Throughout history, cultures have endorsed various forms of body modification.

From neck-

stretching rings in Burma to crippling foot-wrappings in old China, from the castration of males in old

Europe,1 to the female “circumcision” of modern-day Africa,2 people, for cosmetic, cultural, religious, or

“hygienic” reasons, mutilate others. Each of these practices has been or is viewed as culturally

acceptable, yet every one is an abominable, unjustifiable practice. Such mutilations have occurred since

at least as far back as Old Testament times. The nations around Israel engaged in forms of self-cutting

and mutilation, but these practices were forbidden for the people of God.3

But despite divine opinion, cultures have viewed their own practices as acceptable and have

fought to defend them. Despite these “defenses,” mutilation is not appropriate for the Body of Christ.

Regardless of any rationalizations man may drum up, removing or crippling functioning healthy tissue is

an act of disrespect to the God who planned, designed, and made us.

This general truth applies to a specific issue closer to home, to a practice that is - even by modern

American Christians4 - deemed acceptable and sometimes even preferable to God's design. This

acceptance stems from the practice being mistaken for a Biblical one, but sound study of Scripture and

history reveals a large difference between the practice which God instituted and the one introduced in

recent times. Nevertheless, male infant circumcision continues today in about one-third of American

families.

Though there are more serious problems that affect the Church than this one, even “small” issues

must be considered. Christ is to be Victor in every battle and Conqueror of every mountain, whether

greater or smaller, whether “more” or “less” important. He is intent on purifying His bride in every way.

Here is a brief overview of the paper to follow:

1 This includes some Italian boys in recent centuries (the “castratos”), castrated so that their beautiful singing voices would
not fall victim to puberty.
2 Even today, various forms of female circumcision still continue, both in the wild and in surgical hospital environments, in
some places in Africa and Asia. The horrible practice is performed for health reasons (studies indicate lower UTI and
STD risks in “circumcised” females), hygienic and cosmetic “reasons,” or religious and cultural reasons.
3 See, for instance, Deuteronomy 14:1: “You are the sons of the LORD your God. You shall not cut yourselves or make
any baldness on your foreheads for the dead” (ESV).
4 But not with Christians worldwide or throughout history. The modern practice started in the US in the last century.
 1) Historical and Scriptural Evidence – Modern-day “circumcision” is far different – far more
extensive – than the cut God commanded for the Jews in the Old Testament. Biblical, ancient, medieval,
and modern sources all indicate this, and I have yet to find contrary evidence.
2) Complex Anatomy: What is Lost – Unfortunately, many think that modern circumcision
removes only a “flap of skin.” To the contrary, several functions (including one significantly changing
sexual activity) and multiple God-designed structures (including a sphincter and a tendon) are
permanently removed.
3) “Justifications”: Health and Hygiene – Throughout recent history, many justifications for
modern “circumcision” have been offered and disproved. Currently purported health reasons are not
only unsupported but irrelevant. No national medical organization in the world recommends
circumcision. Many are against it, citing fatalities, disfigurements, and sexual and other difficulties that
occur as a result of the procedure.
4) “Justifications”: Being Like Everyone Else (The Low Prevalence of Circumcision) –
Most circumcising families assume that everyone civilized supports the practice and do not want their
boys to feel different. However, people elsewhere do not even consider circumcision. Europe has never
circumcised, and boys in most of the world (England, Asia, Russia, Australia, Canada, Central and
South America, etc.5) are intact. Even in the United States, rates are falling, and now only about 33% of
infant American boys are circumcised.
5) “Justifications”: The Horror Stories (Intact Care) – It seems almost everyone in the United
States has heard a story where a boy “had to be circumcised” later, stories which simply are not heard in
countries that do not circumcise. This is because many American doctors are misinformed and either
cause unintentional damage by premature, forcible retraction or prescribe circumcision for things that
are natural parts of a boy's development.
6) Why Should Christians Care? (The Image of God) – This issue is not simply a medical,
emotional, or practical issue. It is not only worthy of concern because it sometimes results in infants
dying, being severely disfigured, or being doomed to lives of discomfort. It is worthy of concern
primarily because it is an attack on God's image, dishonoring and destroying His created design.

Historical and Scriptural Evidence

In Genesis 17:11,6 the Bible reveals God’s institution of circumcision for Hebrew males. Little

detail is given here, though it is clearly critical for the descendants of Abraham and involves some sort

of excision from the male reproductive organ.

5 Most Muslims and Jews circumcise, hence the exclusion of Africa, the Middle East, and Austronesia from this list.
6 ‫ם‬D‫יכ‬V‫ינ‬V‫י וב‬X‫ינ‬V‫ ב‬,‫רית‬FX ‫אות ב‬F‫ה ל‬R ‫הי‬R ‫ו‬F ;‫ם‬D‫ כ‬F‫ת‬H‫רל‬RF ‫ר ע‬H‫בש‬F ‫ת‬V‫ א‬,‫ם‬D‫ת‬F‫ל‬H‫מ‬F‫יא ונ‬
ESV: “You shall be circumcised in the flesh of your foreskins, and it shall be a sign of the covenant between me and
you.”
 The great majority of modern readers – and many scholars7 as well – assume that the practice

referred to in Genesis 17:11 and in the rest of Scripture must be the same one which is performed today.

However, evidence from history, scholarship, and the Bible itself decisively indicates otherwise.

Obviously, some sort of excision was involved, 8 as with the modern procedure. But the modern

procedure, if it were performed with a knife (as indeed it is in many Jewish “circumcisions” today”),

could only be performed as a multi-step, multi-cut procedure. 9 The 1906 Jewish Encyclopedia describes

the original procedure, “brit milah,” as a one-cut procedure, removing only the actual foreskin (the skin

which extends beyond the glans).10 This makes sense when, for instance, we consider the hurried

circumcision (with a sharp rock!) performed by Zipporah in Exodus 4:24-27.11

This simple one-cut milah procedure did not remove the high amount of complex and varied

tissue removed in modern times (the extent of which tissue we will discuss later). Additional evidence

that the procedure was less extreme is apparent in the circumcision reversals mentioned in I Corinthians

7:18a12 (referring to removing the marks of circumcision by stretching – see the BDAG lexicon) and the

apocryphal book of I Maccabees, chapter 1, verses 14-15a.13 Many passages in the Talmud also refer to

7 A few scholars question or oppose this assumption. Notice, for instance, Brown, Driver, and Briggs including “to become
clipped” as a sub-definition of namal (the word “circumcise” in Genesis 17:11). However, the vast majority of scholars
decline to discuss the method of the procedure with any details at all, as the topic is a sensitive one about which it seems
most are uncomfortable to write.
8 Those who pretend that circumcision was added later in Israel’s history, or was merely a drawing of blood, are turning a
blind eye to the texts of Scripture or claiming them to be fallible. As a believer in the inspiration and infallibility of the
Word of God, I of course disagree with such ideas.
9 Although the process is today simplified by various crushing and cutting devices in hospital circumcisions (though the
same loss results), the natural infant attachment of the foreskin to the glans necessitates, when not using such a device, an
initial snip of the foreskin proper, an extensive tearing of the bonding between the glans and the mucosa and skin
covering it, an additional cut to peel all of the covering back, and, finally, a full circular cut well behind the corona. Only
the initial cut was involved during Old Testament times, as will be shown.
10 “Circumcision.” The Jewish Encyclopedia, (New York: Funk and Wagnalls, 1906-1910). The text is available online in
its entirety at http://www.jewishencyclopedia.com. Internet sources are not, by nature, the most reliable, so the vast
majority of my sources are printed. However, when these sources are available online, I have included URLs for your
convenience.
11 The intense pain endured by the men of Shechem in the incident of Genesis 34 seems to suggest that the procedure was
not simpler as other evidence indicates; however, upon consideration, it soon becomes clear that pain is not related to the
amount of tissue removed but to the size and nature of the wound. For example, if your arm were cut off two inches above
the elbow or four inches above, the pain would be roughly the same, despite more being removed in the latter case.
Because of this, the Genesis 34 episode is no evidence either way.
12 περιτετμημένος τις ἐκλήθη; μὴ ἐπισπάσθω.
ESV: “Was anyone at the time of his call already circumcised? Let him not seek to remove the marks of circumcision.”
13 RSV: “So they built a gymnasium in Jerusalem, according to Gentile custom, and removed the marks of circumcision.”
“drawing the skin back down.” A modern “circumcision” would be tediously difficult to undo by

stretching the “skin back down!”

