It's Mogen David (Hebrew for "Star of David"). That might help you find it.

I'd look in the Jewish food section of your local supermarket. Ask an employee where the matzoh is, and the Mogen David should be right next to it.

There is an illustration on the back of some Prayer Books which shows a tree of some of the major works of Jewish literature it goes something like this:

The Tanach

The Torah

Bereshit | Shemot | Vayikra | Bamidbar | Devarim

The Nevi'im

Yehoshua Shoftim Shmuel Melachim Yirmaya'

Yechezkel Yeshaya' Hoshea Yoel Amos

Ovadiya' Yona Micha Nachum Chabakuk

Tzefaniya' Chagai Zechariya' Melachi

The Ketuvim

Rut Tehilim Iyov Mishlei Kohelet

Shir-Hashirim Eicha Daniel

Esther Ezra Nechemiya' Divrei-Hayomim

Mechilta* | Sifra** | Sifri***

Zohar****

Midrashim

Midrash-Raba Midrash-Tanchuma

Yalkut Shimoni etc,

Shisha Sidrei Mishna

Zeraim | Moed | Nashim | Nezikin | Kodoshin |Tohorot

Beraisa

Tosefta

Talmud Yerushalmi | Talmud Bavli

The Responsa and Books of

Rabanan Savurai

The Responsa and Books of

The Gaonim

AlfasRabeinu Yitzchak Alfasi | RambamRabeinu Moshe Ben Maimon | RoshRabeinu Asher

Turim

Orech Chaim | Yoreh Deah | Even Ha'ezer | Choshen Hamishpat

Shulchan Aruch

Ramo

Orech Chaim1 | Yoreh Deah2 | Even Ha'ezer3 | Choshen Hamishpat4

1.Mogen Dovid | Mogen Avraham

2.Turei Zahav | Sifsei Cohen

3.Chelkat Mechokek | Bet Shmuel

4.Meirat Einayim | Sifsei Cohen

*The Mechilta is on Bereshit and Shemot

**The Sifra is on only Vayikra

***The Sifri is on Bamidbar and Devarim

****The Zohar is on The Torah (Chumash)

After that all the books are based on the ones above.

The last eight names are the pairs of main commentries on the part of the shulchan Aruch above them, for example Mogen David and Mogen Avraham are on Orech Chaim

Look up the names of the books to get more info on the Authors.

This list of course does not include everything like the many books on Jewish Philosophy (Chakira), Mussar and Chasidus

Depending on the type of red wine, there are approximately 24 to 25 calories per fluid ounce. Therefore, approximately 100 calories in a 4 oz glass of red wine. (However, most average serving sizes are 5 fluid ounces per glass.)

For more specific examples of the calorie counts in accordance with the type of red wine, see the page link, further down this page, listed under Sources and Related Links.

.

A: Yes, but the Star of David is always drawn with two equilateral triangles (meaning a triangle of 3 sides of equal length). This is different from what math and science call a hexagram which is simply a 6 pointed Star Polygon composed of two opposing triangles. For a true Star of David one must draw 2 equilateral triangles of the exact same size. Here are a few definitions to help in your understanding-

Star of David (Noun) - a six-pointed star formed from two equilateral triangles; an emblem symbolizing Judaism. - Magen David, Mogen David, Shield of David, Solomon's seal

- WordNet 3.0 Dictionary (at The Free Dictionary.com)

Star of David (or Mogen David) A six-pointed star composed of two equilateral triangles, one superimposed upside down on the other; a symbol of Judaism.

- McGraw-Hill Dictionary of Architecture and Construction (2003)

Star of David (n.) an emblem symbolizing Judaism and consisting of a six-pointed star formed by superimposing one inverted equilateral triangle upon another of equal size. Also called Magen David

- Collins English Dictionary - Complete and Unabridged 2003 (at the Free Dictionary.com)

Star of David نجمة داوود - The hexagram formed by the intersection of two equilateral triangles, known today as the Star of David is the most prominent symbol of the state of Israel, and Judaism today, as can be seen on the flag of Israel.

- Star of David - Solomon's Seal, Baheyeldin.com

Instead of trying to come up with a genuine definition that is not copied or rephrased from primary sources (like the dictionary), I will simply provide you with a comprehensive list of definitions to allow for the fullest understanding of the word 'Star of David'.

WORD: Star of David

DEFINITION: Six-Pointed Hexagram made with two equilateral

triangles. Symbol for Judaism also used by Christian and Muslims for

several centuries.

SYNONYMS : Magen David, Mogen David, Shield of David, Solomon's

seal, estoile, hexagon, hexagram, hexahedron, Jewish star, Magen

David, Star of Bethlehem

FIRST KNOWN USE: circa 1936 ( Merriam-webster.com)

List of Dictionary and Encyclopedia Definitions

STAR OF DAVID: a star with six points that represents the Jewish

religion or Israel

- Longman Dictionary of Contemporary English

STAR OF DAVID: (noun) 1. a hexagram used as a symbol of Judaism.

Also called Magen David, Mogen David, Shield of David.

- Dictionary.com Unabridged (Based on Random House Dictionary)

STAR OF DAVID: (n.) an emblem symbolizing Judaism and consisting of a six-pointed star formed by superimposing one inverted equilateral

triangle upon another of equal size. Also called Magen David

- Collins English Dictionary - Complete and Unabridged 2003

STAR OF DAVID: NOUN [SINGULAR] - a star with six points formed by putting a triangle upside down on top of another triangle. It is used to represent Judaism and the state of Israel.

- Macmillan Dictionary

STAR OF DAVID: (plural Stars of David) A generally recognized symbol of Jewish Community and Judaism, having the shape of a hexagram, the compound of two equilateral triangles.

- Wiktionary

STAR OF DAVID: noun (pl. Stars of David)- a star with six points that is used as a symbol of Judaism and the state of Israel

- Oxford Advanced American Dictionary

STAR OF DAVID: (noun): a hexagram used as a symbol of Judaism. Also called Magen David, Mogen David, Shield of David, Solomon's seal

- Collins World English Dictionary (at Dictionary.reference.com)

STAR OF DAVID: A six-pointed star formed of two, often interlaced, equilateral triangles: a symbol of Judaism and now of the State of Israel: as a mystic symbol in the Middle Ages, called Solomon's Seal

Origin of Star of David: translated, translation ; from Classical Hebrew (language) magen david, literally , shield of David

Proper noun- The Star or Shield of David is a generally recognized

symbol of Jewish Community and Judaism.

- English Wiktionary

STAR OF DAVID: /Star´ of Dav´id/ 1. A symbol consisting of two overlapped equilateral triangles forming a star with six points, used as a symbol of Judaism. It is also called Magen David, Mogen David,and Shield of David, and is shaped identically to the hexagram and Solomon's seal. It is used on the flag of the modern state of Israel.

- Webster's 1913 Dictionary

STAR OF DAVID: (or Mogen David) A six-pointed star composed of two equilateral triangles, one superimposed upside down on the other; a

symbol of Judaism.

- McGraw-Hill Dictionary of Architecture and Construction (2003)

STAR OF DAVID: (n.) an emblem symbolizing Judaism and consisting of a six-pointed star formed by superimposing one inverted equilateral triangle upon another of equal size. Also called Magen David.

- Collins English Dictionary (at the Free Dictionary.com)

STAR OF DAVID: noun [C]- a star with six points that represents Judaism

- Cambridge Academic Content Dictionary

STAR OF DAVID: /Star of Da·vid/ n. a six-pointed figure consisting of two interlaced equilateral triangles, used as a Jewish and Israeli symbol.Also called Magen David.

- The Oxford Pocket Dictionary of Current English 2009

STAR OF DAVID: (Magen David, Shield of David)- The Star of David is the primary modern emblem of the Jewish religion. How it came to be such is a matter of some debate. Legend has it that the emblem was used by the Biblical King David (hence the name Magen David, or shield of David). In reality, it was not associated specifically with the faith until the middle ages, when it began to appear on flags, tombstones, and synagogue decorations. It is probably not coincidental that the symbol was important to the flourishing kabbalistic tradition of the same time period.

Kabbalistically, the hexagram symbolizes the six directions of space,

the divine union of male and female energy, and the four elements. The

Star of David is also important in the Rastafarian and Messianic

Christian faiths.

- Symbol Dictionary, Symboldictionary.net

STAR OF DAVID: (Noun ) - a six-pointed star formed from two equilateral triangles; an emblem symbolizing Judaism. - Magen David, Mogen David, Shield of David, Solomon's seal

- WordNet 3.0 Dictionary (at The Free Dictionary.com)

STAR OF DAVID: (Magan David or Mogen Dovid in Hebrew, Shield of David, Solomon's Seal, or Seal of Solomon) is a generally recognized symbol of Judaism and Jewish identity. It is also known as the Jewish Star. With the establishment of the State of Israel the Jewish Star on the Flag of Israel has also become a symbol of Israel.

- Star of David, Bigpedia, Bigpeida.com

STAR OF DAVID: (Shield of David)- Six-pointed device formed by

opposing two equilateral triangles. Known in Hebrew as Magen David

or Mogen David, it was used as an emblem or magic sign by pagans,

Christians, Muslims, and gradually found its way into Judaism as a

cabbalistic sign. It appears on the flag of the modern state of Israel.

- World Encyclopedia 2005

STAR OF DAVID: An emblem symbolizing Judaism and consisting of a six-pointed star formed by superimposing one inverted equilateral triangle upon another of equal size.

- Collins Discovery Encyclopedia (2005)

STAR OF DAVID: The hexagram formed by the intersection of two equilateral trianglesknown today as the Star of David is the most prominent symbol of the state of Israel, and Judaism today, as can be seen on the flag of Israel. However, this symbol was not adopted by Judaism nor Zionism as their symbol until recent times.

- Star of David - Solomon's Seal, Baheyeldin.com

STAR OF DAVID: (noun) six-pointed star, Jewish star

Synonyms for Star of David - estoile, hexagon, hexagram, hexahedron,

Jewish star, Magen David, Star of Bethlehem

More words related to star of david- Shield of David- (noun.

six-pointed star) Judaism emblem, Magen David, Star of David

- Roget's 21st Century Thesaurus 2013

STAR OF DAVID: Seeing the Star of David in your dream, represents the merging power of love and creativity. It also means the union of

heaven and earth.

- Dream Dictionary, Webster's Dictionary

STAR OF DAVID: A six-pointed star which is a symbol of Judaism.

During the Holocaust, Jews throughout Europe were required to wear

Stars of David on their sleeves or fronts and backs of their shirts and

jackets.

- A Teacher's Guide to the Holocaust

Male Male circumcision (also known as male genital mutilation) is usually an elective In which the parents or guardians of a child show their allegiance to a god or religious tradition by having the Prepuce (foreskin) removed from the penis (prepuce), a fold of uniquely endowed enervated skin that covers and protects the rounded tip of the penis (glans). In the case of infants the prepuce has to be literally torn away from the glans before it is crushed of. After the procedure is done with the penis is left badly damaged and there is real risk of the child being seriously traumatized as well as the numerous medical risks. It is promoted in the USA due to the fact that American doctors make money from it, and some doctors have read old, biased, inaccurate American "medical" books that completely ignore the importance of the foreskin.

In the US, if it is inflicted in infants, it is most commonly done on newborns about 24 hours old

In The US Circumcision for a newborn is usually done by a quack (a fraudulent / poorly trained / unethical doctor) at a clinic, in the hospital, or at an outpatient surgery center. During the procedure:

* The newborn is placed on a firm surface, often called a papoose board. Velcro straps are wrapped around the newborn's arms and legs to keep him very still during the procedure, as babies who are subjected to the mutilation often try to escape.

* The penis is cleaned.

* The surgical area is numbed with a local anesthetic while the baby remains awake. Local anesthetics include ring block, penile nerve block (dorsal penile nerve block or DPNB), or EMLA cream but are rarely used and are ineffective when used due to the extreme pain caused (just as Tylenol / paracetamol does not work well for extreme pain). General anesthesia may be used for males older than 2 to 3 months of age. When the baby is under general anesthesia, a caudal nerve block may be applied to provide postoperative pain relief. However, normally there is no pain relief, and even older babies cannot be given full pain relief. The baby typically screams or goes into silent shock.

* A sterile circumcision clamp or device is placed over the head of the penis. The three most common types of clamps used are the Gomco clamp, the Mogen clamp, and the Plastibell device. Each clamp has disadvantages, although differences between the clamps are often minor. Most doctors use the clamp they are most comfortable with.

* The foreskin is removed using a sterile scalpel or scissors. At least 100 or so infants die as a result of this in the US every year. It's been noted that if 100 people died from, for example, a type of car seat, it would be banned.

The previous (now adjusted) preceding account is however not true in most cases as there is no safe way to use aesthetic on newborns and it is virtually impossible to block out the excruciating pain that it causes a child. This procedure can cause serious trauma and behavior changes in a child. As well as sexual dysfunction (in later adulthood) and in many cases death in infancy, Male circumcision is also becoming known as male genital mutilation.

In rare cases, circumcision is performed to fix an existing medical issue. However, most medical issues with the penis can be fixed by steroid creams and/or antibiotics. Adults can get full pain relief.

Female

Female circumcision is also called Female Genital Mutilation or Cutting. Often the clitoris is removed, and the labia minora can be removed as well. Most of the time, female circumcision only involves a small cut or pierce. Rarely, the vagina is stitched together to allow only a small opening. Female circumcision is illegal in many countries, but is still practiced in some, using the same arguments used to attempt to justy male circumcision.

Definitely not the foreskin is an important part of the penis it protects it and helps maintain its sensitivity, it is a major erogenous part of the penis as well as making the sex experience more pleasurable for the woman. There are no legitimate medical reasons for removing the healthy foreskin. al other reasons are religious or cultural.

MOTHERING: The Magazine of Natural Family Living.

Winter 1997. Pages 36-45.

Santa Fe, New Mexico, USA.

Where Is My Foreskin?

The Case Against Circumcision

Paul M. Fleiss, MD

Western countries have no tradition of circumcision. In antiquity, the expansion of the Greek and Roman Empires brought Westerners into contact with the peoples of the Middle East, some of whom marked their children with circumcision and other sexual mutilations. To protect these children, the Greeks and Romans passed laws forbidding circumcision.[1] Over the centuries, the Catholic Church has passed many similar laws.[2,3] The traditional Western response to circumcision has been revulsion and indignation.

