Humanistic Judaism – Summer, 1988
By Nelly Karsenty
When I began to question the practice of circumcision among American Jews, to say that I had no idea of what a great taboo it was would be an understatement. Coming from a European background where routine circumcisions as practiced in most American hospitals are nonexistent, and where many Jews reject a brit milla as an archaic and barbaric ritual, I simply assumed that the Jewish community had divergent approaches to the issue just as with every other aspect of Judaism. I was stunned to realize that questioning this ritual is the ultimate taboo among American Jews. Not only was I not supposed to question it, but I was not even supposed to have the feelings and concerns that I had toward brit milla. As a Jew, I was expected to repeat and fully believe the established clichés about the spiritual and physical benefits of circumcisions.
The extent of the repression surrounding this issue is astounding. Anyone who dares to question the brit milla ritual is angrily silenced, laughed at, lightly dismissed, or labeled “a traitor undermining Judaism.”
Practically nothing has been published within the Jewish world approaching this issue rationally and dispassionately. Anything written on the subject by any of the branches of Judaism usually emphasizes its sacred aspects: it is an act of faith commanded by God to Abraham and the Jewish people (Gen. 17:9-14). Throughout the ages, Jews have died rather than not fulfill this mitsva, and to question the practice is to desecrate their memory. Outdated medical facts emphasizing the “medical benefits” of circumcision are usually listed. The facts that a Jew may 1) not feel bound to halakha (Jewish law) or to the Scriptures, 2) have no religious faith, 3) feel that if our ancestors have suffered, it is all the more reason to avoid inflicting pain on our children, 4) be convinced that the alleged medical benefits of circumcisions are nonexistent, are ignored.
Astonishingly few people know what the milla or surgery really entails. Most Jews would describe it as “the cutting off of a little piece of skin.” The words most often used when referring to the ritual are: “joyful,” “quick,” and “painless.” Pointing out that we are talking about surgery performed with no anesthetic, raising issues of pain and possible trauma, makes most Jews angry and very defensive. Mentioning that complications do occur and that not all babies respond well to the surgery is taboo — as if pretending that this is not reality somehow makes it unreal.
Since circumcision is one of the Biblical commandments that God requires of the Jewish people, it is understandable that Jews who interpret the Bible’s teachings literally and follow its demands fully and consistently would circumcise their children. For them the issue of pain or any other argument against this practice is irrelevant. It is simply something that God, who is central to their lives, requires.
More puzzling is the case of those Jews who have chosen to reject, ignore or reinterpret traditional practices, but who are adamant about circumcising their sons. After all, if one can reject or question various aspects of Judaism, why not this one? Especially since it is not an easy ritual to experience. A helpless eight-day-old infant, who has not been consulted about what is going to take place, is forcibly restrained with his legs spread apart, while his genitals, which are exposed for everyone to see, are probed and cut with surgical instruments. Blood is then drawn out of the glans (mitsitsa, the shedding of at least one drop of blood is a required part of the ritual); the child us usually screaming and in obvious pain. It takes real faith or an amazing amount of self-deception to view this ritual as “joyful” or “painless.” It is no accident that most people attending a brit carefully avoid looking at the child’s genitals.
As a result of my questioning of brit milla, I have received scores of letters and calls from all over the country, which have convinced me that I am not alone in wanting to hear or talk about more than the usual clichés, tales of past persecutions,or rehashing of classical Jewish sources on the subject. Concerned parents complain that their negative feelings about britot are not taken seriously; they are made to feel guilty for the feelings that they have; their loyalty to Judaism is questioned. There is seldom someone to turn to for help and support in thinking through their feelings; and the information that they are able to gather about circumcision is often confusing and contradictory, making it hard for them to make a truly informed decision.
The main objections to britot can be divided as follows:
- Pain is inflicted on a helpless infant.
- Circumcision is medically unnecessary and presents potential risks and complications.
- The infant has not been consulted.
- Circumcision is ritual genital mutilation.
- Sexist attitudes surround this ritual.
Proponents of the ritual have a variety of responses to these concerns.
