Circumcision,+Male

= Introduction to Male Circumcision = by Amy Pedigo toc

What is Male Circumcision?
Circumcision is the surgical removal of most, all or part of the foreskin (see video of foreskin function below) of the human male penis (Funk, 2016). See diagram (Morris & Eley, 2011): 

The foreskin has natural functions which cannot be performed once the it has been surgically removed. Functions of the foreskin video: media type="youtube" key="VkBsrBHpbDs" width="420" height="315"

A Religious Ritual
Circumcision has been performed as a religious ritual since before written history. A well known rite of passage in the Jewish community, it is also performed in other cultures as a spiritual cleansing (Funk, 2016). See articles regarding circumcision of babies in the American Jewish community as well as the circumcision of young boys in the Philippines and the Bukusu Tribe of Kenya below.

Medical Circumcision in the English Speaking World
Though it was commonly though of as primarily a religious ritual, since the 19th century, many cultures in the Western World have adopted the custom of male circumcision, primarily for medical or purportedly hygienic reasons. In modern hospital practice, circumcision of males is a minor operation usually performed in infancy (see video below). Beginning in the 1950's it was routinely done on newborn boys in the U.S. (Funk, 2016). The incidence among non-Jewish populations of continental Europe, Scandinavia, and South America is low (Carpenter, 2010).

History of Circumcision in the United States
<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Historically, circumcision in the United States was considered a religious ritual, performed mainly in the Jewish Community. In the early 20th century, when childbirth was medicalized and moved into hospitals (Carpenter, 2010) doctors (instead of home-based midwives) began to have more control over the birth process. Gynecologists secured authority over the process and the majority of births were then occurring in a hospital setting. Hospital circumcision is still widely occurring today (about 79% according to circinfo.com) and is currently known as "routine neonatal circumcision" or RNC.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">After births moved into the medical realm, circumcision was performed around the birth process. Circumcision was initially considered a curative measure and later rationalized as a prophylaxis (Szasz, 1996) for disease. It was a cure for a plethora of diseases including hysteria, venereal disease, hypersexuality, and even hiccups (2016, Funk). However, one of the things it was trying to prevent was masturbation. Masturbation was seen as a disease or a symptom of disease in the 18th century. It was a "plague that could be cured and prevented by circumcision" (Szasz, 1996). Circumcision was also claimed to be a prophylaxis for penis cancer (a very rare cancer occurring in middle age), UTIs (it may reduce rates of penis cancer by 1.2%) and HIV Prevention. Critics reject the validity of the claims that circumcision can prevent penis cancer or lower risk of HIV, they argue that such disorders are more likely caused by sexual behaviors. After reviewing the current research, the American Academy of Pediatrics in 1999 put out a policy that stated that the “potential medical benefits” of routine neonatal circumcision were not significant enough to recommend performing the procedure <span style="font-family: 'Times New Roman',Times,serif; font-size: 16px;">(Funk, 2016).

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Routine Neonatal Circumcision (RNC)
<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">See this video showing routine hospital based circumcision on babies: <span style="background-color: #ffffff; font-family: 'Times New Roman',Times,serif; font-size: 14.3px;">media type="youtube" key="KZ833NuSptI" width="560" height="315"

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Prevalence of Routine Neonatal Circumcision
<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">In the 1940's about 60% of newborns underwent RNC. <span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">By the late 1960's that number was up to 95% (Carpenter, 2010). <span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">In 1995 90% undergoing RNC. <span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">In 2004, rates falling down to 79% (circinfo.com). <span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">San Francisco is the epicenter of the anti-RNC movement in the US today.

