Circumcision
- History Fix Podcast
- 2 hours ago
- 17 min read
Episode 145: Why Roughly Half of Americans Perform This Ancient Ritual Without a Clear Reason
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Circumcision was not something I ever really thought about until I had two sons. When you have a baby boy a decision is suddenly thrust upon you, at least in the United States. I mean, there are lots of decisions thrust upon you: what are we going to name him? What about a middle name? What kind of diapers should we buy? Which car seat? Lots of questions, lots of decisions. One of them is next level though. Because, at some point, someone is going to ask you if you want to cut off part of your baby’s penis. And you have to make that decision. I had never really thought about it until then. And, not one to make ill-informed decisions, my mind was suddenly full of questions, the main one being why? Why do well over half of Americans cut off part of their newborn son’s genitalia? Where did circumcision even come from and what caused it to explode as a practice in the US over the last less than 150 years? Let’s fix that.
Hello, I’m Shea LaFountaine and this is History Fix where I tell surprising true stories from history you won’t be able to stop thinking about. Circumcision has been on my list of topic ideas since the literal inception of this podcast. It has been penciled in on the schedule and then replaced with something else time and time again. I don’t know why I kept putting it off but it is finally time. It is time to talk about the history of circumcision and get to the bottom of that question, why? Why are we doing this kind of crazy thing on such a massive scale? Because here’s the thing, while circumcision rates hover at around 50% in the United States today, 75 years ago that was more like 80 to 90% of American males circumcised. But if you could go back to the 1850s that rate would drop precipitously. At that point, the only people circumcising their babies were doing it for religious reasons, because they were either Jewish or Muslim. So what happened? Well, we’ll get to that, but let’s take it all the way back to the beginning first.
Circumcision is actually the oldest surgical procedure that we know about. In fact, circumcised penises, yeah I’m going to be saying the word penis a lot, sorry about that, but circumcised penises appear depicted in paleolithic art from as far back as 40,000 years ago in France, Spain, and the Sahara. This pre-dates evidence of trepanation which I know I have talked about before. Trepanation is drilling a hole into someone’s skull for medical reasons, to relieve pressure or whatever. It’s the earliest surgical procedure for which we have archaeological evidence, actual skulls with holes drilled in them from at least 10,000 years ago. But, while we don’t have bones to prove it, the paleolithic art depictions of circumcised penises prove that it was being done some 30,000 years before trepanation. We don’t get our first sort of forensic evidence until around 6,000 years ago in the form of ancient Egyptian circumcised mummies, but the artwork suggests that it’s been done for at least the last 40,000 years.
According to an article in the Journal of Pediatric Surgery, circumcision likely got its start as a form of genital mutilation that would have been inflicted on prisoners of war. So, typically the preferred form of genital mutilation here would be castration, the cutting off of the testicles. This was often done as a punishment for, like I said, prisoners of war, but it was also sometimes done for religious reasons as sort of like a religious sacrifice sort of thing. It’s very likely that circumcision emerged as a less brutal form of genital mutilation than castration. It was like a leveled down version of castration. Because, I mean, if you’re doing it for religious reasons as like a sacrifice sort of thing to show your piety, kind of nice to have that option right? What I find really interesting is the way that circumcision emerges in various parts of the world. So we have a lot of evidence of it in ancient Egypt, and we’ll talk about that more next. But we also know that it was done in Australia among the Aboriginal people there and in Central and South America, Indigenous Americans were also doing it. Now this is very interesting because these three groups, Egyptians, Australian Aboriginal, and the Indigenous people of the Americas had no contact with each other. So it’s not like the Aztecs were like “hey look what they’re doing to their penises, we should do that too.” They all came up with this idea independently. I don’t know what that says about humans that we would all naturally trend in this very strange direction but that seems to be what happened.