The Jewish community generally like to believe that circumcisions done in hospitals are painful, where britot done by well-trained mohelim are painless. While it is true that some methods will take more time and may subject the infant to more pain, all circumcisions, regardless of who does them and how they are done, require several steps, each of which is painful. The foreskin (sleeve of skin that covers the head or glans of the penis) adheres tightly to the glans in the first few years of a child’s life; it must therefore be forcibly separated from the penis before it can be cut off. This step requires tearing the common membrane between the two. This is usually done by inserting a probe or blade all around the glans (sometimes this is done by pulling the foreskin back very hard). In the direct surgery method, the foreskin is then cut along its full length from the tip to the sulcus (groove), the incision is spread apart to expose the glans, and the foreskin is cut off in a circular motion close to the groove. Other methods involve pulling the foreskin through a clamp after the initial probing and separating, and then squeezing and cutting it off. The healing process, if there are no complications, generally takes about a week.
The foreskin is composed of two layers of tissues. The nerve cells of the inner lining make it very sensitive and erotogenic; it is, in fact, similar to the inner lining of the clitoral foreskin. The area operated on is one of the most tender and sensitive parts of the male body. No anesthetic is used since it would increase the risks involved in the surgery.
For years, it was assumed that babies do not feel pain in the way that adult do, i.e. they cannot localize pain because of their immature nervous system. This year the American Academy of Pediatrics announced what many suspected, namely that newborns feel pain in the same way that adults do. Therefore doctors were advised to use anesthesia when operating on infants; this includes circumcisions. Since anesthesia greatly increases the risk involved in surgeries, one wonders whether doctors will be willing to give general anesthesia in order to perform a medically unnecessary operation.
Research monitoring babies’ physiological response during circumcisions has clearly shown that adrenal cortical responses, heart rate, and other signs are altered in significant ways that indicate a high level of pain.1 Post-operative behavior and sleep and eating disturbances clearly point to serious discomfort.
Research has shown that babies are not just reflective organisms that sleep, cry, eat, and “stool”;2 their sensory capabilities are far greater than was previously believed. While the long-term effects of pain in a newborn are unknown,3 there is no doubt that a brit subjects an infant to a brutal experience. After living for nine months in the protected uterine environment and then going through the birth trauma, the last thing that a neonate needs is surgery on his genitals. Research has shown that babies are profoundly affected by their environment early on; for example, premature babies who are caressed and handled a lot “do nearly twice as well” as those who are not.4
The typical Jewish response to the issue of pain is that there is none; the baby screams because he is being restrained, because the lights are too bright, because the room is too hot or too cold. One mohel stated that he “cuts up live flesh” but that it is painless. One Orthodox rebetsin firmly stated that God would under no circumstances want a baby to suffer, therefore britot cannot possibly hurt.
Some authorities acknowledge that there may be temporary discomfort but insist that the health benefits of circumcision far outweigh its drawbacks. Occasionally someone will acknowledge pain but will rationalize its infliction by stating that it is a gentle and loving introduction to pain, in a world full of pain and sorrows. One rabbi used to slap the bottom of baby girls during a naming ceremony to “lovingly” introduce them to pain, since they will not undergo a brit and its attendant pain. Some Jews will concede that there is pain but consider the ritual so sacred that it must be preserved at all costs.
What is most striking is how angry and defensive Jews will get before going on to fiercely deny that there is any pain. It must have taken a tremendous amount of denial throughout the centuries to avoid this issue, especially when on considers how many deaths must have occurred from this ritual when hygiene was not what it is today, when mitsitsa was performed by sucking blood by mouth directly from the penis, or when fingernails or teeth were used as cutting instruments for the milla.5 If indeed there is no pain and no problem connected with this ritual, then why the tremendous defensiveness?
To argue that pain is irrelevant to a sacred ritual is one thing, but to deny that there is any pain boggles the mind. Many will argue that some babies do not react much to the procedure. What of those who do? Babies who are sedated via the mother if she receives an anesthetic during childbirth are less likely to react to pain. Sometimes the separating of the foreskin from the glans, which many acknowledge as being as painful as the actual cutting, is done before the ceremony, away from the guests, giving the impression that the surgery is faster and less difficult than it really is. It helps to have guests, food, and commotion at a brit; somehow the primitive and raw aspects of the ritual don’t hit you so hard and the crying is more easily overlooked. Of course, the guest will experience the surgery very differently than will the parents.
