The Ritual of Circumcision

Karen Ericksen Paige
Human Nature, pp 40-48, May 1978

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In the United States, the current medical rationale for circumcision
developed after the operation was in wide practice.

Westerners look askance at the ritual mutilations of the body performed in exotic tribes, but they justify their own ritual mutilations as medically appropriate. Europeans sneer at the Maasai custom of lengthening the ear lobes, but they have their own noses bobbed and their faces lifted. Americans are horrified at the Arunta practice of subincision (slitting the penis on the ventral side) or the Sudanese tradition of infibulation (excising much of the female genitals and sewing up the vagina), but they stand with few other modern nations in clinging to a ritual that is no less "barbaric" and no more "hygienic," routine circumcision.

In the United States, the current medical rationale for circumcision developed after the operation was in wide practice. The original reason for the surgical removal of the foreskin, or prepuce, was to control "masturbatory insanity" - the range of mental disorders that people believed were caused by the "polluting" practice of "self-abuse."

But circumcision warrants none of its 19th or 20th Century justifications. It has not stopped masturbation. It has not cured mental illness, neurotic behavior, adolescent rebellion, epilepsy, warts, or frigidity. It does not prevent penile or cervical cancer. It does not make a man more (or less) sexually sensitive. [NOHARMM note: New research indicates that the foreskin is more densely nerve-laden than the rest of the penis and that circumcised men report progressive sensitivity loss.] It is not minor surgery either. On the contrary, circumcision is far more risky and has far more hazardous side effects than most people realize.

The practice developed differently in modem industrial nations than it did in pre-industrial societies. But circumcision was no less a ritual for all its scientific trappings.

Masturbation...was not only a religious sin but a medical problem
that caused physical and mental disease.

Masturbation had been regarded as a religious sin since Biblical times, but in the 18th Century science took over. Onania, or the Heinous Sin of Self-Pollution, And All Its Frightful Consequences, in Both Sexes, Considered was published in 19 editions and sold 38,000 copies before 1750. Masturbation, the book said, was not only a religious sin but a medical problem that caused physical and mental disease. A few years later Samuel Tissot, a Swiss doctor, took the exclusively medical view, arguing that the unnatural loss of semen weakened mind and body and led to masturbatory insanity. (His book, published in 1758, was reprinted as recently as 1905.)

Although Tissot's book sold exceptionally well for the times, it was more than 50 years before belief in masturbatory insanity spread throughout Europe and the United States. One indication of increasing concern is reflected in child-rearing guides. Alice Ryerson analyzed all such books written between 1550 and 1900 and found a steady increase in worry about masturbation in the United States and England. This concern began around 1750 and peaked by the last quarter of the 19th Century, when 60 percent of the books condemned the practice.

Considering the alternatives, circumcision was merciful. In the 1890s, it became a popular technique to prevent, or cure, masturbatory insanity. In 1891 the president of the Royal College of Surgeons in Great Britain published "On Circumcision as Preventive of Masturbation," and two years later another British doctor wrote Circumcision: Its Advantages and How to Perform It, which listed the reasons for removing the "vestigial" prepuce. Evidently the foreskin could cause "nocturnal incontinence," hysteria, epilepsy, and irritation that might "give rise to erotic stimulation and, consequently, masturbation." Another physician, P.C. Remondino, added that "circumcision is like a substantial and well-secured life annuity "...it insures better health, greater capacity for labor, longer life, less nervousness, sickness, loss of time, and less doctor bills." No wonder it became a popular remedy. Illustrations published in: The Anxiety Makers: Some Curious Preoccupations of the Medical Profession by Alex Comfort, Thomas Nelson & Sons/London, 1967.

Girls were spared neither parental worry about masturbation nor similar medical solutions. Female circumcision - removal of the clitoral hood, analogous to the foreskin of the penis, began to be recommended at this time, but other forms of genital surgery were attempted as well, including the removal of the entire clitoris, or clitoridectomy.

