DePaul University Via Sapientiae College of Liberal Arts & Social Sciences Theses and Dissertations College of Liberal Arts and Social Sciences 6-2011 Male circumcision in the United States: The History, an analysis of the discourse, and a philosophical interpretation Jonathan D. Cohen DePaul University, [email protected] Follow this and additional works at: https://via.library.depaul.edu/etd Recommended Citation Cohen, Jonathan D., "Male circumcision in the United States: The History, an analysis of the discourse, and a philosophical interpretation" (2011). College of Liberal Arts & Social Sciences Theses and Dissertations. 87. https://via.library.depaul.edu/etd/87 This Thesis is brought to you for free and open access by the College of Liberal Arts and Social Sciences at Via Sapientiae. It has been accepted for inclusion in College of Liberal Arts & Social Sciences Theses and Dissertations by an authorized administrator of Via Sapientiae. For more information, please contact [email protected]. Male Circumcision in the United States: The History, an Analysis of the Discourse, and a Philosophical Interpretation A Thesis Presented in Partial Fulfillment of the Requirements for the Degree of Master of Arts June, 2011 by Jonathan D. Cohen Department of Liberal Studies College of Liberal Arts and Sciences DePaul University Chicago, Illinois I. Why the Topic of Male Circumcision? Michel Foucault explains in The History of Sexuality Vol. 1 that in the Victorian era reproductive science regarding plants and animals followed the "general scientific normativity" of the time. However, when it came to humans, there was "a medicine of sex conforming to quite different rules of formation" (Foucault, HS, p. 54). Biology, in this case, became only a style of discourse which had to be there to hold authority, "a blanket guarantee under cover of which moral obstacles...and traditional fears could be recast in a scientific-sounding vocabulary" (Foucault, HS, p. 54). Although Foucault never discusses circumcision directly, his theories fit the topic perfectly. The science behind the routinization of male circumcision can now be seen as morality masquerading as science, with a resulting dramatic loss of knowledge of the body, particularly in matters of sexuality. As Foucault's analyses so often demonstrate, we will have to consider that much of this legacy is still with us today. Male circumcision will give us a dramatic view of this persistence of Victorian morality. Like many people, for a long time, I had practically no knowledge of what circumcision was, and no awareness of this gap in my knowledge. As I began to research this topic years ago, learning the basics, such as its rarity in industrialized nations other than the United States, the current medical opinions, and the history of circumcision as part of a cultural war on masturbation, it became increasingly obvious to question its current practice, as so many have done. But from an academic perspective, the story of male circumcision is a revealing one, which may become increasingly important to understandings of masculinity, still framed for us in many ways by understandings from the Victorian era. When something is thoroughly normalized, 2 hidden from view, but then brought into view, it becomes capable of revealing a great deal about society. The story of the institution of routine neonatal circumcision has tremendous potential in any reevaluation of the recent history of sexuality, and in understanding the operations of power related to this, often rooted in the sort of local power operations which Foucault discusses. This is not a paper about Jewish ritual circumcision, a religious practice which accounts for a small percentage of infant circumcision in the United States, but rather about circumcision in its medicalized form. However, one of the most fascinating stories of the institutionalization of medical male circumcision is the discursive use of the Jews as racial proof of the benefits of circumcision, with a complete ignorance of sociological factors. Meanwhile, as circumcision declines as a practice here, a process well underway, the United States is increasingly a proponent of adult male circumcision in Africa, recently beginning programs to circumcise men in multiple African countries, purportedly to assist in a fight against AIDS. We must investigate this topic to see if it is a true medical practice, with authentic science behind it, or if it is once again morality masquerading as science. From a gender studies perspective, this topic of male circumcision, I believe, can be exploited in order to get broader support for the contestation of a medical world which still has too much ability to go unquestioned in its procedures and authority over the body. Also, it should be used to work towards an understanding from a male perspective that sexual oppression is not the concern only of women. The current medical statements make clear enough the weak evidence for a role of circumcision in fighting disease, and the history will show how little the institution of male