United States of America

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Flag of the United States of America (USA)

The United States of America are also known as the United States or simply America or by acronyms such as USA or US or U.S.A. or U.S.. The United States are predominantly an English-speaking nation. As in other English-speaking nations, non-therapeutic circumcision of boys was popularized in the nineteenth century, however, the practice of non-therapeutic circumcision of boys is now in decline.

History

Jews have lived in America since before the Revolutionary War. They have always practiced ritual circumcision (Brit Milah) of boys on the eighth day of life in accordance with the Abrahamic covenant, however this was only for a very small percentage of the population.

One may be certain that the eighteenth century Founding Fathers of the United States of America were men with intact foreskins as were the foreskinned men who fought the American Civil War (1861-1865).

Non-therapeutic circumcision of males for non-religious reasons originated with Claude-Francois Lallemand in 1832 in France but soon spread to the United Kingdom in the early nineteenth century, from which it eventually spread to other English-speaking nations.

Late nineteenth century

The first recorded non-religious circumcision of a boy in the United States occurred in 1870 when Lewis Albert Sayre, a prominent New York City doctor, circumcised a boy of five years of age for paralysis. Sayre then continued to advocate circumcision for numerous reasons until his death in 1900. According to Sayre, circumcision was recommended for paralysis, epilepsy, hernia, lunacy, curvature of the spine, and clubfoot.

M. J. Moses (1871) advocated circumcision to prevent masturbation.

H. H. Kane (1879) 'discovers' that circumcision cures nocturnal emissions and abdominal neuralgia.

Seventh-day Adventist John Harvey Kellogg, M.D., of Battle Creek, Michigan, was an important 19th century promoter of male circumcision. Although masturbation is never mentioned in the Bible, Dr. Kellogg believed that masturbation was immoral, sinful, and caused one to dream "impure dreams", which he believed was harmful to the mental faculties, resuling in mental disorders, such as feeblemindness. He believed that the urge to masturbate could be prevented by eating bland foods, for which purpose, he and his brother invented corn flakes.

Dr. Kellogg also recommended circumcision in cases "in which irritation is produced by retained secretions".

Dr. Kellogg perhaps is most famous for his book, Plain facts for young and old (1879), in which he advocated circumcision of boys as punishment for masturbation.

Dr. William D. Gentry alleged that phimosis in boys produces serious nervous derangements.

Elizabeth Blackwell, ̣̻M.D., (1821 – 1910), born in England, but attended medical school in the United States. She was the first woman to become a medical doctor in the United States. Blackwell thought masturbation was immoral but that circumcision was not the way to correct it. She wrote against it in her 1894 book:

Appeals to the fears of uninstructed parents on the grounds of cleanliness or of hardening the part are entirely fallacious and unsupported by evidence. It is a physiological fact that the natural lubricating secretion of every healthy part is beneficial, not injurious to the part thus protected, and that no attempt to render a sensitive part insensitive is either practicable or justifiable. The protection which nature affords to these parts is an aid to physical purity by affording necessary protection against constant external contact of a part which necessarily remains keenly sensitive; and bad habits in boys and girls cannot by prevented by surgical operations. Where no malformation exists, bad habits can only be forestalled by healthy moral and physical education.

Peter Charles Remondino, M.D., was a San Diego, California physician, who was born in Turin (Torino) in 1846, but migrated with his family to the United States at the age of eight. There is some reason to believe that he was of Sephardic Jewish descent and had been circumcised while still in Turin, however this is uncertain.

Remondino clearly was highly intelligent. He mastered English, started medical school at age 17, treated wounded soldiers during the Civil War, and later moved to San Diego for his health.

After moving to San Diego, he practiced medicine, served as an officer of several medical societies, and other regulatory agencies.

Remondino is famous for his 346 page book, The History of Circumcision.

When Remondino described the foreskin, he used the most horrific, derogatory,and disparaging language. He devoted several chapters to the alleged evils of the foreskin. It is not clear why he had such an extreme dislike for a natural and functional body part. His recommendation, of course, was for circumcision.