Apparently the first clitoridectomy performed in the West occurred in 1858, in England. Isaac Baker Brown published a book describing his success at treating female masturbators with genital operations, after which he was roundly criticised and expelled from the London Obstetrical Society. Most evidence indicates that clitoridectomy, but not female circumcision, was thereafter abandoned in England. No such credit for good sense can be applied to American physicians.

By the 1890s an "Orificial Surgery Society" had been formed in the United States, whose function it was to promote genital operations on women and men. Its official journal advocated that any deviation from a "normal" clitoris "requires attention." If the hood covered the clitoris completely, the clitoris should be amputated. If the hood was too tight, it should be slit open along one side and the wound stitched with catgut.

The United States and England were especially fond of circumcision,
restraints, and punishments to control masturbation.

Such severe medical treatments for masturbation, for both sexes, apparently reached their heyday between 1870 and 1904, but they continued to be recommended in medical textbooks and by practitioners until the 1930s. (The Orificial Surgery Society kept going until 1925.) The United States and England were especially fond of circumcision, restraints, and punishments to control masturbation. Between 1879 and 1904, 75 percent of the British and American medical documents studied by Spitz recommended drastic methods, compared to 51 percent of the documents from Germany and Austria and 55 percent of those from France and other European countries. But after 1925 the proportion of medical writings that favored drastic methods dropped to 25 percent in England, America, and the rest of Europe.

Spitz traced the path of circumcision in the United States by following the course of one classic pediatrics textbook, L.E. Holt's Diseases of Infancy and Childhood, which went through 11 editions between 1897 and 1940. Until 1936, circumcision was recommended as a treatment for masturbation for both sexes, and the social and mental consequences of masturbation were discussed even in the last edition. Holt advocated female circumcision, cauterization of the clitoris, and even blistering of the vulva and prepuce for recalcitrant masturbators.

Several social historians today are starting to trace the rise and fall of what has been called masturbation mania. This odd Western obsession accompanied the transition from an agrarian to an industrial economy in Europe and the United States between 1700 and 1914. Masturbation was always a middle-class worry, and it must have been powerfully threatening to warrant the prolonged attack against it. Masturbation frightened middle-class parents because doctors said it explained why so many young people were neurotic, disobedient, disrespectful of parental authority, and oversexed.

Circumcision may have represented a combined effort of medicine and the family
to defend themselves against the implacable demands and
uncertainties of the new industrial era.

In a recent article, R.P. Neuman argues that the rise of masturbation mania was an attempt to defend the trinity of work, family, and paternal authority against the internal tensions of the family and the external threats of a rapidly changing economy. Parental authority was most threatened among the rising urban middle class, where the work ethic was strongest and sons were most likely to delay marriage. Therefore parental control of children's sexuality was essential. The industrial economy, unlike the family-based economic unit, undercut the parents' power over their children because it drew them away from the home in search of work.

I suspect that circumcision solved some of the dilemmas confronting both middle-class families and the newly established (and not yet entirely respectable) obstetrical and surgical professions. Parents wanted to control the sexual impulses of their children; physicians wanted to demonstrate and consolidate their new powers. Circumcision may have represented a combined effort of medicine and the family to defend themselves against the implacable demands and uncertainties of the new industrial era.

By the end of the 1930s, about three fourths of the middle-class families in the United States were having their sons circumcised, compared to one fourth of lower-class families. (I estimate these percentages from hospital statistics on ward and private patients.) As more and more women from all social classes began to enter hospitals to give birth, circumcision made its way across class and ethnic lines.

By the 1950s the great majority of baby boys, from rich and poor families alike, were routinely circumcised in hospitals. One study of the records of 18 hospitals across the nation revealed that 83 percent of the 14,116 male infants born in 1973 had been circumcised. Among the births financed by a California medical program during the first quarter of 1976, 87 percent of the males were circumcised.

The question is: Why did the United States persist in circumcising males long after the fear of masturbatory insanity declined? The only other country in the world today that reports nearly as high a frequency is Australia, and even there the custom is on the way out. In England, circumcision is virtually extinct. In 1972, according to the Hospital Inpatient Inquiry for England and Wales, less than 1 percent of 400,000 boys under one year old had the operation (0.41 percent). The Scandinavian countries never accepted circumcision, and most of Europe has discontinued it. It survives where it has a religious or cultural tradition: Israel, Arab nations, some tribes in sub-Saharan Africa.