But why is modern “circumcision” so much more extreme? According to the Oxford Dictionary

of the Jewish Religion, brit periah was added to milah after the time of Christ in order to prevent the

very reversal alluded to by Paul. 14 The following paragraph from Jewish World, written by an author

who has conducted much research on the subject, summarizes the issue as follows:

The Biblical command for circumcision had its scope extended by the rabbis to address the
unacceptable practice of epispasm, or de-circumcision, motivated by the wish to assimilate into
Greco-Roman society or possibly convert to Christianity. While the Biblical requirement is to
remove the foreskin (orlah) only (Genesis 17:11), the rabbis introduced complete uncovering
(periah) of the corona.15

It is important to note that the authors quoted here are not from some anti-circumcision faction

within Judaism. They desire the tradition to continue, but are showing that periah is a man-made

tradition, not the original divine directive but an extension of it.

Jewish sources include much evidence for this unauthorized modification: 16 in Jewish writings,

circumcision and periah are treated separately. 17 In addition, the Samaritans and Samaritan historical

sources emphasize that their circumcision tradition, which continues from the pre-periah separation of

14 “Many Hellenistic Jews, particularly those who participated in athletics at the gymnasium, had an operation performed to
conceal the fact of their circumcision (I Me. 1.15). Similar action was taken during the Hadrianic persecution, in which
period a prohibition against circumcision was issued. It was probably in order to prevent the possibility of obliterating the
traces of circumcision that the rabbis added to the requirement of cutting the foreskin that of peri'ah (laying bare the
glans).” ~“Circumcision.” The Oxford Dictionary of the Jewish Religion, ed. Werblowsky, R. J. Zwi and Geoffrey
Wigoder. Oxford U P: New York & Oxford, 1997 (emphasis mine).
15 Rickman, Dan. “Circumcision and its Critics,” Jewish World, http://www.ynetnews.com/articles/0,7340,L-
3780549,00.html
16 I was referred to some of the following sources by: Rubin, Nissan. “On Drawing Down the Prepuce and Peri’ah,” Zion 54
(1989): 105-17 (Hebrew).
17 See especially Cant. Rabbah (ed. S Donsky) [Jerusalem-Tel Aviv: Dvir, 1990]. For example, Cant 1:14, 4:1: “Ah, you are
fair, my darling, ah, you are fair – you are fair in circumcision, you are fair in periah,” and Cant 1:62: “How fair you are,
how beautiful, how fair you are in [observing] neta reva’i [the fourth year's fruits of a tree], and how beautiful you are in
[observing] circumcision; how fair you are in [observing] periah, and how beautiful you are in prayer.”
the Northern and Southern Kingdoms even until today, does not and never has included periah.18, 19 Rav

plainly states: “The commandment of periah was not given to the Patriarch Abraham.”20

Modern “circumcision” is a man-made21 practice which extends beyond the practice authorized

by God.22 But how much more extensive is the new practice than the original?

Complex Anatomy: What is Lost

The variety and amount of things lost in modern “circumcision” is actually quite extensive. 23

Unfortunately, many are unaware of the foreskin's structures and functions and think that only a “flap of

skin” is removed, but this is far from the case. I won’t go into significant detail here, but about a dozen

functions are destroyed. Various immunological and protective functions are lost, especially the

protection of the sensitive glans. The glans surface is mucosa, containing no skin, and is naturally purple

and textured rather like the inside of one's cheek. Without protection, the glans becomes irritated enough

to keratinize, like a fingernail, and protect itself by losing most of its feeling, color, and texture.

Although men don't remember the irritation and pain they experienced as infants, the discomfort

continues for some throughout their entire lives.

The most significant function lost, however, is the “sliding-gliding” function, in which the tube-

like foreskin can freely roll inside-out on itself and back again. This significantly alters sexual activity,

18 Information on this is available in several sources, including: M. Avi-Yonah, “The Samaritan Revolts against the
Byzantine Empire,” Eretz-Israel 4 (1956): 127-32 (Hebrew); Jacob, Son of Aaron, “Circumcision among the Samaritans,”
ed. W. E. Barton; in Bibliotheca Sacra 65 (1908): 695-96; Pummer, “Samaritan Rituals and Customs,” in A. D. Crown,
ed., The Samaritans (Tübingen: J. C. Mohr, 1988); J. Mills, Three Months’ Residence at Nablus, and an Account of the
Modern Samaritans (London: J. Murray, 1864); and R. Kashani, “The Samaritans: History, Tradition, and Customs,” Bi-
Tefutzot ha-Golah 13 (1971): 202-19.
19 Josephus, who opposed the Samaritans strongly, never accused them of abandoning circumcision (periah had not yet been
instituted among the Jews). See Pummer, “Samaritan Rituals and Customs,” 6, n. 23.
20 BT Yevamot 71b, emphasis mine.
21 Though long-standing; scholars estimate that periah was introduced sometime around 140 A.D.
22 For further information, see the attached article, “Circumcision: Then and Now,” by Dr. James Peron, from the
publication Many Blessings. The article lacks source citations, but many good sources have already been quoted here in
this paper.
23 For details on what is lost to circumcision, as well as a list of the health risks and problems associated with the practice,
see the attached medical document “Full Disclosure.” Good sources can also be found at http://www.cirp.org, and an
extensive medical document with many sources is available from Doctors Opposing Circumcision at
http://www.doctorsopposingcircumcision.org/DOC/statement0.html (note: these documents have excellent medical
information, but I do not agree with all of the material in the sections dealing with ethical and psychological issues.)
improving control and preventing friction and dryness. The foreskin itself is by far the most sensitive

and innervated area of a man's body, including tens of thousands of nerves, with some types being

unique to the area.

The structures removed are numerous: an elastic ridged-band sphincter, highly concentrated

masses of nerves and corpuscles, glands, mucosa, multiple square inches of muscular skin,24 and part or

all of a tendon. Far from the simple removal of the skin beyond the glans which God established for the

Jews (but later decreed unnecessary for Gentile Christians), modern “circumcision” removes the entirety

of several complex, functioning, healthy structures wonderfully designed by God.

Circumcised men are left without concept of the motion, function, and structures lost, and this

lack contributes to the circumcision's continuation, as the “fold of skin” seems like it would get in the

way rather than help. In reality, its removal multiplies friction and lubrication problems, besides other

discomforts, disfigurements, and risks.

This is indeed a Pharisaical extension of circumcision - an addition to the Word of God -

designed to prevent the reversals of the procedure which Jews of the time were performing. This modern

“circumcision” was never authorized or approved of by the Creator, and it alters the design which He

Himself proclaimed “very good” in Genesis 1, replacing God's good with a supposed “good” devised by

man.

This mutilation removes much tissue specifically designed by God for many functions including

physical pleasure, as even Jewish sources admit.25 This decrease in sensitivity was the reason for

circumcision's introduction in the United States in the late 18 and early 1900s.26

24 In adulthood, this skin grows to be, when unfolded, about 15 square inches of densely innervated skin – the size of an
average postcard.
25 Maimonides, one of the most important scholars of the Jewish Torah, wrote in Moreh Nevuchim, section three, chapter
49: “And this commandment [circumcision] was not given to complete something lacking in Creation, only to complete
something missing in human behavior, and the physical damage to that organ is the aim…that desire beyond what is
necessary should be removed, and since circumcision reduces the erectile ability of the organ and reduces the pleasure
obtained from sexual relations, there is no doubt that when blood is spilled from that organ and its hood is removed will
be weaker. Chazal clearly states that one who has sexual relations with an uncircumcised man finds it difficult to leave
him; this seems to me to be the most compelling reason for circumcision.”
26 This is readily discovered. See, for instance, the following three quotes from doctors of the time:
“Justifications”: Health and Hygiene

Even if small health, hygiene, or cosmetic reasons did exist for function-altering mutilation

(reasons similar to those behind female “circumcision”),3 the cutting cannot be ethically justified. To

engage in it is simply to dishonor God through dishonoring His creation.

But the health, hygiene, and other reasons claimed as supports for “circumcision” are far from

proven, and are outweighed by the health reasons against the practice. As has been stated, these health

claims, even if true, would be irrelevant. We don’t perform mastectomies or partial mastectomies on

girls to prevent breast cancer, though this would certainly save many lives. We don’t yank teeth out to

prevent infection later, or routinely half-castrate boys to cut their risk of testicular cancer in half, though

that would also save lives. This is because it is not legitimate to remove healthy, functioning tissue in

order to possibly prevent some disease years down the road.

