The Jerusalem Report - April 25, 2011 (pp. 24-27) JEWISH WORLD AS AN INCREASING NUMBER OF AMERICANS - including a sizable number of American Jews - question the act of male circumcision, a group of San Francisco activists are advocating to ban circumcision, or what they call male genital mutilation. These activists are hoping to acquire 7,168 signatures to get a proposed measure on the November city ballot that would impose a maximum fine of $1,000 and up to one year in jail for someone who performs a circumcision. [Much less than the existing penalty for any female genital cutting.] Lloyd Schofield, who is leading the signature effort, tells The Jerusalem Report that his group is "on track" for obtaining the required number of signatures by the April 26 deadline for getting a proposition on the November ballot. If they achieve their objective, during the November 1 mayoral contest, San Francisco voters can vote on the measure, which makes it a "misdemeanor to circumcise, excise, cut or mutilate the foreskin, testicle or penis of another person who has not attained the age of 18." [Words cut and pasted, with the anatomy adapted, from the existing law.] Many of the leading activists against circumcision around the country are Jewish. But not surprisingly, the established Jewish community in the San Francisco Bay Area is furious about the proposed bill. "It is very alienating to Jews in San Francisco to read this proposed language," says Abby Michelson Porth, associate director of the Jewish Community Relations Council in the Bay Area. "It appears to be hostile to many Jews. It´s an attempt to infringe upon our rights as individuals and a faith community." [On the contrary, in enlarges on the rights of the individuals most directly concerned.] Male circumcision is commanded in Genesis 17:10-14 as an outward sign of a man´s participation in the Jewish covenant with God. The rite of circumcision, or brit mila, is performed on the eighth day of a boy´s life. "This is a tradition as ancient as the very first Hebrew, even before Sinai. It is a mitzva that perpetuates the Jewish people," [How?] says Rabbi Shmuel Goldin, Orthodox spiritual leader of Congregation Ahavath Torah in Englewood, New Jersey, and first vice president of the Rabbinical Council of America. Schofield is not unaware of the significance of circumcision to the Jewish community. "We considered the wording and possible religious exclusion because we know that circumcision is important to Coptic Christians, Jews and Muslims. But we believe this is harmful to babies," he says. Opponents of male circumcision believe that circumcision not only inflicts tremendous pain on babies,but also causes psychological damage to men, including feelings of anger, distrust and grief. They believe circumcision hinders full sexual satisfaction since the foreskin that is removed during circumcision includes thousands of sensitive nerve endings. Schofield asserts that he wouldn´t be leading the San Francisco move to ban circumcisions without the support of a lot of Jews. The more I talk to Jews, the more I learn how divisive this is within the Jewish community. The Jewish community is as diverse as any. I get emails from Jews, even Orthodox Jews, who are against circumcision. And I have gotten some support from Muslim men." As hopeful as Schofield is that his group will succeed in getting the bill on the election ballot, and then hopefully passed by voters, he´s not sure if he´d be involved again if it fails and another attempt were made to pass the measure. But the Jewish community in San Francisco and around the country should not believe the efforts to ban circumcision would end, if the measure fails on the West Coast. Other activists against circumcision have been working on both the state level and federal level to get bills passed to ban the practice, which is also prevalent, but declining, among the non-Jewish population in this country. "This is a powerful movement that´s not going away," contends Schofield. IN FACT, THE MAN WHO WROTE THE MEASURE FOR THE San Francisco ballot, Matthew Hess, president of MGMbill.org, (standing for male genital mutilation bill) started the effort to ban circumcision on the federal level as far back as 2003. Each year he attempts to find sponsors of the bill, though he´s not optimistic he´ll succeed. "There´s no reason to expect to find a sponsor of the bill this year," he tells The Report. He points out that female circumcision is against US law and asserts that it is gender discrimination to allow circumcision on males. "If it´s unethical to cut any female genitals, then there shouldn´t be a double standard for boys." In 2007, the proposed bill in Massachusetts actually found a sponsor- which is the furthest his efforts have reached - but it was voted down by the state judiciary committee. Hess is not discouraged. "The level of support to ban male circumcision is rapidly growing, partly due to Facebook, where it´s exploded. When I started, the rate of male circumcision in this country was 56 percent and now it´s 33 percent. In California, it´s only 22 percent. I believe circumcision may be the top civil-rights issue this decade, as gay rights was in the last decade." Hess, whose anti-circumcision advocacy is on a volunteer basis, explains what led him on this unusual journey. "I was circumcised as an infant, but in my late 20s, I slowly lost feeling [in his genitals]. I did some research and was amazed to find out how harmful this surgery is. I underwent a non-surgical foreskin replacement, which reversed some of the damage. There´s been a significant difference; it´s changed my life. I decided I needed to get involved so this wouldn´t be forced on children." He doesn´t accept the arguments that circumcision reduces health issues in males as well as their female partners. "If you give mastectomies to all little girls, you´ll never have breast cancer, but no one considers doing that," he says. Nor does he accept any religious argument for circumcision. "One person´s right to religion doesn´t supersede another´s right not to be harmed. Freedom of religion has limits." There are a number of groups of activists against circumcision in the US, some of whom call