Circumcision started in America during the masturbation hysteria of the Victorian Era, when a few American doctors circumcised boys to punish them for masturbating. Victorian doctors knew very well that circumcision denudes, desensitizes, and disables the penis. Nevertheless, they were soon claiming that circumcision cured epilepsy, convulsions, paralysis, elephantiasis, tuberculosis, eczema, bed-wetting, hip-joint disease, fecal incontinence, rectal prolapse, wet dreams, hernia, headaches, nervousness, hysteria, poor eyesight, idiocy, mental retardation, and insanity.[4]

In fact, no procedure in the history of medicine has been claimed to cure and prevent more diseases than circumcision. As late as the 1970s, leading American medical textbooks still advocated routine circumcision as a way to prevent masturbation.[5] The antisexual motivations behind an operation that entails cutting off part of the penis are obvious.

The radical practice of routinely circumcising babies did not begin until the Cold War era. This institutionalization of what amounted to compulsory circumcision was part of the same movement that pathologized and medicalized birth and actively discouraged breastfeeding. Private-sector, corporate-run hospitals institutionalized routine circumcision without ever consulting the American people. There was no public debate or referendum. It was only in the 1970s that a series of lawsuits forced hospitals to obtain parental consent to perform this contraindicated but highly profitable surgery. Circumcisers responded by inventing new "medical" reasons for circumcision in an attempt to scare parents into consenting.

Today the reasons given for circumcision have been updated to play on contemporary fears and anxieties; but one day they, too, will be considered irrational. Now that such current excuses as the claim that this procedure prevents cancer and sexually transmitted diseases have been thoroughly discredited, circumcisers will undoubtedly invent new ones. But if circumcisers were really motivated by purely medical considerations, the procedure would have died out long ago, along with leeching, skull-drilling, and castration. The fact that it has not suggests that the compulsion to circumcise came first, the "reasons," later.

Millions of years of evolution have fashioned the human body into a model of refinement, elegance, and efficiency, with every part having a function and purpose. Evolution has determined that mammals' genitals should be sheathed in a protective, responsive, multipurpose foreskin. Every normal human being is born with a foreskin. In females, it protects the glans of the clitoris; in males, it protects the glans of the penis. Thus, the foreskin is an essential part of human sexual anatomy.

Parents should enjoy the arrival of a new child with as few worries as possible. The birth of a son in the US, however, is often fraught with anxiety and confusion. Most parents are pressured to hand their baby sons over to a stranger, who, behind closed doors, straps babies down and cuts their foreskins off. The billion-dollar-a-year circumcision industry has bombarded Americans with confusing rhetoric and calculated scare tactics.

Information about the foreskin itself is almost always missing from discussions about circumcision. The mass circumcision campaigns of the past few decades have resulted in pandemic ignorance about this remarkable structure and its versatile role in human sexuality. Ignorance and false information about the foreskin are the rule in American medical literature, education, and practice. Most American medical textbooks depict the human penis, without explanation, as circumcised, as if it were so by nature.

What Is the Foreskin?

The foreskin is a uniquely specialized, sensitive, functional organ of touch. No other part of the body serves the same purpose. As a modified extension of the penile shaft skin, the foreskin covers and usually extends beyond the glans before folding under itself and finding its circumferential point of attachment just behind the corona (the rim of the glans). The foreskin is, therefore, a double-layered organ. Its true length is twice the length of its external fold, comprising 80 percent or more of the penile skin covering,[6] or at least 25 percent of the flaccid penis's length.

The foreskin contains a rich concentration of blood vessels and nerve endings. It is lined with the peripenic muscle sheet, a smooth muscle layer with longitudinal fibers. These muscle fibers are whorled, forming a kind of sphincter that ensures optimum protection of the urinary tract from contaminants of all kinds.

Like the undersurface of the eyelids or the inside of the cheek, the undersurface of the foreskin consists of mucous membrane. It is divided into two distinct zones: the soft mucosa and the ridged mucosa. The soft mucosa lies against the glans penis and contains ectopic sebaceous glands that secrete emollients, lubricants, and protective antibodies. Similar glands are found in the eyelids and mouth.

Adjacent to the soft mucosa and just behind the lips of the foreskin is the ridged mucosa. This exquisitely sensitive structure consists of tightly pleated concentric bands, like the elastic bands at the top of a sock. These expandable pleats allow the foreskin lips to open and roll back, exposing the glans. The ridged mucosa gives the foreskin its characteristic taper.

On the underside of the glans, the foreskin's point of attachment is advanced toward the meatus (urethral opening) and forms a bandlike ligament called the frenulum. It is identical to the frenulum that secures the tongue to the floor of the mouth. The foreskin's frenulum holds it in place over the glans, and, in conjunction with the smooth muscle fibers, helps return the retracted foreskin to its usual forward position over the glans.

Retraction of the Foreskin

At birth, the foreskin is usually attached to the glans, very much as a fingernail is attached to a finger. By puberty, the penis will usually have completed its development, and the foreskin will have separated from the glans.[8] This separation occurs in its own time; there is no set age by which the foreskin and glans must be separated. One wise doctor described the process thus, "The foreskin therefore can be likened to a rosebud which remains closed and muzzled. Like a rosebud, it will only blossom when the time is right. No one opens a rosebud to make it blossom."[9]

Even if the glans and foreskin separate naturally in infancy, the foreskin lips can normally dilate only enough to allow the passage of urine. This ideal feature protects the glans from premature exposure to the external environment.

The penis develops naturally throughout childhood. Eventually, the child will, on his own, make the wondrous discovery that his foreskin will retract. There is no reason for parents, physicians, or other caregivers to manipulate a child's penis. The only person to retract a child's foreskin should be the child himself, when he has discovered that his foreskin is ready to retract.

Parents should be wary of anyone who tries to retract their child's foreskin, and especially wary of anyone who wants to cut it off. Human foreskins are in great demand for any number of commercial enterprises, and the marketing of purloined baby foreskins is a multimillion-dollar-a-year industry. Pharmaceutical and cosmetic companies use human foreskins as research material. Corporations such as Advanced Tissue Sciences, Organogenesis, and BioSurface Technology use human foreskins as the raw materials for a type of breathable bandage.

What Are the Foreskin's Functions?

The foreskin has numerous protective, sensory, and sexual functions.

* Protection: Just as the eyelids protect the eyes, the foreskin protects the glans and keeps its surface soft, moist, and sensitive. It also maintains optimal warmth, pH balance, and cleanliness. The glans itself contains no sebaceous glands--glands that produce the sebum, or oil, that moisturizes our skin.[11] The foreskin produces the sebum that maintains proper health of the surface of the glans.

* Immunological Defense: The mucous membranes that line all body orifices are the body's first line of immunological defense. Glands in the foreskin produce antibacterial and antiviral proteins such as lysozyme.[12] Lysozyme is also found in tears and mother's milk. Specialized epithelial Langerhans cells, an immune system component, abound in the foreskin's outer surface. Plasma cells in the foreskin's mucosal lining secrete immunoglobulins, antibodies that defend against infections.

* Erogenous Sensitivity: The foreskin is as sensitive as the fingertips or the lips of the mouth. It contains a richer variety and greater concentration of specialized nerve receptors than any other part of the penis.[15] These specialized nerve endings can discern motion, subtle changes in temperature, and fine gradations of texture.[16, 17, 18, 19, 20, 21, 22, 23]

* Coverage during Erection: As it becomes erect, the penile shaft becomes thicker and longer. The double-layered foreskin provides the skin necessary to accommodate the expanded organ and to allow the penile skin to glide freely, smoothly, and pleasurably over the shaft and glans.

* Self-Stimulating Sexual Functions: The foreskin's double-layered sheath enables the penile shaft skin to glide back and forth over the penile shaft. The foreskin can normally be slipped all the way, or almost all the way, back to the base of the penis, and also slipped forward beyond the glans. This wide range of motion is the mechanism by which the penis and the orgasmic triggers in the foreskin, frenulum, and glans are stimulated.

* Sexual Functions in Intercourse: One of the foreskin's functions is to facilitate smooth, gentle movement between the mucosal surfaces of the two partners during intercourse. The foreskin enables the penis to slip in and out of the vagina nonabrasively inside its own slick sheath of self-lubricating, movable skin. The female is thus stimulated by moving pressure rather than by friction only, as when the male's foreskin is missing.

The foreskin fosters intimacy between the two partners by enveloping the glans and maintaining it as an internal organ. The sexual experience is enhanced when the foreskin slips back to allow the male's internal organ, the glans, to meet the female's internal organ, the cervix--a moment of supreme intimacy and beauty.

The foreskin may have functions not yet recognized or understood. Scientists in Europe recently detected estrogen receptors in its basal epidermal cells.[24] Researchers at the University of Manchester found that the human foreskin has apocrine glands.[25] These specialized glands produce pheromones, nature's chemical messengers. Further studies are needed to fully understand these features of the foreskin and the role they play.

Care of the Foreskin

The natural penis requires no special care. A child's foreskin, like his eyelids, is self-cleansing. For the same reason it is inadvisable to lift the eyelids and wash the eyeballs, it is inadvisable to retract a child's foreskin and wash the glans. Immersion in plain water during the bath is all that is needed to keep the intact penis clean.[26]

The white emollient under the child's foreskin is called smegma. Smegma is probably the most misunderstood, most unjustifiably maligned substance in nature. Smegma is clean, not dirty, and is beneficial and necessary. It moisturizes the glans and keeps it smooth, soft, and supple. Its antibacterial and antiviral properties keep the penis clean and healthy. All mammals produce smegma. Thomas J. Ritter, MD, underscored its importance when he commented, "The animal kingdom would probably cease to exist without smegma."[27]

Studies suggest that it is best not to use soap on the glans or foreskin's inner fold.[23] Forcibly retracting and washing a baby's foreskin destroys the beneficial bacterial flora that protect the penis from harmful germs and can lead to irritation and infection. The best way to care for a child's intact penis is to leave it alone. After puberty, males can gently rinse their glans and foreskin with warm water, according to their own self-determined needs.

How Common Is Circumcision?

Circumcision is almost unheard of in Europe, South America, and non-Muslim Asia. In fact, only 10 to 15 percent of men throughout the world are circumcised. The vast majority of whom are Muslim.[29] The neonatal circumcision rate in the western US has now fallen to 34.2 percent.[30] This relatively diminished rate may surprise American men born during the era when nearly 90 percent of baby boys were circumcised automatically, with or without their parents' consent.

How Does Circumcision Harm?

The "medical" debate about the "potential health benefits" of circumcision rarely addresses its real effects.

* Circumcision denudes: Depending on the amount of skit cut off, circumcision robs a male of as much as 80 percent or more of his penile skin. Depending on the foreskin's length, cutting it off makes the penis as much as 25 percent or more shorter. Careful anatomical investigations have shown that circumcision cuts off more than 3 feet of veins, arteries, and capillaries, 240 feet of nerves, and more than 20,000 nerve endings.[31]The foreskin's muscles, glands, mucous membrane, and epithelial tissue are destroyed, as well.

* Circumcision desensitizes: Circumcision desensitizes the penis radically. Foreskin amputation means severing the rich nerve network and all the nerve receptors in the foreskin itself Circumcision almost always damages or destroys the frenulum. The loss of the protective foreskin desensitizes the glans. Because the membrane covering the permanently externalized glans is now subjected to constant abrasion and irritation, it keratinizes, becoming dry and tough. The nerve endings in the glans, which in the intact penis are just beneath the surface of the mucous membrane, are now buried by successive layers of keratinization. The denuded glans takes on a dull, grayish, sclerotic appearance.

* Circumcision disables: The amputation of so much penile skin permanently immobilizes whatever skin remains, preventing it from gliding freely over the shaft and glans. This loss of mobility destroys the mechanism by which the glans is normally stimulated. When the circumcised penis becomes erect, the immobilized remaining skin is stretched, sometimes so tightly that not enough skin is left to cover the erect shaft. Hair-bearing skin from the groin and scrotum is often pulled onto the shaft, where hair is not normally found. The surgically externalized mucous membrane of the glans has no sebaceous glands. Without the protection and emollients of the foreskin, it dries out, making it susceptible to cracking and bleeding.

* Circumcision disfigures: Circumcision alters the appearance of the penis drastically. It permanently externalizes the glans, normally an internal organ. Circumcision leaves a large circumferential surgical scar on the penile shaft. Because circumcision usually necessitates tearing the foreskin from the glans, pieces of the glans may be torn off, too, leaving it pitted and scarred. Shreds of foreskin may adhere to the raw glans, forming tags and bridges of dangling, displaced skin.[32]

Depending on the amount of skin cut off and how the scar forms, the circumcised penis may be permanently twisted, or curve or bow during erection.[33] The contraction of the scar tissue may pull the shaft into the abdomen, in effect shortening the penis or burying it completely.[34]

* Circumcision disrupts circulation: Circumcision interrupts the normal circulation of blood throughout the penile skin system and glans. The blood flowing into major penile arteries is obstructed by the line of scar tissue at the point of incision, creating backflow instead of feeding the branches and capillary networks beyond the scar. Deprived of blood, the meatus may contract and scarify, obstructing the flow of urine.[35] This condition, known as meatal stenosis, often requires corrective surgery. Meatal stenosis is found almost exclusively among boys who have been circumcised.

Circumcision also severs the lymph vessels, interrupting the circulation of lymph and sometimes causing lymphedema, a painful, disfiguring condition in which the remaining skin of the penis swells with trapped lymph fluid.

* Circumcision harms the developing brain: Recent studies published in leading medical journals have reported that circumcision has longlasting detrimental effects on the developing brain,[36] adversely altering the brain's perception centers. Circumcised boys have a lower pain threshold than girls or intact boys.[37] Developmental neuropsychologist Dr. James Prescott suggests that circumcision can cause deeper and more disturbing levels of neurological damage, as well. [38, 39]

* Circumcision is unhygienic and unhealthy: One of the most common myths about circumcision is that it makes the penis cleaner and easier to take care of. This is not true. Eyes without eyelids would not be cleaner; neither would a penis without its foreskin. The artificially externalized glans and meatus of the circumcised penis are constantly exposed to abrasion and dirt, making the circumcised penis, in fact, more unclean. The loss of the protective foreskin leaves the urinary tract vulnerable to invasion by bacterial and viral pathogens.

