Circumcision

On July 1st, 17 U.S. states will drop Medicaid coverage of circumcision as part of budget-cutting measures. However, other forms of insurance may still cover the procedure, or families may opt to pay out-of-pocket to cover the expenses. Dropping circumcision coverage comes at a time when movements against the procedure are gaining steam.

A bill banning routine circumcision was introduced in Massachusetts last year, and some other states have similar bills in the works. Circumcision bans have been proposed in municipalities such as Santa Monica and San Francisco. In the November elections, these cities may make circumcision a crime.

Historically, the United States is one of the most circumcision-friendly nations in the world. According to the World Health Organization, circumcision is the most commonly performed medical procedure on American children. It estimates that 75% of men in the United States are circumcised, while only 30% of Canadian men and 6% of UK males are circumcised. Many Americans pursue circumcision as a matter of social custom and/or religious belief. There is a general cultural perception that uncircumcised boys and men face ridicule from peers and mates, and that being uncircumcised is less hygienic.

On the other hand, opponents to circumcision claim that it is a procedure with no real medical justification and that infants are not able to give informed consent for the procedure. At the least, they would have males wait until the age of consent. However, some doctors point out that adult circumcision is a more complicated, expensive, and trying process. Some studies have shown that circumcision slightly reduces incidence of urinary tract infections in infant boys, and that it slightly decreases HIV and other STD transmission in sub-Saharan Africa, but as with any medical procedure, complications such as bleeding and infection from circumcision can occur. The most extreme anti-circumcision activists tend to equate male circumcision with female genital mutilation (FGM), which is commonly illegal and culturally held as a heinous and repugnant practice.

The Jewish Anti-Defamation League (ADL) considers legislative efforts to ban circumcision a violation of free exercise of religion and considers the efforts to be a form of anti-Semitism. In Jewish tradition, the reasons for circumcision are stated in the Torah and relate to a covenant between Abraham and God. In Genesis 17:1-14 the covenant is mentioned, and Abraham is commanded to "circumcise the flesh of your foreskin, as a sign of the covenant between Me and you. At the age of eight days, you shall circumcise every male child born to you throughout the generations."

Circumcision is not mentioned in the Qur'an, but is mentioned in hadith, although rather sparsely. Some hadith indicate that all prophets were born circumcised. One tradition on circumcision mentioned in Shia sources is from Imam Ja'far Sadiq (as), with a nearly identical tradition related from the Prophet (saw): “Do the circumcision of your child on the seventh day of his birth. This is best for him. It is also beneficial for his proper growth and upbringing. Certainly, the earth abhors the urine of the person who has not been circumcised".(Wasail al-shiah, v15, p. 171) Another tradition, from Imam Muhammad Al-Baqir (a.s.) has said: "I asked Abu Ja'far (a.s) about a bondwoman that was captured from the land of polytheism and there was no woman to circumcise her. The Imam said: "The Sunna recommended the circumcision of men and not of women." (quoted from fatwa of Sayyid Fadlullah) As for female circumcision, other hadith are more ambiguous or even apparently recommending it, but scholars have spoken out against female genital mutilation, referring to a saying attributed to the Prophet (saw) that if female circumcision is practiced, it is necessary not to wear out and do not mutilate. The general stance toward female circumcision is that if it does not cause harm and is not required by Shariah, then it is a matter of personal choice, but if it causes harm then it is prohibited. This general guideline applies to male circumcision also, but it is more commonly considered that male circumcision is required by Shariah, or at least strongly recommended.

Practices vary as to the age at which circumcision is usually performed and whether it is considered required. Among the four Sunni schools of thought, Shafis consider it wajib, Hanafis consider it mustahab, and Malikis and Hanbalis consider it ja'iz (allowed, but not recommended for or against). The reason for male circumcision in Muslim tradition is generally considered to be honoring of the covenant between Abraham and God and is thus related with the hajj rites. Many Muslim scholars consider circumcision a prerequisite for performance of hajj by an adult discerning male.

The matter of declining insurance coverage of circumcision likely cannot be construed as stemming from the anti-circumcision movement, but it may reflect a gradual change in cultural sentiment around circumcision in the United States that can be bolstered by declining budgets and vocal anti-circumcision activism. If bans of circumcision gain ground, Muslims may join Jews in concern over religious freedom and may question if motivations lie in anti-Muslim sentiment, just as the ADL is now crying anti-Semitism. At this time, anti-circumcision movements are generally motivated on opinion of cruelty to perform a painful and perhaps medically unnecessary procedure on a child who cannot consent, with anti-religion themes as prominent side-issues. However, people must constantly be alert to threats and erosions of freedoms regardless of their origins, and must educate themselves on the issues and make themselves prepared to self-advocate, because freedom has a way of disappearing when left untended.