Even so, medical reasons for “circumcision” are simply insufficient to recommend the

procedure, ethical concerns aside. No major national medical organization in the world recommends

“circumcision,” and many (such as those in Canada, Australia, and some European countries) take

positions against it.27 Canada, for instance, says it “should not be performed.” In the United States,

though, many doctors, themselves circumcised and accustomed to an accepting culture, continue to
“A remedy for masturbation which is almost always successful in small boys is circumcision. The operation
should be performed by a surgeon without administering an anesthetic, as the brief pain attending the operation will have
a salutary effect upon the mind.... In females, the author has found the application of pure carbolic acid to the clitoris an
excellent means of allaying the abnormal excitement.” (John Harvey Kellogg, M.D., "Treatment for Self-Abuse and its
Effects,” Plain Fact for Old and Young. Burlington, Iowa: F. Segner & Co. (1888). P. 295)
“To obtain the best results one must cut away enough skin and mucous membrane to rather put it on the stretch
when erections come later. There must be no play in the skin after the wound has thoroughly healed, but it must fit tightly
over the penis, for should there be any play the patient will be found to readily resume his practice not begrudging the
time and extra energy required to produce the orgasm... We may not be sure that we have done away with the possibility
of masturbation, but we may feel confident that we have limited it to within the danger lines.” (E.J. Spratling, M.D.
Medical Record, Masturbation in the Adult, vol. 48, no. 13, September 28, 1895, pp. 442-443.)
“[Self abuse] lays the foundation for consumption, paralysis and heart disease. It weakens the memory, makes a
boy careless, negligent and listless. It even makes many lose their minds; others...commit suicide.... Don't think it does no
harm to your boy because he does not suffer now, for the effects of this vice come on so slowly that the victim is often
very near death before you realize.... It is worthy of note that many eminent physicians now advocate the custom of
circumcision...” (Mary R. Melendy, M.D., The Ideal Woman - For Maidens, Wives and Mothers, 1903.)
Informative medical histories are readily available, including the following work (with which I am not in
complete agreement, but which is a good source nonetheless): "From ritual to science: the medical transformation of
circumcision in America", by David L. Gollaher, Journal of Social History, Fall 1994, vol. 28 no. 1, pp. 5-36. The full
text is available at http://www.cirp.org/library/history/gollaher.
27 For many policy statements by major health organizations worldwide, see http://www.cirp.org/library/statements/.
produce reasons for the practice. But their reasons are just as continuously disproved or, at least, never

supported sufficiently by studies to be considered legitimate. Besides the complex and super-sensitive

structures lost, additional damage is done. Attached is a small document by a group of doctors listing

some of the problems experienced by circumcised men – who usually assume their condition to be

normal. Studies even indicate that the intense pain of the operation hinders attachment (documented as

increased difficulty in breastfeeding) and permanently lowers the infant's pain tolerance. For more

information and bibliography, see sources listed at www.cirp.org and www.circumcisionandhiv.com.

The currently popular justification among pro-circumcision advocates is a set of incomplete sub-

Saharan African studies suggesting that circumcision reduces risk of acquiring HIV from 1.3 percent to

0.6 percent. The lack of controls on the studies, the prevention training and rest period given to those

circumcised, religious considerations, incompleteness of the study, and various other confounding

factors, along with the existence of studies suggesting the opposite, prevent these studies from

presenting any serious evidence. Besides, predicting the adult morality of a child and amputating body

parts from him to provide some protection from disease in case he is immoral two decades later is an

argument that immediately shows multiple flaws, at least for believers.

Hygiene arguments are even more absurd, as the boy can prevent infection and bad hygiene by

simply rinsing under his foreskin when he is old enough for it to be retractable. It makes no more sense

than cutting off toes or ears because of the filth that can accumulate between or behind them – simply

teaching kids to wash is a much better solution.

“Justifications”: Being Like Everyone Else (The Low Prevalence of Circumcision)

Some fathers insist that their boys be circumcised so that they do not look “different.” This is a

pointless argument. If an amputee has a son, he should not cut his boy’s leg or arm off just so his boy

will not look “different.” Besides, intact28 boys in the United States are no longer a minority among their
28 When dealing with this issue, the term “intact” is used in the sense of “whole,” that is, unaltered and uncut by modern
“circumcision.”
peers. Over 66% of boys now born in America are not circumcised, and as many as 85% of boys around

the world (the minority being mostly Americans, Jews, and Muslims), in addition to the vast majority of

Christians around the world, are left intact, as well. Americans themselves only began to favor modern

“circumcision” in the early 1900s to prevent masturbation,24 but, as has been said, cutting rates in the US

have recently been dropping dramatically. Intact babies now make up the majority of infant boys in the

United States, and are members of a large majority among the global Church (and, for that matter,

among all people around the world).29

The cosmetic reasons sometimes given for circumcision are barely worth addressing. Other body

modifications are viewed as “more attractive” in their respective cultures, simply depending on to what

its members are accustomed. I find it hard to believe that the dried out, pitted, discolored look of a

modified male, combined with the usually prominent and often crooked scar, can be so cosmetically

preferable to some parents as to encourage them to cut their boys, as if they should be making such

permanent cosmetic judgment calls. But, thanks be to God, this is becoming less common, as well.

“Justifications”: The Horror Stories (Intact Care)

It seems that everyone in the eastern and midwestern United States has heard a story of a boy left

intact who “had to be circumcised later.” With very few exceptions, these circumcisions are

unnecessary. Some are prescribed for things (ballooning during urination, tight foreskin or “phimosis,”

pearls, reddening, attached foreskin, etc.) which are either part of natural development or have very
29 A few additional points, less important than the main presented arguments, could be made from bioethical, legal, and
financial perspectives.
Bioethically, circumcision violates multiple principles allegedly held to by medical professionals, including the autonomy
and “first, do no harm” principles included in most sets of medical vows.
From a legal viewpoint, in the United States, female genital cutting of infants is illegal regardless of culture or religion,
and so it should be. Technically, boys are then also legally protected from genital cutting as infants, as the Equal
Protection Clause of the Fourteenth Amendment of the Constitution forbids states to “deny to any person within its
jurisdiction the equal protection of the laws” (despite the characteristics of the person, including gender). But since the
culture is still somewhat pro-”circumcision” (again, with about a third of boys in the United States still being circumcised
shortly after birth), this principle has continually been ignored.
From a financial viewpoint, modern “circumcisions” cost hundreds of millions of dollars per year, much of which is
taxpayer money and could be used for helpful, not harmful, purposes.
simple fixes that do not involve amputation. In some other cases, ignorant but well-meaning doctors

think the foreskin must be forcibly retracted in infants to clean underneath. As the foreskin is securely

attached until a child grows older (with separation occurring anywhere from a few months old to puberty

or slightly after), this is a traumatic and damaging experience for an infant. It is akin to tearing

fingernails off and results in scarring, adhesions, and risk of infection. If parents, caregivers, and

especially medical professionals would simply leave the foreskin alone, none of these cases would

occur. Circumcision is virtually never necessary.

Why Should Christians Care?

The reasons for Christians to take a stand are many. Infant lives are lost because of modern

“circumcision,”30 so action against it would halt these deaths. Some men circumcised as infants

experience additional disfigurement, discomfort, or sexual dysfunction due to a part of their God-

designed anatomy being removed. Declining the procedure would protect our children against these

troubles.

Most importantly, this is a matter of love. To live just and merciful lives and love our children as

we ought, we must protect them from unnecessary and indeed harmful mutilation. Glorifying God

demands respect for His design and treating our children as His creatures.

Saving lives, saving our children from future dysfunction and disfigurement, showing love and

justice, and glorifying God in the wonder of His creation – are not these reasons enough for Christians to

stand against an extreme male genital cutting which God has never instituted nor approved?

The Image of God

30 For instance, a few months prior to the date of my writing this paper, a 6-week-old baby in South Dakota died as a result
of a circumcision procedure. The event was reported in several places, including the newspaper article “Parents Sue Over
Circumcision Death” in the Sioux Falls Argus Leader. Since there is no reliable registry of deaths due to circumcision,
estimates vary from dozens per year to hundreds.
 The most significant issue here, however, is not health or love, as important as those are. Man is

created in the image of God, and even though the image is marred by the fall, it is still present. 31 Even

though God has no body, His image includes man's body; as God's representative on earth, man needs

his body to do the things that God does without one. Surely God's image has spiritual aspects, but it

nevertheless includes the physical. Man is more than a body, but not less.