The circumcision wound is larger than most people imagine. It is not just the circular point of union between the outer and inner layers of the remaining skin. Before a baby is circumcised, his foreskin must be torn from his glans, literally skinning it alive. This creates a large open area of raw, bleeding flesh, covered at best with a layer of undeveloped protomucosa. Germs can easily enter the damaged tissue and bloodstream through the raw glans and, even more easily, through the incision itself.

Even after the wound has healed, the externalized glans and meatus are still forced into constant unnatural contact with urine, feces, chemically treated diapers, and other contaminants.

Female partners of circumcised men do not report a lower rate of cervical cancer,[40] nor does circumcision prevent penile cancer.[41] A recent study shows that the penile cancer rate is higher in the US than in Denmark, where circumcision, except among Middle Eastern immigrant workers, is almost unheard of.[42] Indeed, researchers should investigate the possibility that circumcision has actually increased the rate of these diseases.

Circumcision does not prevent acquisition or transmission of sexually transmitted diseases (STDs). In fact, the US has both the highest percentage of sexually active circumcised males in the Western world and the highest rates of sexually transmitted diseases, including AIDS. Rigorously controlled prospective studies show that circumcised American men are at a greater risk for bacterial and viral STDs, especially gonorrhoea,[43] nongonoccal urethritis,[44] human papilloma virus,[45] herpes simplex virus type 2,[46] and Chlamydia.[47]

* Circumcision is always risky: Circumcision always carries the risk of serious, even tragic, consequences. Its surgical complication rate is one in 500.[48] These complications include uncontrollable bleeding and fatal infections.[49] There are many published case reports of gangrene following circumcision.[50] Pathogenic bacteria such as staphylococcus, proteus, pseudomonas, other coli forms, and even tuberculosis can cause infections leading to death.[51, 52] These organisms enter the wound because it provides easy entry, not because the child is predisposed to infection.

Medical journals have published numerous accounts of babies who have had part or all of their glans cut off while they were being circumcised.[53 54 55] Other fully conscious, unanesthetized babies have had their entire penis burned off with an electrocautery gun.[56,57,58] The September 1989 Journal of Urologypublished an account of four such cases.[59] The article described the sex-change operation as "feminizing genitoplasty," performed on these babies in an attempt to change them into girls. The March 1997 Archives of Paediatrics and Adolescent Medicinedescribed one young person's horror on learning that "she" had been born a normal male, but that a circumciser had burned his penis off when he was a baby.[60] Many other similar cases have been documented[61,62] Infant circumcision has a reported death rate of one in 500,000.[63,64]

* Circumcision harms mothers: Scientific studies have consistently shown that circumcision disrupts a child's behavioural development. Studies performed at the University of Colorado School of Medicine showed that circumcision is followed by prolonged, unrestful non-REM (rapid eye movement) sleep.[65] In response to the lengthy bombardment of their neural pathways with unbearable pain, the circumcised babies withdrew into a kind of semi coma that lasted days or even weeks.

Numerous other studies have proven that circumcision disrupts the mother-infant bond during the crucial period after birth. Research has also shown that circumcision disrupts feeding patterns. In a study at the Washington University School of Medicine, most babies would not nurse right after they were circumcised, and those who did would not look into their mothers' eyes.[66]

* Circumcision violates patients' and human rights: No one has the right to cut off any part of someone else's genitals without that person's competent, fully informed consent. Since it is the infant who must bear the consequences, circumcision violates his legal rights both to refuse treatment and to seek alternative treatment. In 1995, the American Academy of Paediatrics Committee on Bioethics stated that only a competent patient can give patient consent or informed consent.[67] An infant is obviously too young to consent to anything. He must be protected from anyone who would take advantage of his defencelessness'. The concept of informed parental permission allows for medical interventions in situations of clear and immediate medical necessity only, such as disease, trauma, or deformity. The human penis in its normal, uncircumcised state satisfies none of these requirements.

Physicians have a duty to refuse to perform circumcision. They also must educate parents who, out of ignorance or misguidance, request this surgery for their sons. The healthcare professional's obligation is to protect the interests of the child. It is unethical in the extreme to force upon a child an amputation he almost certainly would never have chosen for himself.

Common Sense

To be intact, as nature intended, is best. The vast majority of males who are given the choice value their wholeness and keep their foreskins, for the same reason they keep their other organs of perception. Parents in Europe and non-Muslim Asia never have forced their boys to be circumcised. It would no more occur to them to cut off part of their boys' penises than it would to cut off part of their ears. Respecting a child's right to keep his genitals intact is normal and natural. It is conservative in the best sense of the word.

A circumcised father who has mixed feelings about his intact newborn son may require gentle, compassionate psychological counselling to help him come to terms with his loss and to overcome his anxieties about normal male genitalia. In such cases, the mother should steadfastly protect her child; inviting her husband to share this protective role and helping him diffuse his negative feelings. Most parents want what is best for their baby. Wise parents listen to their hearts and trust their instinct to protect their baby from harm. The experience of the ages has shown that babies thrive best in a trusting atmosphere of love, gentleness, respect, acceptance, nurturing, and intimacy. Cutting off a baby's foreskin shatters this trust.

Circumcision wounds and harms the baby and the person the baby will become. Parents who respect their son's wholeness are bequeathing to him his birthright--his body, perfect and beautiful in its entirety.

Paul M. Fleiss, MD, MPH, is assistant clinical professor of paediatrics at the University of Southern California Medical Centre. He is the author of numerous scientific articles published in leading national and international medical journals.

Notes

1. T. J. Ritter and G. C. Denniston, Say No to Circumcision: 40 Compelling Reasons, 2nd ed. (Aptos, CA Hourglass 1996), 6-20.

2. "Incipit Libellus De Ecclesiasticis Disciplinis et Religione Christiana Collectus. Liber II.XC, XCI" in Patrologiae Cursus Completus, vol. 132 (Paris: Apud Garnier Fratres, Editores et J. P. Migne Successores, 1880), 301-302.

3. S. Grayzel, The Church and the Jews in the Xllth Century, vol. 2, ed. K. R. Stow (Detroit, MI: Wayne State University Press, 1989), 246-247.

4. See Note 10, 17-40.

5. M. E Camphor "The Male Genital Tract and the Female Urethra," in Urology, eds. M. E. Campbell and J. H. Harrison, vol. 2, 3rd ed. (Philadelphia: W. B. Saunders, 1970), 1836.

6. See photographic series: J. A. Erickson, "Three Zones of Penile Skin." In M. M. Lander, "The Human Prepuce," in G. C. Denniston and M. E. Milos, eds., Sexual Mutilations: A Human Tragedy (New York: Plenum Press, 1997), 79-81.

7. M. Davenport, "Problems with the Penis and Prepuce: Natural History of the Foreskin" (photograph 1), British Medical Journal 312 (1996): 299-301.

8. J. Oster, "Further Fate of the Foreskin," Archives of Disease in Childhood 43 (1968): 200-203.

9. H. L. Tan, "Foreskin Fallacies and Phimosis," Annals of the Academy of Medicine, Singapore 14 (1985): 626-630.

10. F. A. Hodges, "Short History of the Institutionalization of Involuntary Sexual Mutilation in the United States" in G. C. Denniston and M. E. Milos, eds., Sexual Mutilations: A Human Tragedy (New York: Plenum Press, 1997), 35.

11. A B. Hyman and M. H. Brownstein, "Tyson's 'Glands": Ectopic Sebaceous Glands and Papillomatosis Penis," Archives of Dermatology 99 (1969): 31-37.

12. A. Ahmed and A. W. Jones, "Apocrine Cystadenoma: A Report of Two Cases Occurring on the Prepuce, "British Journal of Demmatology 81 (1969): 899-901.

13. G. N. Weiss et al., "The Distribution and Density of Langerhans Cells in the Human Prepuce: Site of a Diminished Immune Response?" Israel Journal of Medical Sciences 29 (1993): 42-43.

14. P. J. Flower et al., "An Immunopathologic Study of the Bovine Prepuce," Veterinary Pathology 20 (1983): 189-202.

15. Z. Halata and B. L. Munger, "The Neuroanatomical Basis for the Protopathic Sensibility of the Human Glans Penis," Brain Research 371 (1986): 205-230.

16. J. R. Taylor et al., "The Prepuce: Specialized Mucosa of the Penis and Its Loss to Circumcision," British Journal of Urology 77 (1996): 291-295.

17. H. C. Bazett et al., "Depth, Distribution and Probable Identification in the Prepuce of Sensory End-Organs Concerned in Sensations of Temperature and Touch; Themometic Conductivity," Archives of Neurology and Psychiatry 27 (1932): 489-517.

18. D. Ohmori, "Ueber die Entwicklung der Innervation der Genitalapparate als Peripheren Aufnahmeapparat der Genitalen Reflexe," Zeitschriht fuer Anatomie and Entwicklungspeschichte 70 (1924): 347-410.

19. A. De Girolamo and A. Cecio, "Contributo alla Conoscenza dell'innervazione Sensitiva del Prepuzio Nell'uomo," Bollettino delta Societa Italiana de Biologia Sperimentak 44 (1968): 1521-1522.

20. A. S. Dogiel, "Die Nervenendigungen in der Haut der aeusseren Genitalorgane des Menschen," Archiv fuer Mikroskopische Anatomie 41 (1893): 585-612.

21. A. Bourlond and R. K. Winkelmann, "L'innervation du Prepuce chez le Nouveau-ne," Archives Beiges de Demmatologie et de Syphiligraphie 21 (1965): 139-153.

22. R. K. Winkelmann, "The Erogenous Zones: Their Nerve Supply and Its Significance," Proceedings of the Staff Meetings of the Mayo Clinic 34 (1959): 39-47.

23. R. K. Winkelmann, "The Cutaneous Innervation of Human Newborn Prepuce," Journal of Investigative Demtotology 26 (1956): 53-67.

24. R. Hausmann et al., "The Forensic Value of the Immunohistochemical Detection of Estrogen Receptors in Vaginal Epithelium," International Journal of Legal Medicine 109 (1996): 10-30.

25. See Note 12.

26. American Academy of Pediatrics, Newboms: Care of the Uncircumcised Penis Guidelines for Parents (Elk Grove Village, IL: American Academy of Pediatrics, 1994).

27. See Note 1.

28. See Note 1.

29. S. A. Aldeeb Abu-Sahlieh, Jehovah, His Cousin Allah, and Sexual Mutilations," in Sexual Mutilations A Human Tragedy, eds. G. C. Denniston and M. F. Milos (New York: Plenum Press, 1997), 41-62.

30. National Center for Health Statistics of the United States Department of Health and Human Services, 1994.

31. See Note 17.

32. G. I Klauber and J. Boyle, "Preputial Skin-Bridging: Complication of Circumcision," Urology 3 (1974): 722-723.

33. J. P. Gearhart, "Complications of Pediatric Circumcision," in Urologic Complications, Medical and Surgical, Adult and Pediatric, ed. E. E. Marshall (Chicago: Year Book Medical Publishers, 1986), 387-396.

34. R. D. Talarico and J. E. Jasaitis, "Concealed Penis: A Complication of Neonatal Circumcision," Journal of Urology 110 (1973): 732-733.

35. R. Persad et al., "Clinical Presentation and Pathophysiology of Meatal Stenosis Following Circumcision," British Journal of Urology 75 (1995): 90-91.

36. A. Taddio et al., "The Effect of Neonatal Circumcision on Pain Responses during Vaccination in Boys," Lancet 345 (1995): 291-292.

37. A. Taddio et al., "The Effect of Neonatal Circumcision on Pain Response during Subsequent Routine Vaccination," Lancet 349 (1997): 599-603.

38. J. W. Prescott, "Genital Pain vs. Genital Pleasure: Why the One and Not the Other" Truth Seeker 1 (1989): 14-21.

39. R. Goldman, Circumcision: The Hidden Trauma (Boston: Vanguard Publications, 1997), 139-175.

40. M. Terris et al, "Relation of Circumcision to Cancer of the Cervix," American Joumal of Obstetrics and Gynecology 117 (1973): 1056-1065.

41. C J. Cold et al., "Carcinoma in Situ of the Penis in a 76-Year-old Circumcised Man," Journal of Family Practice 44 (1997): 407-410.

42. M. Frisch et al., "Falling Incidence of Penis Cancer in an Uncircumcised Population (Denmark 1943-90)," British Medical Journal 311 (1995): 1471.

43. B. Donovan et al., "Male Circumcision and Common Sexually Transmissible Diseases in a Developed Nation Setting," Genitourinary Medicine 70 (1994): 317-320.

44. G L Smith et al., "Circumcision as a Risk Factor for Urethritis in Racial Groups,"American Journal of Public Health 77 (1987): 452-454.

45. L. S. Cook et al., "CIincal Presentation of Genital Warts among Circumcised and Uncircumcised Heterosexual Men Attending an Urban STD Clinic," Genitourinary Medicine 69 (1993): 262-264.

46. I. Bassett et al., "Herpes Simplex Virus Type 2 Infection of Heterosexual Men Attending a Sexual Health Centre," Medical Journal of Australia 160 (1994): 697-700.

47. E. O. Laumann et al., "Circumcision in the United States: Prevalence, Prophylactic Effects, and Sexual Practice," Journal of the American Medical Association 277 (1997): 1052-1057.

48. W. E. Gee and J. S. Ansel, "Neonatal Circumcision: A Ten-year Overview With Comparison of the Gomco Clamp and the Plastibell Device," Pediatrics 58 (1976): 824-827.

49. G. W. Kaplan, "Complications of Circumcision," Urologic Clinics of North America 10 (1983): 543-549.

50. S. J. Sussman et al., "Fournier's Syndrome: Report of Three Cases and Review of the Literature," American Journal of Diseases of Children 132 (1978): 1189-1191.

51. B. V. Kirkpatrick and D. V. Eitzman, "Neonatal Septicemia after Circumcision," Clinical Pediatrics 13 (1974): 767-768.

52. J. M. Scurlock and R J. Pemberton, "Neonatal Meningitis and Circumcision," Medical Journal of Australia 1 (1977):332-334.

53. G. R. Gluckman et al., "Newborn Penile Glans Amputation during Circumcision and Successful Reattachment," Journal of Urology 153 (1995): 778-779.