So let’s talk about circumcision in Egypt. Evidence of circumcision in the form of engravings on walls dates back to around 8,000 years ago in Egypt and then of course there are the mummies who had been circumcised from around 6,000 years ago. While we think it may have started as a form of punishment, as I said, it eventually entered the realms of religion. At some point Egyptian priests and nobility adopted the practice. We don’t really know why, it was likely associated with purity and spiritual and intellectual development. It seems to have been done as a rite of passage in a very public ceremony mostly just among the elite. It was likely a mark of distinction for the elite, it set them apart as greater than, that they had publicly chopped off part of their penis. Humans are so weird. There’s mention in the Egyptian Book of the Dead that the sun god Ra circumcised himself. So, it’s clearly a very honorable thing to do. Which is ironic, considering it likely started as punishment for prisoners. So, full 180 at some point happening here. It goes from marking the lowest of the low to marking the highest of the high.
Probably during their time spent enslaved in Egypt, Jewish people eventually adopted the tradition of circumcision for religious reasons. The practice is prominently mentioned in the Hebrew bible. According to the Torah, Abraham and God enter into a little agreement. It says quote “This is my covenant, which ye shall keep, between me and you and thy seed after thee: every male among you shall be circumcised," end quote. So then Abraham circumcises himself at the age of 99. He also circumcises his many sons and the men that he enslaved. And so here we see a sort of deviation from it being a thing only the elite do because Abraham is circumcising enslaved men as well. Now, in the Jewish religion at least, every man is doing it regardless of social status. Jesus, being Jewish, is also mentioned as being circumcised 8 days after he is born. Today, circumcision is still almost universally practiced among Jewish populations 8 days after birth. Why? Because of Abraham’s covenant with God. Now, does God say why he wants all the boys circumcised? Unfortunately no, not really. It’s just a sign, a physical sign of this covenant. So it leaves us to wonder somewhat. It seems to be some form of blood sacrifice. I mean, remember, God also told Abraham to kill his son Isaac as a sacrifice in order to test his faith and then thankfully was like “no, stop, nevermind, but good job being willing to do it. That was a test.” So sacrifices in the name of God are definitely a thing which is interesting because we tend to think of blood sacrifices as more of a pagan thing now but whatever. Some scholars have also proposed that it was done to make hygiene easier in hot, sandy climates. But typically the reason given is just religious reasons and I guess that’s reason enough: cause God said so. He doesn't have to give a reason just get to choppin. Blind faith baby.
Ancient Greeks, on the other hand, were very opposed to circumcision, which can be clearly seen in the artwork they left behind. Lots of uncircumcised penis statues and whatnot. They were super okay with male nudity, it wasn’t about they were squeamish about it or anything. They did the naked wrestling and all that just fine but circumcised penises were seen as grotesque and were really very taboo. In fact, In 168 BC, King Antiochus IV made circumcision punishable by flogging, crucifixion, or stoning. When Alexander the Great conquered the Middle East in the 300s BC and spread Greek culture all through that area and into Egypt, he brought anti-circumcision Greek values with him. This was a problem for Jewish people of course to whom it was a very important religious ritual, essentially mandatory. Rules against circumcision were often used in Ancient Greece and in Ancient Rome to force Jewish people to assimilate. So a big motive of Antiochus IV’s anti-circumcision law in 168 BC was likely to punish Jewish people and sort of force them to assimilate with Greek society.
Although it’s never actually mentioned outright in the Quran, Muslims also pretty much universally practice circumcision. They are the largest religious group to do so. In Islam, it’s a form of purification and a confirmation of their relationship with God. And, you know, Islam is also a Abrahamic faith, like Judaism. Muslims trace their roots back to Abraham as well. Two of Abraham’s sons Isaac and Ishmael respectively serve as patriarchs for Judaism an Islam. So it all goes back to Abraham and that covenant with God.
What about Christians though? Christianity is also an Abrahamic religion. Does the covenant apply to Christians? No, it doesn’t seem to. Even though Christ, the guy the whole religion is based on, was circumcised 8 days after birth, Christians were like nah. We’ll pass on that. In the New Testament of the bible, Paul wrote in Galatians 5:6 quote “in Christ Jesus neither circumcision nor uncircumcision count for anything,” end quote. Also, a Papal Bull issued in 1442 by the Roman Catholic Church said quote, “Therefore it strictly orders all who glory in the name of Christian, not to practise circumcision either before or after baptism, since whether or not they place their hope in it, it cannot possibly be observed without loss of eternal salvation,” end quote. Meaning circumcision does nothing to get you closer to God essentially. Don’t place your hope in it. In a lot of ways the Christian baptism replaced circumcision as this purifying rite of passage that confirmed a relationship with God. Christians are using baptism for that purpose instead of circumcision like the Jews and the Muslims.
