January 2005

Cut babies and the horror of sex




Evolving almost in parallel with the "problem of homosexuality" through the last 150 years or so, has been an equally intense and misinformed debate about circumcision. And like the "problem of homosexuality", the battlefields have been mostly the Anglo-saxon countries. 

As a matter of fact, these two "issues" share the same roots -- a crisis of sexuality that came with industrialisation, urbanisation and a breakdown of agrarian (thus limited mobility) highly-patriarchal social systems. 

A scene from the film Kinsey captured brilliantly the tortured self-denial prevalent during the height of the crisis. The teenaged Alfred Kinsey was out camping with his younger brother, who raised the subject of nocturnal ejaculation. The only response permitted by the climate of the times was to refer to some text about how the loss of semen would weaken the male body and lead to physical and mental disease such as acne, sleeplessness, epilepsy and insanity, not to mention going to hell. And the only remedy was to pray. 

At about this point, you'd notice that I have lumped together quite different things: circumcision, masturbation and nocturnal ejaculation (more euphemistically termed nocturnal emission in earlier texts). But that's how it started, a very confused horror of our natural bodies and urges.


Hysteria over "masturbatory insanity"

Up until the 18th century, medical textbooks hardly mentioned masturbation at all.  But around that time, a popular science book appeared in England, titled "Onania, or the Heinous Sin of Self-Pollution and all its frightful consequences in both sexes, considered."

Onania, or onanism was the archaic term for masturbation, and it was believed to be "self-polluting" because one polluted oneself with sin by doing so. The "frightful consequences" were elaborated on by Samuel Tissot, a Swiss physician, who in 1758 published a medical treatise claiming that masturbation was the primary cause of mental illness. Even then, there were rebuttals aplenty, but somehow, Tissot's ideas became very widespread. Probably, the social conditions were such that people wanted to believe them. 

Then the Americans took over and in 1834, Dr Sylvester Graham wrote that loss of semen, even during marital sex, was injurious to health, an idea that would become very popular. He felt that even married men shouldn't have sex more than 12 times a year, and advocated mild foods to reduce sexual cravings. In the 1880s, none other than John Harvey Kellogg took up the mission.  He was obsessed about the harm from masturbation and created his bland corn flakes as an aid to curtail children's tendency to play with themselves.

By the standards of the time, Kellogg was humane. Others were inventing and patenting various chastity belts for children and young men. Some had spikes facing inwards such that if the penis became erect, it would feel pain. 

Somewhere along the way, the foreskin was made the enemy of all that was good and pure. Indeed, the way the foreskin slides upon the glans can be very erotic, and boys at an early age soon discover the pleasure of doing so. Get rid of the foreskin, and we'd make it harder for self-abuse to occur, it was felt. Not only would the world have less sin and "pollution", the white race would be healthier, with a lower incidence of hysteria, insanity and numerous physical maladies.

And thus the great cutting began. The earlier the better, and soon it became standard to have all neonates circumcised before they even left the maternity hospital. Very often, it was done without anaesthesia. Amazingly, people held the belief that babies couldn't feel the pain, despite the loud crying that anyone should have noticed, or if the adults conceded that perhaps it did hurt, then they might have echoed Kellogg's heartless rationalisation, "Brief pain has a salutary effect upon the mind."

The horrors that religious fanatics would commit in pursuit of their sin-free world!


Onan was a character mentioned in just 2 lines or so in the Old Testament of the Bible. He was asked by his father to inseminate his (Onan's) sister-in-law, after her husband (Onan's elder brother) had been killed by God. It's appears to have been the practice in those ancient societies that brothers inherited the property (which included the women) of the deceased. Anyway, for some unexplained reason, Onan didn't want a child by her, and so he pulled out just before he climaxed. In other words: coitus interruptus. He "spilled his seed on the ground", the Bible reported. 

In those days, people believed that each male contained in his body a limited amount of semen, every drop of which was precious, and when infant (and adult) mortality was high, wasting semen was a danger to the survival of the tribe. 