The question is: Why did the United States persist in circumcising males
long after the fear of masturbatory insanity declined?

Just when the mental illness rationale for circumcision began to decline in the 1930s, the cancer prevention rationale took its place. This theory was launched in 1932 when A.L. Wolbarst published a detailed article in the English medical journal Lancet. Wolbarst wanted to show that national and religious groups that routinely practiced circumcision had lower rates of penile cancer than groups that did not circumcise their boys. His specific evidence is important because physicians are still using his data to argue on behalf of circumcision.

Wolbarst gathered records from 205 American hospitals for the years between 1925 and 1930. Of the 830 cases of cancer of the penis that occurred during that five year period, only one patient was Jewish - and he had not been circumcised. Wolbarst also interviewed doctors, who reported that they had never seen a case of penile cancer among their Jewish patients, but they had seen cases among non-Jews.

It was an impressive argument, but unfortunately it overlooked the most elementary rules of statistics. Jews represent a very small percentage of the population (at Wolbarst’s writing, 3 percent), and penile cancer is even rarer than that. To report numbers of cancer cases without controlling for differences in rates of the disease and proportion of Jews in the nation misrepresents the data.

Next Wolbarst compared the rates of penile cancer among Muslims, who circumcise young boys, and Hindus, who do not circumcise, in four Indian hospitals during the same time span. Only 2 percent of the cases of penile cancer involved circumcised Muslims, though Muslims made up 21 percent of the patients in the hospitals. Wolbarst concluded that Muslims were vastly underrepresented among penile cancer patients, and that the reason must be the fact of their circumcision.

Again Wolbarst erred. The appropriate denominator for comparisons is not the religious composition of hospital patients, but Hindu and Muslim cancer rates relative to the proportion of each group in India. Even then, the comparison between religious groups must be heavily qualified when the groups also differ in social, economic, and educational levels, and in their health standards and opportunities.

The carcinogenic culprit that Wolbarst implicated was smegma and other "debris" that accumulates between the foreskin and the glans of the penis. The sooner a boy is circumcised, Wolbarst thought, the less chance he has of infecting himself or his partner with this dirty substance. As Jews seem to have a lower rate of penile cancer than Muslims, the reason must be that Jewish boys are circumcised at birth and Muslim boys in later childhood.

No one debated a man's ability to wash the foreskin
and clean off the supposedly carcinogenic smegma, but some physicians
recommended universal circumcision as a way to protect certain
"unclean" minorities who could not be relied on to wash their penises.
...Some doctors even argued that circumcision should be done for purely aesthetic reasons.

Wolbarst's persuasive arguments helped establish the belief that routine circumcision for baby boys was essential to prevent cancer in men. As time went by, other rationales were added. No one debated a man's ability to wash the foreskin and clean off the supposedly carcinogenic smegma, but some physicians recommended universal circumcision as a way to protect certain "unclean" minorities who could not be relied on to wash their penises. (The inner ear collects dirt too, one physician later observed, but no one suggests that the external ear should be routinely excised.)

Some doctors even argued that circumcision should be done for purely aesthetic reasons: A penis without a foreskin, they said, is more pleasing to the eye, neater and less likely to produce bad odors. One physician, Willard Goodwin, wrote that "circumcision is a beautification comparable to rhinoplasty [a nose job]," and that the circumcised penis "appears in its flaccid state as an erect uncircumcised organ - a beautiful instrument of precise intent."

Clearly, medical and personal motives were getting confused.
...Once established, circumcision survived on its own momentum.

Clearly, medical and personal motives were getting confused. The 1957 and 1968 editions of Benjamin Spock's Baby and Child Care advised circumcision because it makes a boy feel "regular" (In his latest edition, Spock changed his mind, saying that routine circumcision was not medically necessary.) Parents continued to have their sons circumcised so that the boys would conform to their fathers and siblings. Once established, circumcision survived on its own momentum.