themselves "intactists" - activists for leaving men intact. Ronald Goldman, executive director of the Circumcision Resource Center in Boston, who has been fighting circumcision since 1991, says his organization is purely educational. "We want people to make informed decisions not to circumcise their sons. We think education will persuade people not to do it. The US is the only country in the world that circumcises for non-religious purposes." He tells The Report that he attended a brit mila and found it "very distressing to hear the baby cry in agony for over 20 minutes." He expresses some hope that national groups, such as the Center for Disease Control (CDC) and the American Academy of Pediatrics (AAP) - both expected to release new public health recommendations about circumcision this year - will speak out against the procedure. Salina Cranor, a spokeswoman in CDC´s National Center for HIV/AIDS, Viral Hepatitis, STD (sexually transmitted diseases) and TB (tuberculosis) Prevention, tells The Report that the "CDC is working on some recommendations on male circumcision for HIV prevention in the United States, but those recommendations are still in progress and we can´t offer a timeline for publication." SIMILARLY, A MEMBER OF THE CIRCUMCISION TASK force of the AAP predicts their final document won´t be published until the end of the year or in early 2012 . Dr. Doug Diekema says the task force has taken its responsibility very seriously, spending the first six to nine months reviewing vast amounts of literature, of data and studies of the benefits and repercussions of male circumcision. "At the last meeting, we wrestled with what the recommendation should be and now we´re working on the wording and what support evidence needs to be provided," he tells The Report. Once there is a document, it goes through an academic review process, which takes about three months. The present policy of the AAP was written 10 years ago and "basically says that there are no medical benefits sufficient to recommend that newborns be routinely circumcised," says Diekema. The policy recognized some benefits and some risks, but leaves the decision to the parents with consultation from their pediatrician. It´s not unusual for policies to be reviewed every few years, he explained. But there isn´t a standing committee to review circumcisions, so every 10 years they must put together a task force to review new data and new studies. "All options [with the new policy] are on the table," Diekema said. "The task force has no constraints to establish a new policy." But there is some extra sensitivity. Last year the AAP released a new policy on female circumcision that "recognized that by offering some families a ritual nick, draws little blood and serves as a ritual. This caused a firestorm and we withdrew the policy. Now we´re opposed to all forms of female genital cutting ." Diekema, however, strongly notes that it´s "not appropriate to equate male and female circumcision. The procedures are not analogous. The male equivalent of female mutilation would be removing the penis and scrotum and that´s not it. The removal of the clitoral hood is most analogous." [And illegal.] In addition, he said, there are no known medical benefits to any female cutting and "there is evidence of medical benefits for men. The arguments against male circumcision are based on the assumption of no medical benefits and that means ignoring much data." [No, there are plenty of things that have medical benefits that we just don't do. Castrated men live longer.] AMONG THE MEDICAL BENEFITS, HE POINTS OUT, are a decrease in incidence of urinary tract infections for babies under a year of age, a reduction in risk of penile cancer and most new data shows a lowering of risk for a number of sexually transmitted diseases including lowering the risk of contracting and transmitting HIV. [As the links show, all those claims are contested.] He argues with the opinions of opponents of male circumcision that the procedure can increase the likelihood of males getting autism or attention deficit disorder (ADD), or that it increases anger and anxiety in male adults or increases the incidence of divorce. "It sounds like an attempt to blame these issues on something they don´t like, namely circumcision," Diekema said. "I don´t have a lot of respect for this. There´s no data and to speculate is irresponsible." [Those are virtually straw-man arguments, not the bedrock of our case.] He does take seriously, however, circumcision´s sexual impact. "The data on sexual function doesn´t show a difference. There´s no compelling argument one way or another." He noted that the fact that the foreskin is loaded with sensory endings doesn´t answer the question. "There are all kinds of sensory endings, hot and cold, pain, etc. and we don´t know if removal of some sensory endings, with some remaining, makes any difference." [Well isn't that a scandal in itself? In other words, they cut part off without knowing just what they are doing.] While Diekema wouldn´t divulge any opinions from the task force, he said it is safe to say that the AAP won´t suggest banning circumcision. "The new data runs more in favor of circumcision than against. The evidence of benefit is stronger and the evidence doesn´t show more risk." [Diekema is silent on ethics here, though elsewhere he says "...