famously obsessed with the perils of masturbation. From therapeutic circumcision as a cure for insomnia there was only a short step toward circumcision as a way to dull the “out of control” libido.
In the thirties, another argument for routine circumcision presented itself. Research suggested a link between circumcision and reduced risk of penile and cervical cancer. In addition to the obvious health implications, the finding strengthened the idea of the foreskin as unclean. On par with deodorant and a daily shower, circumcision became a means of assimilating the immigrant and urbanizing the country bumpkin—a civilizing cut. And so at the century’s midpoint, just as the rest of the English-speaking world began souring on the practice (the British National Health Service stopped covering it in 1949), the U.S. settled into its status as the planet’s one bastion of routine neonatal circumcision—second only to Israel.