54. B. S. Strimling, "Partial Amputation of Glans Penis during Mogen Clamp Circumcision,"Pediatrics 87 (1996): 906-907.

55. J. Shemman et al., Circumcision: Successful Glandular Reconstruction and Survival Following Traumatic Amputation," Journal of Urology 156 (1996): 842-844.

56. J. R. Sharpe and R. P. Finney, "Electrocautery Circumcision,"Urology 19 (1982): 228.

57. C. K. Pearlman, "Caution Advised on Electrocautery Circumcisions," Urology 19 (1982): 453.

58. C. K. Pearlman, "Reconstruction Following Iatrogenic Burn of the Penis" Journal of Pediatric Surgery 11 (1976): 121-122.

59. J. P. Gearhart and J. A. Rock, "Total Ablation of the Penis after Circumcision with Electrocautery: A Method of Management and Long-Term Followup," Journal of Urology 142 (1989): 799-801.

60. M. Diamond and H. K. Sigmundson, "Sex Reassignment at Birth: LongTerm Review and Clinical Implications," Archives of Pediatrics and Adolescent Medicine 151(1997): 298-304.

61. J. Money, "Ablatio Penis: Normal Male Infant Sex-Reassigned as a Girl," Archives of Sexual Behavior 4 (1975): 65-71.

62. D. A. Gilbert et al, "Phallic Construction in Prepubertal and Adolescent Boys," Journal of Urology 149 (1993): 1521-1526.

63. R. S. Thompson, "Routine Circumcision in the Newborn: An Opposing View," Journal of Family Practice 31 (1990): 189-196.

64. T. E. Wiswell, "Circumcision Circumspection," New England Journal of Medicine 336 (1997): 1244-1245.

65. R N. Emde et al., "Stress and Neonatal Sleep," Psychosomatic Medicine 33 (1971): 491-497.

66. R. E. Marshall et al., "Circumcision: II. Effects upon Mother-Infant Interaction," Early Human Development 7 (1982): 367-374.

67. Committee on Bioethics, "Informed Consent, Parental Permission, and Assent in Pediatric Practice," Pediatrics 95 (1995): 314-317.

For More Information

Organizations

Doctors Opposing Circumcision (DOC)

2442 N.W. Market Street, Suite 42

Seattle, WA 98107 206-368-8358

The National Organization of Circumcision Information Resource Centers (NOCIRC)

Box 2512

San Anselmo, CA 949792512

415-488-9883

The National Organization to Halt the Abuse and Routine Mutilation of Males (NOHARMM)

PO Box 460795

San Francisco, CA 94146-0795

415-826-9351

Nurses for the Rights of the Child

369 Montezuma, Suite 354

Santa Fe, NM 87501

505-989-7377

Books

Available from bookstores, from the publishers, or from NOCIRC

Bigelow, Jim, Ph. D. The Joy of Uncircumcising! Exploring Circumcision: History, Myths Psychology, Restoration, Sexual Pleasure and Human Rights. 2nd ed. Aptos, CA: Hourglass, 1995.

Denniston, George C., MD, MPH, and Marilyn Fayre Milos, RN, eds. Sexual Mutilations: A Human Tragedy (Proceedings of the Fourth International Symposium on Sexual Mutilations, Lausanne, Switzerland, 1996.) New York: Plenum Press, 1997.

Goldman, Ronald, PhD. Circumcision: The Hidden Trauma: How an American Cultural Practice Affects Infants and Ultimately Us All. Boston: Vanguard Publications, 1997.

Goldman, Ronald, PhD. Questioning Circumcision: A Jewish Perspective. 2nd ed. Boston: Vanguard Publications, 1997.

O'Mara, Peggy, ed. Circumcision: The Rest of the Story-A Selection of Articles, Letters and Resources 1979-1993. Santa Fe, NM: Mothering, 1993.

Ritter, Thomas J., MD, and George C. Denniston, MD. Say No to Circumcisions: 40 Compelling Reasons Why You Should Respect His Birthright and Keep Your Son Whole. 2nd ed. Aptos, CA: Hourglass, 1996.

Video

Whose Body, Whose Rights? Examining the Ethics and the Human Rights Issue of Infant Male Circumcision. Award-winning documentary. 56 min. VHS.

Personal use: VideoFinders, 1-800-343-4727

Educational Facilities:

UC Center for Media and Independent Learning

2000 Center Street 4th Floor

Berkeley CA 94704

510-642-0460

It is definitely better to stay the way you are " genitaly intact".less then 20% of the worlds males are circumcised and most of these for purely religious and cultural reasons there is a minority that inflicts this on their children because they are told it is healthy. However those in the medical fraternity that promote its benefits always have a conflict of interest as they are making money from it and or have religious leanings in that direction.

MOTHERING: The Magazine of Natural Family Living.

Winter 1997. Pages 36-45.

Santa Fe, New Mexico, USA.

The Case Against Circumcision

Western countries have no tradition of circumcision. In antiquity, the expansion of the Greek and Roman Empires brought Westerners into contact with the peoples of the Middle East, some of whom marked their children with circumcision and other sexual mutilations. To protect these children, the Greeks and Romans passed laws forbidding circumcision.[1] Over the centuries, the Catholic Church has passed many similar laws.[2,3] The traditional Western response to circumcision has been revulsion and indignation.

Circumcision started in America during the masturbation hysteria of the Victorian Era, when a few American doctors circumcised boys to punish them for masturbating. Victorian doctors knew very well that circumcision denudes, desensitizes, and disables the penis. Nevertheless, they were soon claiming that circumcision cured epilepsy, convulsions, paralysis, elephantiasis, tuberculosis, eczema, bed-wetting, hip-joint disease, fecal incontinence, rectal prolapse, wet dreams, hernia, headaches, nervousness, hysteria, poor eyesight, idiocy, mental retardation, and insanity.[4]

In fact, no procedure in the history of medicine has been claimed to cure and prevent more diseases than circumcision. As late as the 1970s, leading American medical textbooks still advocated routine circumcision as a way to prevent masturbation.[5] The antisexual motivations behind an operation that entails cutting off part of the penis are obvious.

The radical practice of routinely circumcising babies did not begin until the Cold War era. This institutionalization of what amounted to compulsory circumcision was part of the same movement that pathologized and medicalized birth and actively discouraged breastfeeding. Private-sector, corporate-run hospitals institutionalized routine circumcision without ever consulting the American people. There was no public debate or referendum. It was only in the 1970s that a series of lawsuits forced hospitals to obtain parental consent to perform this contraindicated but highly profitable surgery. Circumcisers responded by inventing new "medical" reasons for circumcision in an attempt to scare parents into consenting.

Today the reasons given for circumcision have been updated to play on contemporary fears and anxieties; but one day they, too, will be considered irrational. Now that such current excuses as the claim that this procedure prevents cancer and sexually transmitted diseases have been thoroughly discredited, circumcisers will undoubtedly invent new ones. But if circumcisers were really motivated by purely medical considerations, the procedure would have died out long ago, along with leeching, skull-drilling, and castration. The fact that it has not suggests that the compulsion to circumcise came first, the "reasons," later.

Millions of years of evolution have fashioned the human body into a model of refinement, elegance, and efficiency, with every part having a function and purpose. Evolution has determined that mammals' genitals should be sheathed in a protective, responsive, multipurpose foreskin. Every normal human being is born with a foreskin. In females, it protects the glans of the clitoris; in males, it protects the glans of the penis. Thus, the foreskin is an essential part of human sexual anatomy.

Parents should enjoy the arrival of a new child with as few worries as possible. The birth of a son in the US, however, is often fraught with anxiety and confusion. Most parents are pressured to hand their baby sons over to a stranger, who, behind closed doors, straps babies down and cuts their foreskins off. The billion-dollar-a-year circumcision industry has bombarded Americans with confusing rhetoric and calculated scare tactics.

Information about the foreskin itself is almost always missing from discussions about circumcision. The mass circumcision campaigns of the past few decades have resulted in pandemic ignorance about this remarkable structure and its versatile role in human sexuality. Ignorance and false information about the foreskin are the rule in American medical literature, education, and practice. Most American medical textbooks depict the human penis, without explanation, as circumcised, as if it were so by nature.

The foreskin is a uniquely specialized, sensitive, functional organ of touch. No other part of the body serves the same purpose. As a modified extension of the penile shaft skin, the foreskin covers and usually extends beyond the glans before folding under itself and finding its circumferential point of attachment just behind the corona (the rim of the glans). The foreskin is, therefore, a double-layered organ. Its true length is twice the length of its external fold, comprising 80 percent or more of the penile skin covering,[6] or at least 25 percent of the flaccid penis's length.

The foreskin contains a rich concentration of blood vessels and nerve endings. It is lined with the peripenic muscle sheet, a smooth muscle layer with longitudinal fibers. These muscle fibers are whorled, forming a kind of sphincter that ensures optimum protection of the urinary tract from contaminants of all kinds.

Like the undersurface of the eyelids or the inside of the cheek, the undersurface of the foreskin consists of mucous membrane. It is divided into two distinct zones: the soft mucosa and the ridged mucosa. The soft mucosa lies against the glans penis and contains ectopic sebaceous glands that secrete emollients, lubricants, and protective antibodies. Similar glands are found in the eyelids and mouth.

Adjacent to the soft mucosa and just behind the lips of the foreskin is the ridged mucosa. This exquisitely sensitive structure consists of tightly pleated concentric bands, like the elastic bands at the top of a sock. These expandable pleats allow the foreskin lips to open and roll back, exposing the glans. The ridged mucosa gives the foreskin its characteristic taper.

On the underside of the glans, the foreskin's point of attachment is advanced toward the meatus (urethral opening) and forms a bandlike ligament called the frenulum. It is identical to the frenulum that secures the tongue to the floor of the mouth. The foreskin's frenulum holds it in place over the glans, and, in conjunction with the smooth muscle fibers, helps return the retracted foreskin to its usual forward position over the glans.

At birth, the foreskin is usually attached to the glans, very much as a fingernail is attached to a finger. By puberty, the penis will usually have completed its development, and the foreskin will have separated from the glans.[8] This separation occurs in its own time; there is no set age by which the foreskin and glans must be separated. One wise doctor described the process thus, "The foreskin therefore can be likened to a rosebud which remains closed and muzzled. Like a rosebud, it will only blossom when the time is right. No one opens a rosebud to make it blossom."[9]

Even if the glans and foreskin separate naturally in infancy, the foreskin lips can normally dilate only enough to allow the passage of urine. This ideal feature protects the glans from premature exposure to the external environment.

The penis develops naturally throughout childhood. Eventually, the child will, on his own, make the wondrous discovery that his foreskin will retract. There is no reason for parents, physicians, or other caregivers to manipulate a child's penis. The only person to retract a child's foreskin should be the child himself, when he has discovered that his foreskin is ready to retract.

Parents should be wary of anyone who tries to retract their child's foreskin, and especially wary of anyone who wants to cut it off. Human foreskins are in great demand for any number of commercial enterprises, and the marketing of purloined baby foreskins is a multimillion-dollar-a-year industry. Pharmaceutical and cosmetic companies use human foreskins as research material. Corporations such as Advanced Tissue Sciences, Organogenesis, and BioSurface Technology use human foreskins as the raw materials for a type of breathable bandage.

The foreskin has numerous protective, sensory, and sexual functions.

* Protection: Just as the eyelids protect the eyes, the foreskin protects the glans and keeps its surface soft, moist, and sensitive. It also maintains optimal warmth, pH balance, and cleanliness. The glans itself contains no sebaceous glands--glands that produce the sebum, or oil, that moisturizes our skin.[11] The foreskin produces the sebum that maintains proper health of the surface of the glans.

* Immunological Defense: The mucous membranes that line all body orifices are the body's first line of immunological defense. Glands in the foreskin produce antibacterial and antiviral proteins such as lysozyme.[12] Lysozyme is also found in tears and mother's milk. Specialized epithelial Langerhans cells, an immune system component, abound in the foreskin's outer surface. Plasma cells in the foreskin's mucosal lining secrete immunoglobulins, antibodies that defend against infections.

* Erogenous Sensitivity: The foreskin is as sensitive as the fingertips or the lips of the mouth. It contains a richer variety and greater concentration of specialized nerve receptors than any other part of the penis.[15] These specialized nerve endings can discern motion, subtle changes in temperature, and fine gradations of texture.[16, 17, 18, 19, 20, 21, 22, 23]

* Coverage during Erection: As it becomes erect, the penile shaft becomes thicker and longer. The double-layered foreskin provides the skin necessary to accommodate the expanded organ and to allow the penile skin to glide freely, smoothly, and pleasurably over the shaft and glans.

* Self-Stimulating Sexual Functions: The foreskin's double-layered sheath enables the penile shaft skin to glide back and forth over the penile shaft. The foreskin can normally be slipped all the way, or almost all the way, back to the base of the penis, and also slipped forward beyond the glans. This wide range of motion is the mechanism by which the penis and the orgasmic triggers in the foreskin, frenulum, and glans are stimulated.

* Sexual Functions in Intercourse: One of the foreskin's functions is to facilitate smooth, gentle movement between the mucosal surfaces of the two partners during intercourse. The foreskin enables the penis to slip in and out of the vagina nonabrasively inside its own slick sheath of self-lubricating, movable skin. The female is thus stimulated by moving pressure rather than by friction only, as when the male's foreskin is missing.

The foreskin fosters intimacy between the two partners by enveloping the glans and maintaining it as an internal organ. The sexual experience is enhanced when the foreskin slips back to allow the male's internal organ, the glans, to meet the female's internal organ, the cervix--a moment of supreme intimacy and beauty.

The foreskin may have functions not yet recognized or understood. Scientists in Europe recently detected estrogen receptors in its basal epidermal cells.[24] Researchers at the University of Manchester found that the human foreskin has apocrine glands.[25] These specialized glands produce pheromones, nature's chemical messengers. Further studies are needed to fully understand these features of the foreskin and the role they play.