Many attacks on the image have occurred throughout history, from the incredibly severe assaults

of abortion and murder to lesser assaults like female and male “circumcision” and other permanent,

harmful body modifications. Respect for God and His creation requires respect for His image in man,

and such respect is not served by cutting away body parts in ways God has never suggested. As was said

earlier, modern “circumcision” alters the design which He Himself proclaimed “very good” in Genesis

1, replacing God's good with a so-called “good” devised by man.

Let us love our own future sons by protecting them from this. Let us help our children love our

future grandsons in this protective way and help edify those under our care and teaching by inspiring

them to love and protect their own sons in this way. The Church of Christ may have more pressing

problems, but Christ points at every place – not just every mountain but also every foothill – and

proclaims, “Mine!”

(Several documents attached.)

31 ”Whoever sheds man's blood, by man his blood shall be shed; for in the image of God He made man” (Genesis 9:6,
NKJV).
For more information regarding medical aspects of modern "circumcision," please start with
http://www.cirp.org, http://www.circumcisionandhiv.com, and
http://www.doctorsopposingcircumcision.com.

Attached are two documents:

1) "Full Disclosure: Circumcision Information for Health Professionals and Parents," by a

coalition of medical doctors and other professionals. This is a brief summary of the permanent
losses inflicted by modern "circumcision," as well as some of the detriments experienced by all
or some circumcised individuals.

2) "Circumcision: Then and Now," by Dr. James Peron, from the Christian magazine Many
Blessings.
 FULL DISCLOSURE:
Circumcision Information for Health Professionals and Parents
© 2001, by: Rio Cruz, PhD, Executive Co-Director, International Coalition for Genital Integrity <www.icgi.org> • George Denniston, MD,
Founder, Doctors Opposing Circumcision (DOC) <http://faculty.washington.edu/gcd/DOC> • Gary L. Harryman, National Organization of
Restoring Men, So. California Chapter <www.norm-socal.org> • George Hill, Director, NOCIRC of Louisiana—Port Allen <www.NOCIRC.org>
• J. Steven Svoboda, MA, JD, Executive Director, Attorneys for the Rights of the Child <www.ARCLaw.org> • John W. Travis, MD, MPH,
Alliance for Transforming the Lives of Children <www.aTLC.org> • Robert Van Howe, MD, FAAP, Editor, Circumcision <www.uphcn.org/
directry/docuphcn/vanhowr1.html> • Eileen Marie Wayne, MD, Director, Informed Consent <www.InformedConsent.org>
To make an informed choice, parents of all male infants should be given accurate and unbiased information.
—Circumcision Policy Statement, American Academy of Pediatrics, March 1, 1999
Introduction
The history of medicalized circumcision is a fascinating 2. The foreskin contains an estimated 240 feet of nerves,
study in Victorian medicine and anti-sexuality.1 The including branches of the dorsal nerve and perineal
phenomenon of circumcising boys and girls for pseudomedical nerve, encapsulated Vater-Pacinian cells, Merkel’s cells,
reasons was almost exclusively confined to the English- nocioceptors, between 10,000 to 20,000 specialized
speaking world. American pseudomedical circumcision began erotogenic nerve endings of several types (which can
in 1870 when New York physician Lewis A. Sayre treated a discern slight motion, stretch, subtle changes in
boy for paralysis by amputating his foreskin.2 The operation temperature, and fine gradations in texture), and
appeared to succeed. Thereafter circumcision was relentlessly thousands of coiled fine-touch mechanoreceptors called
promoted as a necessity for hygiene as well as a treatment for Meissner’s corpuscles—one of the most important
all sorts of illnesses, including masturbation, epilepsy, sensory components. The foreskin is the most sexually
elephantiasis, insanity, asthma, alcoholism, hernia, premature sensitive part of the penis.10
ejaculation, penile cancer, cervical cancer, and virtually 3. Just inside the tip of the foreskin lies the ridged band
every other identified ailment3 While all of these justifications which forms an elastic-like closure around the head of
have been proven false, advocates of circumcision have the penis to help keep the tissues healthy and moist.
promulgated a seemingly inexhaustible supply of pretexts for This belt of densely innervated, sexually sensitive tissue
this needless and harmful genital cutting. Circumcision soon is removed with circumcision,11 reducing the fullness and
was firmly established in the American psyche as a beneficial complexity of sexual response.
and desirable procedure.
More recent conjectures that circumcision reduces the 4. The foreskin constitutes 50% or more of the mobile
incidence of urinary tract infections, penile cancer, HIV and penile skin, including approximately half of the
other STDs have similarly not withstood scientific scrutiny.4 temperature-sensitive smooth muscle sheath called the
Approximately eighty-five percent of the world’s males are dartos fascia.7 This tissue shields the glans or head of
not circumcised, including most of those in Europe, Latin the penis and the surrounding inner foreskin from dirt,
America, and Asia.5 Even though medicalized circumcision bacteria, and other contaminants.12 Just like the glans
was primarily confined to the English-speaking countries, clitoris and female prepuce, the glans penis and inner
most of those countries have either ceased performing them foreskin are internal organs lined with mucosal
altogether or have dramatically reduced the practice during membrane similar to that found in the vagina, mouth,
the past 20 years. Today, the United States and South Korea and eyelids. When exposed to air and harsh
(due to American influence) are the only countries in the environments through circumcision, the glans develops
world where the majority of boys are circumcised for non- a tough, dry covering of cells through a process called
religious reasons. Twenty years ago, 90% of American boys keratinization. 8 As a result the sensitivity of the
were being circumcised at birth, but currently this figure has underlying nerve endings becomes dulled.
dropped to about 59%.6 In the seven Western states, only 5. The frenulum—the very sensitive V-shaped, web-like
about 35% of boys now have their foreskin amputated.7 On tethering structure on the underside of the glans is a
March 1, 1999, the American Academy of Pediatrics (AAP), continuum with the ridged band and is designed to assist
after an exhaustive two-year study, concluded that the routine in uncovering and recovering the glans. It is one of the
circumcision of male infants was not essential to their current most densely innervated tissues in the body and
wellbeing and could not be justified on medical grounds. The constitutes an essential component of sexual stimulation.
Academy therefore could not recommend this procedure.3 By Circumcision destroys both its function and its normal
taking this stand, the AAP is now aligned with every other potential for full erogenous sensations.
national medical society in the world.8 6. The smooth mucosa of the inner foreskin is part of the
Anatomy of the Male Foreskin and What Is Lost to Circumcision immunological defense system that produces
1. The male prepuce or foreskin is part of a complex tissue antibacterial and antiviral proteins such as lysozymes
system designed to protect the penis as well as to provide (also found in mother’s milk), and plasma cells which
sexual pleasure.9 secrete antibodies.10 It also contains specialized epithelial

