To the Editor:
Insofar as Jon D. Levenson’s “The New Enemies of Circumcision” [March] touches on my book, Circumcision: A History of the World’s Most Controversial Surgery, I would like to clarify two points. First, when it comes to the circumcision wars, I am simply a historian—not in any sense the “activist” Mr. Levenson believes me to be. My conclusion that neonatal circumcision lacks a persuasive medical rationale is drawn from analyzing the available evidence. In recent years, the American Academy of Pediatrics and the Canadian Pediatric Society have reached similar conclusions.
Second, and far more outrageous, is Mr. Levenson’s claim that he detects in books like mine and Lawrence A. Hoffman’s erudite Covenant of Blood: Circumcision and Gender in Rabbinic Judaism “the whiff of anti-Semitism (and/or Jewish self-hate).” This would be libelous if it were not so absurd. Alas, in light of circumcision’s history of stirring passionate controversy, I guess one should expect antagonists to seize any weapon at hand.
La Jolla, California
To the Editor:
Despite being a lifelong practicing Jew and the mother of a circumcised son, I consider myself a conscientious objector to this observance. As Jews, we would at least like the assurance that we are not engaged in a ritual that is medically unjustified—but, despite Jon D. Levenson’s arguments to the contrary, we are.
It is well known that circumcised men can and do contract HIV and other sexually transmitted diseases, which means that all men need to practice safe sex regardless of whether they have been circumcised. Urinary tract infections (UTI’s) should be treated not by surgery but with antibiotics—as they are in women, who contract UTI’s much more often than do men. Renal failure is almost always the result of serious genital anomalies, which may require all sorts of surgical intervention—not merely circumcision. Penile cancer, which appears to be linked to promiscuity, is exceedingly rare. There is, then, little point to Mr. Levenson’s contribution to the never-ending search for the medical benefits of circumcision.
What is not discussed in Mr. Levenson’s article is our right to bodily integrity. The cavalier attitude toward the removal of the foreskin is based on the widely held belief that it is a “useless flap of skin.” But why, then, do we recoil in horror when we hear about female genital mutilation (FGM)? Mr. Levenson invokes all the complications of FGM, but one could argue that they would be greatly reduced if performed in a sterile hospital setting. Would that make it more palatable?
A frank discussion of sexuality and sexual anatomy is necessary in order to have a full understanding of all the issues involved in circumcision, but the taboos surrounding the practice—and anti-Semitic diatribes against it—have made enlightenment difficult to achieve. My hope is that the Jewish people will lead the way in this necessary discussion.
To the Editor:
Jon D. Levenson digs through 200 pages of excellent scholarship by David Gollaher, looking for something to which he can attach the libel of anti-Semitism. He should learn instead from a much greater scholar, Maimonides, who, though an apologist for Judaism, was not afraid to face the truth.
In his Guide for the Perplexed, Maimonides, who was also a great physician, dismisses as absurd any claim of medical benefits for circumcision. Instead, he explains,
One of its objects is to limit sexual intercourse, and to weaken the organ of generation as far as possible, and thus cause man to be moderate. . . . The bodily injury caused to that organ is exactly that which is desired; it does not interrupt any vital function, nor does it destroy the power of generation. Circumcision simply counteracts excessive lust; for there is no doubt that circumcision weakens the power of sexual excitement, and sometimes lessens the natural enjoyment.
Moreover, Maimonides goes on to admonish, “No one . . . should circumcise himself or his son for any other reason but pure faith; for circumcision is not like an incision on the leg, or a burning in the arm, but a very difficult operation.”
As parents, Jewish and non-Jewish alike, we must ponder Maimonides’ words and ask ourselves whether we still have the right to inflict this harmful and anti-sexual surgery on our non-consenting sons, whatever motivation we might claim. This is particularly true when, as Mr. Levenson himself concedes, “All sorts of other practices bearing the warrant of tradition—Sabbath, dietary laws, daily prayer—have fallen by the wayside” for those who feel that the reasons once inspiring them no longer apply in our modern, secular lives.
Delgado Community College
New Orleans, Louisiana
To the Editor:
Like many others, Jon D. Levenson seems to think that cutting off part of a baby’s genitals is a practice justified by its antiquity. The great virtue of David Gollaher’s book is that it puts this tradition into perspective. Contrary to Mr. Levenson, both medical circumcision and brit milah are expressions of parental control, and his defense cannot escape the fact that at the heart of the proceedings there is a helpless baby.
Mr. Levenson writes that “classical Jewish texts value the willingness to suffer for a worthy cause.” This is rather different from a willingness to make someone else suffer.
Pukerua Bay, New Zealand
To the Editor:
I am a Jewish mother who chose not to have her son circumcised. My research has led me to believe that there are serious if unrecognized physical and psychological effects connected with the procedure.