In 1970 E. Noel Preston reviewed studies done on circumcision and cancer. His review showed, first, that the small percentage of men who got prostate or penile cancer tend to come from lower socioeconomic groups, for whom health care and information about disease symptoms are less available than for the middle class. Second, the "debris" that accumulates beneath the foreskin is not carcinogenic. In one study, human smegma was injected into monkey vaginas once or twice a week for three years; no cancers of the cervix or vagina developed. A similar experiment with mice got the same results, but this time a control group was also injected with known carcinogens that did produce vaginal cancers.

In 1973 Milton Terris, Fitzpatrick Wilson, and James Nelson, Jr, completed a thorough and controlled study of the role of smegma in cervical cancer The researchers matched 172 women with three grades of cervical infection (invasive carcinoma, carcinoma in situ, and cervical dysplasia) with a control group of healthy women. The husbands of the women were examined for the extent of circumcision (complete, partial, or none) and presence or absence of smegma.

Contrary to current impression, the cancer patients and the healthy women were equally likely to be married to circumcised men. Nor was there any difference between the husbands of patients and the husbands of controls in the amount of smegma under the foreskin.

Preston's review also demolished other assumptions about cancer and circumcision. In 1964 J. T. Boyd and R. Doll found no differences in cervical cancer rates between Jewish and non-Jewish women, and E. G. Jones and his colleagues found no differences between women married to circumcised men and those married to uncircumcised men. One study even compared women whose uncircumcised husbands used a condom as a contraceptive (thereby preventing smegma or semen from entering the vagina and cervix) with women whose husbands never used condoms; again, no differences in cervical cancer rates. Preston also notes that the well-known low rate of cervical cancer among nuns, usually attributed to their never having intercourse with uncircumcised males, fails to consider that they do not have intercourse with circumcised males either.

Many arguments in favor of circumcision derived from a study by Adolf Apt, who in 1965 compared rates of prostate cancer in Sweden (where men are not circumcised) to those in Israel (where men are). The incidence of prostate cancer was higher in Sweden, so it seemed that lack of circumcision was the cause. But, as Preston was first to point out, Apt overlooked the age differences in the two countries. Prostate cancer is a disease of older men - and there are seven times as many men over age 60 in Sweden as in Israel. Once the age difference is adjusted, Apt's data suggest that rates of prostate cancer are higher in the circumcised population.

In any case, prevention of a rare problem is no reason to perform surgery on everyone.
More people die of appendicitis than get phimosis,
yet no one recommends universal appendectomy in infants as insurance.

Circumcision has been advocated for medical reasons other than cancer prevention. Circumcision of infants is supposed to prevent the occurrence of phimosis (narrowness of the opening of the prepuce, preventing its being drawn back over the glans) and balanitis (inflammation of the glans), and eliminate the dangers of a too-tight foreskin. The incidence of each of these problems is rare, however, and their future likelihood impossible to detect in infants. Only a small proportion of baby boys have a fully retractable foreskin at birth; it takes about three years before 90 percent of all boys have a retractable foreskin. Unfortunately many doctors, observing the unretractable foreskin of the infant, assume the child has phimosis and recommend circumcision. In any case, prevention of a rare problem is no reason to perform surgery on everyone. More people die of appendicitis than get phimosis, yet no one recommends universal appendectomy in infants as insurance.

American attitudes about sex and circumcision have undergone a dramatic reversal. When Americans believed that sexual impulses in general, and masturbation in particular, were harmful, circumcision was believed to repress sexual sensation. In the last few years the prevailing opinion has been that sexual activities, including masturbation, are beneficial. Circumcision is now believed to enhance sexual sensation for both sexes.

Men have debated the sexual sensitivity question for centuries. Circumcised men think that they have the more sensitive penises; uncircumcised men think that the constant exposure of the naked glans to clothes and the elements toughens it. Some men think that having a foreskin delays orgasm, giving a man more control; others think just the opposite. This discussion is never going to be settled. Sexual sensitivity appears to be in the mind of a man, not in his foreskin.