By the end of the nineteenth century, America had at least one prominent physician and surgeon on the east coast promoting circumcision and another prominent physician and surgeon on the west coast promoting circumcision. There was no real medical science with which to dispute and discredit their false claims. Non-therapeutic circumcision of males was now well-established in the United States.

Early twentieth century

Ernest G. Mark (1901) noted that the "pleasurable sensations that are elicited from the extremely sensitive" inner lining of the foreskin may encourage a child to masturbate, which is why he recommended circumcision since it "lessens the sensitiveness of the organ".

Brimhall (1902) reported an amputation of a penis after circumcision.

Roswell Park (1902) publishes paper 'proving' that foreskin causes epilepsy and that circumcision cures it.

L. Emmett Holt (1913) reported that tubercular mohels were infecting infant Jewish boys with tuberculosis during ritual circumcision.

Abraham L. Wolbarst, M.D., a Jewish New York doctor, apparently considered Holt's paper to be an attack on ritual circumcision or perhaps Judaism. He collected opinions from other doctors of the alleged value of circumcision for health and published those opinions as scientific fact in a 1914 JAMA article. Wolbarst's paper appeared shortly before the start of World War I. It is thought that Wolbarst's false claims inspired some military commanders to require men under their command to be circumcised so as to reduce venereal disease (VD).

Reuben (1916) (1917) reported additional cases of tuberculosis after ritual circumcision.

Brennermann (1921) reported that meatal disease occurs only in circumcised boys who lack the protection of the foreskin.

Wolbarst (1926) made his claim for the first time that male circumcision prevents penile cancer.

Wolbarst (1932) put forward his claim again that circumcision would prevent penile cancer in the British journal, The Lancet. In those long ago days, the true causes of cancer were unknown so it was impossible to disprove Wolbarst's falsehoods.

Laumann et al., writing in 1997, reported an incidence of circumcision of 31 percent in 1933.

Hiram S. Yellen and Aaron Goldstein invented the Gomco clamp in 1934-5. The clamp, by crushing the foreskin in an intensely painful procedure, reduced the risk of hemorrhage, but increased the pain. The availability of the Gomco clamp increased the popularity of non-therapeutic infant circumcision.

Brown (1937) reported restoration of the skin of the penis after a denudation complication of circumcision.

Laumann et al. (1997) reported an incidence of circumcision of 53 percent in 1941.

World War II. America entered the war after the Empire of Japan attached the American naval base at Pearl Harbor, Hawaii on 7 December 1941. This was followed by Germany declaring war on the United States.

The information on military circumcision in WWII is sketchy and anecdotal. It appears that many foreskinned American men were encouraged and, in some cases, forced to be circumcised. It seems that the American military's foreskin-phobia and circumcision policy persisted through the Korean War (1950-52) but was discontinued by a change in policy thereafter.

The "Sand Myth" circulated among English-speaking armies. According to the Sand Myth, foreskinned men who fought in the Saharan desert had medical issues due to sand collecting under the foreskin. Intact Italian and German men who fought in the same desert had no such problems.

In the post-war era after WWII, the popularity of non-therapeutic circumcision, driven by medical promotion by doctors seeking a nice surgical fee as an alleged preventive of penile cancer and by the adamant request of circumcised men home from the war who became fathers.

Non-therapeutic, medically-unnecessary circumcision of boys had become a "routine" surgical operation that usually was performed automatically on newborn boys even without consent from anyone.

Laumann et al. (1997) reported an incidence of non-therapeutic circumcision of boys of 85 percent in 1948.

The publication of a landmark article by Douglas Gairdner (1949) in the United Kingdom showing that infant circumcision is non-therapeutic, unnecessary, causes deaths, and which called for preservation of the foreskin was totally ignored by the circumcision industry in the United States.

Late twentieth century

The Congress of the United States created the Medicaid program in 1965. Medicaid is a joint federal/state program that pays the medical expenses of low-income Americans. Medicaid pays for medically-unnecessary, non-therapeutic circumcision in most states, although it appears to be a violation of law to do so.