circumcision had anything to do with modern scientific understanding of disease. Thus I will limit the time spent on understandings of circumcision and disease today, in order to focus more 3 on the origins of the institutionalization of male circumcision, on some further issues within the discourse as found in various media today, and in the placing of male circumcision within the broader field of the medicalization of childbirth. Following this, I will move on to some more general philosophical issues, using theories of Nietzsche and Freud, which may provide more light on how a culture which considers itself scientific with regard to the body may be caught up in very unscientific modes of thinking. Male circumcision has importance for understanding much beyond circumcision itself. A look at the discourse around male circumcision reveals highly charged forces determining the directions of the current debate, forces which are not always apparent to the participants in the debate. It should be no surprise that, regarding matters of sexuality and the genitals, there may be a great deal of unconscious content in the thinking of individuals and of society as a whole. Thinkers who cast suspicion on our understandings of ourselves, and who seek out hidden meanings, such as Freud and Nietzsche, will be very useful in analyzing this phenomenon of male circumcision. We may wish to look at our period of history as one in which we have moved beyond Victorian understandings of sexuality, but we are not freed from our past so easily. We must look instead at our present as still bound to this past, often in invisible ways. A belief in a linear historical progress is dangerous; it allows us to deceive ourselves about our own culture. Science, just as well, moves in more than one direction. Our science, as Foucault and Nietzsche will help us understand, is a human science, always bound to our cultural existence, never purely rational. Long eras of sexual morality do not disappear overnight - they leave an impact on scientific practice. The forces which preceded institutionalization of male circumcision are in many ways still present. 4 Male circumcision will serve as an excellent diagnostic tool to pry into understandings of the dynamics of our culture, a culture that sees itself as both scientific and liberated, but one engaged in an often unconscious struggle with itself. Cultural philosophy, added to an examination of discourse, can help us gain additional understandings of the forces which are observable through male circumcision, and help us to reveal something about how we handle our sexuality in the current time. I will begin with an analysis of the statements from official medical authorities and current coverage of male circumcision in the media. Very quickly, we will find contradictions within statements which point to the need for a much more complex understanding of male circumcision than is generally found in official and mainstream discourse. II. The Male Circumcision 'Controversy' - Media Invention? Many people may assume that male circumcision is a surgery that is carried out for medical reasons. Mainstream media coverage of male circumcision encourages this belief, often presenting male circumcision as a controversial and ongoing debate, with health benefits and cultural justifications posed against minor risks and the possibility of trauma to the infant. However, this controversy is somewhat of a creation of the media, partly fueled by the need to generate interesting news stories, in order to fill space in newspapers and on television. The appearance of this controversy is supported by the social normalization the circumcised penis has acquired. However, this controversy portrayed in the media, with a medical authority attempting to preserve a space for male circumcision to prevent disease in the face of resistance, is not at all consistent with the view of male circumcision given in the statements of medical authorities. 5 The American Medical Association's most recent major document on medical circumcision, the "Report 10 of the Council on Scientific Affairs", from 1999, was created by their "Council on Science and Public Health". It provides the statistic that "The prevalence of circumcision in the United States increased from about 30% in the 1930s to nearly 80% by the early 1970s"1. The rate of male circumcision in the U.S. may have been around 10% in 1880, when it was just beginning to become a legitimate medical procedure, and grew in popularity steadily until it's peak in the 1980's (Wallerstein, p. 217). Male circumcision is not routinely reported by hospitals, as reporting of this is optional, and data of this type is inaccurate and generally based on sample studies. As this procedure varies in its performance geographically and culturally, in some regions it may have reached near 100% rates. Claims of needing to circumcise an infant so that he would appear 'normal' in life, while not being a medical justification, has had a basis in fact; to be circumcised was, in many places, to have normal male genitals.