Friday, November 2, 2012

Circumcision Decision: Jewish Couples in Crisis


By REBECCA WALD

Back in the days when I was dating, before I met my wonderful husband, I would mention my views about circumcision early in a relationship, namely that I was against it and had no plans to circumcise any future sons. I figured I could marry someone with different interests or even political views, but when it came to circumcising a child, that was a deal-breaker. 

Of course, not everyone is passionate about this issue before they have kids. Many people don’t give a second thought to circumcision until they are expecting. By then, if turns out there are strong views in opposite directions, it can lead to a lot of heartache.

The situation of couples at odds about whether to circumcise is becoming increasingly common. Years ago, few people in the U.S. were talking about circumcision and almost everyone was doing it. Today circumcision rates have plummeted. According to the Centers for Disease Control and Prevention, in 2010 the rate of hospital circumcision in the United States was just 55%. There is more media attention over the issue as people are becoming increasingly aware of
circumcision's many harms. The 2011 film What to Expect When Youre Expecting took a humorous approach to one a couple’s disagreement over whether to circumcise. In real life, it’s never funny.          

Since starting Beyond the Bris, I have been contacted by a number of parents-to-be. It’s exciting to hear from couples looking for information about about brit shalom—an alternative to the traditional bris that does not include circumcision. Others contact me because they are in crisis-mode about whether to circumcise. One thing I’ve noticed is that most couples who agree about leaving their child intact are both Jewish. Couples who disagree with each other tend to be intermarried, with the Jewish spouse in favor of circumcising.

If you and your partner are disagreeing about whether to circumcise, and if one or both of you are Jewish, here are a few things to consider:

1. This is an emotional issue—on both sides. No amount of talking is likely to convince the other person. However, becoming more knowledgeable can move the discussion. Both sides should become fully educated about circumcision. Understand the different procedures used to circumcise an infant. Watch videos of infants undergoing the procedure, learn about the involved anatomy, understand the difference between intact versus circumcised, and stay focused on the child’s best interest, staying away from personal attacks and other concerns.

2. Try to hear what’s right about what your partner is saying. Don’t listen just to refute. You might find there are deep issues at work, such as who’s in control in the relationship, the desire for approval, and personal perceptions about what “looks better. If you can identify and resolve underlying issues, it might be helpful.        

3. Circumcision can never be undone. If you are on-the-fence as a couple, or deadlocked with your partner, consider letting the child decide for himself when he is grown. This is just what some rabbis advise when counseling couples in serious conflict on this issue. While they say they would prefer to see Jewish children have a brit milah, they also realize broken marriages (or badly damaged ones) are not in the best interests of children. One day it may also be easier for a son to hear, “We couldn’t decide, so we left it up to you," rather than that his parents disagreed and one parent was strong-armed into a decision.

People make a big fuss about how “awful it would be to get circumcised as an adult. In fact, adult circumcision is considered a minor outpatient procedure. In addition to wanting the procedure and giving consent:



  • An adult can provide information about pain level, so it can be adequately controlled during and after surgery. Pain relief in infants is far more complicated, dangerous, and is rarely given after surgery, if at all.  
  • Doctor and patient can discuss how much skin should be removed for the desired cosmetic and functional outcome. It's also easier to determine the amount of skin that should be removed on an adult, since one does not have to "guess" about penis size.
  • In an adult, the post-surgical wound is not continually coming into contact with a urine and feces soaked diaper, which causes pain and increases the risk of infection. 

4. Although brit milah has been practiced by Jews for thousands of years and is a very significant religious act, it’s being born to a Jewish mother that conveys lineage according to rabbinic law, not a man's circumcision status. There are also plenty of Jewish reasons not to circumcise. Jewish parents who feel circumcision is very important should think about why. If it’s about demonstrating a commitment to Judaism, this can be accomplished in many other ways, that may be much more significant. Synagogue affiliation and participation, sending the kids to Hebrew school, and celebrating Shabbat are all ways that Jewishness can be affirmed.