The extent to which some members of the Jewish community will go to avoid or deny issues of pain often borders on the irrational or the bizarre: One rabbi advocated that each father should circumcise his own sons for some vague spiritual rewards.6 Britot are hard enough under the best circumstances, but do-it-yourself circumcisions? One mohel insists that babies scream during a brit only because they may be urinating or having bowel movements. Do babies always scream when they urinate or have bowel movements?
Technically the issue of whether circumcisions are medically beneficial or useless should be irrelevant, since brit milla was never intended as a health measure, but as an affirmation of the covenant between God and the Jewish people. However, many Jews circumcise their sons for alleged health benefits, as well as out of a vague sense that an uncircumcised Jew is not a Jew. This is especially true of parents who have doctors perform the surgery on their children in hospitals without the religious ceremony, not realizing that from a Jewish point of view, the child has not been properly circumcised. A great many Jews do not know that according to halakha, a child is born a Jew (if he has a Jewish mother) and is born into the covenant; circumcision will not make him Jewish in the way that baptism will make a child Christian.
For a great many secular or cultural Jews, viewing a brit as a health procedure makes the ritual more palatable and civilized, thus making the primitive aspects of this initiation ritual (i.e., cutting up part of the genitals and drawing blood) less disturbing.
Actually, the United States is the only medically advanced country in the world that practices circumcision; all the others reject it as an aberration. Eighty percent of the world’s population is not circumcised;7 where circumcision is done routinely, it is performed as a religious rite or puberty rite. Even in the United States, the trend is away from circumcision — down from about 90 percent of all American men to (for example) 50 percent in California hospitals.8
For years circumcision was credited with preventing a variety of ailments, ranging from masturbation to cancer, and was thought to be more hygienic. The smegma, which the foreskin produces, was thought to be a carcinogen and “unclean.” Females also produce smegma, yet we do not remove the clitoral hoods (foreskin) with no anesthetic to promote better hygiene. Much of the earlier thinking about circumcisions has been rejected: The American Academy of Pediatrics, the American College of Obstetrics and Gynecology, and the Pediatric Urologists Association have all stated that circumcisions should not be performed routinely; the former stated that “there are no valid medical indications for circumcision in the neonatal period.9
A perfectly normal and healthy organ has no need to be altered and operated on. The foreskin serves a number of useful functions, one of which is to protect the glans. This protection is especially necessary for babies in diapers, to keep the glans from coming in contact with urine or feces which might lead to irritations or infections.10 Not only is the surgery of questionable benefit, but it subjects an infant to a number of potential risks and complications ranging from death to hemorrhage, infections, urethral damage, and excessive skin removal. According to the National Center for Health Statistics, two or three babies die each year from complications resulting from this procedure.
Many older physicians and lay people seem to be unaware of the recent medical findings with regard to circumcision. We can assume that as the awareness of these facts increases, fewer circumcisions will be performed in this country; this will no doubt affect the Jewish population as well, just as it has in other countries.11
Lack of Child Consent
The infant, the central person during a brit milla, is the only passive participant. He is the one who has not been consulted about having his penis operated on in front of an audience for no legitimate surgical indication, having his body violated and altered in a significant way for the rest of his life, and being subjected to severe pain. Similarly, we do not know whether he wishes to participate in this religious ritual and to affirm his link to God and the Jewish people in this particular fashion.
While concerned parents raise issues of “child abuse” and lack of respect for the child, classic Jewish response is that parents have to subject their children to a great many unpleasant things, such as braces or going to school. As for displaying their genitals in public, babies often run naked around swimming pools. Similarly, Jewish parents make Jewish choices for their children (i.e., kashrut, getting a Jewish education) in the hope that they will ultimately make Jewish choices for themselves.
One wonders if braces, which correct an existing problem, or going to school are really comparable to having one’s genitals surgically altered for no immediate medical reason. Is running around a pool naked comparable to being forcibly restrained while one’s penis is being operated on in front of a group of people? As for making Jewish choices for our children, how many Jews who circumcise their children bother to provide them with a solid Jewish education? Are the “impositions” of kashrut or Shabbat really comparable to the physical pains and demands of a brit? What about the hypocrisy of those Jews who ask so little of themselves as Jews, whether it be in the form of participation in Jewish communal or religious activities, but who find it so easy to demand so much of their sons?