The natural penis requires no special care. A child's foreskin, like his eyelids, is self-cleansing. For the same reason it is inadvisable to lift the eyelids and wash the eyeballs, it is inadvisable to retract a child's foreskin and wash the glans. Immersion in plain water during the bath is all that is needed to keep the intact penis clean.[26]

The white emollient under the child's foreskin is called smegma. Smegma is probably the most misunderstood, most unjustifiably maligned substance in nature. Smegma is clean, not dirty, and is beneficial and necessary. It moisturizes the glans and keeps it smooth, soft, and supple. Its antibacterial and antiviral properties keep the penis clean and healthy. All mammals produce smegma. Thomas J. Ritter, MD, underscored its importance when he commented, "The animal kingdom would probably cease to exist without smegma."[27]

Studies suggest that it is best not to use soap on the glans or foreskin's inner fold.[23] Forcibly retracting and washing a baby's foreskin destroys the beneficial bacterial flora that protect the penis from harmful germs and can lead to irritation and infection. The best way to care for a child's intact penis is to leave it alone. After puberty, males can gently rinse their glans and foreskin with warm water, according to their own self-determined needs.

Circumcision is almost unheard of in Europe, South America, and non-Muslim Asia. In fact, only 10 to 15 percent of men throughout the world are circumcised. The vast majority of whom are Muslim.[29] The neonatal circumcision rate in the western US has now fallen to 34.2 percent.[30] This relatively diminished rate may surprise American men born during the era when nearly 90 percent of baby boys were circumcised automatically, with or without their parents' consent.

The "medical" debate about the "potential health benefits" of circumcision rarely addresses its real effects.

* Circumcision denudes: Depending on the amount of skit cut off, circumcision robs a male of as much as 80 percent or more of his penile skin. Depending on the foreskin's length, cutting it off makes the penis as much as 25 percent or more shorter. Careful anatomical investigations have shown that circumcision cuts off more than 3 feet of veins, arteries, and capillaries, 240 feet of nerves, and more than 20,000 nerve endings.[31]The foreskin's muscles, glands, mucous membrane, and epithelial tissue are destroyed, as well.

* Circumcision desensitizes: Circumcision desensitizes the penis radically. Foreskin amputation means severing the rich nerve network and all the nerve receptors in the foreskin itself Circumcision almost always damages or destroys the frenulum. The loss of the protective foreskin desensitizes the glans. Because the membrane covering the permanently externalized glans is now subjected to constant abrasion and irritation, it keratinizes, becoming dry and tough. The nerve endings in the glans, which in the intact penis are just beneath the surface of the mucous membrane, are now buried by successive layers of keratinization. The denuded glans takes on a dull, grayish, sclerotic appearance.

* Circumcision disables: The amputation of so much penile skin permanently immobilizes whatever skin remains, preventing it from gliding freely over the shaft and glans. This loss of mobility destroys the mechanism by which the glans is normally stimulated. When the circumcised penis becomes erect, the immobilized remaining skin is stretched, sometimes so tightly that not enough skin is left to cover the erect shaft. Hair-bearing skin from the groin and scrotum is often pulled onto the shaft, where hair is not normally found. The surgically externalized mucous membrane of the glans has no sebaceous glands. Without the protection and emollients of the foreskin, it dries out, making it susceptible to cracking and bleeding.

* Circumcision disfigures: Circumcision alters the appearance of the penis drastically. It permanently externalizes the glans, normally an internal organ. Circumcision leaves a large circumferential surgical scar on the penile shaft. Because circumcision usually necessitates tearing the foreskin from the glans, pieces of the glans may be torn off, too, leaving it pitted and scarred. Shreds of foreskin may adhere to the raw glans, forming tags and bridges of dangling, displaced skin.[32]

Depending on the amount of skin cut off and how the scar forms, the circumcised penis may be permanently twisted, or curve or bow during erection.[33] The contraction of the scar tissue may pull the shaft into the abdomen, in effect shortening the penis or burying it completely.[34]

* Circumcision disrupts circulation: Circumcision interrupts the normal circulation of blood throughout the penile skin system and glans. The blood flowing into major penile arteries is obstructed by the line of scar tissue at the point of incision, creating backflow instead of feeding the branches and capillary networks beyond the scar. Deprived of blood, the meatus may contract and scarify, obstructing the flow of urine.[35] This condition, known as meatal stenosis, often requires corrective surgery. Meatal stenosis is found almost exclusively among boys who have been circumcised.

Circumcision also severs the lymph vessels, interrupting the circulation of lymph and sometimes causing lymphedema, a painful, disfiguring condition in which the remaining skin of the penis swells with trapped lymph fluid.

* Circumcision harms the developing brain: Recent studies published in leading medical journals have reported that circumcision has longlasting detrimental effects on the developing brain,[36] adversely altering the brain's perception centers. Circumcised boys have a lower pain threshold than girls or intact boys.[37] Developmental neuropsychologist Dr. James Prescott suggests that circumcision can cause deeper and more disturbing levels of neurological damage, as well. [38, 39]

* Circumcision is unhygienic and unhealthy: One of the most common myths about circumcision is that it makes the penis cleaner and easier to take care of. This is not true. Eyes without eyelids would not be cleaner; neither would a penis without its foreskin. The artificially externalized glans and meatus of the circumcised penis are constantly exposed to abrasion and dirt, making the circumcised penis, in fact, more unclean. The loss of the protective foreskin leaves the urinary tract vulnerable to invasion by bacterial and viral pathogens.

The circumcision wound is larger than most people imagine. It is not just the circular point of union between the outer and inner layers of the remaining skin. Before a baby is circumcised, his foreskin must be torn from his glans, literally skinning it alive. This creates a large open area of raw, bleeding flesh, covered at best with a layer of undeveloped protomucosa. Germs can easily enter the damaged tissue and bloodstream through the raw glans and, even more easily, through the incision itself.

Even after the wound has healed, the externalized glans and meatus are still forced into constant unnatural contact with urine, feces, chemically treated diapers, and other contaminants.

Female partners of circumcised men do not report a lower rate of cervical cancer,[40] nor does circumcision prevent penile cancer.[41] A recent study shows that the penile cancer rate is higher in the US than in Denmark, where circumcision, except among Middle Eastern immigrant workers, is almost unheard of.[42] Indeed, researchers should investigate the possibility that circumcision has actually increased the rate of these diseases.

Circumcision does not prevent acquisition or transmission of sexually transmitted diseases (STDs). In fact, the US has both the highest percentage of sexually active circumcised males in the Western world and the highest rates of sexually transmitted diseases, including AIDS. Rigorously controlled prospective studies show that circumcised American men are at a greater risk for bacterial and viral STDs, especially gonorrhea,[43] nongonoccal urethritis,[44] human papilloma virus,[45] herpes simplex virus type 2,[46] and chlamydia.[47]

* Circumcision is always risky: Circumcision always carries the risk of serious, even tragic, consequences. Its surgical complication rate is one in 500.[48] These complications include uncontrollable bleeding and fatal infections.[49] There are many published case reports of gangrene following circumcision.[50] Pathogenic bacteria such as staphylococcus, proteus, pseudomonas, other coliforms, and even tuberculosis can cause infections leading to death.[51, 52] These organisms enter the wound because it provides easy entry, not because the child is predisposed to infection.

Medical journals have published numerous accounts of babies who have had part or all of their glans cut off while they were being circumcised.[53 54 55] Other fully conscious, unanesthetized babies have had their entire penis burned off with an electrocautery gun.[56,57,58] The September 1989 Journal of Urologypublished an account of four such cases.[59] The article described the sex-change operation as "feminizing genitoplasty," performed on these babies in an attempt to change them into girls. The March 1997 Archives of Pediatrics and Adolescent Medicinedescribed one young person's horror on learning that "she" had been born a normal male, but that a circumciser had burned his penis off when he was a baby.[60] Many other similar cases have been documented[61,62] Infant circumcision has a reported death rate of one in 500,000.[63,64]

* Circumcision harms mothers: Scientific studies have consistently shown that circumcision disrupts a child's behavioral development. Studies performed at the University of Colorado School of Medicine showed that circumcision is followed by prolonged, unrestful non-REM (rapid eye movement) sleep.[65] In response to the lengthy bombardment of their neural pathways with unbearable pain, the circumcised babies withdrew into a kind of semicoma that lasted days or even weeks.

Numerous other studies have proven that circumcision disrupts the mother-infant bond during the crucial period after birth. Research has also shown that circumcision disrupts feeding patterns. In a study at the Washington University School of Medicine, most babies would not nurse right after they were circumcised, and those who did would not look into their mothers' eyes.[66]

* Circumcision violates patients' and human rights: No one has the right to cut off any part of someone else's genitals without that person's competent, fully informed consent. Since it is the infant who must bear the consequences, circumcision violates his legal rights both to refuse treatment and to seek alternative treatment. In 1995, the American Academy of Pediatrics Committee on Bioethics stated that only a competent patient can give patient consent or informed consent.[67] An infant is obviously too young to consent to anything. He must be protected from anyone who would take advantage of his defenselessness. The concept of informed parental permission allows for medical interventions in situations of clear and immediate medical necessity only, such as disease, trauma, or deformity. The human penis in its normal, uncircumcised state satisfies none of these requirements.

Physicians have a duty to refuse to perform circumcision. They also must educate parents who, out of ignorance or misguidance, request this surgery for their sons. The healthcare professional's obligation is to protect the interests of the child. It is unethical in the extreme to force upon a child an amputation he almost certainly would never have chosen for himself.

To be intact, as nature intended, is best. The vast majority of males who are given the choice value their wholeness and keep their foreskins, for the same reason they keep their other organs of perception. Parents in Europe and non-Muslim Asia never have forced their boys to be circumcised. It would no more occur to them to cut off part of their boys' penises than it would to cut off part of their ears. Respecting a child's right to keep his genitals intact is normal and natural. It is conservative in the best sense of the word.

A circumcised father who has mixed feelings about his intact newborn son may require gentle, compassionate psychological counseling to help him come to terms with his loss and to overcome his anxieties about normal male genitalia. In such cases, the mother should steadfastly protect her child, inviting her husband to share this protective role and helping him diffuse his negative feelings. Most parents want what is best for their baby. Wise parents listen to their hearts and trust their instinct to protect their baby from harm. The experience of the ages has shown that babies thrive best in a trusting atmosphere of love, gentleness, respect, acceptance, nurturing, and intimacy. Cutting off a baby's foreskin shatters this trust.

Circumcision wounds and harms the baby and the person the baby will become. Parents who respect their son's wholeness are bequeathing to him his birthright--his body, perfect and beautiful in its entirety.

Paul M. Fleiss, MD, MPH, is assistant clinical professor of pediatrics at the University of Southern California Medical Center. He is the author of numerous scientific articles published in leading national and international medical journals.

Notes

1. T. J. Ritter and G. C. Denniston, Say No to Circumcision: 40 Compelling Reasons, 2nd ed. (Aptos, CA Hourglass 1996), 6-20.

2. "Incipit Libellus De Ecclesiasticis Disciplinis et Religione Christiana Collectus. Liber II.XC, XCI" in Patrologiae Cursus Completus, vol. 132 (Paris: Apud Garnier Fratres, Editores et J. P. Migne Successores, 1880), 301-302.

3. S. Grayzel, The Church and the Jews in the Xllth Century, vol. 2, ed. K. R. Stow (Detroit, MI: Wayne State University Press, 1989), 246-247.

4. See Note 10, 17-40.

5. M. E Camphor "The Male Genital Tract and the Female Urethra," in Urology, eds. M. E. Campbell and J. H. Harrison, vol. 2, 3rd ed. (Philadelphia: W. B. Saunders, 1970), 1836.

6. See photographic series: J. A. Erickson, "Three Zones of Penile Skin." In M. M. Lander, "The Human Prepuce," in G. C. Denniston and M. E. Milos, eds., Sexual Mutilations: A Human Tragedy (New York: Plenum Press, 1997), 79-81.

7. M. Davenport, "Problems with the Penis and Prepuce: Natural History of the Foreskin" (photograph 1), British Medical Journal 312 (1996): 299-301.

8. J. Oster, "Further Fate of the Foreskin," Archives of Disease in Childhood 43 (1968): 200-203.

9. H. L. Tan, "Foreskin Fallacies and Phimosis," Annals of the Academy of Medicine, Singapore 14 (1985): 626-630.

10. F. A. Hodges, "Short History of the Institutionalization of Involuntary Sexual Mutilation in the United States" in G. C. Denniston and M. E. Milos, eds., Sexual Mutilations: A Human Tragedy (New York: Plenum Press, 1997), 35.

11. A B. Hyman and M. H. Brownstein, "Tyson's 'Glands": Ectopic Sebaceous Glands and Papillomatosis Penis," Archives of Dermatology 99 (1969): 31-37.

12. A. Ahmed and A. W. Jones, "Apocrine Cystadenoma: A Report of Two Cases Occurring on the Prepuce, "British Journal of Demmatology 81 (1969): 899-901.

13. G. N. Weiss et al., "The Distribution and Density of Langerhans Cells in the Human Prepuce: Site of a Diminished Immune Response?" Israel Journal of Medical Sciences 29 (1993): 42-43.

14. P. J. Flower et al., "An Immunopathologic Study of the Bovine Prepuce," Veterinary Pathology 20 (1983): 189-202.

15. Z. Halata and B. L. Munger, "The Neuroanatomical Basis for the Protopathic Sensibility of the Human Glans Penis," Brain Research 371 (1986): 205-230.

16. J. R. Taylor et al., "The Prepuce: Specialized Mucosa of the Penis and Its Loss to Circumcision," British Journal of Urology 77 (1996): 291-295.

17. H. C. Bazett et al., "Depth, Distribution and Probable Identification in the Prepuce of Sensory End-Organs Concerned in Sensations of Temperature and Touch; Themometic Conductivity," Archives of Neurology and Psychiatry 27 (1932): 489-517.

18. D. Ohmori, "Ueber die Entwicklung der Innervation der Genitalapparate als Peripheren Aufnahmeapparat der Genitalen Reflexe," Zeitschriht fuer Anatomie and Entwicklungspeschichte 70 (1924): 347-410.

19. A. De Girolamo and A. Cecio, "Contributo alla Conoscenza dell'innervazione Sensitiva del Prepuzio Nell'uomo," Bollettino delta Societa Italiana de Biologia Sperimentak 44 (1968): 1521-1522.

20. A. S. Dogiel, "Die Nervenendigungen in der Haut der aeusseren Genitalorgane des Menschen," Archiv fuer Mikroskopische Anatomie 41 (1893): 585-612.