5. There are a growing number of Jewish families with intact sons. If a couple chooses not to circumcise, they are not alone. These days there are plenty of intact Jewish boys participating in all aspects of Jewish life. Progressive branches of Judaism don’t insist, and the reality is that even in more religious communities rabbis don’t inspect. A boy’s intact status turns out to be a virtual non-issue in most cases, unless his parents choose to make it one. 

6. If parents don’t circumcise they can still celebrate their child’s birth with a bris. Brit shalom (or bris shalom) is becoming a sought after way to recognize the Abrahamic covenant without circumcision. For a list of rabbis and others that openly perform brit shalom click here. However this list is not comprehensive. Many progressive rabbis are questioning circumcision and performing brit shalom, and in more traditional branches of Judaism there are rabbis willing to perform naming ceremonies for intact boys—if asked.

7. While couples cannot compromise on infant circumcision—they either do it or they don’t—it is possible to bargain for leading a life that affirms the culture and traditions of Judaism. If your non-Jewish spouse is opposed to circumcision, you might honor his choice in exchange for his promise be part of, and fully support, making your Jewish heritage front and center in your child’s life. In the end, it’s these things that are going to most shape your child’s identity as a Jew.    

8. There are going to be people reading this who will take serious issue with my final points; however, I believe they convey important information to couples who are determined to circumcise in the face of all of the evidence as to why it’s harmful.

If you must circumcise, insist on anesthesia, be present during the operation, and comfort the baby immediately. Know who is doing the surgery beforehand and make sure they are experienced. Medical residents perform circumcisions as a right of passage, usually having only watched one. If a mohel is doing the procedure, insist on sterile conditions and make sure there is never direct oral to genital contact. 
You might want to think about asking for a “loose cut—that is, make sure the circumciser leaves extra shaft skin to ensure adult erections are not tight and painful. This is a common problem with brit milah men don't often discuss. A loose cut removes the highly innervated ridged band, with its ability to close over the glans, but it’s still preferable to a tight circumcision. Some disagree with the logic of loose cuts, however

Please note that according to Jewish law, the entire frenulum and foreskin must be obliterated and therefore a loose cut isn’t kosher. However many Jews circumcise in a hospital in the absence of religious ritual anyway, so this might not be a concern for you. With a loose cut, during healing, it is essential to retract any excess skin back behind the glans during diaper changes and apply Vaseline each time so no adhesions or skin bridges form. This should be done for several months, longer than is routinely advised, as the extra skin wants to reattach itself to the glans. 

In addition to this site, there are a number of excellent resources for Jewish parents questioning circumcision. I recommend Dr. Ronald Goldman’s book Questioning Circumcision: A Jewish Perspective and also the Jewish Circumcision Resource Center, among others. 

4 comments:

  1. I am surprised that your views on this tender topic were formed before your thoughts turned to marriage. You are a very unusual Jewish woman.

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  2. I agree that talking and focusing on the infant's needs are key aspects to a good outcome. Parents discussing infant circumcision have found the website Circumcision Decision-Maker useful. While it was not written exclusively for Jewish parents, it has helped a lot of parents. http://circumcisiondecisionmaker.com/

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  3. I was with you until you wrote the words 'If you must circumcise...' Pragmatism at the expense of arguing for the Human Rights of the boy child? Are you actually giving advice to parents who want to allow a violent sexual assault resulting in mutilation against their son? Would you also give advice to Somalis about making sure they insist on proper anaesthesia when they cut their daughters? Seriously?

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  4. I have read that the original Jewish circumcision of the house of Abraham (Ibrihim) was exactly the very loose cut keeping the frenulum and nearly all the foreskin. This was also the circ of Jesus and the famous statue of David by Michelangelo. This was changed about 215a.d.. I would argue that this very loose circ should be acceptable for parents to choose, as it is the historical circ of Jews, Christians and Muslims too. Beyond this an adult who wishes a more extreme cut could get one. I had friends in school who had such a cut, and a nephew and some of his friends also got this. I think it is also a great compromise for parents in conflict, who can honor religion and still allow their sons to grow up looking much like their intact peers. This choice may not be considered kosher now, but for thousands of years it fulfilled the covenant without question. I wish every doctor would ask all parents to consider taking just that little off the end rather than the radical cut common these days.

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