So, for this trouble of birth control, God killed Onan.

Future generations of Christians thus believed that the Sin of Onan (heavily confused with masturbation, though you'd note from the story that he wasn't masturbating) was a heinous wrong that merited the most extreme punishment. 

You'd also understand now why the Pope doesn't like condoms. The "seed" goes into the rubber and then is chucked into the trash bin, you see, and God would strike us all with bolts of lightning.


At its peak

By the middle of the 20th century, circumcision was almost universal among newborn males in the US. In other English-speaking countries -- Australia, Canada and New Zealand, it reached over 90%. In the UK, it rose substantially (e.g. estimated to be about 35% of male infants by the 1930s) but didn't become as universal as in America. 

Yet, by the 1930s the religious argument had lost much of its force. The mental illness argument was also receding, having not been supported by any data at all. In their place, came the medicalisation of the circumcision argument  -- that smegma would cause penile and cervical cancer, and that prepuces had a tendency to be inflamed and fine sand might accumulate under the foreskin, thus irritating the glans. The latter had especial force during the desert campaigns of the 2nd World War. 

It didn't take long for these claims to be debunked, starting with a few cases of penile cancer seen among Jewish men who had been circumcised since birth. As for the chance of the foreskin being inflamed, someone asked, why then don't we routinely order appendectomies on newborns, in order to forestall the chance that one day in adult life, they might get appendicitis? 

Many of the infection, inflammation and grit-accumulation arguments simply assumed that people couldn't or didn't wash under their foreskins. In a way, that was true, because the same religious state of mind also got hysterical about touching oneself, and so boys were never taught to pull back the skin to wash. The very pulling back was too erotic to be recommended. By itself, it led halfway to hell. 


Pulling back

Fortunately, cooler heads prevailed in the professional bodies. The lack of credible medical grounds for neonatal, non-therapeutic circumcision was gradually accepted as convincing. Weighed against that was an irreducible danger of accidents and infection. The risks seemed greater than the speculative benefits.

In 1950, the UK National Health Service (NHS) dropped non-therapeutic circumcisions from its list of covered procedures. Since, in the UK, most people expected the NHS to pay their medical bills, once it was dropped, circumcision rates fell rapidly. By the late 1990s, it was estimated at only about 3.8% of young British males would be circumcised by the time they reached age 15. The national statistics for 2000 found that just 15.8% of British males aged 16 44 were circumcised. 

New Zealand, probably the most British of the dominions, followed in similar fashion. From 95% of babies circumcised in the 1940s, the incidence fell to 0.35% of babies born in public hospitals in 1995. 

Bigger countries like Australia and Canada have less uniformity. Rates varied from one side of the country to the other, but even so, by Feb 2004, the average for Australia was only 12.7% of babies (under 6 months) circumcised. In Canada, 1996/1997, it was reported that less than 17% of male neonates were cut. 

In the US, the American Academy of Paediatrics finally acted in 1971. That year, they declared that there were "no valid medical indications for circumcision in the neonatal period," and the incidence of this procedure began a slow decline thereafter. 

In America, medical care is, generally speaking, privately paid for, so the fall-off of circumcision was not as abrupt as in the UK where people relied more on the NHS. Nevertheless below are the figures for neonatal circumcisions by US regions, 1999:

Northeast: 65%
Midwest: 81%
Southern: 64%
Western: 36%

The majority of newborns in the US are still circumcised. 

The two special cases in Asia

The coda to this story may well be right here in Asia. Outside of the Muslim areas, non-therapeutic circumcision is rare, with two big exceptions: South Korea and the Philippines. Interestingly, these two are the most Christian nations in Asia, but Christian in quite different ways. The Philippines is majority Catholic and has been so for generations. Korean Christianity is much more recent, less than 100 years old, and tends to be of the fervent Protestant variety. 