The fundamental argument for the brit is that even it if it is not medically necessary, it is religiously necessary, i.e., God requires it. The question that arises is: How many Jews really do it because God demands it as a pure and unconditional act of faith? It is worth recalling Maimonides’ statement: “No one, however, should circumcise himself or his son for any other reason but pure faith.”12
Dictionaries define mutilation as cutting off, injuring, damaging, altering, or making imperfect a healthy limb or parts of a person. As such, circumcision falls into the category of genital mutilations. While the male or female genital modifications or mutilations practiced in many parts of the “non-civilized” world would fill us with horror (i.e., slitting the penis or removal of the clitoral foreskin or part of the clitoris or labia), few Americans would view a circumcision this way. Yet is it all that different? A perfectly healthy and normal organ is altered surgically for no adequate medical reason and is deprived of the protection that nature intended it to have.
In the case of a brit, we are talking about a religious rite altering forever not an elbow or a knee, but the organ of reproduction with all of its powerful symbolism. If no blood is shed during the ritual, the glans must be nicked to draw out blood (similarly, a circumcised adult convert must have his glans nicked to shed a symbolic drop of blood during the conversion ceremony). It is a raw and primitive ritual, and as such it is very powerful.
This rite is very much a reflection of the primitive times from which it sprang. No doubt it was a great improvement over the bloody rites practiced by other nations four thousand years ago, but it runs counter to modern sensibilities and humanitarian concerns.
That Judaism is a very patriarchal religion is no secret to anyone and that little boys and the mighty phallus are given so prominent a place in Jewish life and ritual is no accident. For Jewish feminists, a brit milla is a little girl’s first major experience of exclusion from the exclusive men’s club of patriarchal Judaism. This exclusion continues; women are often excluded from meaningful participation in religious and communal life. In the halakhic realm, women still suffer from severe legal disabilities. Jewish women are subjected to male-defined laws and a system of life regulated and interpreted by men. Women may be called “queen” or may be put on a pedestal, but an Orthodox man still thanks God every morning for not having been created a woman.
While several movements within the American Jewish world have tried to remedy this situation, few women have real power within the established Jewish community; most are still tea-and-cookies servers.
A brit is very much a men’s ritual, from which the mother, who bore the child for nine months and gave birth to him, is traditionally excluded, one rationale being that she will be too vulnerable in her post-partum state to witness the surgery. (If it is hard on a mother, why is it generally assumed that it will not be hard on a newborn infant?) Women’s concerns and pain about having their infants undergo the ritual are often lightly brushed aside. Mothers are made to feel ashamed of their feelings, as if such feelings were “un-Jewish.” Most rabbis patronizingly attribute such feelings to a “mother’s heart” and dismiss them swiftly and firmly.
The traditional Jewish response to the above concerns is that boys and girls have God-given differences: Women are born into the covenant and do not need a sign on their bodies in the way that men do. One yeshiva I attended in Israel used to teach that women were born already circumcised. Women have through their bodies a natural connection with God and the spiritual realm, thus they have no need for a physical sign on their bodies; men, not being as wise or spiritual as women, need to be circumcised in order to curb their sexual appetites.
More liberal Jews will argue that baby girls are now given a baby naming ceremony so as not to feel excluded; but is this really comparable to the power of a brit? There have been some bizarre attempts to subject baby girls to a hymenotomy (piercing of the hymen) in order to imitate a brit. Rather than envying and imitating male models, a woman who experiences a powerful closeness to the child who has grown inside her body should value rather than denigrate her concerns about her infant undergoing a brit. Such feelings can be used as the foundation for developing a more humane ritual.
Considering all the arguments listed above, one might reasonably ask why it is that the vast majority of Jews who show no particular attachment to the details of the Jewish covenant with God so tenaciously defend this particular commandment. There are, I believe, a number of factors that account for the tremendous amount of denial and repression of this issue within the American Jewish community and for the powerful need to preserve the status quo:
- Jews are a very unusual group in that they are constantly faced with a struggle between religion and nationality. In the pre-modern period, nationality and religion were inseparable. With the rise of secularism, many Jews chose an ethnic identity as opposed to a religious one but found that there is no available system of national (ethnic) symbols independent of religious ones. Therefore, those Jews who wish to identify as Jews have only religious symbols through which to declare their Jewishness. We thus find Jews who have no religious faith or commitments, and who fiercely reject divine authority, yet who are adamant about circumcising their sons, an act of faith commanded by the very God that they reject.