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© 2001, International Coalition for Genital Integrity, POB 8462, Santa Cruz, CA 95061 (831) 423-6105 <www.icgi.org>. Used with permission. 1
 Langerhans cells,11 a component of the immune system
along with lymphatic vessels, which provide lymph flow.
Loss of these structures disrupts their protective function.
7. During intercourse, the foreskin “glides” over itself.13, 14
If unfolded and spread out flat, the average adult foreskin
measures about 15 square inches. This highly erogenous,
specialized, self-lubricating mobile skin gives the penis
its unique ability to glide in and out of itself—permitting
normal stimulation of oneself and one’s partner during
intercourse. This non-abrasive gliding of the penis within
the vagina facilitates smooth, comfortable, pleasurable
intercourse for both partners.9 Without this gliding
action, the corona of the circumcised penis functions as
a one-way valve, drawing out vaginal lubricants and
increasing the need for artificial lubricants during
intercourse.9
8. At birth, the foreskin is fused to the glans by what is
known as balano-preputial lamina.15 These lamina—
similar to the structures that adhere fingernails to their
beds—tightly fuse the foreskin and the glans together
for protection while the penis develops. The first person
to retract a foreskin should be the boy himself (and it
may not be fully retractable until puberty). Forcibly
retracting the foreskin usually causes infection and
scarring.16
9. Several feet of blood vessels, including the frenular
artery8 and branches of the dorsal artery, help supply
blood to the penis and are essential for proper growth
and function. The loss of this dense vascularity interferes
with normal blood flow to the shaft and glans of the
penis,12 possibly stunting their complete development.
Blockage of these vessels may also result in ad hoc re-
connections, producing unsightly lumps and varicosities.
Potential Complications of Circumcision
According to the Fetus and Newborn Committee of the
Canadian Paediatric Society,17 “the incidence rate of the
complications of circumcision reported in published articles
varies, but it is generally in the order of 0.2% to 2%. Most
complications are minor, but occasionally serious
complications occur. There is a need for good epidemiological
data on the incidence of the surgical complications of
circumcision, of the later complications of circumcision, and
of problems associated with lack of circumcision….
Circumcision may lead to complications, which range from
minor to severe. They include easily controllable bleeding,18 , 19
amputation of the glans,17, 20 acute renal failure,21 life-
threatening sepsis, and, rarely, death.17, 18 The evidence of
postoperative complications is unknown.17 The rates of
complications reported in several large case series are low,
from 0.2% to 0.6%.4 However, published rates range as widely
as 0.06%22to 55%.23 Williams and Kapila have suggested that
a realistic rate is between 2% and 10%.”24
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2 © 2001, International Coalition for Genital Integrity, POB 8462, Santa Cruz, CA 95061 (831) 423-6105 <info@icgi.org>,<www.icgi.org>. Used with permission.
The following are possible complications of circumcision:
1. Hemorrhage (bleeding): Serious hemorrhaging occurs
in about two percent of infants, resulting in shock and
sometimes death.18,22 Boys with unrecognized bleeding
disorders are at risk for serious hemorrhage.
2. Infections: Localized or systemic infections include
septicemia,25 meningitis,26 lung abscess,27 diphtheria,28
tuberculosis,29 staphylococcal scalded skin syndrome,30, 31
gangrene of the penis and scrotum,32, 33scrotal abscess,34
impetigo,35 necrotizing fascitis of the abdominal wall,36
tetanus,37 and necrosis of the perineum.38 Patel rported
an infection rate of 8%.23
3. Urinary retention: Swelling from the trauma of surgery,
pain associated with attempts at urination, and
sometimes the Plastibell device can cause the retention
of urine,39 possibly leading to acute obstructive uropathy
(the bladder distends to the point of rupture).40
4. Excessive penile skin loss: Occurs when so much of
the prepuce is drawn forward that the entire penile skin
sheath is removed.41, 42 From puberty on, penile bowing
(curvature) and pain occur at the time of erection. With
erection, pubic hair can be pulled forward onto the
penile shaft and bleeding during sex can occur from shaft
skin tears. Skin grafts are sometimes required.
5. Beveling deformities of the glans: Varying amounts of
the glans are shaved off leaving a scarred, beveled
surface43 and, at times, the entire glans is amputated.44
6. Iatrogenic or urethral fistulas: Urethral fistulas can also
result from circumcision. When the frenular area
(underside of the penis) is drawn too far forward, the
crushing bell may injure the urethra at the time the
foreskin is removed, resulting in a urethral opening on
the underside of the shaft.45
7. Epispadias: If one limb of the hemostat is inadvertently
passed into the urethra and closed, it crushes the upper
portion of the urethra and glans, creating a urethral
opening on the dorsum (top) of the glans.46
8. Retention of the Plastibell ring: The Plastibell, which
normally falls off in 10 days, may get buried under the
skin, causing ulceration and/or necrosis.47 Loss of the
glans has also been reported.
9. Iatrogenic chordee (permanent bowing of the penis):
Dense scarring at the frenular area can cause the penis
to bow upon erection and may require plastic surgery to
repair.19
10. Keloid formation: Prominent scars can occur where the
skin or mucous membrane has been excised, incised,
crushed, or sutured.48, 49
11. Skin bridges and penile adhesions: These constitute a
common complication consisting of one or more thick
areas of scar tissue that form bridges between the
 coronal edge of the exposed glans and the circumcision
wound on the shaft.50, 51, 52 For some men, this condition
can be quite painful during erection, restricting the free
movement of the shaft skin and causing a pull on the glans.
12. Phimosis of remaining foreskin: When only a segment of
the foreskin is removed, the remaining tip sometimes
becomes tight and non-retractable, requiring a second
surgery.53
13. Preputial cysts: Preputial cysts may be caused by infection
or mechanical distortion blocking the sebaceous glands. 13
14. Skin tags: A cosmetic problem may occur at the
circumcision line when pieces of skin are present at
places along the line due to an uneven removal of skin.
15. Loss of part or all of the penis: In the event of constriction
caused by the Plastibell, the electrocautery device,54 or
more frequently by infection, the penis becomes
increasingly necrotic (dead) until the entire organ drops
off.47 This has resulted in castration and sex reassignment.55
16. Meatitis: This condition consists of an inflammation of
the meatus (urethral opening), leading to ulceration and
meatal stenosis (narrowing).13
17. Meatal ulceration: Caused by meatitis and/or abrasions
from diapers (dry or soiled). Meatal ulceration does not
occur in the intact penis but occurs in up to 50% of
circumcised boys.56
18. Meatal stenosis: In advanced meatal ulceration, scar tissue
can constrict the urethral opening causing urinary
obstruction. Meatal stenosis is usually not apparent for
several years, occurring to some degree in about one-third
of all circumcised infants and not at all in intact males.57
19. Ammoniacal dermatitis: This can happen with or without
a foreskin. When it occurs without the protective covering
of the foreskin, the ammonia breakdown product of urine
burns the unprotected tissue and can ulcerate the urethral
meatus (Brennemann’s ulcers).58 When the ulcers heal,
the scar formation causes meatal stenosis.
20. Tachycardia, heart failure, and myocardial injury: These
have all been reported to have been associated with
circumcision.59
21. Progressive loss of glans sensitivity: This is the most
common complaint of adult circumcised men. Some
report that over-stimulation is needed to the point of
pain in order to achieve orgasm.9
22. Sexual dysfunction: Impotence and premature
ejaculation are more common in circumcised males.60
23. Nonspecific urethritis: Nonspecific urethritis is a
venereal disease with the following characteristics, side
effects, causes, etc. The condition is more commonly
found in circumcised adults.61
24. Death: While accurate data are not recorded, it has been
estimated that approximately 230 boys die each year in the
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United States alone from circumcision-related
complications.62, 63
Medical Indications for Circumcision
1. Cancer of the foreskin: An extremely rare and easily
diagnosed condition found mostly in elderly patients who
smoke and who have poor lifestyle habits—may not
require the amputation of the complete foreskin if
detected early.
2. Trauma: Some accidents involving the foreskin may
require complete or partial circumcision.
3. Balanitis xerotica obliterans (BXO): A rare chronic
inflammation causing a hardened, whitish area near the
tip of the penis. This may cause preputial stenosis and
meatal scarring which can block the urethra and the flow
of urine and semen.64 In most cases, circumcision can be
avoided by use of antibacterial or anti-inflammatory
creams (corticosteriods), or by laser therapy, but often
the urethra must be reopened surgically.
Complications from Anesthesia (if used)
Most infant circumcisions in the United States are
performed without anesthesia.65 The American Academy of
Pediatrics now recognizes that significant pain occurs during
the procedure and states that pain relief should be provided.2, 66
The permanent psychological trauma of circumcision shortly
after birth without anesthesia has not been fully investigated.67
Nevertheless, many studies show there is significant, long-
term psychological harm.69, 68, 69, 70 In addition to being of very
doubtful effectiveness, some of the complications from
administering anesthesia are:
1. Bleeding: Bleeding as a complication of anesthesia usu-
ally arises as a result of small ecchymoses (bruises) at