21. A. Bourlond and R. K. Winkelmann, "L'innervation du Prepuce chez le Nouveau-ne," Archives Beiges de Demmatologie et de Syphiligraphie 21 (1965): 139-153.

22. R. K. Winkelmann, "The Erogenous Zones: Their Nerve Supply and Its Significance," Proceedings of the Staff Meetings of the Mayo Clinic 34 (1959): 39-47.

23. R. K. Winkelmann, "The Cutaneous Innervation of Human Newborn Prepuce," Journal of Investigative Demtotology 26 (1956): 53-67.

24. R. Hausmann et al., "The Forensic Value of the Immunohistochemical Detection of Estrogen Receptors in Vaginal Epithelium," International Journal of Legal Medicine 109 (1996): 10-30.

25. See Note 12.

26. American Academy of Pediatrics, Newboms: Care of the Uncircumcised Penis Guidelines for Parents (Elk Grove Village, IL: American Academy of Pediatrics, 1994).

27. See Note 1.

28. See Note 1.

29. S. A. Aldeeb Abu-Sahlieh, Jehovah, His Cousin Allah, and Sexual Mutilations," in Sexual Mutilations A Human Tragedy, eds. G. C. Denniston and M. F. Milos (New York: Plenum Press, 1997), 41-62.

30. National Center for Health Statistics of the United States Department of Health and Human Services, 1994.

31. See Note 17.

32. G. I Klauber and J. Boyle, "Preputial Skin-Bridging: Complication of Circumcision," Urology 3 (1974): 722-723.

33. J. P. Gearhart, "Complications of Pediatric Circumcision," in Urologic Complications, Medical and Surgical, Adult and Pediatric, ed. E. E. Marshall (Chicago: Year Book Medical Publishers, 1986), 387-396.

34. R. D. Talarico and J. E. Jasaitis, "Concealed Penis: A Complication of Neonatal Circumcision," Journal of Urology 110 (1973): 732-733.

35. R. Persad et al., "Clinical Presentation and Pathophysiology of Meatal Stenosis Following Circumcision," British Journal of Urology 75 (1995): 90-91.

36. A. Taddio et al., "The Effect of Neonatal Circumcision on Pain Responses during Vaccination in Boys," Lancet 345 (1995): 291-292.

37. A. Taddio et al., "The Effect of Neonatal Circumcision on Pain Response during Subsequent Routine Vaccination," Lancet 349 (1997): 599-603.

38. J. W. Prescott, "Genital Pain vs. Genital Pleasure: Why the One and Not the Other" Truth Seeker 1 (1989): 14-21.

39. R. Goldman, Circumcision: The Hidden Trauma (Boston: Vanguard Publications, 1997), 139-175.

40. M. Terris et al, "Relation of Circumcision to Cancer of the Cervix," American Joumal of Obstetrics and Gynecology 117 (1973): 1056-1065.

41. C J. Cold et al., "Carcinoma in Situ of the Penis in a 76-Year-old Circumcised Man," Journal of Family Practice 44 (1997): 407-410.

42. M. Frisch et al., "Falling Incidence of Penis Cancer in an Uncircumcised Population (Denmark 1943-90)," British Medical Journal 311 (1995): 1471.

43. B. Donovan et al., "Male Circumcision and Common Sexually Transmissible Diseases in a Developed Nation Setting," Genitourinary Medicine 70 (1994): 317-320.

44. G L Smith et al., "Circumcision as a Risk Factor for Urethritis in Racial Groups,"American Journal of Public Health 77 (1987): 452-454.

45. L. S. Cook et al., "CIincal Presentation of Genital Warts among Circumcised and Uncircumcised Heterosexual Men Attending an Urban STD Clinic," Genitourinary Medicine 69 (1993): 262-264.

46. I. Bassett et al., "Herpes Simplex Virus Type 2 Infection of Heterosexual Men Attending a Sexual Health Centre," Medical Journal of Australia 160 (1994): 697-700.

47. E. O. Laumann et al., "Circumcision in the United States: Prevalence, Prophylactic Effects, and Sexual Practice," Journal of the American Medical Association 277 (1997): 1052-1057.

48. W. E. Gee and J. S. Ansel, "Neonatal Circumcision: A Ten-year Overview With Comparison of the Gomco Clamp and the Plastibell Device," Pediatrics 58 (1976): 824-827.

49. G. W. Kaplan, "Complications of Circumcision," Urologic Clinics of North America 10 (1983): 543-549.

50. S. J. Sussman et al., "Fournier's Syndrome: Report of Three Cases and Review of the Literature," American Journal of Diseases of Children 132 (1978): 1189-1191.

51. B. V. Kirkpatrick and D. V. Eitzman, "Neonatal Septicemia after Circumcision," Clinical Pediatrics 13 (1974): 767-768.

52. J. M. Scurlock and R J. Pemberton, "Neonatal Meningitis and Circumcision," Medical Journal of Australia 1 (1977):332-334.

53. G. R. Gluckman et al., "Newborn Penile Glans Amputation during Circumcision and Successful Reattachment," Journal of Urology 153 (1995): 778-779.

54. B. S. Strimling, "Partial Amputation of Glans Penis during Mogen Clamp Circumcision,"Pediatrics 87 (1996): 906-907.

55. J. Shemman et al., Circumcision: Successful Glandular Reconstruction and Survival Following Traumatic Amputation," Journal of Urology 156 (1996): 842-844.

56. J. R. Sharpe and R. P. Finney, "Electrocautery Circumcision,"Urology 19 (1982): 228.

57. C. K. Pearlman, "Caution Advised on Electrocautery Circumcisions," Urology 19 (1982): 453.

58. C. K. Pearlman, "Reconstruction Following Iatrogenic Burn of the Penis" Journal of Pediatric Surgery 11 (1976): 121-122.

59. J. P. Gearhart and J. A. Rock, "Total Ablation of the Penis after Circumcision with Electrocautery: A Method of Management and Long-Term Followup," Journal of Urology 142 (1989): 799-801.

60. M. Diamond and H. K. Sigmundson, "Sex Reassignment at Birth: LongTerm Review and Clinical Implications," Archives of Pediatrics and Adolescent Medicine 151(1997): 298-304.

61. J. Money, "Ablatio Penis: Normal Male Infant Sex-Reassigned as a Girl," Archives of Sexual Behavior 4 (1975): 65-71.

62. D. A. Gilbert et al, "Phallic Construction in Prepubertal and Adolescent Boys," Journal of Urology 149 (1993): 1521-1526.

63. R. S. Thompson, "Routine Circumcision in the Newborn: An Opposing View," Journal of Family Practice 31 (1990): 189-196.

64. T. E. Wiswell, "Circumcision Circumspection," New England Journal of Medicine 336 (1997): 1244-1245.

65. R N. Emde et al., "Stress and Neonatal Sleep," Psychosomatic Medicine 33 (1971): 491-497.

66. R. E. Marshall et al., "Circumcision: II. Effects upon Mother-Infant Interaction," Early Human Development 7 (1982): 367-374.

67. Committee on Bioethics, "Informed Consent, Parental Permission, and Assent in Pediatric Practice," Pediatrics 95 (1995): 314-317.

For More Information

Organizations

Doctors Opposing Circumcision (DOC)

2442 N.W. Market Street, Suite 42

Seattle, WA 98107 206-368-8358

The National Organization of Circumcision Information Resource Centers (NOCIRC)

Box 2512

San Anselmo, CA 949792512

415-488-9883

The National Organization to Halt the Abuse and Routine Mutilation of Males (NOHARMM)

PO Box 460795

San Francisco, CA 94146-0795

415-826-9351

Nurses for the Rights of the Child

369 Montezuma, Suite 354

Santa Fe, NM 87501

505-989-7377

Books

Available from bookstores, from the publishers, or from NOCIRC

Bigelow, Jim, Ph. D. The Joy of Uncircumcising! Exploring Circumcision: History, Myths Psychology, Restoration, Sexual Pleasure and Human Rights. 2nd ed. Aptos, CA: Hourglass, 1995.

Denniston, George C., MD, MPH, and Marilyn Fayre Milos, RN, eds. Sexual Mutilations: A Human Tragedy (Proceedings of the Fourth International Symposium on Sexual Mutilations, Lausanne, Switzerland, 1996.) New York: Plenum Press, 1997.

Goldman, Ronald, PhD. Circumcision: The Hidden Trauma: How an American Cultural Practice Affects Infants and Ultimately Us All. Boston: Vanguard Publications, 1997.

Goldman, Ronald, PhD. Questioning Circumcision: A Jewish Perspective. 2nd ed. Boston: Vanguard Publications, 1997.

O'Mara, Peggy, ed. Circumcision: The Rest of the Story-A Selection of Articles, Letters and Resources 1979-1993. Santa Fe, NM: Mothering, 1993.

Ritter, Thomas J., MD, and George C. Denniston, MD. Say No to Circumcisions: 40 Compelling Reasons Why You Should Respect His Birthright and Keep Your Son Whole. 2nd ed. Aptos, CA: Hourglass, 1996.

Video

Whose Body, Whose Rights? Examining the Ethics and the Human Rights Issue of Infant Male Circumcision. Award-winning documentary. 56 min. VHS.

Personal use: VideoFinders, 1-800-343-4727

Educational Facilities:

UC Center for Media and Independent Learning

2000 Center Street 4th Floor

Berkeley CA 94704

510-642-0460

That is perfectly simple. Here is the case against circumcision

MOTHERING: The Magazine of Natural Family Living.

Winter 1997. Pages 36-45.

Santa Fe, New Mexico, USA.

The Case Against Circumcision

Western countries have no tradition of circumcision. In antiquity, the expansion of the Greek and Roman Empires brought Westerners into contact with the peoples of the Middle East, some of whom marked their children with circumcision and other sexual mutilations. To protect these children, the Greeks and Romans passed laws forbidding circumcision.[1] Over the centuries, the Catholic Church has passed many similar laws.[2,3] The traditional Western response to circumcision has been revulsion and indignation.

Circumcision started in America during the masturbation hysteria of the Victorian Era, when a few American doctors circumcised boys to punish them for masturbating. Victorian doctors knew very well that circumcision denudes, desensitizes, and disables the penis. Nevertheless, they were soon claiming that circumcision cured epilepsy, convulsions, paralysis, elephantiasis, tuberculosis, eczema, bed-wetting, hip-joint disease, fecal incontinence, rectal prolapse, wet dreams, hernia, headaches, nervousness, hysteria, poor eyesight, idiocy, mental retardation, and insanity.[4]

In fact, no procedure in the history of medicine has been claimed to cure and prevent more diseases than circumcision. As late as the 1970s, leading American medical textbooks still advocated routine circumcision as a way to prevent masturbation.[5] The antisexual motivations behind an operation that entails cutting off part of the penis are obvious.

The radical practice of routinely circumcising babies did not begin until the Cold War era. This institutionalization of what amounted to compulsory circumcision was part of the same movement that pathologized and medicalized birth and actively discouraged breastfeeding. Private-sector, corporate-run hospitals institutionalized routine circumcision without ever consulting the American people. There was no public debate or referendum. It was only in the 1970s that a series of lawsuits forced hospitals to obtain parental consent to perform this contraindicated but highly profitable surgery. Circumcisers responded by inventing new "medical" reasons for circumcision in an attempt to scare parents into consenting.

Today the reasons given for circumcision have been updated to play on contemporary fears and anxieties; but one day they, too, will be considered irrational. Now that such current excuses as the claim that this procedure prevents cancer and sexually transmitted diseases have been thoroughly discredited, circumcisers will undoubtedly invent new ones. But if circumcisers were really motivated by purely medical considerations, the procedure would have died out long ago, along with leeching, skull-drilling, and castration. The fact that it has not suggests that the compulsion to circumcise came first, the "reasons," later.

Millions of years of evolution have fashioned the human body into a model of refinement, elegance, and efficiency, with every part having a function and purpose. Evolution has determined that mammals' genitals should be sheathed in a protective, responsive, multipurpose foreskin. Every normal human being is born with a foreskin. In females, it protects the glans of the clitoris; in males, it protects the glans of the penis. Thus, the foreskin is an essential part of human sexual anatomy.

Parents should enjoy the arrival of a new child with as few worries as possible. The birth of a son in the US, however, is often fraught with anxiety and confusion. Most parents are pressured to hand their baby sons over to a stranger, who, behind closed doors, straps babies down and cuts their foreskins off. The billion-dollar-a-year circumcision industry has bombarded Americans with confusing rhetoric and calculated scare tactics.

Information about the foreskin itself is almost always missing from discussions about circumcision. The mass circumcision campaigns of the past few decades have resulted in pandemic ignorance about this remarkable structure and its versatile role in human sexuality. Ignorance and false information about the foreskin are the rule in American medical literature, education, and practice. Most American medical textbooks depict the human penis, without explanation, as circumcised, as if it were so by nature.

The foreskin is a uniquely specialized, sensitive, functional organ of touch. No other part of the body serves the same purpose. As a modified extension of the penile shaft skin, the foreskin covers and usually extends beyond the glans before folding under itself and finding its circumferential point of attachment just behind the corona (the rim of the glans). The foreskin is, therefore, a double-layered organ. Its true length is twice the length of its external fold, comprising 80 percent or more of the penile skin covering,[6] or at least 25 percent of the flaccid penis's length.

The foreskin contains a rich concentration of blood vessels and nerve endings. It is lined with the peripenic muscle sheet, a smooth muscle layer with longitudinal fibers. These muscle fibers are whorled, forming a kind of sphincter that ensures optimum protection of the urinary tract from contaminants of all kinds.

Like the undersurface of the eyelids or the inside of the cheek, the undersurface of the foreskin consists of mucous membrane. It is divided into two distinct zones: the soft mucosa and the ridged mucosa. The soft mucosa lies against the glans penis and contains ectopic sebaceous glands that secrete emollients, lubricants, and protective antibodies. Similar glands are found in the eyelids and mouth.

Adjacent to the soft mucosa and just behind the lips of the foreskin is the ridged mucosa. This exquisitely sensitive structure consists of tightly pleated concentric bands, like the elastic bands at the top of a sock. These expandable pleats allow the foreskin lips to open and roll back, exposing the glans. The ridged mucosa gives the foreskin its characteristic taper.