==<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;"> Circumcision in the Jewish Community == <span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">by Isobel Connors

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Judaism in the United States functions as both religion and culture, and circumcision is significant rite of passage in both contexts. While routine neonatal circumcision is primarily an aesthetic choice in the United States, circumcision has great religious and cultural significance in Jewish communities ("Brit Milah," 2016; Freeman, 2011; Ladizinski, Rukhman, & Kachiu, 2014). This page examines some of the existential, evaluative, and pre/proscriptive beliefs of the Jewish community in the United States and describes the brit milah ceremony. This wiki page ends with a discussion of the impact of cultural worldview on the practice metzizah b'peh--the traditional practice of direct oral-genital suction of the circumcision wound by the mohel--and its reception outside of the Jewish community in the United States.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;"> Circumcision in the Bukusu Tribe, Kenya
<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">by Gaby Marantz

<span style="color: #222222; font-family: 'Times New Roman',serif; font-size: 12pt;">The Bukusu are a tribe of people living in Kenya who have been practicing compulsory, traditional male circumcision for generations. Their ceremony is an extensive rite of passage marking the transition of adolescent boys into adult male community members (Marck, 1997). Despite this longstanding tradition, an increasing number of Bukusu are choosing to have their sons circumcised in a clinical setting for education, financial, religious, and health reasons (Egesah, Wanyama, & Muange, 2014). The health-related piece of this cultural divergence is of particular interest to those who would like to use circumcision as a method of reducing HIV transmission risks (Bailey, Egesah, & Rosenberg, 2008; Westercamp & Bailey, 2006).

<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;"> Circumcision in the Philippines
<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">by Bea Daily

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Circumcision in the Philippines is a very common practice that is not linked to religion (Gopal, 2009). Tuli (circumcision) is a long standing historical tradition and is considered a right of passage into adulthood for adolescent boys. How the circumcision's are done vary, depending if the boy lives in an urban or rural area. Urban hospitals schedule mass circumcisions days and are done with anesthesia, whereas rural area tuli's are done once a year, and no anesthesia is used (Ramos & Boyle, 2001).

<span style="font-family: 'Times New Roman',Times,serif; font-size: 16pt;">Recommendations for working cross-culturally
<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">By Amy Pedigo

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Though non-therapeutic neonatal circumcision was once thought of as a religious ritual, it has become a cultural norm in the United States since the 1950's when it was adopted as a routine medical procedure performed on male bodied neonates. This means that even though a family in the United States may not think of neonatal circumcision as a religious practice, they may still value it as a secular cultural practice (Sarajlic, 2014). These cultural norms (values like physical similarity of parental bodies) can be just as powerful and important to new parents as religion (Sarajlic, 2014). This means that their desire for social or cultural reason rather than a therapeutic reason for choosing circumcision has to be given considerations when deciding on the procedure. When it comes to making judgements about the pros and cons of circumcision as an educator or a clinician, you will need to take into account the many reasons (religious, social, cultural) that may be involved. These may include "autonomy, consent, individual rights, bodily integrity, the freedom to join (or to leave) a religion, the needfulness of protecting the vulnerable in society against the unwarranted exertions of the powerful, and a child's interests in-or as some would have it, 'rights to'-self-determination and an open future" (Earp, 2013).

=<span style="font-family: 'Times New Roman',Times,serif; font-size: 120%;">References =

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Bailey, R. C., Egesah, O., & Rosenberg, S. (2008). Male circumcision for HIV prevention: A prospective study of complications in clinical and traditional settings in Bungoma, Kenya. //Bulletin of the World Health Organization//, 86(9), 669–677. doi: 10.2471/BLT.08.051482

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Brit milah: The covenant of circumcision. (2016). //Jewish Practice: Lifecycle Events.// Retrieved from[|http://www.chabad.org/library/article_cdo/aid/144122/jewish/Brit-Milah-Circumcision.htm]

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Carpenter, L. M. (2010). On remedicalisation: male circumcision in the United States and Great Britain. //<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Sociology of Health & Illness //<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">, 32(4) 613–630. doi: 10.1111/j.1467-9566.2009.01233.x

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Circumcision. (2016). Funk & Wagnalls New World Encyclopedia, 1p. 1.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Dorsal Slit. (n.d). In //wikipedia//. Retrieved from: []

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Earp, B. D. (2013). The ethics of infant male circumcision. //Journal of Medical Ethics//, 39(7), 418. doi:http://dx.doi.org/10.1136/medethics-2013-101517