California Medicaid (Medi-Cal) announced in 1968 that non-therapeutic circumcision would not be a covered benefit.

WKC Morgan, a Canadian medical doctor then on the faculty of the University of Maryland School of Medicine, in a highly critcal letter pubished by JAMA (1965), slammed the practice of non-therapeutic circumcision of boys as it had developed in the United States.

Preston considered the matter of infant circumcision. He examined and debunked claims that male circumcision could prevent cancer of the cervix in women, cancer of the penis and cancer of the prostate in men. Preston concluded:

Routine circumcision of the newborn is an unnecessary procedure. It provides questionable benefits and is associated with a small but definite incidence of complications and hazards. These risks are preventable if the operation is not performed unless truly medically indicated. Circumcision of the newborn is a procedure that should no longer be considered routine.

Preston's paper elicited a response from CJ Falliers, M.D. (1970) who cited the "sensory pleasure induced by tactile stimulation of the foreskin."

Laumann et al. reported an incidence of newborn circumcision of 78 percent in 1971.

The American Academy of Pediatrics (AAP) is not an "academy" at all. It is a medical trade association that protects and advances the business and financial interests of its pediatrician "fellows". Influenced by Preston's paper, the AAP published a manual on the hospital care of newborn infants in 1971. The manual included the statement:

There are no valid medical indications for circumcision in the neonatal period.

The statement in the 1971 manual was good medical science, then and now, but it did not sit well with the membership of the AAP because it provided no basis on which to promote non-therapeutic circumcision for profit. A four-member "ad hoc" task force was formed to produce a new statement to fit the desires of the membership which was published in Pediatrics in 1975. The new statement had not a single citation of any other document. While it recognized the validity of the 1971 statement, It claimed without any basis that parents had a right to circumcise a newborn infant boy for "traditional, cultural, and religious factors".

The statement claimed facilitation of hygiene, prevention of phimosis, and prevention of penile cancer as reasons that parents may elect non-therapeutic infant circumcision.

The statement expressed no concern for the pain of circumcision, nor did it provide information on the functions and value of the foreskin nor did it recognize the child as a person with domestic and international rights to self-determination and physical integrity. The statement carefully avoided recommending circumcision and placed the responsibility for the certain amputation injury on the parents rather than on the attending physician.

The 1975 statement served as the AAP's position statement until 1989.

The AAP supplemented the 1975 statement in 1977 by stating:

There are no medical indications for routine circumcisions, and the procedure cannot be considered an essential component of health care. If an infant is circumcised, the procedure must be delayed until the infant is at least 24 hours old and stable, without bleeding tendency or any other illness. Circumcision must never be done at time of delivery.

Infant circumcision traditionally had been carried out without any kind of anesthesia or analgesia because of the false belief that infants could not feel pain. Researchers started to investigate the pain of circumcision in the 1970s.

David Grimes, M.D. (1978), recognized the increasing controversy regarding the practice of non-therapeutic infant circumcision. Grimes discussed several concerns including:

• Irrational patient selection.
• Lack of information prior to consent.
• Pain and anesthesia management.
• Improper surgical objectives.
• Lack of cost-effectiveness.

Grimes concluded:

However, until the benefits of routine circumcision of the neonate can be proved worth the risk and cost, medical resources probably should be allocated to measures of demonstrated value.

The American circumcision industry appears to have totally ignored Grimes' concerns.

It was at about this time that several small organizations that opposed non-therapeutic circumcision of boys started to appear. One such organization was the Remain Intact Organization of Larchwood, Iowa, which was lead by Rev. Russell Zangger.

Edward Wallerstein (1985) pointed out that the American way of practicing non-religious circumcision of boys is without parallel anywhere else in the world.

Marilyn Fayre Milos, R. N., while a nursing student at Marin General Hospital, witnessed an unanesthetized circumcision of a newborn boy. Shocked by the horror of it, she became an opponent of infant circumcision and was forced to resign from her position at Marin General Hospital. She started the National Organization of Circumcision Information Resource Centers (NOCIRC) in 1985.