On the underside of the glans, the foreskin's point of attachment is advanced toward the meatus (urethral opening) and forms a bandlike ligament called the frenulum. It is identical to the frenulum that secures the tongue to the floor of the mouth. The foreskin's frenulum holds it in place over the glans, and, in conjunction with the smooth muscle fibers, helps return the retracted foreskin to its usual forward position over the glans.

At birth, the foreskin is usually attached to the glans, very much as a fingernail is attached to a finger. By puberty, the penis will usually have completed its development, and the foreskin will have separated from the glans.[8] This separation occurs in its own time; there is no set age by which the foreskin and glans must be separated. One wise doctor described the process thus, "The foreskin therefore can be likened to a rosebud which remains closed and muzzled. Like a rosebud, it will only blossom when the time is right. No one opens a rosebud to make it blossom."[9]

Even if the glans and foreskin separate naturally in infancy, the foreskin lips can normally dilate only enough to allow the passage of urine. This ideal feature protects the glans from premature exposure to the external environment.

The penis develops naturally throughout childhood. Eventually, the child will, on his own, make the wondrous discovery that his foreskin will retract. There is no reason for parents, physicians, or other caregivers to manipulate a child's penis. The only person to retract a child's foreskin should be the child himself, when he has discovered that his foreskin is ready to retract.

Parents should be wary of anyone who tries to retract their child's foreskin, and especially wary of anyone who wants to cut it off. Human foreskins are in great demand for any number of commercial enterprises, and the marketing of purloined baby foreskins is a multimillion-dollar-a-year industry. Pharmaceutical and cosmetic companies use human foreskins as research material. Corporations such as Advanced Tissue Sciences, Organogenesis, and BioSurface Technology use human foreskins as the raw materials for a type of breathable bandage.

The foreskin has numerous protective, sensory, and sexual functions.

* Protection: Just as the eyelids protect the eyes, the foreskin protects the glans and keeps its surface soft, moist, and sensitive. It also maintains optimal warmth, pH balance, and cleanliness. The glans itself contains no sebaceous glands--glands that produce the sebum, or oil, that moisturizes our skin.[11] The foreskin produces the sebum that maintains proper health of the surface of the glans.

* Immunological Defense: The mucous membranes that line all body orifices are the body's first line of immunological defense. Glands in the foreskin produce antibacterial and antiviral proteins such as lysozyme.[12] Lysozyme is also found in tears and mother's milk. Specialized epithelial Langerhans cells, an immune system component, abound in the foreskin's outer surface. Plasma cells in the foreskin's mucosal lining secrete immunoglobulins, antibodies that defend against infections.

* Erogenous Sensitivity: The foreskin is as sensitive as the fingertips or the lips of the mouth. It contains a richer variety and greater concentration of specialized nerve receptors than any other part of the penis.[15] These specialized nerve endings can discern motion, subtle changes in temperature, and fine gradations of texture.[16, 17, 18, 19, 20, 21, 22, 23]

* Coverage during Erection: As it becomes erect, the penile shaft becomes thicker and longer. The double-layered foreskin provides the skin necessary to accommodate the expanded organ and to allow the penile skin to glide freely, smoothly, and pleasurably over the shaft and glans.

* Self-Stimulating Sexual Functions: The foreskin's double-layered sheath enables the penile shaft skin to glide back and forth over the penile shaft. The foreskin can normally be slipped all the way, or almost all the way, back to the base of the penis, and also slipped forward beyond the glans. This wide range of motion is the mechanism by which the penis and the orgasmic triggers in the foreskin, frenulum, and glans are stimulated.

* Sexual Functions in Intercourse: One of the foreskin's functions is to facilitate smooth, gentle movement between the mucosal surfaces of the two partners during intercourse. The foreskin enables the penis to slip in and out of the vagina nonabrasively inside its own slick sheath of self-lubricating, movable skin. The female is thus stimulated by moving pressure rather than by friction only, as when the male's foreskin is missing.

The foreskin fosters intimacy between the two partners by enveloping the glans and maintaining it as an internal organ. The sexual experience is enhanced when the foreskin slips back to allow the male's internal organ, the glans, to meet the female's internal organ, the cervix--a moment of supreme intimacy and beauty.

The foreskin may have functions not yet recognized or understood. Scientists in Europe recently detected estrogen receptors in its basal epidermal cells.[24] Researchers at the University of Manchester found that the human foreskin has apocrine glands.[25] These specialized glands produce pheromones, nature's chemical messengers. Further studies are needed to fully understand these features of the foreskin and the role they play.

The natural penis requires no special care. A child's foreskin, like his eyelids, is self-cleansing. For the same reason it is inadvisable to lift the eyelids and wash the eyeballs, it is inadvisable to retract a child's foreskin and wash the glans. Immersion in plain water during the bath is all that is needed to keep the intact penis clean.[26]

The white emollient under the child's foreskin is called smegma. Smegma is probably the most misunderstood, most unjustifiably maligned substance in nature. Smegma is clean, not dirty, and is beneficial and necessary. It moisturizes the glans and keeps it smooth, soft, and supple. Its antibacterial and antiviral properties keep the penis clean and healthy. All mammals produce smegma. Thomas J. Ritter, MD, underscored its importance when he commented, "The animal kingdom would probably cease to exist without smegma."[27]

Studies suggest that it is best not to use soap on the glans or foreskin's inner fold.[23] Forcibly retracting and washing a baby's foreskin destroys the beneficial bacterial flora that protect the penis from harmful germs and can lead to irritation and infection. The best way to care for a child's intact penis is to leave it alone. After puberty, males can gently rinse their glans and foreskin with warm water, according to their own self-determined needs.

Circumcision is almost unheard of in Europe, South America, and non-Muslim Asia. In fact, only 10 to 15 percent of men throughout the world are circumcised. The vast majority of whom are Muslim.[29] The neonatal circumcision rate in the western US has now fallen to 34.2 percent.[30] This relatively diminished rate may surprise American men born during the era when nearly 90 percent of baby boys were circumcised automatically, with or without their parents' consent.

The "medical" debate about the "potential health benefits" of circumcision rarely addresses its real effects.

* Circumcision denudes: Depending on the amount of skit cut off, circumcision robs a male of as much as 80 percent or more of his penile skin. Depending on the foreskin's length, cutting it off makes the penis as much as 25 percent or more shorter. Careful anatomical investigations have shown that circumcision cuts off more than 3 feet of veins, arteries, and capillaries, 240 feet of nerves, and more than 20,000 nerve endings.[31]The foreskin's muscles, glands, mucous membrane, and epithelial tissue are destroyed, as well.

* Circumcision desensitizes: Circumcision desensitizes the penis radically. Foreskin amputation means severing the rich nerve network and all the nerve receptors in the foreskin itself Circumcision almost always damages or destroys the frenulum. The loss of the protective foreskin desensitizes the glans. Because the membrane covering the permanently externalized glans is now subjected to constant abrasion and irritation, it keratinizes, becoming dry and tough. The nerve endings in the glans, which in the intact penis are just beneath the surface of the mucous membrane, are now buried by successive layers of keratinization. The denuded glans takes on a dull, grayish, sclerotic appearance.

* Circumcision disables: The amputation of so much penile skin permanently immobilizes whatever skin remains, preventing it from gliding freely over the shaft and glans. This loss of mobility destroys the mechanism by which the glans is normally stimulated. When the circumcised penis becomes erect, the immobilized remaining skin is stretched, sometimes so tightly that not enough skin is left to cover the erect shaft. Hair-bearing skin from the groin and scrotum is often pulled onto the shaft, where hair is not normally found. The surgically externalized mucous membrane of the glans has no sebaceous glands. Without the protection and emollients of the foreskin, it dries out, making it susceptible to cracking and bleeding.

* Circumcision disfigures: Circumcision alters the appearance of the penis drastically. It permanently externalizes the glans, normally an internal organ. Circumcision leaves a large circumferential surgical scar on the penile shaft. Because circumcision usually necessitates tearing the foreskin from the glans, pieces of the glans may be torn off, too, leaving it pitted and scarred. Shreds of foreskin may adhere to the raw glans, forming tags and bridges of dangling, displaced skin.[32]

Depending on the amount of skin cut off and how the scar forms, the circumcised penis may be permanently twisted, or curve or bow during erection.[33] The contraction of the scar tissue may pull the shaft into the abdomen, in effect shortening the penis or burying it completely.[34]

* Circumcision disrupts circulation: Circumcision interrupts the normal circulation of blood throughout the penile skin system and glans. The blood flowing into major penile arteries is obstructed by the line of scar tissue at the point of incision, creating backflow instead of feeding the branches and capillary networks beyond the scar. Deprived of blood, the meatus may contract and scarify, obstructing the flow of urine.[35] This condition, known as meatal stenosis, often requires corrective surgery. Meatal stenosis is found almost exclusively among boys who have been circumcised.

Circumcision also severs the lymph vessels, interrupting the circulation of lymph and sometimes causing lymphedema, a painful, disfiguring condition in which the remaining skin of the penis swells with trapped lymph fluid.

* Circumcision harms the developing brain: Recent studies published in leading medical journals have reported that circumcision has longlasting detrimental effects on the developing brain,[36] adversely altering the brain's perception centers. Circumcised boys have a lower pain threshold than girls or intact boys.[37] Developmental neuropsychologist Dr. James Prescott suggests that circumcision can cause deeper and more disturbing levels of neurological damage, as well. [38, 39]

* Circumcision is unhygienic and unhealthy: One of the most common myths about circumcision is that it makes the penis cleaner and easier to take care of. This is not true. Eyes without eyelids would not be cleaner; neither would a penis without its foreskin. The artificially externalized glans and meatus of the circumcised penis are constantly exposed to abrasion and dirt, making the circumcised penis, in fact, more unclean. The loss of the protective foreskin leaves the urinary tract vulnerable to invasion by bacterial and viral pathogens.

The circumcision wound is larger than most people imagine. It is not just the circular point of union between the outer and inner layers of the remaining skin. Before a baby is circumcised, his foreskin must be torn from his glans, literally skinning it alive. This creates a large open area of raw, bleeding flesh, covered at best with a layer of undeveloped protomucosa. Germs can easily enter the damaged tissue and bloodstream through the raw glans and, even more easily, through the incision itself.

Even after the wound has healed, the externalized glans and meatus are still forced into constant unnatural contact with urine, feces, chemically treated diapers, and other contaminants.

Female partners of circumcised men do not report a lower rate of cervical cancer,[40] nor does circumcision prevent penile cancer.[41] A recent study shows that the penile cancer rate is higher in the US than in Denmark, where circumcision, except among Middle Eastern immigrant workers, is almost unheard of.[42] Indeed, researchers should investigate the possibility that circumcision has actually increased the rate of these diseases.

Circumcision does not prevent acquisition or transmission of sexually transmitted diseases (STDs). In fact, the US has both the highest percentage of sexually active circumcised males in the Western world and the highest rates of sexually transmitted diseases, including AIDS. Rigorously controlled prospective studies show that circumcised American men are at a greater risk for bacterial and viral STDs, especially gonorrhea,[43] nongonoccal urethritis,[44] human papilloma virus,[45] herpes simplex virus type 2,[46] and chlamydia.[47]

* Circumcision is always risky: Circumcision always carries the risk of serious, even tragic, consequences. Its surgical complication rate is one in 500.[48] These complications include uncontrollable bleeding and fatal infections.[49] There are many published case reports of gangrene following circumcision.[50] Pathogenic bacteria such as staphylococcus, proteus, pseudomonas, other coliforms, and even tuberculosis can cause infections leading to death.[51, 52] These organisms enter the wound because it provides easy entry, not because the child is predisposed to infection.

Medical journals have published numerous accounts of babies who have had part or all of their glans cut off while they were being circumcised.[53 54 55] Other fully conscious, unanesthetized babies have had their entire penis burned off with an electrocautery gun.[56,57,58] The September 1989 Journal of Urologypublished an account of four such cases.[59] The article described the sex-change operation as "feminizing genitoplasty," performed on these babies in an attempt to change them into girls. The March 1997 Archives of Pediatrics and Adolescent Medicinedescribed one young person's horror on learning that "she" had been born a normal male, but that a circumciser had burned his penis off when he was a baby.[60] Many other similar cases have been documented[61,62] Infant circumcision has a reported death rate of one in 500,000.[63,64]

* Circumcision harms mothers: Scientific studies have consistently shown that circumcision disrupts a child's behavioral development. Studies performed at the University of Colorado School of Medicine showed that circumcision is followed by prolonged, unrestful non-REM (rapid eye movement) sleep.[65] In response to the lengthy bombardment of their neural pathways with unbearable pain, the circumcised babies withdrew into a kind of semicoma that lasted days or even weeks.

Numerous other studies have proven that circumcision disrupts the mother-infant bond during the crucial period after birth. Research has also shown that circumcision disrupts feeding patterns. In a study at the Washington University School of Medicine, most babies would not nurse right after they were circumcised, and those who did would not look into their mothers' eyes.[66]

* Circumcision violates patients' and human rights: No one has the right to cut off any part of someone else's genitals without that person's competent, fully informed consent. Since it is the infant who must bear the consequences, circumcision violates his legal rights both to refuse treatment and to seek alternative treatment. In 1995, the American Academy of Pediatrics Committee on Bioethics stated that only a competent patient can give patient consent or informed consent.[67] An infant is obviously too young to consent to anything. He must be protected from anyone who would take advantage of his defenselessness. The concept of informed parental permission allows for medical interventions in situations of clear and immediate medical necessity only, such as disease, trauma, or deformity. The human penis in its normal, uncircumcised state satisfies none of these requirements.

Physicians have a duty to refuse to perform circumcision. They also must educate parents who, out of ignorance or misguidance, request this surgery for their sons. The healthcare professional's obligation is to protect the interests of the child. It is unethical in the extreme to force upon a child an amputation he almost certainly would never have chosen for himself.

To be intact, as nature intended, is best. The vast majority of males who are given the choice value their wholeness and keep their foreskins, for the same reason they keep their other organs of perception. Parents in Europe and non-Muslim Asia never have forced their boys to be circumcised. It would no more occur to them to cut off part of their boys' penises than it would to cut off part of their ears. Respecting a child's right to keep his genitals intact is normal and natural. It is conservative in the best sense of the word.