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Egesah, O. B., Wanyama, M., & Muange, V. (2014). The Relevance of Intangible Cultural Heritage in Modern Times: Evidence from Babukusu Male Circumcision. //Sociology and Anthropology//, 2(7), 273–283.[|http://doi.org/10.13189/sa.2014.020703]

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Eley, C. and Morris, B.J. (2011). Male Circumcision: An Appraisal of Current Instrumentation, Biomedical Engineering - From Theory to Applications, Prof. Reza Fazel (Ed.), InTech, DOI: 10.5772/18543. Available from: http://www.intechopen.com/books/biomedical-engineering-from-theory-to-applications/male-circumcision-an-appraisal-of-current-instrumentation

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Freeman, T. (2011). Why aren't men born circumcised? //Jewish Practice: Brit Milah Circumcision.// Retrieved from[|http://www.chabad.org/library/article_cdo/aid/1475939/jewish/Why-Arent-Men-Born-Circumcised.htm]

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Gopal, R. (2009). Religion, culture and the Male cut in Asia. //Exchange on HIV/AIDS, sexuality and gender,// (3), 14-15. Retrieved from:

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<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Khamis, N. (2014, November 24). Becoming a man [Web log post]. Retrieved from[|https://widerimage.reuters.com/story/becoming-a-man]

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Koltko-Rivera, M. E. (2004). The psychology of worldviews. //Review of General Psychology,// 8(1), 3-58.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Ladizinski, B., Rukhman, E., & Kachiu, L. C. (2014). Male circumcision as a religious ritual. //JAMA Dermatol,// 150(1),103. doi:10.1001/jamadermatol.2013.8367

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Leas, B. & Umscheid, C. A. (2015). Neonatal herpes simplex virus type 1 infection and jewish ritual circumcision with oral suction: a systematic review. //Journal of Pediatric Infectious Diseases,// 4 (2): 126-131. doi: 10.1093/jpids/piu075

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Lee, R. B. (2005). Circumcision practice in the Philippines: community based study. //Sexually transmitted infections,// 81(1), 91-91. DOI: 10.1136/sti.2004.009993

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Lustosa, K. (2015, Aug. 26). //Brit milah ceremony with the mohel Ishay Choter.// [Youtube video]. Retrieved from

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Male Circumcision Guide for Doctors, Parents, Adults and Teens, Rate of circumcision in adults and newborns. Retrieved from: [|http://www.circinfo.net/rates_of_circumcision.html]

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Marck, J. (1997). Aspects of male circumcision in subequatorial African culture history*. //Health Transition Review//, 7(Supplement), 337–359. Retrieved from [|http://htc.anu.edu.au/pdfs/Marck1.pdf]

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Ondeko, G. (2013, May 31). Bukusu circumcision ceremony [Web log post]. Retrieved from[]

<span style="background-color: #ffffff; font-family: 'Times New Roman',Times,serif; font-size: 16px;">Oppenheim, D. (2016). //<span style="font-family: 'Times New Roman',Times,serif; font-size: 16px;">The tradition of brit milah //<span style="background-color: #ffffff; font-family: 'Times New Roman',Times,serif; font-size: 16px;">. Retrieved from <span style="font-family: 'Times New Roman',Times,serif; font-size: 16px;">[]

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Ramos, S., &, Boyle, G. J. (2001). Ritual and Medical Circumcision among Filipino Boys. In Understanding Circumcision (pp. 253-270). Springer US. Retrieved from: []

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Sarajlic, E. (2014). Can Culture Justify Infant Circumcision?. //Res Publica// (13564765), 20(4), 327-343. doi:10.1007/s11158-014-9254-x

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Szasz, T. (1996). Routine neonatal circumcision: Symbol of the birth of the therapeutic state. Journal of Medicine & Philosophy, 21(2), 137-148.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 12pt;">Westercamp, N., & Bailey, R. C. (2006). Acceptability of male circumcision for prevention of HIV/AIDS in Sub-Saharan Africa: A review. //AIDS and Behavior,// 11(3), 341–355. []