Jewish mothers report that circumcising their sons forces them, the mothers, to distrust their most basic instinct—to protect their child from harm. Others suffer a sense of loss and an alienation from Judaism because of their doubts about this important Jewish act. As an outspoken enemy of circumcision, I do not feel my opposition represents any “fault line within contemporary Jewry,” in Mr. Levenson’s words, but rather a traditional Jewish process of reflection and evaluation that could result in a healthy dialogue.
To the Editor:
Jon D. Levenson ably defends circumcision from its philosophical, medical, and moral critics, but I wonder where his heart is. I now have a two-year-old son whom I could not put under the knife even though I am Jewish, live in Israel, and believe in God. As I watch him grow up, I know that this boy is perfect the way he is. Nothing needs to be taken from him—not even a small piece of skin—for him to be the greatest present God has ever given me. Contrary to what Mr. Levenson claims, my son is Jewish regardless of whether he is circumcised—because his mother and I are Jewish, because we teach him Jewish values, and because his grandparents died in Auschwitz.
Ramat Gan, Israel
To the Editor:
For the last hundred years, a steady stream of Jewish American doctors has cleverly defended circumcision on medical grounds. The conflict of interest here is glaring. The rabbis give the doctors a wink, secretly pleased by the validation of what otherwise would be perceived as an act of barbarism. The doctors, meanwhile, find one excuse after another to connect their modern obsession with physical hygiene to the Jewish demands for moral hygiene.
The antisexual sentiments expressed by Mr. Levenson in his concluding paragraph, in which he calls for a restoration of the traditional virtues of “sacrifice, discipline, and obedience,” hint at an awareness of the sexual pleasure to be had from the foreskin of the penis. Little do today’s mohelim (ritual circumcisers) know that they are preparing a generation of plaintiffs who will be claiming a loss of sexual pleasure in a class-action lawsuit filed against them.
Norman L. Cohen
To the Editor:
In his essay, Jon D. Levenson makes the following analogy: “To say that a Jewish child will decide whether to fulfill the [commandment of circumcision] himself upon reaching adulthood . . . is like saying that he will at the same point decide what his mother tongue will be.” This makes no sense. When it comes to teaching their child the only language that they know and that their neighbors and countrymen speak, most parents have no choice. When it comes to circumcision, all parents have a choice. A mother tongue is a product of the language instinct, a natural human phenomenon; circumcision is an artificial religious marker.
To the Editor:
Jon D. Levenson is to be commended for defending the values of the Jewish covenant with God against me “new enemies of circumcision.” I believe, however, that in the process he has misrepresented the position of Reform Judaism. Moreover, in quoting out of context from an article that I wrote almost a decade ago, he has mistakenly suggested that some Reform rabbis protest the practice because of their own “spiritual and moral void.”
Here are the rhetorical questions I raised in my article, written after my own son’s brit: “Had I somehow abandoned [my son in his pain] for the sake of the ceremony? What kept me from aborting the ceremony on his behalf?” Mr. Levenson suggests that “implicitly . . . unanswerable” questions such as mine are meant to undermine the Jewish people’s commitment to circumcision. Had he read my entire article, however, he would have found that I discuss several reasons outside the halakhic (legal) ones for preserving the rite of circumcision—despite the anguish that we parents often experience during the ceremony, and despite the fact that many of us no longer feel that circumcision is a divine imperative.
Thus, for example, I argue from psychoanalytic theory that the parents’ psychological ambivalence is an important and indeed profoundly Jewish contribution to the brit—a dynamic that might unconsciously commit parents to a heightened sense of compassion and empathy for their children. Furthermore, I suggest that as informed medical consumers, parents should be taking a more active role in minimizing (if not completely eliminating) the child’s pain by employing a mohel willing to anesthetize the site. Many Reform mohelim are now trained in this technique, adopted in some Orthodox circles as well.
While many substantive issues do divide liberal from traditional Judaism, the brit should not be included among them. With ample respect to Mr. Levenson’s necessary defense of circumcision, he misjudged Reform Judaism’s commitment to this life-cycle event.
[Rabbi] Michael Herzbrun
Rochester, New York
To the Editor:
Jon D. Levenson presents the arguments of a number of anticircumcision advocates and demolishes them all, with the exception of the claim that the procedure inflicts too much pain on the infant.
In the last several years parents have been advised by mohelim to apply lidocaine to the penis following the procedure. Even prior to the advent of this medication, however, neurologists assured us that since an infant’s nervous system is still undeveloped at eight days, no pain registers in the child’s brain. When an infant cries, it is not during the procedure itself but rather at the removal of his diaper.
