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Curzon
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Curzon

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February 20th, 2008

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The History of Male Circumcision, Part 2: America and the English Speaking World

As of the time of this posting, my first post on this topic recieved zero comments, which either means readers are disgusted, bored, or disinterested.

Nonetheless, moving onwards: today, most Americans think of circumcision as natural procedure for male babies. Neonatal circumcision is the most common operation carried out in the U.S. today. Nationally, rates are as high as 60%, down from a peak of 75% in the 1970s. But when compared to the rest of the English speaking world, America is unique. Great Britain, Canada and Australia have current rates of male circumcision at about 15%, whereas New Zealand is lower than 5%. In the US, the rate differs by regionally, with high rates of circumcision in the white South, but low circumcision rates among babies of Hispanic origin. Most of the rest of the Western world has retained the abhorence of male circumcision that has existed in Europe since the time of the ancient Greeks (and as noted in the last post, some in 18th century England feared Jewish emancipation meant universal circumcision!). What happaned in the US that made the procedure so popular?

There are a number of reasons that brough circumcision to prominence in America in the early 20th century.

1. Circumcision as a cure for maladies. In 1870, Dr. Lewis Sayre of New York (and vice president of the newly-formed American Medical Association), examined a boy who was unable to straighten his legs and whose condition had so far defied regular treatment. Upon noting that the boy’s genitals were inflamed, Sayre hypothesized that chronic irritation of the boy’s foreskin had paralyzed his knees via reflex neurosis. Sayre circumcised the boy, and within a few weeks he recovered from his paralysis. After additional positive results, Sayre began to promote circumcision as an orthopedic remedy, and his prominence within the medical profession and the newly formed AMA allowed him to reach a wide audience. Over the next decades, the list of ailments reputed to be treatable through circumcision grew to include hernia, bladder infections, kidney stones, insomnia, rheumatism, epilepsy, asthma, erectile dysfunction, syphilis, insanity, and a handful of other syndromes.

2. Stop Masterbation! Advocates were aided by the puritanical moral sentiment of the day, as circumcision was promoted as a way to discourage masturbation. (Modern surveys have actually shown the opposite to be true.)

3. Hospitals. Compounded by cause no. 1, as hospitals proliferated in urban areas, more children were under the care of physicians in hospitals rather than with midwives in the home. Some historians have even theorized that circumcision became a “class marker” of those wealthy enough to afford a hospital birth.

4. Easier Surgical Procedures. The discovery in 1885 of hypodermic cocaine as a local anaesthetic made it easier for doctors without expertise in the use of chloroform to perform minor surgeries. Several mechanically-aided circumcision techniques, forerunners of modern clamp-based circumcision methods, were first published in the medical literature of the 1890s, allowing surgeons to perform circumcisions more safely and successfully.

Circumcision was at a statistical height of about 75% of the country from 1950 to 1970. Today it is becoming less popular, partially because of high numbers of Hispanic immigrants, and growing opposition in the more progressive northeast and west (it remains overwhelmingly common in the South). Today, the major medical societies in the USA do not recommend routine non-therapeutic infant circumcision. This has long also been the case in the rest of the English speaking world, which has never seen circumcision rates as high as the United States.

Fun fact: all three ComingAnarchy North American-born contributors are circumcised—one at birth, one as a young teen, and one as a young adult.

Comments to this entry

Adrian
February 21, 2008
1:28 am
"Fun" fact? Or TMI? Oy.
Richardson
February 21, 2008
1:45 am
I echo Adrian - "fun fact"?