injection sites at a rate of around 1.2%.71
2. Methemoglobinemia: A reduction of the oxygen carry-
ing capacity of the blood may occur as a complication of
anesthesia for circumcision.72
Recently Cited Alleged Benefits
Benefits cited by proponents of circumcision include
reducing the incidence of:
1. Urinary tract infections (UTIs): A few studies have
suggested that boys who are not circumcised may have a
one percent chance of developing a UTI.2 These studies
have all been done in either military or inner-city
hospitals and suffer serious methodological flaws.2 The
one study that was not done in such a hospital showed a
urinary tract infection rate of 0.12%—the same as for
boys who were circumcised. The risk of urinary tract
infections in Sweden, where few boys are circumcised,
is 0.5%. There is also evidence that circumcision may
mask the symptoms of serious urinary tract
abnormalities.73 The 1999 AAP report points out the
numerous methodological flaws of the UTI research that
fail to evaluate the impact of confounding variables such
3
 as prematurity, breastfeeding, rooming-in, and urine
sample collection.2 Studies done in Israel show an actual
increase in UTIs following circumcision.17, 74, 75
2. Penile cancer: Infants do not get penile cancer. Penile
cancer is extremely rare, affecting only about 1 in 100,000
men in the United States. Studies from the 80s and 90s
have shown that penile cancer generally occurs in older
men who have exhibited cancer-inducing behaviors in
association with contracting the human papilloma
virus.76, 77, 78, 79, 80 This rate is twice to three times higher
than the rate measured in non-circumcising,
industrialized countries such as Denmark, Norway,
Finland, and Japan.81, 82, 83, 84 Consequently, circumcision
promoters advocate the circumcision of 99,999 babies
in order to allegedly protect one of them from a rare
disease in old age that can be successfully treated with
less drastic measures. Furthermore, according to statistics
of the American Cancer Society (ACS), more men
contract and die of breast cancer in this country than
penile cancer. According to the ACS, “Circumcision is
not of value in preventing cancer of the penis.”85
3. Phimosis (narrow foreskin opening): A narrow foreskin
opening is normal in all boys. “Phimosis” is a frequent
misdiagnosis by American doctors ignorant of this fact.
As boys age and develop, their foreskin opening will
naturally widen. True phimosis occurs in fewer than 1%
of boys, wherein 90% of those affected can be successfully
treated with steroid cream.86 The remaining 10% can be
treated with plastic surgery that preserves the foreskin.87
4. AIDS and other sexually transmitted diseases (STDs):
Some studies in Africa have suggested that HIV infections
are more common in men with foreskins. These studies
did not account for cultural, economic, and religious
differences between different groups.88 The United States
has one of the highest rates of circumcision in the world
as well as one of the most rapid increases in HIV
infections.89 While Japan, Norway, Finland, and Denmark
have similar or lower rates of HIV and other STDs than
does the US, none of these countries routinely circumcise.
According to the American Medical Association,
American Academy of Pediatrics, and the Australasian
Association of Paediatric Surgeons, behavioral factors are
far more important risk factors for acquisition of HIV and
other sexually transmissible diseases than circumcision
status, and circumcision cannot be responsibly viewed as
protecting against such infections.4, 8, 90
Ethical and Legal Considerations
An infant can neither be informed nor give consent for
elective surgery.91 Removal of healthy tissue is forbidden by
medical ethics as well as by universally accepted principles of
human rights. All children are supposedly protected by the
5th, 14th, and 19th Amendments to the United States
Constitution, which provide equal protection and prohibit
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4 © 2001, International Coalition for Genital Integrity, POB 8462, Santa Cruz, CA 95061 (831) 423-6105 <info@icgi.org>,<www.icgi.org>. Used with permission.
discrimination on the basis of gender. If a parent requests an
amputation of part of a child’s body, such as an ear, finger,
labia, or foreskin, the physician must make an independent
assessment and decision about such a procedure.92, 93 If an
irreversible procedure such as circumcision has no clear
medical justification, the physician must refuse the parent’s
request. To do otherwise makes the physician legally liable.94
Only the person affected can consent to damaging
procedures.95, 96
This raises a serious ethical question for physicians and
parents. The issue of informed consent in pediatric practice
was addressed by the American Academy of Pediatrics (AAP)
Committee on Bioethics in 1995.97 Several statements are
relevant to circumcision, among them:
“Parents and physicians should not exclude children
and adolescents from decision-making without persuasive
reasons. Thus ‘proxy consent’ poses serious problems for
pediatric health care providers. Such providers have legal
and ethical duties to their child patients to render competent
medical care based on what the patient needs, not what
someone else expresses.
“A patient’s reluctance or refusal to assent should also
carry considerable weight when the proposed intervention
is not essential to his or her welfare and/or can be deferred
without substantial risk.”
The legal status quo in the United States, whereby
circumcisions are not punished either criminally or civilly as
long as they are done “competently” and with “consent” of
the parents, must be unstable. Parental consent is invalid
except under certain limited circumstances not met by
routine infant circumcision.98
Recent policy statements by the Australasian Association
of Paediatric Surgeons are even more clear in their ethical
position:
“We do not support the removal of a normal part of the
body, unless there are definite indications to justify the
complications and risks which may arise. In particular, we are
opposed to male children being subjected to a procedure,
which had they been old enough to consider the advantages
and disadvantages, may well have opted to reject the operation
and retain their prepuce.”99
We recognize the inherent right of all
human beings to an intact body.
Without racial or religious prejudice,
we affirm this basic human right.
—International Coalition for Genital Integrity
THE INTERNATIONAL COALITION FOR GENITAL INTEGRITY IS
AN ALLIANCE OF 21 ORGANIZATIONS DEDICATED TO
PROTECTING THE NORMAL ANATOMY OF MALES AND FEMALES.
ITS MEMBERS INCLUDE HEALTH CARE PROFESSIONALS,
PSYCHOLOGISTS, RESEARCHERS, ATTORNEYS, JOURNALISTS,
ETHICISTS, ACADEMICIANS, AND CITIZEN ACTIVISTS DEDICATED
TO ENDING UNNECESSARY GENITAL SURGERY.
 References*
1. Moscucci O. Clitoridectomy, Circumcision, and the Politics of Sexual
Pleasure In: Sexualities in Victorian Britain. Eds: Andrew H. Miller and James
Eli Adams. Bloomington, IN: Indiana University Press, 1996: p 63-65.
2. Gollaher DL. From ritual to science: the medical transformation of
circumcision in America. Journal of Social History 1994;28(1):5-36.
3. Hodges F. A short history of the institutionalization of involuntary
sexual mutilation in the United States. In: Denniston GC, Milos
MF, editors. Sexual Mutilations: A Human Tragedy. New York:
Plenum Press; 1997. p. 17-40.
4. American Academy of Pediatrics Task Force on Circumcision.
Circumcision Policy Statement, Pediatrics 1999;103(3):686-693.
5. Wallerstein E. Circumcision: the uniquely American medical
enigma. Urologic Clinics of North America 1985;12(1):123-132.
6. Bollinger D, Normal versus Circumcised: U.S. Neonatal Male
Genital Ratio, white paper, 7/1/2001.
7. National Center for Health Statistics. Beltsville, MD. Online:
<www.census.gov/population/www/socdemo/birth.html>.
8. American Medical Association. Report 10 of the Council on
Scientific Affairs (I-99). Neonatal Circumcision.
9. Cold CJ, Taylor JR. The prepuce. BJU International 1999;83 Suppl.
1:34-44.
10. Winkelmann RK. The erogenous zones: their nerve supply and
significance. Proceedings of the Staff Meetings of the Mayo Clinic
1959;34(2):39-47.
11. Taylor JR, Lockwood AP, Taylor AJ. The prepuce: specialized mucosa of
the penis and its loss to circumcision. Br J Urol 1996;77:291-295.
12. Fleiss P, Hodges F, Van Howe RS. Immunological functions of
the human prepuce. Sex Trans Inf 1998;74:364-367.
13. Warren J, Bigelow J. The case against circumcision. Br J Sex Med
1994; Sept/Oct:6-8.
14. Milos MF, Macris DR. Circumcision: male—effects upon human
sexuality. In: Human Sexuality: An Encyclopedia Vern L. Bullough
and Bonnie Bullough. (eds.) New York: Garland Publishers,
1994:p. 119-122.
15. Deibert, GA. The separation of the prepuce in the human penis.
Anat Rec 1933;57:387-399.
16. Spock B, Parker SJ. Baby and Child Care (7th edition) New York,
Pocket Books, 1998:p. 94.
17. Fetus and Newborn Committee, Canadian Paediatric Society. Neonatal
Circumcision Revisited. Can Med Assoc J 1996;154(6):769-780.
18. Kaplan GW. Complications of circumcision. Urol Clin N Amer
1983;10:543-549.
19. Kaplan GW: Circumcision: an overview. Curr Probl Pediatr
1977;7(5):1-33.
20. Gluckman GR, Stoller ML, Jacobs MM, et al: Newborn penile
glans amputation during circumcision and successful
reattachment. J Urol 1995;153:778-779.
21. Eason JD, McDonell M, Clark G: Male ritual circumcision
resulting in acute renal failure. BMJ 1994;309:660-661.
22. Speert H: Circumcision of the newborn: an appraisal of the present
status. Obstet Gynecol 1953;2:154-172.
23. Patel H. The problem of routine infant circumcision. Can Med
Assoc J 1996;95:576-581.
24. Williams N, Kapila L. Complications of circumcision. Brit J Surg
1993;80:1231-1236.
25. Kirkpatrick BV, Eitzman DV. Neonatal septicemia after
circumcision. Clin Pediatr 1974;13:767-768.
26. Scurlock JM, Pemberton PJ. Neonatal meningitis and
circumcision. Med J Aust 1977;1(10):332-334.
* Many of these articles, or their abstracts, can be viewed online using links in the web
version of this document at www.icgi.org