[P]roviders 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. ... The pediatrician's responsibilities to his or her patient exist independent of parental desires or proxy consent."] Opponents of male circumcision will most likely question the source of the AAP policy, namely pediatricians who perform male circumcision. But Diekema says "most members on the task force don´t make money from circumcisions and I don´t do them. The Academy doesn´t have a vested interest in circumcision. Few pediatricians make substantial money from them." Whatever policy the AAP publishes in the next few months, the controversy about circumcision is not likely to diminish. Georganne Chapin, executive director of Intact America, an Internet-based movement whose newest campaign is called "Put Down the Knife," considers the AAP "collaborators." If anything, the new AAP guidelines might increase the debate - particularly among Jews. Goldman, from the Circumcision Resource Center, says he specifically encourages Jews to question circumcision, pointing to the website www.jewishcircumcision.org. Moreover, he wrote a book entitled, "Questioning Circumcision: A Jewish Perspective." Chapin says she doesn´t believe that circumcision "is a Jewish issue. Many Jews in this movement feel conflicted about this." Miriam Pollack is one of those. Part of the NOCIRC (National Organization for Circumcision Resource Centers) group, Pollack says her "attachment and connection to Judaism is so profound," yet her mind was changed, over time, by witnessing the brit mila ceremony. She is now "unequivocally opposed to circumcision." She explains: "I assumed that as the central mitzva of the faith and tradition that I love, it was beyond reproach, that it was spiritually and medically superior. And, more than that, anyone who would intimate differently was ipso facto an anti-Semite. But this mitzva is so different from what I and everyone else had been led to believe." "We need to tell parents about the sexual function of the foreskin, that it contains 20,000 of the most highly sensitive touch receptors in the penis and that the traumatizing of the child is significant," Pollack tells The Report. "Much research has been done on babies, including measuring the heart beat, respiratory rates and cortisol levels during circumcision. There´s nothing holy about it. Still most of Judaism I really embrace, but this piece is not OK." Pollack is by no means alone. Eliyahu Ungar-Sargon, who was brought up Orthodox, produced a documentary called "Cut: Slicing Through the Myths of Circumcision," which examines male circumcision from a religious, scientific and ethical perspective. He also interviews his Orthodox father and his brother in the film. Another American Jew who works against circumcision is Laurie Evans, the director of the New York Hudson Valley chapter of NOCIRC. "I went to a brit and couldn´t believe I was standing in a room of people who usually question so much, but didn´t think of the baby. It was one of the worst days of my life. I feel our religion is in our heart and soul, not in our genitals." When Evans´s children were born, she wanted to be more involved Jewishly, despite not being brought up to be practicing. She still maintains some of the Jewish customs, but her difficulty with circumcision has created a fissure between her and Judaism. "It´s hard for me to accept that we don´t accept tattooing and we like questioning, but this can´t be talked about. I see it like foot-binding in China." Englewood´s Rabbi Goldin says he isn´t surprised that an increasing number of American Jews don´t circumcise their sons. "I´m not surprised because the more assimilated the Jewish community becomes, the more likely they will choose not to circumcise." He tells Jews, "Before you give up something, understand what challenges Jews have met across time to keep the tradition. We are a people that has maintained a tradition against tremendous odds, and not doing this undermines our continuity as a people." Moreover, he adds, "Once you pick and choose which mitzvot that are logical and sensible to you, you begin to undermine the tradition." [Some traditions need to be undermined. We see that readily after it has happened.] There is an alternative initiative to the brit mila. Brit shalom is a non-cutting naming ceremony for newborn Jewish boys, similar to the now-popular naming ceremonies for Jewish girls. Retired physician Mark D. Reese [sic], the originator [sic] of Brit Shalom, created [sic] a website called circumstitious.com [sic]. [The Intactivism pages, www.circumstitions.com - you're there - hosts Dr Reiss's contact list of Brit Shalom celebrants.] BUT CHOOSING TO LEAVE A SON INTACT IS NOT JUST a choice being made by American Jews. Increasingly, Israeli Jews are making this choice. Kahal was established in June 2000 by parents in the Tel Aviv area who decided not to circumcise their sons. The community is not a formal organization and includes only parents with intact sons. Another website, www.gonnen.org, in Hebrew cites reasons against circumcision and quotes the Guide for the Perplexed in which Maimonides (Rambam) says: "This is also one of the reasons for circumcision, to minimize intercourse and weaken this member." Raquel Lazar-Paley is a parent who chose not to circumcise her son and she says she has several friends in the Haifa area who made the same decision. Goldin says the fact that there are an increasing number of parents in Israel who decide not to circumcise their sons is just another indication of the growing rift there between the religious and secular. Circumcision, he explains, is a symbol of the Jewish people´s partnership with God in creation. Woman, he says, was created after man so she doesn´t need a sign, and women have other mitzvot, such as going to the mikve (ritual bath). And, in answer to the question, if God wanted men to be circumcised, why weren´t they created that way, Goldin said the answer is in the Talmud. A Jew goes to Rabbi Akiva with the question and the rabbi shows the man both wheat and bread and asks, which is more valuable? When the man responds that the bread is, Akiva asks, then why didn´t God create it that way? Goldin adds that for thousands of years, "men have experienced this without serious ramification, unless you think we´re permanently scarred," he laughs. Some of the Jewish anti-circumcision advocates expressed some concern that the sons they do not circumcise would be considered Jewish, even if the mother is Jewish. Goldin put those fears to rest. "They are still Jewish, even if they´re not circumcised." ... Ultimately, whether or not male circumcision will ever be banned in San Francisco or elsewhere in the United States may be immaterial. The subject is becoming so much a part of the discussion among American Jews that late last year, Lisa Braver Moss published the first novel dealing with the circumcision controversy. "The Measure of His Grief," is about a Jewish doctor in Berkeley, California, who wages a campaign against circumcision, and finds himself feeling more Jewish as a result.