It's a matter of religious tradition, medical criteria, legal considerations and political sensitivities: the debate on religious circumcision of baby boys has several layers.

"There are many fundamental rights that clash with each other and that's what makes the discussion very difficult," says Christian Zainhofer, board member of Deutscher Kinderschutzbund, a child protection group.

And that's exactly why he thinks Berlin has found a good compromise with its proposed law to legalize circumcision even if medically not necessary. But there remains opposition from the German Medical Association.

Berlin wants to permit circumcision

Jewish boys are circumcised when they are eight days old

In May, a local court in Cologne ruled that the circumcision of a young boy was bodily harm. Jews, Muslims and many circumsized Christians were outraged and saw this as an infringement on religious rights.

A legal solution had to be found: a proposed bill from the German government aims to have circumcision legalized, even if there's no medical necessity. But a condition would be that the operation would have to be carried out under recognized medical standards.

In the first six months of a boy's life, qualified religious representatives are to be permitted to conduct the operation. It's a special compromise in light of the Jewish tradition that on the eighth day, the circumcision is traditionally performed by the so-called Mohel. In the case of Muslims, the circumcision is usually performed by a medical doctor when the boy is already several years old.

The German Pediatrics Society has protested against this special compromise and insists that only a medical doctor could guarantee that the operation is painless, as prescribed in the proposed bill.

But for the doctors its about more that just the proper medical procedure. They condemn the severing of the foreskin of the penis as mutilation in cases where there is no medical necessity. Jews and Muslims view circumcision as a fundamental and inseparable part of their religion.

The German child protection group has warned not to ban the practice as it would increase circumcision tourism to other countries and also drive communities to perform circumcisions in secret under poor medical conditions, warns Zainhofer. "Then you'll have the problem that you will actually increase the dangers to young boys."

In Muslim tradition, the boys usually are already a few years old

Not just Jews and Muslims

Circumcision is not just an issue for Jews and Muslims. In addition to these religious communities, about one in ten boys overall in Germany undergo circumcision, pediatrician Maximilian Stehr told DW.

For more than ten years Stehr has been dealing with the issue, and says that in more than 50 percent of the non-religious cases there is also no medical necessity for the operation. But circumcision is often performed because of a condition known as phimosis, a constriction of the foreskin,

The World Health Organization (WHO) recommends circumcision as a way to reduce the risk for HIV and other sexually transmitted diseases. From this perspective it might also be useful in Germany, says Stehr.

The measure only matters once a boy is sexually active, so that there's no need for the operation before the boy becomes a teenager. "This can be done at a later age," says Stehr. "And by that time it's also possible to talk to the boy about it and let him decide for himself." However, the advantage of conducting the procedure shortly after birth is that the child has virtually no recollection of the operation later in life.

Responsible decisions

Doctors warn that often there is no medical need for a circumcision

The German child protection group recommends a solution which wiould have boys decide themselves whether they want the operation or not. "We want a debate on the question as to whether there's a possibility to do without circumcisions as it's an operation that essentially can be avoided," Zainhofer explains.

Yet at the same time it's also a tradition dating back some 4000 years. "We trust that parents who have their children circumcised, take this decision responsibly." What's especially important, Zainhofer argues, is a dialogue with the parents so they are fully aware about the risks of the operation and about whether it is medically necessary.

The debate has heated up in the past weeks. Opponents depict Jews and Muslims as barbaric for what they claim is the mutilazation of their children. Some rabbis, in turn, have compared those accusations to the Nazi regime. The proposed bill is meant to calm those emotions. But the reactions of religious groups, politicians, children's rights groups, doctors and lawyers suggest that the debate will not be over soon.