CIRCUMCISION, sûr-kem-sizh'en, in men, the surgical
removal of all or part of the foreskin, the sleeve of tissue covering
the glans of the penis. In women the term circumcision refers primarily
to removal of the clitoral foreskin and secondarily to a variety of
other genital operations.
Male Circumcision. Circumcision is an obligatory
religious or puberty rite among Muslims, Jews, many black Africans,
and some other peoples, including Maya, Aztecs, and Fiji Islanders.
When, where, how, and by whom the operation is performed vary from
group to group. Circumcision is not practiced by about 80% of the
world's population, including most residents of continental Europe
and Asia (except Muslims), and most residents of the Western Hemisphere
south of the Rio Grande.
An ancient operation of unknown origin, circumcision of males was
performed originally with flint knives prior to the use of metal.
The earliest artifacts - from Egypt - are dated at about 4000 B.C.,
centuries before its adoption by the ancient Hebrews. In traditional
Judaism circumcision represents a covenant between God and Abraham
(Genesis 17). Early Christians rejected the practice (Acts 15). Although
the word does not appear in the Koran, circumcision was practiced
among Arabs in pre-Islamic times.
Originally, it is likely that no health claims were attributed to
circumcision. Millennia later, however, Herodotus, Philo, and other
ancient Greeks suggested that the practice might have hygienic benefits,
although it was not adopted by the Greeks. In the late 19th century,
circumcision came to be viewed in English-speaking countries as a
panacea to stop masturbation, which was thought to cause many illnesses.
The American physician P.
C. Remondino, in his once highly regarded and often-quoted book
History of Circumcision From the Earliest Times to the Present
(1891), claimed that circumcision prevented or cured about 100 ailments,
including among them alcoholism, epilepsy, hernia, and lunacy.
Circumcision for reasons of health continued in all English-speaking
countries well into the mid-20th century. Today, however, the practice
has been virtually abandoned in Britain and New Zealand, and circumcision
rates have been reduced markedly in Canada and Australia. But in the
United States about 80% of infant boys still are circumcised in spite
of authoritative medical opposition to the practice. [Editor's note:
the rate of infant circumcision in the U.S. has dropped. Today, approximately
60% of American boys are circumcised in infancy.]
In 1975
the American Academy of Pediatrics reported that "there are no valid
medical indications for circumcision in the neonatal period." In 1978
the American College of Obstetricians and Gynecologists endorsed the
academy's position. Both of these groups reaffirmed this judgment
in a 1983 report, Guidelines for Perinatal Care.
Nevertheless, some U.S. physicians claim that circumcision is essential
for penile hygiene; that it prevents venereal disease and premature
ejaculation; and that smegma (the normal sebaceous gland secretion
under the foreskin) is a carcinogen, causing cancer of the penis,
prostate, and cervix. These claims are not supported by epidemiological
data. Moreover, smegma can be found under the clitoral foreskin of
women, as well as under the foreskins of some other mammals of both
sexes, and it apparently causes no harm.
Circumcision occasionally is a medical necessity and is so recognized
worldwide. However among 80% of the world's population where circumcision
is not practiced, the initial approach to foreskin problems is usually
medical and only rarely surgical. As a surgical procedure, circumcision
may result in hemorrhage, infection, surgical injury and even, although
it happens very rarely, in death.
Female Circumcision. The origin of the various
forms of female circumcision is unknown. Still practiced in Africa,
including parts of Egypt, Sudan, Somalia, and Kenya, the method and
timing of the operation vary from group to group. According to a 1981
United Nations report, the practice is declining owing to opposition
by African women.
Clitoridectomy was performed in England and the United States from
the 1860's to about 1920 to treat what were considered "emotional"
problems of women. It rarely is performed today except for advanced
cancer or extreme enlargement of the clitoris. True female circumcision
is occasionally employed in the United States to attempt to enhance
orgasmic response. The success of the procedure has not been scientifically
evaluated.
[Encyclopedia entry written by] Edward Wallerstein,
Author of "Circumcision: An American Health Fallacy"