For women the same issue has more serious consequences. Most people are not aware that female circumcision was ever practiced at all in the United States. Although circumcision of the clitoris never became as widespread a custom as circumcision of the penis, the operation is not uncommon. Like male circumcision, the female operation continued even after the masturbation mania subsided in the 1930s - it just changed rationales.

In 1937 a Texas doctor, Frank Iiams, recommended female circumcision as a way to make women more sexually responsive. Female frigidity he said, was caused by a clitoris that was too long or too tight (the same problems once thought to encourage masturbation). Surgical removal of the prepuce, he said, would restore "a more happy and contented marital life." [NOHARMM note: This persisted into the late 1950s. Read Female Circumcision: Indications and a New Technique]

In 1973 precisely the same justification for surgery came from a New York doctor, Leo Wollman, whose patients are referred to him by psychoanalysts and clinical psychologists. The only complication he reports is the formation of a hematoma (blood clot) at the place where the incision is made to remove the foreskin. Sometimes the hematoma grows as large as a goose egg. Wollman concedes that such a complication may be "distressing" to the patient, but warns that telling all women of its likelihood prior to surgery was "psychologically inadvisable" - but legally prudent.

The issue of female circumcision has come to public attention. In 1977 a California woman brought suit against her doctor, who performed the operation to cure her "sexual insensitivity." The medical profession is divided on the matter, as usual. One physician who testified at the hearing, unidentified in the newspaper accounts, said he "could see no reason in the world why this operation had to be performed," while the chairman of the Department of Obstetrics and Gynecology at Stanford University Medical School said it is "a matter of judgment."

Two years ago The New York Times carried a front-page story on unnecessary surgical practices. The Times reported that male circumcision was the most common surgical procedure in the United States, but there were "not untrivial" complications. The Times understated the case.

The three most serious complications are hemorrhage, infection, and surgical trauma. Infection of the wound, often from contact with feces and urine, can lead to inflammation and ulceration of the penis. In one Canadian study, Hawa Patel examined 100 circumcised infant boys and found common, though "usually minor" complications, including hemorrhage (35 boys), ulcers of the urethral passage (31), infection (8), and phimosis (1). In rare instances, infections have led to septicemia and pulmonary abscesses, causing the baby's death.

Sometimes circumcision fails because too much foreskin is pulled over the shaft and excised, leaving a denuded shaft. Sometimes circumcisions are incomplete. In a study of cervical cancer patients by Terris and his colleagues, a large number of the husbands had had partial circumcisions, in which much of the foreskin had been left.

The consequences of circumcision can be horrible. Some years ago, John Money and Anke Ehrhardt reported a case of twin boys, one of whom had been transformed surgically into a girl. The case has been widely cited as an example of how social learning can turn a genetic boy into a psychological girl. Readers of this study tend to avoid the paragraph that tells why the operation had to be done in the first place: The infant boy was the victim of a "mistake" during a routine circumcision. His penis was burned off. [NOHARMM note: This is the John/Joan case in Canada that hit the media headlines in 1997. Again, most of the media never divulged the circumcision tragedy (until July, 1998). Instead, they initially focused on "intersexuals" - those born with ambiguous genitalia.]

Overall, the complication rate for routine circumcision stands at only 1 percent of all operations. Still, for every one million boys, that is 10,000 complications -including two deaths. And physicians are still not sure about the hidden effects. The psychological and stress consequences of early circumcision are just now coming under investigation. Yvonne Brackbill finds that circumcised baby boys show greater increases in heart rate in response to sounds than do girls and uncircumcised boys. Luther Talbert and his colleagues find that after circumcision, male babies show increased adrenal cortical hormone levels -hormones known to increase in response to stress. And after circumcision, I.F. Anders and R.J. Chalemian report, male babies change their sleep patterns, staying awake for longer periods of time than they did before the operation. Other researchers have found that male babies, at three weeks and at three months of age, cry more and sleep less than females, and are harder to console when they get irritable. In short, infants are put under stress by the operation, and the potential effects of such stress should not be ignored.