My boy is 7 months old and we had him done on day two - won't remember a thing...
Joe
February 21, 2008
8:23 am
I happen to know a grown man who ripped his foreskin open while doing the dirty deed. Imagining how that must feel makes me totally in favor of neonatal circumcision.
Chirol
February 21, 2008
8:31 am
With comments like these, maybe it was better to not have any on the first post, I feel like I'm reading my spam folder! =)
visitor
February 21, 2008
10:01 am
Another reason was the belief in supposed prevention (not just treatment) of diseases: I went on a tour last year of a historic military site in California, and the tour guide, who claimed to be a professional historian (so I'm trusting he had his facts straight), told us that in 1941, as part of the U.S. troops preparation for battle in WWII, all soldiers had to be circumcised. The reason for this was that they thought it would help in the prevention of venereal disease... In retrospect, it's surprising there weren't more conscientious objectors!
Curzon
February 21, 2008
10:46 am
Joe: how does "this":http://en.wikipedia.org/wiki/David_Reimer influence that view?
Felonious Punk
February 21, 2008
3:58 pm
Um, this is a little detailed, but...
I wasn't circumcised as an infant, and I sure as hell have no desire to as an adult! I'm the son of immigrant parents (from England), and they had to PERSUADE the doctor from doing it to me. This was 1976, in NYC. I won't go into detail of what I see as some specific benefits of being uncircumcised, but I will say even a light breeze is a lot more fun for me that it is for most others -- based on some totally non-scientific, yet exceedingly enjoyable experiments I've conducted in my "lab".
Either way you look at it though, it IS unnecessary genital mutilation.
Hugh
February 21, 2008
9:08 pm
"Won't remember a thing" Yeah, that's what a drug rapist says, too. But he will certainly know it's been done, and as it goes out of fashion, you get less and less guarantee that he will like it.

Interesting story about it being compulsory in 1941. I'd like to see the official records, though. Puts a new slant on a boy being done "to look like his father" - it's like the old story about the wife cutting the ends off the meatloaf because her mother did (and the great grandmother turned out to have done it because HER meatloaf tray was short). Don't take that parallel too far.

Now a study has just come out showing that circumcision DOESN'T prevent STDs. It's by Dickson et al at J Pediatr 2008;152:383-7. Of the 499 men remaining in a 32 year old birth cohort in Dunedin NZ, 40% were circumcised. "the incidence rates for all STIs were not statistically significantly different — 23.4 and 24.4 per 1000 person-years for the uncircumcised and circumcised men, respectively." What do you bet this study won't get worldwide headlines, like the one that claimed it did?
Diodotus
February 21, 2008
10:20 pm
Awesome post, very informative. It's always blown me away that we are so ready to condemn the cutting of little girls in Africa but insist on the right to slice baby boys, often w/o anesthetic. The American Academy of Pediatrics has said there is no medical rationale for this.

There's an entire international movement emerging to treat routine neonatal circumcision as a bodily integrity violation analogous to FGM. Check out the campaign website at http://www.icgi.org/.
lirelou
February 21, 2008
11:44 pm
I think our visitor has been deceived by said historian. I never heard of any WWII policy to circuncise GIs, and every male member of my father's family served, and none were circumcised to my knowledge. Nor did I ever hear any reference to circumcision among my NCOs when I enlisted (1962), and most of them were WWII veterans.
Hugh
February 22, 2008
3:14 am
Joe wrote: "I happen to know a grown man who ripped his foreskin open while doing the dirty deed." He more likely tore his frenulum, the membrane under the foreskin, sometimes known as the banjostring. It's not uncommon, is almost painless, does no harm and is soon healed.

"Imagining how that must feel makes me totally in favor of neonatal circumcision." This is known as the Fallacy of the Vivid Instance. Nobody is posting the stories of the billions of men who lived all their lives with foreskins to which nothing much ever happened. Yet every single mishap gets spread about like confetti, and is made the excuse for many more (unnecessary) circumcisions.
Mutantfrog
February 22, 2008
5:02 am
"The American Academy of Pediatrics has said there is no medical rationale for this."
Are you sure that isn't out of date? It's been widely reported over the last couple of years that circumcision cuts the chance of HIV transmission by a very large percentage.
http://www.nytimes.com/2007/03/29/health/29hiv.html

The NYT is here reporting, just under one year ago, that the WHO is recommending universal circumcision for this very reason.
Lydia
February 22, 2008
5:49 am
Excellent post! I guess I'm curious to know why the two contributors were circumcised in their teen/adult years. I'm wondering if it was personal preference or for health reasons and if they would automatically have their newborns circumcised?