Published by: International Coalition for Genital Integrity. Permission granted to freely reproduce in whole or in part (indicate if excerpted) using this credit line:
© 2001, International Coalition for Genital Integrity, POB 8462, Santa Cruz, CA 95061 (831) 423-6105 <www.icgi.org>. Used with permission.
27. Sauer LW. Fatal staphylococcus bronchopneumonia following ritual
circumcision. Am J Obstetr Gynecol 1943;46:583.
28. Rosenstein JL. Wound diptheria in the newborn infant following
circumcision. J Pediatr 1941;18:657-658.
29. Mahlberg FA, Rodermund OE, Muller RW. Ein Fall von
Zirkumzision-stuberkulose. [A case of circumcision tuberculosis]
Hautarzt 1977;28:424-425.
30. Annunziato D, Goldblum LM. Staphylococcal scalded skin
syndrome. A complication of circumcision. Am J Dis Child
1978;132(12):1187-1188.
31. Anday EK, Kobori J. Staphylococcal scalded skin syndrome: a
complication of circumcision. Clin Pediatr Phila 1982;21:420.
32. Hamm WG, Kanthak FF. Gangrene of the penis following circumcision
with high frequency current. South Med J 1949;42:657-659.
33. Evbuomwan I, Aliu AS. Acute gangrene of the scrotum in a one-
month-old child. Trop Geogr Med 1984;36:299-300.
34. Uwyyed K, Korman SH, Bar Oz B, Vromen A. Scrotal abscess
with bacteremia caused by Salmonella Group D after ritual
circumcision. Pediatr Infect Dis J 1990;9:65-66.
35. Stranko J, Ryan ME, Bowman AM. Impetigo in newborn infants
associated with a plastic bell clamp circumcision. Pediatr Infect Dis
1986;5:597-599.
36. Ngan JH, Waldhausen J, Santucci R. “I think this child has an
infected penis after neonatal circumcision...”. Online Pediatric
Urology April 1996.
37. Gosden M. Tetanus following circumcision. Trans R Soc Trop Med
Hyg 1935;28:645-648.
38. Sussman SJ, Schiller RP, Shashikumar VL. Fournier’s syndrome.
Report of three cases and review of the literature. Am J Dis Child
1978;132(12):189-1191.
39. Lee LD, Millar AJW. Ruptured bladder following circumcision
using Plastibell device. Br J Urol 1990;65:216-217.
40. Craig JC, Grigor WG, Knight JF. Acute obstructive uropathy—a rare
complication of circumcision. Eur J Pediatr 1994;153:369-371.
41. Van Duyn J, Warr WS. Excessive penile skin loss from circumcision.
J Med Assoc Georgia 1962;51:394-396.
42. Sotolongo JR Jr, Hoffman S, Gribetz ME. Penile denudation
injuries after circumcision. J Urol 1985;133(1):102-103.
43. Hanash KA. Plastic reconstruction of partially amputated penis at
circumcision. Urology 1981;18(3):291-293.
44. Gluckman GR. Newborn penile glans amputation during
circumcision and successful reattachment. Journal of Urology
1995;153(3):778-779.
45. Baskin LS. Canning DA. Snyder III HM. Duckett JW Jr. Surgical
repair of urethral circumcision injuries. Journal d’Urologie
1997;158(6):2269-2271.
46. McGowan Jr AW. A complication of circumcision. JAMA
1969;207(11):2104.
47. Jonas G. Retention of a Plastibell circumcision ring: report of a
case. Obstetr Gynecol 1984;24:835.
48. Eldin US. Post-circumcision keloid—a case report. Annals of Burns
and Fire Disasters 1998;XII(3):174.
49. Köksal, T, Kadioglu A, & Tefekli A. Keloid as a complication after
circumcision. BJU Int 2000;85(6):1-2.
50. Klauber GT, Boyle J. Preputial skin-bridging. Complication of
circumcision. Urology 1974;3:722-723.
51. Sathaye VU, Goswami AK, Sharma SK. Skin bridge—a
complication of paediatric circumcision. Br J Urol 1990;66:214.
52. Ritchey ML, Bloom DA. Re: Skin bridge—a complication of
paediatric circumcision. Br J Urol 1991;68:331.
(over)
5
 53. Redman JF, Schriber LJ, Bissada NK. Postcircumcision phimosis
and its management. Clin Pediatr 1975;14:407-409.
54. Gearhart JP, Rock JA. Total ablation of the penis after circumcision
with electrocautery: a method of management and long-term
followup. J Urol 1989;142(3):799-801.
55. Bradley SJ, Oliver GD, Chernick AB. Experiment of nurture:
Ablatio penis at 2 months, sex reassignment at 7 months, and a
psychosexual follow-up in young adulthood. Pediatrics
1998;102(1):e9.
56. Meyer HF. Meatal ulcer in the circumcised infant. Med Times
1971;99:77-78.
57. Persad R, Sharma S, McTavish J, et al. Clinical presentation and
pathophysiology of meatal stenosis following circumcision. Br J
Urol 1995;75(1):91-93.
58. Brennemann, J. The ulcerated meatus in the circumcised child,
Am J Dis Child 1921;21:38-47.
59. Ruff ML, Clarke TA, Harris JP, et al. Myocardial injury following
immediate postnatal circumcision. Am J Obstet Gynecol
1982;144:850-851.
60. Zwang G. Functional and erotic consequences of sexual mutilations.
In: Marilyn F. Milos and George C. Denniston, (eds.) Sexual
Mutilations: A Human Tragedy, New York: Plenum Press, 1997.
61. Smith GL, Greenup R, Takafuji ET. Circumcision as a risk factor
for urethritis in racial groups. Am J Public Health 1987;77:452-454.
62. Gellis, SS. Circumcision. Am J Dis Child 1978;132:1168.
63. Baker RL Newborn male circumcision: Needless and Dangerous
Sexual Medicine Today, 1979;3(11):35-36.
64. Rickwood AMK, Hemalatha V, Batcup G, Spitz L. Phimosis in
boys. Brit J Urol 1980;52:147-150.
65. Stang HJ, Snellman LW. Circumcision practice patterns in the
United States. Pediatrics 1998;101:e5.
66. American Academy of Pediatrics. Committee on Fetus and
Newborn, Committee on Drugs, Section on Anesthesiology,
Section on Surgery. Prevention and management of pain and stress
in the neonate. Pediatrics 2000;105(2):454-461.
67. Goldman R. The psychological impact of circumcision. BJU
International 1999;83 Suppl.1:93-103.
68. Cansever G. Psychological effects of circumcision. Brit J Med Psychol
1965;38:321-331.
69. Richards MPM, Bernal JF, Brackbill Y. Early behavioral differences:
Gender or circumcision? Dev Psychobiol 1976;9:89-95.
70. Taddio A, Katz J, Ilersich AL, et al. Effect of neonatal circumcision
on pain response during subsequent routine vaccination. The Lancet
1997;349:599-603.
71. Snellman LW, Stang HJ. Prospective evaluation of complications
of dorsal penile nerve block for neonatal circumcision. Pediatrics
1995;95(5):705-708.
72. Arda IS, Özbek N, Akpek E. Ersoy E. Toxic neonatal
methaemoglobinaemia after prilocaine administration for
circumcision. BJU International 2000,85(9),1-1.
73. Fetus and Newborn Committee, Canadian Paediatric Society.
Neonatal circumcision revisited. Can Med Assoc J 1996;154(6):769-
780.
74. Cohen H, et al. Postcircumcision urinary tract infection. Clinical
Pediatrics 1992;31(6):322-324.
75. Goldman M, Barr J, Bistritzer T, Aladjem M. Urinary tract infection
following ritual Jewish circumcision. Israel Journal of Medical
Sciences 1996;32(11):1098-1102.
76. Bissada NK, Morcos RR, el-Senoussi M. Post-circumcision carcinoma
of the penis. I. Clinical aspects. J Urol 1986 Feb;135(2):283-5.
Published by: International Coalition for Genital Integrity. Permission granted to freely reproduce in whole or in part (indicate if excerpted) using this credit line:
6 © 2001, International Coalition for Genital Integrity, POB 8462, Santa Cruz, CA 95061 (831) 423-6105 <info@icgi.org>,<www.icgi.org>. Used with permission.
77. McCance DJ, Kalache A, Ashdown K, et al. Human
papillomavirus types 16 and 18 in carcinomas of the penis from
Brazil. Int J Cancer 1986;37:55-59.
78. Kaufman RH, Adam E: Herpes simplex virus and human papilloma
virus in the development of cervical carcinoma. Clin Obstet
Gynecol 1986;3:678-692.
79. Poland RL. The Question of Routine Neonatal Circumcision. The
New England Journal of Medicine,1990;22(18):1312-1315.
80. Cupp MR, Malek RS, Goellner JR, Smith TF, Espy MJ The
detection of human papillomavirus deoxyribonucleic acid in
intraepithelial, in situ, verrucous and invasive carcinoma of the
penis. Journal of Urology, 1995;154(3):1024-1029.
81. Frisch M, Friis S, Kjear SK, Melbye M. Falling incidence of penis
cancer in an uncircumcised population (Denmark 1943-90). BMJ
(London) 1995;311(7018):1471.
82. Iverson T, et al. Squamous cell carcinoma of the penis and of the
cervix, vulva and vagina in spouses: is there any relationship? An
epidemiological study from Norway, 1960-92. Br J Cancer.
1997;76:658.
83. Maiche AG, Epidemological aspect of cancer of the penis in
Finland. Eur J Cancer Prev 1992;1:153-158.
84. Cendron M, Elder JS, Duckett JW. Perinatal urology. In: Campbell’s
Urology. 7th edition. Vol. 3. Philadelphia: W.B. Saunders
Company;1998. p. 2151.
85. The American Cancer Society’s Online Cancer Resource
Center—Penile Cancer Resource Center <www3.cancer.org/
cancerinfo/load_cont.asp?st=pr&ct=35>.
86. Orsola A, Caffaratti J, Garat JM. Conservative treatment of phimosis
in children using a topical steroid. Urology 2000;56(2):307-310.
87. Lane TM, South LM. Lateral preputioplasty for phimosis. J R Coll
Surg Edinb 1999;44(5):310-312.
88. de Vincenzi I, Mertens T. Male circumcision: a role in HIV
prevention? AIDS 1994;8(2):153-160.
89. Van Howe RS. Circumcision and HIV infection: Review of the
literature and meta-analysis. Int J STD AIDS 1999;10:8-16.
90. Australasian Association of Paediatric Surgeons, Guidelines for
Circumcision. Herston, QLD: 1996.
91. Task Force on Pediatric Research, Informed Consent, and Medical
Ethics. Consent. Pediatrics 1976;57(3):414-417.
92. Bioethics Commitee, Canadian Paediatric Society. Treatment
Decisions for Infants and Children. Reference B86-01. Ottawa (1986).
93. American Academy of Pediatrics Committee on Bioethics.
Informed consent, parental permission, and assent in pediatric
practice. Pediatrics 1995;95(2):314-317.
94. Gregory J Boyle, J Steven Svoboda, Christopher P Price, J Neville
Turner. Circumcision of Healthy Boys: Criminal Assault? 7 J Law
Med 301 (2000).
95. Somerville MA. Medical Interventions and the Criminal Law. 26
McGill Law Journal 82 (1980).
96. Somerville MA. Therapeutic and non-therapeutic medical
procedures—What are the distinctions? Health Law in Canada
1981;2(4):85-90.
97. American Academy of Pediatrics, Committee on Bioethics.
Informed consent, parental permission, and assent in pediatric
practice. Pediatrics 1995;95:314-317.
98. Svoboda JS, Van Howe RS, Dwyer JG. Informed consent for
neonatal circumcision: an ethical and legal conundrum. J Contemp
Health Law Policy 2000;17(1):60-134.
99. Guidelines for Circumcision. Australasian Association of
Paediatric Surgeons. Hersion, QLD: 1996.
Many Blessings, Volume III, Pages 41-42,
Spring 2000.