When a custom persists after its original functions have died,
it may be accorded the status of ritual.

For all of these reasons the American Pediatric Society finally concluded in 1975 that "there are no valid medical indications for circumcision" in infancy. But obstetricians, who generally perform the surgery, have not endorsed this stand, and health insurance companies are still spending some $200 million annually to pay for the $50 to $75 operation [1978 prices].

When a custom persists after its original functions have died, it may be accorded the status of ritual. American parents and physicians no longer cite masturbatory insanity as a reason to circumcise children, but they have found other justifications for the ritual that they believe in as firmly. When the same operation is variously reputed to accomplish antithetical goals - in the case of circumcision, to repress sexuality and to liberate it, to make the penis or clitoris less sensitive and more sensitive - we can be sure we are dealing with ritual, not rational thinking. It is astonishing that such a little bit of skin carries such a great load of power.

Anthropologists and psychoanalysts have attempted many explanations of circumcision and other forms of genital surgery in tribal cultures. Psychoanalysts concentrate on unconscious motives, castration anxiety, and father-son rivalry. Circumcision, they say, represents a boy's willingness to sacrifice a part of his penis in deference to his father's power, or the father's efforts to show his son who is boss.

The trouble with these theories is that in no society do boys circumcise themselves, and only rarely do fathers circumcise their own sons. The operation is almost always done by a third party: the tribal chief, a physician, the boy's uncle, or a professional (the Jewish mohel).

Only 23 cultures in our sample practice circumcision, and they tend to share
a particular economy and form of social organization. ...strong fraternal-interest groups,
related males who are united to pursue common political objectives.

Some anthropologists regard circumcision rituals as a rite of passage, a part of manhood training. The trouble with this approach is that across cultures, boys are circumcised at different ages: some in infancy, some in childhood, some as adolescents. In most societies boys are forcibly subjected to the ceremony when they are far too young to understand the meaning of masculinity.

To understand the functions of circumcision, Jeffery Paige and I studied a world-wide sample of 114 tribal societies. We asked first how prevalent the custom is, and where it occurs. Only 23 cultures in our sample practice circumcision, and they tend to share a particular economy and form of social organization. These societies are all advanced horticulturalists or nomadic pastoralists - such as the Tiv of Nigeria or the Kazakh of Russia - that share a common political structure. They are composed of what we call strong fraternal-interest groups, related males who are united to pursue common political objectives. Because of the strength of these large groups, kinsmen are especially successful in defending property, allocating resources, and negotiating explicit agreements over women and wealth. Women are pawns in such societies, exchanged in kinship bargains and marriages.

For whom is the circumcision ceremony performed?

We next asked: For whom is the circumcision ceremony performed? Not for the child, not even for the father The child is a passive participant, according to most ethnographic accounts. The most common pattern is for a village elder or chief to command a reluctant father to have his sons circumcised. Among the Thonga the chief orders the ceremony for all boys between 10 and 16, and if necessary he will use force to carry out the command. Victor Turner, who studied the Ndembu of Zambia, observed one wily old chief revive his flagging power over factions within his tribe. He called for a circumcision of the warring factions' sons - and he presided. Because the timing of the ritual varies from infancy to adolescence, both across and within cultures, kinsmen continually fight over who should do the operation and when. Sometimes the scheduling of a circumcision settles a brewing feud - or escalates one.

...male circumcisions are a public demonstration by fathers to elder kinsmen
of their loyalty to the fraternal-interest group

Evidence like this persuaded us that male circumcisions are a public demonstration by fathers to elder kinsmen of their loyalty to the fraternal-interest group. The greatest sign of loyalty is to entrust one's son's reproductive ability to someone else, and it is precisely because the ritual involves this risk that it is such a powerful emotional symbol. (Tiv fathers laugh nervously during the ceremony, telling the circumciser: "Easy, easy, many women will weep if you err.")

There is a reason these societies perform ritual mutilations on the penis, the organ of ...power,
... obedience of fathers and sons is of particular economic and political importance.

