Debate Over Male Circumcision Heats Up As Voters in Two California Cities Are Asked to Ban the Practice

In my parents’ living room, there is a special section on the bookshelf that, were one to label it, might be called, “books by our family” or “books we wrote.”  It’s a small section; just three deep. It contains the children’s book my mother wrote in 1969 (Nicholas, a now-inappropriate tale of a young boy riding the subway alone and getting lost), Predictable Pairings (a psychological profile of marriages by my grandfather), and Preventing V.D. and Cancer by Circumcision, which was written by my great-grandfather, Abraham Ravich. Now I admit that while I felt some sort of family pride (and have always hoped to add my own tome to the shelf), I haven’t read them all. I can quote Nicholas, but I only got as far the dedication in my grandfather’s book (it is, in part, dedicated to my sister and me), and haven’t even cracked open the book on circumcision, so what I know about it is second or third hand.

My great-grandfather was a urologist in Brooklyn in the 30s, 40s, and 50s. To hear my family tell it, many of his patients were Jewish immigrants and he observed that they had a lower rate of what was then called V.D. (now I suppose STDs or STIs) and prostate cancer.  He theorized that circumcision played a role in these reduced rates.  I have to admit, it never struck me as particularly interesting and it never occurred to me that it would be quite controversial but as my mother says, you learn something new every day. Today, in writing this story, I learned that in some circles Poppy Abe (whose formal portrait now hangs in my downstairs bathroom) is considered a “zealot” who “invented” the claims of a cancer connection to advance the practice of male circumcision.

In fact, there is a growing movement against male circumcision which activists (who like to use the term "intactivists") call “male genital mutilation.” Activists in California collected over 7,100 signatures in order to get a new initiative on the November ballot in San Francisco that would ban the practice of male circumcision within the city limits.  They argue that the procedure is medically unnecessary and say that they hope this initiative is the start of a wave of laws on this issue.  Matthew Hess, the author of the San Francisco measure and a similar measure slated for Santa Monica’s November 2012 ballot, explained:“The end goal for us is making cutting boys’ foreskin a federal crime.”

Jena Troutman is also advocating for the ballot initiative. Ms. Troutman, who is the mother of two boys, runs a website called wholebabyrevolution.com. She explains that through her activism she is just trying to “save little babies” from a procedure that “can do serious damage.”  Ms. Troutman apparently approaches pregnant women on the beach to warn them of the dangers of circumcision. 

In truth, there are few dangers in circumcision. A study conducted by SDI Health for the Centers for Disease Control and Prevention (CDC) in 2010 found that there was very low rate of complications associated with newborn circumcisions, that most complications were considered mild, and that no babies died. The claims that male circumcision is akin to female genital mutilation are also refuted by many.  Dr. David Baron, a family physician, certified mohel (someone who performs Jewish ritual circumcision), and former chief of staff at Santa Monica-U.C.L.A., told the New York Times that that he viewed the effort to ban the procedure as “ridiculous and dishonest.” He added: “to say it is mutilation is wrong from the get-go.”

There is also new research that suggests my great-grandfather may not have been all that far off when he said that circumcision could prevent V.D. and cancer. Based on scientific evidence, male circumcision is now being promoted in Africa as one of the most important ways to prevent HIV. And, a couple of weeks ago, I wrote an article on a new research study that suggested the male foreskin could be a reservoir for HPV, the virus that causes genital warts and is responsible for most cases of cervical cancer. 

That said, there is not enough evidence for medical experts to suggest routine circumcisions of male infants in this country. As the American Pediatric Association explains:

“Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data arenot sufficient to recommend routine neonatal circumcision. Incircumstances in which there are potential benefits and risks,yet the procedure is not essential to the child’s current well-being,parents should determine what is in the best interest of the child.”  

If voters in San Francisco and elsewhere pass measures like this, however, parents will not have a choice. Moreover, these measures do not contain any religious exemptions despite the fact that to many—Jews and Muslims in particular—circumcision is a religious ritual of the utmost importance.  As Brad Greenberg of the godblog.org explains 

“This custom is as old as Judaism itself. Commanded by God to a 99-year-old Abraham, circumcision was to signify fidelity to the Lord. It has been a central part of Jewish tradition ever since, so much so that even Yom Kippur—the holiest of holidays—doesn't delay the circumcision of an infant.” 

In fact, some have gone as far as to call the ballot measures themselves anti-Semitic and likened them to bans on circumcision that existed in Soviet-era Russia and Eastern Europe and in ancient Roman and Greek times.

Even without such bans, however, the “intactivists,” may be making more progress than we realize as rates of circumcision are dropping all over the United States.  While over 90 percent of infant males in the United States were circumcised in the 1970s this was down to 64 percent in 1995 and just 33 percent in 2009. 

I wonder what Poppy Abe would think?

This post was originally published at RH Reality Check, a site of news, community and commentary for reproductive health and justice