[Rabbi] Eugene J. Cohen
New York City
To the Editor:
Jon D. Levenson presents a lucid account of “the new enemies of circumcision.” He notes that circumcision reduces the incidence of penile cancer and sexually transmitted diseases, including HIV. His claim is confirmed by the 1999 edition of Sexually Transmitted Diseases:
The weight of evidence indicates that male circumcision decreases host susceptibility to several sexually transmitted diseases, particularly including chancroid and HIV. . . . [I]t seems inescapable that this is one of the most neglected risk factors in the HIV epidemic in developing countries . . . and more attention to this issue in prevention efforts . . . is urgently needed.
What is more, there is evidence that female partners of circumcised males show a lower incidence of cervical cancer and sexually transmitted diseases, including HIV. All this information is important to men’s and women’s health, but it almost never appears in the media.
A popular radio doctor condemns circumcision and even advises men to have the procedure surgically reversed. Yet the same doctor speaks nonjudgmentally about tattooing and body piercing, despite the risk of transmitting hepatitis and other diseases. A procedure with definite health benefits and minute risks is condemned, while procedures with definite risks and no health benefits are discussed neutrally and evoke no groups intent on putting a stop to them.
Why the difference? Is it a coincidence that the Bible mandates circumcision but forbids tattooing and body piercing? In our haste to destroy the guideposts, especially the religious guide-posts, that helped prior generations, we are throwing out the baby with the bathwater.
David C. Stolinsky, M.D.
Los Angeles, California
Jon D. Levenson writes:
Having pronounced the medical evidence on neonatal circumcision “stunningly contradictory,” as he does at one point in his book, David Gollaher now claims (as he did at another point in his book) that the procedure “lacks a persuasive medical rationale.”
Let me go over this ground again. In his book, when Mr. Gollaher evaluates the many studies that speak to the hygienic benefits of circumcision, he demands a high standard of evidence and does what he can to undermine their conclusions—wondering, for example, whether circumcised men are dramatically less likely to be infected with HIV because they “eat different foods than the uncircumcised.” When, on the other hand, he confronts anticircumcision claims in the contemporary literature—for example, Ronald Goldman’s assertion that circumcision lowers men’s self-esteem, makes them avoid intimacy with women, and raises the rate of divorce as well as that of “assault, rape, and murder”—he lets them pass with nary a peep of protest or curiosity as to whether they are supported by any scientific evidence.
In a related vein, when Mr. Gollaher comes across a blatant example of the medieval blood libel, he simply pronounces it an “indication of bizarre practices” among Jews. And yet he now wonders what makes me detect “a whiff of anti-Semitism and/or Jewish self-hate” in the anticircumcision movement.
Why the double standard? Despite Mr. Gollaher’s claim that he is a disinterested historian, the conclusion seems inescapable that his own opposition to circumcision has determined how he evaluates evidence. Moreover, given the role that circumcision has played in the history of anti-Semitism, the danger is real that when opponents of circumcision adopt a double standard of the kind I have just described, a revived anti-Semitism will result, whatever the intention. (Contrary to what Mr. Gollaher writes in his letter, I did not charge Lawrence A. Hoffman with anti-Semitism or self-hate.)
Although Kayla Hanocka identifies herself as a practicing Jew, she breaks dramatically with the Jewish tradition by demanding that brit milah have a medical justification. (Her assumption that male “bodily integrity” requires the foreskin is also, to put it mildly, not drawn from Judaism.) What is more, her own medical reasoning can be dangerous to health. It is one thing to argue that cost-benefit analysis does not warrant routine neonatal circumcision. It is quite another—and highly inaccurate—to claim that the practice has no benefits.
The evidence is that circumcision helps protect against venereal disease; despite this evidence, Kayla Hanocka would have men rely solely upon “safe sex.” Studies show that circumcision reduces significantly the rate of urinary-tract infections (UTI’s); in the face of these studies, she suggests that such infections “should be treated not by surgery but with antibiotics, as they are in women.” But why condemn parents who prefer a more active approach, sparing their sons a potentially dangerous initial infection? If there existed a safe surgical procedure that significantly reduced the rate of UTI in women, and that could be performed on an outpatient basis in a matter of minutes, I suspect that many medical authorities would endorse it enthusiastically.
Finally, Kayla Hanocka’s claim that the complications of female genital mutilation (FGM) would be reduced if it were “performed in a sterile hospital setting,” though true up to a point, misses the crucial difference between this practice and male circumcision—a common error among anticircumcision partisans. The excision of the clitoris and the narrowing of the vaginal opening are not complications of FGM but usually its very goal. From the standpoint of anatomy, the male equivalent of a clitoridectomy would be not the removal of the foreskin but the amputation of the glans penis.
