To Cut or Not to Cut?

“The history of circumcision goes back to Abraham,” says Carolyn McKay, a pediatrician at Fairview Children’s Clinic, noting that, historically, the procedure “marked the child as a member of the tribe of Israel.” McKay has been explaining circumcision to parents and performing the procedure since she left medical school in 1968. “Of course, when I’m being irreverent,” she adds, “I say I think Abraham may have spent too much time in the hot sun.”

Though circumcision has been performed as a religious ritual or a rite of puberty for thousands of years, it achieved a wider popularity during the Victorian era as a “cure” for everything from epilepsy to “self-abuse.” In the late 1800s, one doctor announced that genital irritation caused “an insanity of the muscles,” which could be relieved by removing the foreskin. And circumcision wasn’t promoted only for babies, but also for older boys and young men who masturbated. Not that it was ever proven effective. Great Britain eventually dropped circumcision from its national health care coverage in 1948, and now fewer than one in a hundred male infants there undergoes the procedure.

The story has been quite different on this side of the pond, where an estimated 77 percent of adult white and African American men in a 1992 national probability sample reported having been circumcised. (It’s worth noting that precise, up-to-date numbers are hard to come by. One study found that almost a third of adolescent males incorrectly identified their circumcision status before a physical exam.)

During the world wars, the armed services promoted the procedure as a hygiene measure. Many fathers of baby boomers expected their sons to “look like me”—still the most frequently expressed reason dads favor circumcision. In the Midwest, circumcision rates reached as high as 86 percent during the baby boom and in more recent years have hovered near 80 percent. The Minnesota Department of Health doesn’t track circumcisions, but local hospital claims submitted in 2005 showed the rate to be about 72  percent.

Why is circumcision still so common in our part of the country? It could be because the Midwest is relatively less ethnically diverse—until recently, whites favored circumcision at much higher rates than did African Americans, Hispanics, and several other groups. It could be because of our strong economy—circumcision is more common among infants born to families of higher socioeconomic status. It could even have to do with history. Coincidentally or not, the Midwest was the home of one of the nation’s leading circumcision promoters, John Harvey Kellogg, the Battle Creek, Michigan, doctor best remembered for inventing corn flakes. (He believed corn flakes reduced the human sex drive. He also administered yogurt enemas to his sanitarium patients.) In an infamous 1877 tract, Kellogg suggested that circumcision was the best “remedy” for masturbation. “The operation,” he insisted, “should be performed by a surgeon without administering an anaesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases.”

This unfortunate quote and the procedure’s promotion by quacks and sexually repressed religious fanatics is often cited as proof of its dubious provenance by members of the current anti-circumcision movement, which includes groups such as Mothers Against Circumcision and Doctors Opposing Circumcision. The critics’ rhetoric is frequently heated. “During the 20th century, more than 120 million foreskins were severed from American penises, more than in any other country in the world,” reads one broadside. “At the height of the circumcision frenzy, a foreskin was being sundered, and a penis crippled, every 17 seconds.” The photos can be even more unsettling.

Sometimes known as “intactivists,” circumcision opponents argue that the procedure is as abhorrent as the female genital mutilation practiced in some parts of the world, and they claim that it cuts male sexual response by almost half. They point to a recent study funded by an anti-circumcision group, during which 163 men each rigged with nineteen pressure-sensitive filaments watched erotic films; according to the study, the five most sensitive points of the penis are in the portions removed by circumcision. The study’s author, Michigan State University pediatrician Robert Van Howe, an outspoken critic of the procedure, says his results will be replicated by others. “It would be hard to fake,” he noted.