For the record, I am a maternity room nurse. I can honestly say most doctors are financially motivated to recommend and perform circumcisions. Some of them flat out lie or use scare tactics to pressure parents to consent, while others take a neutral stance (even if they'd never circumcise their own child, they don't mind accepting payment for cutting someone else's child).

And also for the record, infant circumcision is not recommended by ANY medical organization world wide. I believe when the WHO recommended circumcision it was for adults only in the high HIV regions of Africa.
But babies are not having sex. They would only catch HIV through an infected mother or a blood transfusion, and circumcision would protect them from neither.
Plenty of grown men in the US have acquired HIV and all other std's despite being circumcised as both infants and adults. Because of that, I can not believe that circumcision does anything to lower my own child's risk of disease. Abstinence or condom use, without exception, is the only thing that will keep any of us "safe".

Lastly, I'd like to comment on the info on the demographics of those choosing not to circumcise. While it's true that some Hispanics are not circumcising, some do to be more "Americanized". I personally know plenty of US born, white, Christian, "mainstream" parents in the south and SE who are not circumcising their boys. I did not because as a nurse I know how painful it can be and how often complications occur. I also know MD's, vets, teachers, engineers, ministers, a few waitresses and even a pilot from the south who did not circumcise their boys. So while circumcision still may be prevalent in the south, there are those of us educated enough not to put our babies through unnecessary and risky surgery for no apparent reason.
Thanks!
Lydia
dj
February 22, 2008
7:14 am
Something is very strange about this topic. I don't understand why some people are so anti-circumcision. If no one told me it was done to me I would have never known. So it don't view it as mutilation or anything. I am comfortable with it but some people feel that I should be. Something political behind it.
Circumcision Has a Short History in Korea | The Marmot's Hole
February 24, 2008
12:56 am
[...] at the Coming Anarchy, Curzon has posted on the history of circumcision around the world.    Introduced to Korea after WWII apparently by Americans, circumcision has become the norm [...]
David
February 24, 2008
7:13 am
The only two countries in the world now that circumcise infants are the USA and Israel. But the thing is Israel has a reason, they are Jewish over there. Hello America, anybody home?
Joe
February 24, 2008
11:58 pm
This is known as the Fallacy of the Vivid Instance. Nobody is posting the stories of the billions of men who lived all their lives with foreskins to which nothing much ever happened. Yet every single mishap gets spread about like confetti, and is made the excuse for many more (unnecessary) circumcisions.
I don't consider this statistically. I would just rather lose what seems to be a useless part of the anatomy--at a time when I won't remember it--than have to deal with it later when any problem will be much more painful and embarrassing.
A Tale of Circumcision | East Windup Chronicle
February 27, 2008
4:54 am
[...] above). The blog Coming Anarchy has a History of Male Circumcision, told in two parts here and here, and I recommend it as a means of getting your feet wet on the [...]
Zorn Gottes
March 30, 2008
9:41 am
"all three ComingAnarchy North American-born contributors are circumcised—one at birth, one as a young teen, and one as a young adult."

You fellows are not typical adult white hospital-born Americans, a tribe that was overwhelmingly circumcised at birth. Many boys who fit this description and came of age before 1980 or so, did not learn that their penises had been surgically altered until after high school.

The popularity of infant circumcision is not highest in the South (which is heavily black, and some blacks still refuse circumcision) but in the Midwest. It is weakest west of Denver, wherever Latinos are numerous, and in university towns.

Canadians are pretty much the same people as Americans, and have similar medical and hygiene practices. But there's a difference: they, unlike Americans, have pretty much given up on circumcision. A big natural experiment has begun. If the foreskin is a bad thing, a comparison of USA and Canadian urology records around 2040 or so will let us know for sure.