And so, for a very long time, circumcision was a religious ritual used almost exclusively by Jewish people and Muslims. White male Christians were not doing it, no way. So what the heck happened? Well, we have to fast way forward to 1855. This was the first time that anyone suggested circumcision might have health benefits. And that timing makes since because mid to late 1800s was really the emergence of modern medicine, there’s germ theory, this new idea that people are getting sick because of microscopic organisms, that sort of thing. This idea that circumcision might have health benefits started with a British physician named Jonathan Hutchinson. Hutchinson started noticing that Jewish people that he treated were much less likely to have syphilis. Based on this observation he suggested that circumcision reduced your chances of getting syphilis, which it does actually seem to based on more recent observational studies done in Africa. So for the next 50 years of Hutchinson’s career he advocated for circumcision for health reasons. He was really the first person to do this.
Now, over in the United States, another guy becomes an advocate for totally different health related reasons. In 1870, an orthopedic surgeon named Lewis Sayre, who also happened to be Vice President of the American Medical Association, was presented with a troubling case. A 5 year old boy had been referred to him for contracture of the legs which is a shortening and hardening of the muscles and tendons and what not leading to stiffness and difficulty moving. The boy was having trouble walking and standing up straight because of this. So Sayre jumps into action. He’s trying to figure out how to help this kid. He decides the best thing to do is to cut the hamstring tendons, because they are way too short and then apply an electric current to the muscles which must be paralyzed. But before he gets a chance to carry out this questionable scheme, one of the nurses says to him in passing quote “don’t touch his pee pee, it’s very sore.” So Sayre goes “hmm, his pee pee you say?” and he decides upon examining it, that this kid needs to be circumcised. So he does that sort of experimentally, he performs a circumcision and then reports that the boy was quote “able to extend his limbs…and in less than a fortnight was able to walk alone,” end quote. So Sayre thinks he’s onto something here. He starts to believe that circumcision somehow was able to cure paralysis and neuromuscular disease. He performed two additional circumcisions with the same results and claimed that other doctors had sent him letters reporting the same. So Sayre becomes this huge advocate for circumcision in the United States based on these findings. He calls this theory “reflex genital irritation” and wrote quote “peripheral irritation of the foreskin would ultimately…produce the loss of controlling power,” end quote. Although he admits that he doesn’t really understand how or why it works that way. That doesn’t stop him from advocating for the circumcision of every male child in the United States though. He spoke at many medical meetings both locally, the New York Medical Society, and worldwide, the International Medical Congress. And remember he was part founder and current vice president of the AMA, the American Medical Association, so his word carried some clout.
Sayre takes things even further though. He moves past circumcision as a way of curing musculoskeletal problems and he starts baselessly claiming that it also affects intelligence and behavior. He believed that circumcision could transform a child who was quote “like a lunatic” into a more civilized and docile person. He’s all “it’ll fix your tight hamstrings and make you smarter.” Now, we know that’s not true at all. But at his insistence, doctors in the US started performing circumcisions left and right. Even after they realized that Sayre’s medical claims were complete nonsense and that circumcision had nothing to do with either of those things, they continued to do it while searching for other health reasons to back it up. Which seems rather backwards to me. They’re like “yeah, I’m sure there’s a good reason for this, snip snip, we’ll figure it out soon enough.”