A circumcised father who has mixed feelings about his intact newborn son may require gentle, compassionate psychological counseling to help him come to terms with his loss and to overcome his anxieties about normal male genitalia. In such cases, the mother should steadfastly protect her child, inviting her husband to share this protective role and helping him diffuse his negative feelings. Most parents want what is best for their baby. Wise parents listen to their hearts and trust their instinct to protect their baby from harm. The experience of the ages has shown that babies thrive best in a trusting atmosphere of love, gentleness, respect, acceptance, nurturing, and intimacy. Cutting off a baby's foreskin shatters this trust.

Circumcision wounds and harms the baby and the person the baby will become. Parents who respect their son's wholeness are bequeathing to him his birthright--his body, perfect and beautiful in its entirety.

Paul M. Fleiss, MD, MPH, is assistant clinical professor of pediatrics at the University of Southern California Medical Center. He is the author of numerous scientific articles published in leading national and international medical journals.

Notes

1. T. J. Ritter and G. C. Denniston, Say No to Circumcision: 40 Compelling Reasons, 2nd ed. (Aptos, CA Hourglass 1996), 6-20.

2. "Incipit Libellus De Ecclesiasticis Disciplinis et Religione Christiana Collectus. Liber II.XC, XCI" in Patrologiae Cursus Completus, vol. 132 (Paris: Apud Garnier Fratres, Editores et J. P. Migne Successores, 1880), 301-302.

3. S. Grayzel, The Church and the Jews in the Xllth Century, vol. 2, ed. K. R. Stow (Detroit, MI: Wayne State University Press, 1989), 246-247.

4. See Note 10, 17-40.

5. M. E Camphor "The Male Genital Tract and the Female Urethra," in Urology, eds. M. E. Campbell and J. H. Harrison, vol. 2, 3rd ed. (Philadelphia: W. B. Saunders, 1970), 1836.

6. See photographic series: J. A. Erickson, "Three Zones of Penile Skin." In M. M. Lander, "The Human Prepuce," in G. C. Denniston and M. E. Milos, eds., Sexual Mutilations: A Human Tragedy (New York: Plenum Press, 1997), 79-81.

7. M. Davenport, "Problems with the Penis and Prepuce: Natural History of the Foreskin" (photograph 1), British Medical Journal 312 (1996): 299-301.

8. J. Oster, "Further Fate of the Foreskin," Archives of Disease in Childhood 43 (1968): 200-203.

9. H. L. Tan, "Foreskin Fallacies and Phimosis," Annals of the Academy of Medicine, Singapore 14 (1985): 626-630.

10. F. A. Hodges, "Short History of the Institutionalization of Involuntary Sexual Mutilation in the United States" in G. C. Denniston and M. E. Milos, eds., Sexual Mutilations: A Human Tragedy (New York: Plenum Press, 1997), 35.

11. A B. Hyman and M. H. Brownstein, "Tyson's 'Glands": Ectopic Sebaceous Glands and Papillomatosis Penis," Archives of Dermatology 99 (1969): 31-37.

12. A. Ahmed and A. W. Jones, "Apocrine Cystadenoma: A Report of Two Cases Occurring on the Prepuce, "British Journal of Demmatology 81 (1969): 899-901.

13. G. N. Weiss et al., "The Distribution and Density of Langerhans Cells in the Human Prepuce: Site of a Diminished Immune Response?" Israel Journal of Medical Sciences 29 (1993): 42-43.

14. P. J. Flower et al., "An Immunopathologic Study of the Bovine Prepuce," Veterinary Pathology 20 (1983): 189-202.

15. Z. Halata and B. L. Munger, "The Neuroanatomical Basis for the Protopathic Sensibility of the Human Glans Penis," Brain Research 371 (1986): 205-230.

16. J. R. Taylor et al., "The Prepuce: Specialized Mucosa of the Penis and Its Loss to Circumcision," British Journal of Urology 77 (1996): 291-295.

17. H. C. Bazett et al., "Depth, Distribution and Probable Identification in the Prepuce of Sensory End-Organs Concerned in Sensations of Temperature and Touch; Themometic Conductivity," Archives of Neurology and Psychiatry 27 (1932): 489-517.

18. D. Ohmori, "Ueber die Entwicklung der Innervation der Genitalapparate als Peripheren Aufnahmeapparat der Genitalen Reflexe," Zeitschriht fuer Anatomie and Entwicklungspeschichte 70 (1924): 347-410.

19. A. De Girolamo and A. Cecio, "Contributo alla Conoscenza dell'innervazione Sensitiva del Prepuzio Nell'uomo," Bollettino delta Societa Italiana de Biologia Sperimentak 44 (1968): 1521-1522.

20. A. S. Dogiel, "Die Nervenendigungen in der Haut der aeusseren Genitalorgane des Menschen," Archiv fuer Mikroskopische Anatomie 41 (1893): 585-612.

21. A. Bourlond and R. K. Winkelmann, "L'innervation du Prepuce chez le Nouveau-ne," Archives Beiges de Demmatologie et de Syphiligraphie 21 (1965): 139-153.

22. R. K. Winkelmann, "The Erogenous Zones: Their Nerve Supply and Its Significance," Proceedings of the Staff Meetings of the Mayo Clinic 34 (1959): 39-47.

23. R. K. Winkelmann, "The Cutaneous Innervation of Human Newborn Prepuce," Journal of Investigative Demtotology 26 (1956): 53-67.

24. R. Hausmann et al., "The Forensic Value of the Immunohistochemical Detection of Estrogen Receptors in Vaginal Epithelium," International Journal of Legal Medicine 109 (1996): 10-30.

25. See Note 12.

26. American Academy of Pediatrics, Newboms: Care of the Uncircumcised Penis Guidelines for Parents (Elk Grove Village, IL: American Academy of Pediatrics, 1994).

27. See Note 1.

28. See Note 1.

29. S. A. Aldeeb Abu-Sahlieh, Jehovah, His Cousin Allah, and Sexual Mutilations," in Sexual Mutilations A Human Tragedy, eds. G. C. Denniston and M. F. Milos (New York: Plenum Press, 1997), 41-62.

30. National Center for Health Statistics of the United States Department of Health and Human Services, 1994.

31. See Note 17.

32. G. I Klauber and J. Boyle, "Preputial Skin-Bridging: Complication of Circumcision," Urology 3 (1974): 722-723.

33. J. P. Gearhart, "Complications of Pediatric Circumcision," in Urologic Complications, Medical and Surgical, Adult and Pediatric, ed. E. E. Marshall (Chicago: Year Book Medical Publishers, 1986), 387-396.

34. R. D. Talarico and J. E. Jasaitis, "Concealed Penis: A Complication of Neonatal Circumcision," Journal of Urology 110 (1973): 732-733.

35. R. Persad et al., "Clinical Presentation and Pathophysiology of Meatal Stenosis Following Circumcision," British Journal of Urology 75 (1995): 90-91.

36. A. Taddio et al., "The Effect of Neonatal Circumcision on Pain Responses during Vaccination in Boys," Lancet 345 (1995): 291-292.

37. A. Taddio et al., "The Effect of Neonatal Circumcision on Pain Response during Subsequent Routine Vaccination," Lancet 349 (1997): 599-603.

38. J. W. Prescott, "Genital Pain vs. Genital Pleasure: Why the One and Not the Other" Truth Seeker 1 (1989): 14-21.

39. R. Goldman, Circumcision: The Hidden Trauma (Boston: Vanguard Publications, 1997), 139-175.

40. M. Terris et al, "Relation of Circumcision to Cancer of the Cervix," American Joumal of Obstetrics and Gynecology 117 (1973): 1056-1065.

41. C J. Cold et al., "Carcinoma in Situ of the Penis in a 76-Year-old Circumcised Man," Journal of Family Practice 44 (1997): 407-410.

42. M. Frisch et al., "Falling Incidence of Penis Cancer in an Uncircumcised Population (Denmark 1943-90)," British Medical Journal 311 (1995): 1471.

43. B. Donovan et al., "Male Circumcision and Common Sexually Transmissible Diseases in a Developed Nation Setting," Genitourinary Medicine 70 (1994): 317-320.

44. G L Smith et al., "Circumcision as a Risk Factor for Urethritis in Racial Groups,"American Journal of Public Health 77 (1987): 452-454.

45. L. S. Cook et al., "CIincal Presentation of Genital Warts among Circumcised and Uncircumcised Heterosexual Men Attending an Urban STD Clinic," Genitourinary Medicine 69 (1993): 262-264.

46. I. Bassett et al., "Herpes Simplex Virus Type 2 Infection of Heterosexual Men Attending a Sexual Health Centre," Medical Journal of Australia 160 (1994): 697-700.

47. E. O. Laumann et al., "Circumcision in the United States: Prevalence, Prophylactic Effects, and Sexual Practice," Journal of the American Medical Association 277 (1997): 1052-1057.

48. W. E. Gee and J. S. Ansel, "Neonatal Circumcision: A Ten-year Overview With Comparison of the Gomco Clamp and the Plastibell Device," Pediatrics 58 (1976): 824-827.

49. G. W. Kaplan, "Complications of Circumcision," Urologic Clinics of North America 10 (1983): 543-549.

50. S. J. Sussman et al., "Fournier's Syndrome: Report of Three Cases and Review of the Literature," American Journal of Diseases of Children 132 (1978): 1189-1191.

51. B. V. Kirkpatrick and D. V. Eitzman, "Neonatal Septicemia after Circumcision," Clinical Pediatrics 13 (1974): 767-768.

52. J. M. Scurlock and R J. Pemberton, "Neonatal Meningitis and Circumcision," Medical Journal of Australia 1 (1977):332-334.

53. G. R. Gluckman et al., "Newborn Penile Glans Amputation during Circumcision and Successful Reattachment," Journal of Urology 153 (1995): 778-779.

54. B. S. Strimling, "Partial Amputation of Glans Penis during Mogen Clamp Circumcision,"Pediatrics 87 (1996): 906-907.

55. J. Shemman et al., Circumcision: Successful Glandular Reconstruction and Survival Following Traumatic Amputation," Journal of Urology 156 (1996): 842-844.

56. J. R. Sharpe and R. P. Finney, "Electrocautery Circumcision,"Urology 19 (1982): 228.

57. C. K. Pearlman, "Caution Advised on Electrocautery Circumcisions," Urology 19 (1982): 453.

58. C. K. Pearlman, "Reconstruction Following Iatrogenic Burn of the Penis" Journal of Pediatric Surgery 11 (1976): 121-122.

59. J. P. Gearhart and J. A. Rock, "Total Ablation of the Penis after Circumcision with Electrocautery: A Method of Management and Long-Term Followup," Journal of Urology 142 (1989): 799-801.

60. M. Diamond and H. K. Sigmundson, "Sex Reassignment at Birth: LongTerm Review and Clinical Implications," Archives of Pediatrics and Adolescent Medicine 151(1997): 298-304.

61. J. Money, "Ablatio Penis: Normal Male Infant Sex-Reassigned as a Girl," Archives of Sexual Behavior 4 (1975): 65-71.

62. D. A. Gilbert et al, "Phallic Construction in Prepubertal and Adolescent Boys," Journal of Urology 149 (1993): 1521-1526.

63. R. S. Thompson, "Routine Circumcision in the Newborn: An Opposing View," Journal of Family Practice 31 (1990): 189-196.

64. T. E. Wiswell, "Circumcision Circumspection," New England Journal of Medicine 336 (1997): 1244-1245.

65. R N. Emde et al., "Stress and Neonatal Sleep," Psychosomatic Medicine 33 (1971): 491-497.

66. R. E. Marshall et al., "Circumcision: II. Effects upon Mother-Infant Interaction," Early Human Development 7 (1982): 367-374.

67. Committee on Bioethics, "Informed Consent, Parental Permission, and Assent in Pediatric Practice," Pediatrics 95 (1995): 314-317.

For More Information

Organizations

Doctors Opposing Circumcision (DOC)

2442 N.W. Market Street, Suite 42

Seattle, WA 98107 206-368-8358

weber.u.washington.edu/~gcd/DOC/

The National Organization of Circumcision Information Resource Centers (NOCIRC)

Box 2512

San Anselmo, CA 949792512

415-488-9883

www.nocirc.org

The National Organization to Halt the Abuse and Routine Mutilation of Males (NOHARMM)

PO Box 460795

San Francisco, CA 94146-0795

415-826-9351

www.nohammm.org

Nurses for the Rights of the Child

369 Montezuma, Suite 354

Santa Fe, NM 87501

505-989-7377

www.cirp.org/nrc/

Books

Available from bookstores, from the publishers, or from NOCIRC

Bigelow, Jim, Ph. D. The Joy of Uncircumcising! Exploring Circumcision: History, Myths Psychology, Restoration, Sexual Pleasure and Human Rights. 2nd ed. Aptos, CA: Hourglass, 1995.

Denniston, George C., MD, MPH, and Marilyn Fayre Milos, RN, eds. Sexual Mutilations: A Human Tragedy (Proceedings of the Fourth International Symposium on Sexual Mutilations, Lausanne, Switzerland, 1996.) New York: Plenum Press, 1997.

Goldman, Ronald, PhD. Circumcision: The Hidden Trauma: How an American Cultural Practice Affects Infants and Ultimately Us All. Boston: Vanguard Publications, 1997.

Goldman, Ronald, PhD. Questioning Circumcision: A Jewish Perspective. 2nd ed. Boston: Vanguard Publications, 1997.

O'Mara, Peggy, ed. Circumcision: The Rest of the Story-A Selection of Articles, Letters and Resources 1979-1993. Santa Fe, NM: Mothering, 1993.

Ritter, Thomas J., MD, and George C. Denniston, MD. Say No to Circumcisions: 40 Compelling Reasons Why You Should Respect His Birthright and Keep Your Son Whole. 2nd ed. Aptos, CA: Hourglass, 1996.

Video

Whose Body, Whose Rights? Examining the Ethics and the Human Rights Issue of Infant Male Circumcision. Award-winning documentary. 56 min. VHS.

Personal use: VideoFinders, 1-800-343-4727

Educational Facilities:

UC Center for Media and Independent Learning

2000 Center Street 4th Floor

Berkeley CA 94704

510-642-0460

For World Wide Web preview and more ordering information:

www.cirp.org/CIRP/pages/reviews/whosebody/

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