One More Reason Not to Circumcise

I've been in favor of leaving male penises intact for many years.

I wrote an article about it for the San Francisco Examiner in 1993. My emphasis then was on sexual functioning, pleasure and health. It was also on the psychological health of males.

What must it be like to be just days old and be strapped to a board and have part of one's genitals removed? As a woman, I'll never know. (Female genital mutilation is another topic altogether that I will address at another time.)

The topic of male circumcision stirred up much emotion for many reasons. For example, while preparing for a radio show on which I had been a frequent guest, I was told by the producer not to bring up the topic of circumcision because the host did not want to discuss it. Even though it was the host's pattern to discuss the recent articles I had written in my weekly newspaper column, he wanted no part of that discussion. (Luckily, it was a somewhat frequent topic by another host, a physician, on that same station -- so there was some airing of the issue for that station's listeners.)

Over the years, I've urged parents to seriously consider leaving their male newborns intact. I've asked them to resist the weak argument that "we want him to look just like his dad" and leave what isn't "broken" alone.

Then I came across even one more reason to stop a surgical procedure which most of the rest of the world does not practice. Here's the story.

In 2004, the New York City Department of Health received reports of three newborn, male babies who contracted herpes simplex virus (HSV-1). All of them required weeks of hospital care and intravenous injections of powerful antiviral medication. Tragically, one of them died from the infection. Unlike a mere cold sore or bothersome genital blisters, herpes for a newborn is a matter of life and death. The herpes virus can destroy a newborn's brain rapidly.

The New York City Department of Health figured out that all of these babies contracted herpes shortly after undergoing a ritual circumcision by the same mohel, the religious figure in the Jewish faith charged with conducting the longstanding ceremony called a bris.

Under Jewish law, the mohel is required to draw blood from the circumcision site, to remove what the Old Testament refers to as "impurities." The thought, back then, was that a flow of blood away from the circumcision site would carry these potentially dangerous entities away from the baby.

But the traditional way to do this, a practice called Metzizah bi peh, calls for the mohel to use his mouth and suck out the blood.

Make no mistake, this method of viral spread is rare. But, there have been eleven cases of male babies who contracted herpes following circumcisions that included Metzizah bi peh reported over the past five years in New York, Canada, and Israel. In 2005, there were four infected babies in New York City. They were all circumcised by the same New York-based mohel (who only recently was persuaded to stop).

According to New York City's Commissioner of Health, coincidence does not explain this. There is no doubt that the practice of Metzizah bi peh has infected several infants in New York City with the herpes virus, including one child who has died and another who has evidence of brain damage.

Since more than 70% of all adults 40 years of age or older are infected with the herpes simplex virus; the mouth is the most common site of HSV-1 infection; and most adults with oral herpes typically do not have symptoms, but can still spread the infection to others -- one can begin to understand the potential public health problems associated with such a tradition.

Indeed, this is why the Chief Rabbinate in Israel and the New York-based Rabbinical Council of America, began urging all mohels to avoid the potential spread of infection by using a tiny, sterile glass tube to draw the blood instead of putting their mouths directly on the circumcision wound. The overwhelming majority of mohels working today follows this manner of keeping the custom.

Yet the ultra-Orthodox Hasidic Jewish community insists in maintaining this practice. No one can deny that this practice presents a real and serious health risk. And, equally upsetting is that there have been Jewish parents who, while less Orthodox in their religious practices, hired ultra-Orthodox mohels without knowledge that they practiced the potentially risky Metzizah bi peh procedure.

Taking one giant step back from the specifics of this situation, I'll offer my viewpoint in just a few words: "A foreskin is not a birth defect."

Related Topics: Rare Circumcision Ritual Carries Herpes Risk, American Academy of Pediatrics: Circumcision Policy Statement

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