By the turn of the 20th century circumcision had become universally recommended throughout the English speaking world, so that’s the US, Canada, Australia, the UK, and South Africa. They just started doing it to everyone, every boy at least. It did not catch on like that in the rest of Europe - France, Germany, etc. - and experts are sort of puzzled as to why. One major theory deals with attitudes towards Jewish people. Remember, before this circumcision was very much a Jewish thing. It’s possible Jewish people were more highly respected in countries like the US and Great Britain than they were in, for example, Germany. There were a lot of prominent and well respected Jewish people in English speaking countries. Perhaps circumcision being seen as a Jewish thing made it not catch on as much in countries in continental Europe that didn’t necessarily value Jewish people the same.
After World War II a clear split happened though. An article came out in the UK in 1949 by pediatrician Douglas Gairdner called “The Fate of the Foreskin.” This article argued that the risks of circumcision outweighed any known medical benefits and, because of it, circumcision rates dropped dramatically in the UK down to around 20% today compared to 60 plus in the US. Because around that same time, the opposite thing was happening in the US. Pediatrician Benjamin Spock was arguing the exact opposite in his book “The Common Sense Book of Baby and Child Care.” He was saying that circumcision was worth it and should be done which led to circumcision rates skyrocketing even further in the US. In the 1970s both Canada and Australia issued recommendations against routine circumcision. Both country’s national medical associations stated that any potential health benefits did not outweigh the risks and ethical concerns of performing essentially genital mutilation on another person without their consent. Because the risks and benefits were so balanced, they said that it was not actually a medical decision and so they would no longer recommend it. Parents could still do it if they wanted to, but it was not a medical decision. It was religious maybe, or societal, cultural.
So basically every other country that was pushing for routine circumcision dropped out. They were like “eh, actually, nevermind.” Except for the US. The US continued to push for it based on the word of this Dr. Spock guy who wrote that book “The Common Sense Book of Baby and Child Care.” I find it so ironic that baby care advice like this was so commonly coming from men when, for literally ever and always it had been the women almost exclusively who were caring for the babies. Like, why are we listening to this guy? What does he really know about baby and child care as a man in the 1940s?
So today, we see these really interesting statistics where most of the world does not universally practice circumcision as like a routine recommended medical procedure. It’s really mostly just the US doing that along with South Korea interestingly, because of American influence after the Korean war. And then some places in Africa who have legit medical reasons to do it. We do have predominantly Muslim and Jewish countries who are doing it for religious reasons. But, the US is one of the last men standing when it comes to this push for circumcision medically. Why? Are there actual health benefits? What are the health benefits? Well, circumcision is supposed to reduce the risk of urinary tract infections as well as the transmission of sexually transmitted infections. It also appears to reduce the risk of penile cancer although that’s already exceptionally rare so not a huge selling point. According to Advanced Urological Care though quote “To date no conclusive evidence-based data is available supporting the medical benefits of circumcision with regard to hygiene, cancer prevention, or HIV prevention,” end quote. They also cite a litany of what they call under-reported complications including bleeding, injury, loss of protection from injury, decreased sensitivity, and possible sexual dysfunction later in life and claim that these are often under-reported because currently health insurance covers circumcision in the US. If negative reports were coming out about it that were weighing against these marginal health benefits, they worry that health insurance companies would no longer pay for it. So it’s a money thing of course. Cause, turns out you guys, Americans spend a reported 5.4 billion dollars every year on circumcisions. If health insurance stops paying for that because of reported complications they then have to pay to fix, a lot of parents stop circumcising their boys, and the medical industry is out 5.4 billion dollars a year. So, of course they’re pushing for it and of course they are underreporting complications. None of this surprises me. As in almost all things, simply follow the money trail.
Now there are health benefits to take into account though, especially the reduced transmission STIs most notably HIV which of course leads to AIDS. Semi recent studies suggest that circumcision reduces a man's risk of contracting HIV from a female partner by around 60%. So it has been proposed that, because of this, circumcision’s benefits do outweigh its negatives in countries with high rates of HIV and AIDS, countries in Africa mostly, and it is being used there for that purpose. So there, in those high risk countries, the scale tips towards circumcision actually having health benefits.
