Circumcision: A History of the World's Most Controversial Surgery

You might think that the most common surgery in the United States would also be the least controversial-an operation whose medical necessity and benefits have proved beyond question. And you would be wrong. As this fascinating history of that procedure makes clear, circumcision is rooted not in medical science, but in the deepest recesses of religion and culture. Circumcision is performed on more than one million infant and prepubescent boys around the world every year. In America, even though a growing number of physicians dispute its benefits, circumcision remains the most frequently performed elective surgical procedure. In 1995, 64.1% of US male newborns were circumcised-yet there is no proven medical benefit to this practice on normal infants. This book, by medical historian David L. Gollahar presents a fascinating history of this controversial practice and why it has persisted over time through vastly different social contexts.As this book shows, the removal of genital foreskin has a long and varied history: from the extraordinarily painful initiation rite of the ancient Egyptians, through the Hebrew purification ritual, through its use by nineteen-century doctors as prevention for ailments including bedwetting, paralysis, syphilis, and epilepsy, to the present persistence of female circumcision in African cultures. Gollaher also addresses the current controversy over the procedure's continuance, and those opposing routine circumcision will find support here.Gollaher concludes that "if male circumcision were confined to developing nations," similar to the status of female circumcision, "it would by now have emerged as an international cause célèbre."David L. Gollaher (1949- ) is President and CEO of the California Healthcare Institute, a statewide public policy research and advocacy institute. He holds a PhD in History from Harvard and has served on the facilities of San Diego State University's Graduate School of Public Health and the University of California, San Diego.

At 200+ pages you would think that the author could tell you everything you wanted to know about circumcision, but I found myself wishing he had written more. Because of Mr. Gollaher's writing I found myself fascinated by a subject that does not easily lend itself to fascination. By keeping to the facts, Mr. Gollaher is able to write a scathing rebuke of circumcision as America's cultural ritual, a ritual not unlike those practiced by 'primative' peoples. Mr. Gollaher strips away any medical justification for circumcision leaving it, as some claim, a form of legalized criminal assult on newborn babies. After reading his book, one cannot continue to belittle male circumcision as a poor cousin to female circumcision. In fact, I hope that Mr. Gollaher's book will be one of the driving forces that make non-medically justified male circumcision illegal in this country, just as female circumcision is illegal. Every prospective parent and every doctor should read this book. If education is the key to ending circumcision, then this book is a gigantic step in the right direction.

Dr. Gollaher has written the best and most intellectual bookabout circumcision since Edward Wallerstein's ground breaking book,published two decades ago. Since Wallerstein's book circumcision has fallen from about 90 to perhaps 60 perecent in the United States and virtually disappeared in all other industrialized countries.Why should Americans persist in insisting on circumcision while Canada, Britain, all of Europe, find the curious practice as a routine disgusting? Dr. Gollaher covers all thye myths and even touches on some of the personalities within the grass roots battle for and against the foreskin. In addition all the medical studies attempting to rationalize circumcision are stated and evaluated in a balanced way. This book does not use either a pro or con rhetoric, rather it states the history of circumcision and how what was a tribal and middle easteren mutilation of males became a routine for Americans. Many of the irrational rationalizations FOR the procedure are exposed and documented with reasoned and referenced material. All persons who have wondered, as I have, how such a bizzare and apparently irrational procedure could be deployed universally without religious imperative, will find this book a treasure.

The value of what medical historian Gollaher has accomplished here cannot be overstated. By producing a book of such intellectual independence and quality, he not only demystifies circumcision's cultural cachets but virtually demolishes its far-flung (and variously far-fetched) utilitarian rationales as well.Tracing its long and stubborn history, Gollaher examines with clarity the confounded insights of circumcision apologists from Philo and Maimonides to Bruno Bettelheim and John Harvey Kellogg. But this is by Gollaher's own admission "a history, not a polemic or tract for the times," and therein lies the achievement. Maintaining an attitude of rigorous detachment, he declines to proselytize in favor of anti-cutting activists yet ultimately supports their brief by letting evidence rather than emotion hold the floor. And his summary of the foreskin restoration movement, the first to appear in a mainstream press publication, will destigmatize its appeal to a larger audience. There are a few gaps in his otherwise meticulous research-- his language regarding sexual consequences is equivocal, and he curiously overlooks the Anand-Hickey neonatal pain investigation in favor of less reliable studies-- but the sweep and relevance of the project are no less comprehensive. "Circumcision" will go a long way toward laying the dual ghost of the procedure's imagined medical and behavioral benefits, and thus hasten the day when it is consigned to the obsolescent realm of other, ironically more advanced forms of bloodletting.

This book has so many interesting facets that it's hard to do it justice in a brief review. For my money, though, the chapter on how circumcision entered modern Anglo-American medicine -- how it was transformed from a Jewish ritual into a routine medical procedure deemed suitable for all boys -- is the highlight. By explaining the intellectual and cultural context of medicine in the 1870s, Gollaher explains why circumcision came to seem so reasonable (and so powerful). He clearly opposes routine circumcision, though not in a tendentious way. It's the cumulative weight of available evidence. I am the mother of two boys who were circumcised in the hospital. I had no real concept of what was done to them. The pediatrician didn't sell the procedure very hard, but he did say that most parents had it done and that he didn't see much harm in it. After reading "Circumcision," I wish my husband and I had given it more thought. We probably would have made a different decision.