The ancient circumcision in Egypt
IN the Philippines circumcision—the removal of all or part of the prepuce (pronounced "pre'pyoos") or foreskin—is not related to religion. The vast majority of Filipinos are circumcised—whether they are Catholic, Muslim, or whatever. It is a "coming of age" ritual, and traditional for a boy to prove his manhood properly, it should be done without anesthetic.
In the United States and most industrialized countries, circumcision is usually performed on the first or second day after birth and usually takes only about five to 10 minutes. In comparison, most boys are circumcised between the ages of 10 and 12 in the Philippines.
"The decision about having a newborn circumcised usually depends on the parents' religious beliefs or personal preferences," states The Merck Manual of Medical Information. "The main medical reason for circumcision is to remove an unusually tight foreskin that is obstructing the flow of urine."
Circumcision is an ancient operation of unknown origin, performed originally with flint (stone) knives prior to the use of metal. The earliest known artifacts from Egypt are dated at about 4000 BC, centuries before circumcision's adoption by the ancient Hebrews.
For thousands of years, circumcision has been widely practiced as a religious rite. It is a ritual obligation for infant Jewish boys, and is also a common rite among Muslims, who account for the largest share of circumcised men worldwide.
In tribal settings, circumcision is nearly always associated with traumatic puberty rites. Occasionally the severed part is offered as a sacrifice to spirit beings. According to Encarta Encyclopedia, the operation certifies the subject's readiness for marriage and adulthood and testifies to his or her ability to withstand pain. Circumcision may also distinguish cultural groups from their uncircumcised neighbors.
In Jewish religious tradition, infant male circumcision is required as part of Abraham's covenant with God. The Levitical law says that every Jewish male infant had to be circumcised on the eighth day after birth, under penalty of ostracism from the congregation of Israel. Jews employ a mohel to perform the rite. After a ritual prayer, the mohel circumcises the infant and then names and blesses the child.
Among the Arabs, circumcision existed before the time of Muhammad (before 570 AD). Although the Koran does not mention it, Islamic custom demands that Muslim males be circumcised before marriage; the rite is generally performed in infancy.
Meanwhile, Herodotus, Philo and other ancient Greeks first suggested that circumcision might have hygienic benefits (ironically, the Greeks did not adopt the practice). Some theories have it that circumcision probably originated as a hygiene measure in communities living in hot and dry environments.
Since the 19th century, many English-speaking peoples have adopted the custom of circumcision, primarily for medical reasons. In modern medical practice, circumcision of males is a minor operation usually performed in infancy for hygienic purposes. It is currently estimated that 85 percent of North American males are circumcised. The incidence among non-Jewish populations of continental Europe, Scandinavia and South America is low.
Studies comparing disease rates among circumcised and uncircumcised men in the AIDS-ravaged Africa show on average three times more HIV infection among the uncircumcised. One study of a group of HIV-infected men having sex with men in the United States also found a correlation.
Dr. William Cameron, an associate professor at the University of Ottawa in Canada who co-authored several African studies, theorizes that the uncircumcised foreskin sustains tiny abrasions during intercourse, allowing HIV to enter the bloodstream. Several studies have found that such sexually transmitted diseases like syphilis also occur somewhat more frequently among the uncircumcised.
Meanwhile, the medical case for circumcision is unproved and controversial, says Dr. Donald F. Tuzin, an American professor of Anthropology at the University of California in San Diego. He says physicians in the 19th century advised the operation for many ailments, including hysteria, sexually transmitted disease, hypersexuality and even hiccups.
Removal of the foreskin also precludes phimosis or the inability to retract the foreskin. Louis XVI of France, a famous phimosis sufferer, was unable to have sex with his wife Marie Antoinette until he was circumcised at age 21.
Modern proponents suggest that diseases result from the buildup of smegma, a substance secreted under the foreskin. Also cited is evidence that circumcised populations (especially Jews) display low rates of penile and cervical cancer. Critics reject the validity of these claims, arguing that such disorders are more likely caused by poor hygiene and by contact with multiple sex partners.
In the early days of Christianity, a controversy arose over whether Christians should be circumcised, as Jews were. The Apostle Paul emphatically told Gentiles in his epistle to the Galatians: "For in Jesus Christ neither circumcision availeth any thing, nor uncircumcision."
To cut or not to cut—this is now one of the most debated subjects among the medical profession. In fact, there are now Filipino doctors who won't perform circumcision. "I have convinced quite a number of adolescent males who came to my clinic not to have circumcision anymore," one surgeon admits. "Those who are convinced are happy and thankful to me. Those who are not convinced seek other surgeons to do the circumcision for them."
In America "it's still an ongoing controversy about whether circumcision is really necessary," says Jack Sherman, M.D., associate chairman of pediatrics at Nassau County Medical Center in East Meadow, New York. "In 1971 and 1975, the American Academy of Pediatrics [AAP] said it wasn't necessary. Later, they amended their policy statement, citing studies about lowered penile cancer and first-year urinary-tract infections among circumcised males."
The AAP's 1999 policy statement, based on a review of 40 years of data, states that circumcision has potential medical benefits. "But they advise that parents not use that as their primary criterion when making a decision," says Sherman. "That's like not expressing an opinion at all."
Opponents against the practice say that in circumcision, the baby has no "power" to say no. Others suggest that circumcising an infant imprints violence on the baby's brain. Still, others contend that circumcision will leave the male species traumatized by the removal of their foreskins.
Dr. Yehuda Nir, a psychoanalyst who was formerly head of child psychiatry at Memorial Sloan-Kettering Hospital in New York, says he hasn't observed circumcision trauma. "The only thing men are concerned about with regard to the penis is its size."
Or listen to the words of a Filipino-British man, who's uncircumcised: "I guess sex with an uncircumcised man is just as good as any. I'm definitely sure that 90 percent of the women I slept with didn't leave disappointed."