In Korea, circumcision was virtually unknown before 1950. Then, with the Korean War, the American influence grew strong, and it became socially desirable to be circumcised. The same arguments about preventing penile and cervical cancer were propagated, but before that, perhaps the same subliminal desire to suppress sex (Christianity, remember?) provided fertile ground for these medical rationalisations to take root. 

Interestingly, the more recent "advantages", touted by newspaper articles no less, point in quite the opposite direction: that of enhancing sexual performance! 

Demand really took off in the 1960s and 1970s. In 1971,only 5% of the military service intake were circumcised, but by 2000, over 80% of those born after 1950 are cut.

At first, young Korean men chose it for themselves, then high school boys had it done, through clinical and social pressure, and now neonatal circumcisions are on the increase. 

South Korea seems to be where America was about 30 or 40 years ago, where it is nearly universal and where parents do it to their babies as a matter of course. 


In the Philippines, while circumcision rates are over 90%, there is a gathering movement to debunk its non-therapeutic use. However, the practice is of much longer standing than in Korea, and didn't depend on religious fanaticism or even medical rationalisation to flourish, so it's not going to be easy for clinicians to reverse it. 

Centuries ago, Islam had already taken root in the archipelago before the arrival of the Spanish, and circumcision was already practised. Moreover, it is speculated that, being related to the culture of the Pacific Islands, the indigenous Filipinos had it in their cultural practices even before Islam. 

Whatever the Spanish thought through their three centuries of rule (and Catholicism in Europe didn't approve of circumcision), they had little effect on popular practice, rooted as it was in local village traditions. Then the Americans came and made the cut cock the symbol of modernity. 

Today, the social pressures are huge. Filipino boys who have been through the rite of passage tease those who haven't.  No boy wants to be called "supot". 

Yawning Bread 


Circumcision as a rite of passage 

The opponents of routine neonatal circumcision, through the decades of the long battle, pointed out that most of the world did not circumcise their newborns. Indeed, that is true. As a practice, it is unknown almost everywhere outside the English-speaking world: China, Japan, Europe, Russia, India, Latin America. The main exception may be Iran (see below). 

(I deliberately did not mention Israel. With 5 million people, it is an insignificant exception unless one begins with a Judeo-Christian mindset that exaggerates the importance of Jewish practices.) 

On the other hand, circumcision of pre-adolescent boys, usually occurring between 7 13 years of age) is fairly common in quite a number of countries. 

Coming to mind immediately would be how circumcision is considered obligatory in Muslim societies. Interestingly, it is not mentioned at all in the Quran, but flows from the example set by the Prophet Muhammed who was believed to be circumcised, while, as I understand it, there are also some sayings in the Hadith. Thus, it is not part of the covenant between Allah and humankind. Nor is there any hard and fast rule of when the circumcision should be performed. Shiite Iran tends to do it neonatally, though most other Muslim societies wait till the boy is at least 7 or 8 years old. Even more interestingly, there is today a small current of opinion among Muslims that not only is circumcision not required, it contradicts the Quranic injunction against self-mutilation too. 

Where the Muslims are circumcised, their neighbours often take pride in their uncut status to better distinguish themselves. The Orthodox Christians (Russians, Serbs, Bulgarians, etc)  and Hindus thus have a strong aversion to circumcision and use the uncut penis as a badge of identification. In times of conflict, men are often stripped by vigilantes to determine who is who. 

Circumcision is often a cultural practice, i.e. with no scriptural authority or religious meaning behind it. It's just something that's done and been done for generations, perpetuated through social custom and peer pressure. In many Pacific Island communities (e.g. Samoa, Fiji, Tonga, Vanuatu), the circumcision ceremony would be a rite of passage into adulthood. However, the procedure in this part of the world traditionally involved a slitting of the upper part of the prepuce, not a complete removal in the American style. 

Africa is a patchwork. In Kenya for example, the Kikuyu and Masai tribes cut, but the Luo and Turkana tribes don't. Like in the Pacific, the practice is cultural, not religious, and is seen as a major rite of passage for the young male.