In the passage from the Guide for the Perplexed that Ari Zighelboim excerpts, Maimonides makes the psychological observation (perhaps obsolete today) that only someone acting out of firm religious conviction would undertake circumcision. He is not making a normative statement about who ought to do so. Lest readers be misled by Mr. Zighelboim’s attempt to enlist Maimonides (of all people) in the campaign against brit milah, let me quote from the beginning of his discussion of this topic in his great law code, the Mishneh Torah:
It is the [Jewish] father’s obligation to circumcise his son. If the father transgressed . . . and did not circumcise [his son], he has been derelict of a positive commandment . . . and it is the obligation of the rabbinical court to circumcise that son . . . in his proper time. They must not leave any uncircumcised male among the Jewish people. . . . If the matter escaped the attention of the rabbinical court and they did not circumcise him, when he reaches majority, he is obligated to have himself circumcised, and with each day that passes after he has reached majority without his having had himself circumcised, he is derelict of a positive commandment.
Not a lot of ambivalence there.
Contrary to Hugh Young’s view, I do not think that the antiquity of brit milah is what justifies it I do believe that responsible parents inevitably make decisions that cause their children pain and that for Jewish parents to decide in favor of the ceremonies required by Jewish law is highly responsible and commendable. I also maintain that those parents, Jewish or gentile, who see the health benefits of circumcision as justifying the practice have a scientific basis for their judgment.
How many Jewish mothers react to brit milah as Wendy Zieve reports is unknown. But there has never been a lack of Jewish mothers for whom the mitzvah is important—in Hellenistic times, many Jewish mothers chose martyrdom rather than violate this commandment—and these are still the majority. Of course, the validity of the practice is neither disproved nor confirmed by the emotional reaction that people may have to it at the time it is performed, especially if their knowledge of the relevant history and theology is weak.
Marc Gelkopf is eager to demonstrate his Jewish authenticity, even invoking the ancestors of his young son who perished in Auschwitz. But when it comes to brit milah, the “Jewish values” he espouses mysteriously vaporize, and all he can see is a “perfect” baby being heartlessly “put under the knife.” Mr. Gelkopf attributes to me the position that the brit is what makes a boy Jewish, but I actually wrote the reverse: “circumcision symbolizes but does not effectuate the covenant.”
Norman L. Cohen is correct that I condemn the hedonism of those who argue that circumcision should be given up because the foreskin supposedly enhances sexual pleasure. He is incorrect, however, to think that the only alternative to the hedonism I criticize is the “antisexual sentiments” that he mistakenly attributes to me. In any case, there is reason to question the claim that long-term sexual pleasure is enhanced, rather than diminished, when “traditional virtues” are scuttled.
Here is the point of the analogy that James Hoyle misses: the analogy, that is, between saying that a Jewish boy will decide for himself upon reaching majority whether to have a brit and saying that he will at the same point decide what his mother tongue is. Given the almost unparalleled importance of brit milah in Jewish practice (see Maimonides, above), a boy raised in an environment in which this key mitzvah has been deliberately violated will have a very hard time approaching the question of Jewish observance and identity from a neutral position. The likelihood, in other words, is that his mind will have been made up beforehand. I suspect that most of the new enemies of circumcision know that. They also know that when the procedure is performed on an adult, healing takes longer and the pain may be more intense.
I thank Michael Herzbrun for noting that he personally does not regard as unanswerable the objections to brit milah that he pointedly raised in his article. But if he doubts that others find them unanswerable, he need only read the letters preceding his. Since I was careful at every stage to acknowledge the diversity of opinion within Reform Judaism on this issue, I cannot see how I have misrepresented Reform’s position. If brit milah is to thrive among Jews of that affiliation, as Rabbi Herzbrun believes it will, then the movement will have to develop a more emphatic response to the forces, both internal and external, that are currently undermining it. It should, for example, repudiate the normless subjectivism of the cochairman of the brit milah board of Reform Judaism who wrote that “people have to fulfill their inner sense” as to whether the rite is “a meaningful way of connecting with the Jewish people.”
Reform will also need to take something other than a laissez-faire attitude toward young rabbis, who, like those in the anecdote I quoted from Lawrence Hoffman, “frequently harbored intense rage at themselves for allowing [the brit] to happen.” When a significant number of rabbis are furious with themselves for allowing a “life-cycle event” (to use Rabbi Herzbrun’s term) to take place, surely it is proper to wonder about the commitment to that practice of the Jewish movement with which they are affiliated. Time will tell whether the psychoanalytic defense of brit milah that Rabbi Herzbrun proposes has the depth and durability of the classical theological and halakhic rationale that it is meant to replace.
I thank Eugene J. Cohen for raising the interesting possibility of employing anesthesia after the brit. The use of anesthetics during the brit is sufficiently controversial in Jewish law that I decided not to discuss it in my article. The weight of scientific research does not, however, support Rabbi Co-hen’s claim that “no pain registers in the child’s brain.”
I would also like to thank David C. Stolinsky for citing some of the mounting evidence for the advantage of circumcision in combating the spread of sexually transmitted diseases, and for pointing out the irrationality and inconsistency of some opponents of the practice.