- Secondly, human beings seem to have a powerful need for rituals, especially around life cycle events. A Jew might never set foot in a synagogue but will circumcise his son. He might not do it as a religious ritual, but he will do it on the eighth day.
- Circumcision is seen as a symbolic loyalty oath stating that one belongs to the Jewish tribe.13It is easier to do so by circumcising one’s son than by demanding of oneself to pray three times a day or to observe the dietary laws or the Shabbat each week.
- Jews are a people who are very historically conscious; they have been oppressed and have suffered from persecutions for centuries. Thus they tend to be very sensitive about anything that might smack of anti-Semitism. Since circumcision has been, at times of persecution, the first precept forbidden to them, they tend to view abrit as a sign of defiance and a proud assertion of their Jewish identity. The automatic Jewish response to anyone questioning britot is that our ancestors have died rather than not circumcise their children; not to do so is to desecrate their memory. Jews tend to view the rejection of a brit as a classical denial of Jewish identity, i.e., if you are not circumcised, you do not want to be Jewish; thus to question britot is to give Hitler a posthumous victory.
- There is still much confusion in this country about the alleged health benefits ofbritot; many Jews still feel that they are saving their children from cancer by circumcising them.
- Finally, thebrit milla is one of the major ways in which Judaism differs from Christianity; therefore many Jews have the sense that a rejection of circumcision implies an embracing of Christianity.
All of these concerns are very real, very much a part of the Jewish world, and deeply rooted in the Jewish psyche. Nevertheless, for concerned parents who wish to approach this issue rationally, these need not be insurmountable obstacles. To give up the milla (surgery) does not necessarily mean rejecting a brit (covenant) ceremony and need not imply a rejection of Judaism.14 Many committed and strongly identified Jews, especially women who feel that they have been left out of meaningful participation in religious life for too long, are creating new rituals and adding to, subtracting from, or enriching existing ones. New birthing ceremonies are being created; some Jewish parents have used naming ceremonies for baby boys without any surgery and a few rabbis have been willing to participate in these bloodless rituals. There are a great many ways to express one’s Jewishness; this issue can help us to be more aware of what we choose to do as Jews and why.
Judaism has survived in spite of, or because of, changes. It is not so shaky and vulnerable that this or any other change should undermine it or threaten it with eventual destruction. For those who wish to do so, the brit milla ritual can be reinterpreted and changed just as other aspects of Judaism have been over the centuries.
1 Williamson P. and Williamson M. Physiologic Stress Reduction by a Local Anesthetic During Newborn Circumcision. Pediatrics (1983):36-40.
2 Klaus M. and Klaus P. The Amazing Newborn (New York:Addison-Wesley, 1986).
3 Kirya C. and Werthmann M.W. Neonatal Circumcision Journal of Pediatrics 92, no. 6 (June, 1978):1000.
4 Brazelton B. Doctor and Child (New York: Delacotte Press, 1976), 31.
5 Wallerstein E. Circumcision: An American Health Fallacy. (New York: Springer Publishing Co., 1980). 156. This award-winning book presents a detailed review of medical aspects of circumcision.
6 Kozberg C. A Father Performs Brit Milah. Journal of Reform Judaism. (Winter 1985).
7 Wallerstein E. Circumcision: Ritual Surgery or Surgical Ritual? Law and Medicine (1983):91.
8 Donovan J. The Big Controversy over Circumcision. San Francisco Chronicle (May 30, 1985).
9 Report of the Ad Hoc Task Force on Circumcision, Committee on Fetus and Newborn. Pediatrics 56, no.4 (October 1975).
10 Preston N. Whither the Foreskin? Journal of the American Medical Association 213, no. 11 (Sept. 14, 1970):1853-58.
11 This author grew up in France in a traditional Jewish family. Not a single male of her generation or her children’s generation within her large family (or in her circle of Jewish friends) was ever circumcised.
12 Maimonides, Moses. Guide of the Perplexed (New York: Dover Publication, 1956), 378.
13 Paige K.E. and Paige J. The Politics of Reproductive Ritual. (Berkeley: University of California Press, 1981).
14 It is worth noting that the Reform movement did reject brit milla in the latter part of the nineteenth century.