There is a reason these societies perform ritual mutilations on the penis, the organ of procreation and power, and not on the ear, or finger, or elbow. In societies that practice circumcision, the obedience of fathers and sons is of particular economic and political importance. A father who leaves the fraternal-interest group, taking with him the reproductive power of his sons and of his sons' sons, represents an immense threat to the continuing ability of the group to defend itself and its valuable resources. Among tribes that lack fraternal-interest groups, such as the Mbuti hunter/gatherers, individuals break off from their kin groups frequently; but the departure of a son's family is no loss of power or wealth for the father, since they control nothing of great value in the first place. Only when military and political power depends on continual expansion of males in the father's line does the departure of a son and his reproductive assets represent a major political crisis.

Female circumcision and other genital mutilations are generally confined
to the same types of societies that practice male circumcision.

Female circumcision and other genital mutilations are generally confined to the same types of societies that practice male circumcision. (Not all cultures that circumcise males also perform genital surgery on females.) In non-Western cultures genital operations are primarily intended to preserve a girl's virginity until marriage. In these strong fraternal-interest groups, a bride's virginity guarantees economic alliance and political power for her male kin, as well as economic support and protection for the woman and her female kin.

The ancient Hebrews had the exact form of economic and political organization in which
male circumcision (and female virginity tests at marriage) is most likely to occur today.

The ancient Hebrews had the exact form of economic and political organization in which male circumcision (and female virginity tests at marriage) is most likely to occur today. Indeed, the story of Genesis is a story of fissions and feuds, of a growing tribe that needed unity and the strength of its male defenders to survive in a hostile human and ecological environment. Genesis 17 describes the bargain between God and Abraham: "This is my covenant which ye shall keep, between me and you and thy seed after thee; Every man child among you shall be circumcised.... And the uncircumcised man child whose flesh of his foreskin is not circumcised, that soul shall be cut off from his people; he hath broken my covenant."

But the ancient Jews knew exactly what circumcision was: a loyalty oath, a political deal.

Modern Jews often defend circumcision by arguing that the custom, like the pork taboo, protected Jews against disease and illness whether they were aware of it or not. But the ancient Jews knew exactly what circumcision was: a loyalty oath, a political deal. Any Jew, even today, who does not circumcise his sons is announcing the limitations of his loyalty to the tribe.

Karen Ericksen Paige is associate professor of psychology at the University of California at Davis. She received her Ph.D. at the University of Michigan in 1969, where she began her studies of the cultural and personality components of mood changes and physical symptoms associated with the menstrual cycle. She and her husband, Jeffery M. Paige, have just completed a four-year study of world patterns in reproductive rituals such as circumcision and couvade. Their book, Politics and Reproductive Ritual, will be published by the University of California Press. Paige is continuing research on world patterns in female puberty rites and practices associated with premarital virginity - concentrating on the themes of honor and shame - and she is also studying critical transition points in the life cycle of American women and men.

References

Neuman, R.P. "Masturbation, Madness and the Modern Concepts of Childhood and Adolescence" Journal of Social History, Spring 1975, pp.1-27.

Preston, E. Noel. "Whither the Foreskin?" Journal of the American Medical Association, vol. 213, no. 11.

Richards, M.P.M., J.F. Bernal and Yvonne Brackenbill "Early Behavioral Difference: Gender or Circumcision?" Developmental Psychobiology, vol. 9, no. 1.

Ryerson, Alice Judson. "Medical Advice on Childrearing, 1550-1900" Harvard Educational Review, vol. 31, no. 3.

Spitz, René. "Authority and Masturbation: Some Remarks on a Bibliographic Investigation" Yearbook of Psychoanalysis, vol. 9, International Universities Press, 1953.

Terris, Milton, Fitzpatrick Wilson and James Nelson, Jr. "Relation of Circumcision to Cancer of the Cervix" American Journal of Obstetrics and Gynecology, vol. 117, no. 8.

Wolbarst, A.L. "Circumcision and Penile Cancer" The Lancet, January 16, 1932, pp. 150-153.

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