CIRCUMCISION: THEN AND NOW

By: James E. Peron, Ed.D.
Milah: Symbolic Circumcision of Covenant
The original Biblical circumcision of Abraham's time was a relatively minor ritual circumcision
procedure in which only the redundant end of the foreskin extending beyond the tip of the glans
was removed. This was called "Milah". It is from this term that the Jewish Religious Covenant
circumcision ritual Bris Milah or Brith Milah got its name.
Following "Milah", a penis so circumcised would still contain a considerable portion of the
foreskin and the penis would have continued to go through its natural development since most of
the foreskin would have remained intact. Protection of the glans would still have occurred. The
foreskin would not be stripped back off the glans and would naturally separate from the glans
gradually as the child matures, much as it would had the child not been circumcised. The sensitive
frenulum would not have been disturbed or moved, and the foreskin remaining would continue to
cover and protect a substantial portion of the glans, especially when flaccid, and the glans would
appear as uncircumcised. There would be minimal loss of sensitivity or intended protection.
This type circumcision continued throughout the ages and during the time of Christ. The
circumcision of Christ would have been this type circumcision as referred to in the bible. Indeed,
biblical reference to circumcision is strictly this form of circumcision. It continued into the New
Testament. It has been argued that Michelangelo's David should show David as Circumcised.
Interestingly, Michelangelo presented David precisely as he should have appeared following an
infant "Milah" circumcision. His glans is essentially covered with only the tip of the glans
showing.
Changes to the Ritual Circumcision Procedure:
No other feature was added to the religious ritual until about 140 AD when a second step to the
ritual circumcision procedure was introduced.
Periah: The laying bare of the glans
After performing "milah", the cutting back of the end of the infant's foreskin, a second step, periah
was then performed. Periah consists of tearing and stripping back the remaining inner mucosal
lining of the foreskin from the glans and then, by use of a sharp finger nail or implement,
removing all of the inner mucosal tissue, including the excising and removal of the frenulum from
the underside of the glans. The objective was to insure that no part of the remaining penile skin
would rest against the glans corona. If any shreds of the mucosal foreskin tissue remained, or
rejoined to the underside of the glans, the child was to be re-circumcised.
This is a much more radical form of circumcision. It was dictated by man, and is not the biblical
commanded circumcision rite. Its introduction has a bizarre history. The rabbinate sought to put an
end to the practice of youths desiring to appear uncircumcised by stretching the remainding
foreskin for social economic benefits and for sports competitions. By introducing the painful and
debilitating "Periah" they would obliterate the foreskin completely such that proper circumcised
Jew could not disguise "the seal of the covenant". From this point in Jewish history, the male's
glans is directly affected by the circumcision procedure, and the denuded glans and traumatized
infant will heal with considerable nerve damage and loss of sensitivity. Again, it is important to
note that this is not the Covenant circumcision of Abraham defined in the Bible.
Metzitzeh: (Mezzizza/Mizizah) The sucking of blood from the wound
During the Talmudic period (500-625 A.D.), a third step was added to the Orthodox circumcision
ritual. It was not universally adopted by all Jewish groups, but became a practice of the more
Orthodox groups. This third step was called "Metzitzah". During "Metzitzah", the mohel takes the
now badly bleeding penis into his mouth and sucks the blood from the wounded pant. This was
most probably adopted to collapse the major blood vessels to stem bleeding and to extract any
induced bacteria from the wound and blood system. In effect, it often introduced infection, such as
tuberculosis and venereal diseases, with very serious and tragic consequence, as reported
throughout history. More modern day mohels use a glass tube placed over the infant's penis for
suction of the blood when performing metzitzah. In many Jewish ritual circumcisions this step of
Metzitzah has been eliminated.
The introduction of Routine Infant Circumcision:
Routine Infant Circumcision was introduced during the late 1800's and throughout the 1900's on
the pretext that it offered health and hygiene benefits, would stop the habit of masturbation, and
proffered an endless list of presumed cures for a variety of ailments and diseases. As mother's
opted to use physicians to give birth in hospitals or clinics, rather than using a midwife for home
birth, the practice of routine circumcision of male infants blossomed and became nearly universal.
As one would expect, many of those experienced in the procedure were Jewish physicians and
mohels. They taught new physicians to perform the surgical procedure as was practiced by Jewish
ritual circumcision procedures. This meant that most infants underwent a fairly radical complete
form of circumcision. What was performed was the Jewish "Milah" followed by "Periah", with
most if not all of the foreskin being removed and the frenulum either severely damaged or
completely removed. This remains the routine infant circumcision procedure to this day. Many
males throughout these past decades have suffered the lasting physical, psychological, and sexual
dysfunctional consequences of routine circumcision.