But what about here where that doesn’t seem to be the case? Why do so many parents in the United States choose to circumcise their sons despite this balance, this stalemate of risk vs. benefit that caused other countries, the UK, Canada, Australia, to recommend against it? Why are we so determined to continue it here? Well, a lot of that, unfortunately, is social. According to Dr. Catherine Hankins, Chief Scientific Advisor for UNAIDS quote “The desire to conform is an important motivation for circumcision in places where the majority of boys are circumcised,” end quote. According to a study carried out in Denver, Colorado, parents, mostly fathers specifically, cited social reasons as the determining factor for deciding to circumcise their baby boys. A UNAIDS article says quote “In the Philippines, where circumcision is almost universal and typically occurs at age 10-14, a survey of boys found two-thirds of those surveyed choosing to be circumcised simply ‘to avoid being uncircumcised’, and 41% stating that it was ‘part of the tradition’. And it’s done so much in the Philippines because they were a US territory for around 50 years. So, just like in South Korea, it’s because of American influence or, better yet, interference there. Social concerns were also the primary reason for circumcision in South Korea with 61% of respondents in one study believing they would be ridiculed by their peer group unless they were circumcised,” end quote. And I know this comes into play in the United States in a big way. I personally remember boys being made fun of in like middle school for not being circumcised. I know of one in particular who chose to get circumcised as a teenager to avoid this kind of ridicule.
So, to sum all that up, there are essentially 3 types of reasons we circumcise boys. Number one is religious reasons, specifically if you are Jewish or Muslim. Okay, fine. I mean the genital mutilation of babies as a form of blood sacrifice or convenant with God seems a bit archaic to me this day in age but whatever. Not my religion, who am I to say? The second reason is health related, the idea that the procedure has health benefits that outweigh all possible complications and ethical concerns like maybe it does in Africa. The third reason is social, the fear of being different, of being made fun of for not being circumcised in a country where the majority of boys are. So if we look at the United States, if we look at the reason why some two thirds of American males are circumcised, it’s not religious. I mean for a handful it is but for that vast majority it is not. We are not a majority Jewish or Muslim country so that’s not it. I don’t know that we can argue that it’s health related at this point either. I know they are clinging to that hard in the medical community likely due to that 5.4 billion dollar annual circumcision spending, but I think I’m on the side of Canada and Australia and the UK here. Yes there are some health benefits, but do they outweigh the negatives? If you live in an HIV prone population in Africa yeah, they probably do. I think there are health reasons to do it there. Here? I think they are negligible at best. So that leaves us with social reasons. I think the vast majority of Americans are circumcising their boys simply because it's what everyone else does and they don’t want their kid to be the odd man out, a target for ridicule. I really do think that’s what it comes down to at this point and that is really sad. Like, you are willing to chop off a piece of your new born baby’s body without his consent because of a fear of ostracisation from society? What is wrong with us? That hints towards serious fundamental societal problems that we can’t just treat people with respect regardless of sameness or differentness. Maybe we should focus less on the chopping off of parts of the penis and more on teaching our children to be kind to one another regardless of the status of anyone’s penis.
I think it’s so ironic, I know I use that word a lot but so much of history is so very ironic. I think it’s so ironic that what most likely started as a punishment, a form of genital mutilation as punishment enacted on prisoners of war, has since transformed into this societal status symbol. Like, if you didn’t cut off part of your penis then you are not in the cool kids club. That’s insane. And so I think you guys can probably guess by now the decision I made. I’m not here to tell you whether or not you should chop off part of your baby’s penis, of course, just present you with the backstory so you can hopefully make your own informed decision. I will say though, looking at the statistics, it’s trending downward even in the US from around 54% of males circumcised in 2012 to 49% in 2022. So, you know, that likely partly due to the increasing hispanic population, they don’t typically choose circumcision. But, I hope it also means people are starting to actually think about it and weigh the pros and cons a little more and not just do it because everyone else is. That’s never a good reason to do anything, especially something as extreme and irreversible as chopping off part of your baby’s body. So, hopefully you found this thought provoking. Like I said, not here to pass judgement on anyone who did or didn’t choose circumcision. Not medical advice, obviously. But it’s a serious decision and I think it helps to know the history of where this came from and why we do it. So, consider it fixed.
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