Medicalization and the Mainstreaming of Circumcision in Mid-twentieth-century America

Abstract

Medicalization and the Mainstreaming of Circumcision in Mid-twentieth-century America Elizabeth Reis1 (bio) During the 1950s, circumcision rates soared in the United States, affecting Americans far beyond the Jewish community. Physicians performed the procedure in a hospital setting, shortly after a baby boy's birth, for ninety percent of the non-Jewish population by 1959.2 As many scholars have noted, circumcision's appeal among non-Jews has a curious history in both this country and in Great Britain, one that involved the glorification of hygiene and sanitation and the concomitant demonization of the foreskin, as historian Robert Darby aptly put it.3 Touted first as a [End Page 321] cure for masturbation and then as a prophylactic measure against it, the procedure gradually became the norm in the United States.4 With the widespread adoption of circumcision as a hospital event, the practice of medicine intersected with the practice of Judaism. In the postwar era, Jews were assimilating and becoming more secular, and they wanted to be (and be seen as) modern. During this period, they found ways to accommodate and adapt their religiosity to American life. As scholars have noted, even as other religious rituals diminished in importance for the majority of Jews—keeping kosher or observing the Sabbath, for example—circumcision endured. But it, too, changed. Who would perform the ritual? Where would it be done? And when would it occur? As we shall see, an underlying question for physicians, Jewish parents, and religious leaders alike motivated these debates: Should circumcision be considered surgery or religious ritual? This paper examines a particularly controversial time and place: 1950s New York City. Analyzing the records of the New York Board of Rabbis (an interdenominational association of rabbis, founded in the 1880s) during this period, I explore the tension among observant Jews regarding the spiritual and medical significance of circumcision. All agreed on the ritual's singular importance, but there was much less consensus on the particulars of the procedure itself, given the broader changes in the practice of medicine—and the practice of Judaism—at the time. I suggest that observant Jews were caught in a bind between tradition and medical protocol. To some extent, they encouraged and embraced the medicalization of ritual circumcision, but they resisted it as well, particularly when the religious aspect of the procedure seemed threatened. For centuries, a Jewish family needing a bris (a ritual circumcision) had to find a mohel (a ritual circumciser) to come to their home eight days after the birth. But in mid-twentieth-century America, mothers increasingly elected to have their babies in hospitals, not at home, and because they often remained hospitalized for over a week, and tradition required circumcision on the eighth day after birth, mohels had to minister to [End Page 322] babies in that institutional setting.5 At first, many New York hospitals did not permit mohels to perform circumcisions in their facilities, unless they were also physicians.6 This obstacle provided the impetus for the New York Board of Rabbis to certify mohels and convince hospital administrators to admit them as professional practitioners who adhered to rigorous medical guidelines, even if they weren't doctors. As hospitals increasingly accommodated Jewish families who wanted their child's circumcision performed by a mohel in the hospital, they also obliged Jews who wanted their pediatrician or obstetrician-gynecologist to provide the operation before the mother and baby were discharged—that is, prior to the traditionally prescribed day of the rite. The medical profession in turn extended its orbit and authority, incorporating a practice (and increasingly monopolizing a procedure for non-Jews) that had not been strictly "medical" in the past. Though Jews had an interest in cultivating the notion that circumcision was a benign surgery with significant health benefits, the procedure's entry into a hospital setting raised unforeseen consequences for rabbis, mohels, and Jewish families.7 The attention to mohel certification to guarantee circumcision safety began even earlier in the twentieth century, and so we must turn briefly to this history to understand the later insistence on sterile, surgical [End Page 323] conditions and mohel competency.8 To ensure infants' wellbeing, and to combat...