Losing them, fixing them, forgetting to put them in
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I was raised in a family of four girls. When my sisters and I are together, we speak a private language composed largely of different pitches of laughter that causes our exasperated father to demand to know what’s so funny. I am most at home when I am sharing clothes, secrets, and a bathroom with other women. So when I became pregnant for the second time, I looked forward to giving my four-year-old daughter a sister. I was not expecting our ultrasound technician to hand me a small black-and-white picture of a baby with a tiny penis. I squinted at the hazy image and brought it close to my face. I turned it sideways and reexamined it in the bright light of the hospital corridor. There was no doubt about it: I was carrying a boy. Until that moment, I had felt like a babushka doll, hiding within me a smaller version of myself. I had imagined tiny ovaries growing next to my own, a tiny womb somewhere inside of mine. It was difficult for me to conceive of a little penis growing in my belly.
A few months later, my husband, Ismail, and I invited a friend to dinner who casually asked us if we intended to have our son circumcised. To me the answer was obvious. We had just prepared a detailed birth plan with our midwife, outlining a strategy to cushion our son’s transition into this world: the lights in the birthing room would be low; my baby would rest on my chest immediately after birth; he would stay with us at all times in the hospital. Why would we go to such lengths to minimize trauma and then subject him to a painful and unnecessary procedure? As I shook my head, I was astonished to see Ismail nodding affirmatively on the other side of the table. It had never occurred to me that he might have a different opinion, though it should have: he’d spent the first half of his life in Libya and been raised according to Muslim traditions.
As a young man, Ismail had left North Africa to come to the United States, where he’d reinvented himself. He’d cast off the outward signs of his background — the style of dress, the diet, the language — and transformed himself from a traditional North African Muslim into a progressive middle-class American. He relished his new freedom to openly date women, to jog down the street in running shorts, to protest the government. But some traditions can’t be discarded as easily as a wardrobe or a cuisine. Not even Ismail knew that circumcision was in his blood until he discovered he had fathered a son.
My husband had already rejected any aspects of Muslim culture that felt archaic and oppressive to him. When we visited his family in Libya, Ismail was distressed by the ways patriarchal traditions constrained his four sisters. He had explosive arguments with his father in which he defended his sisters’ right to choose their own husbands — and then, years later, he admonished those husbands to help their wives with the household duties. While the rest of the men sat waiting to be served, Ismail insisted on working side by side in the kitchen with the women in his family.
He was skeptical about the oppressive aspects of American culture as well: debt, for example, which he feared would make him an indentured servant to large financial institutions. He objected to American standards of feminine beauty, which encouraged women to develop eating disorders or have plastic surgery to conform to the culture’s unrealistic expectations. He refused to be defined by his job, and he struggled to maintain a balance among work, home, and community. Given all of this, I found his position on circumcision as nonsensical as the thought that he would demand a dowry for our daughter on her wedding day.
After our guest had left, I asked Ismail why he wanted his son to be circumcised. He was unable to provide a clear explanation. My practical husband, the scientist who trusted reason more than intuition, was still inexplicably tethered to this particular tradition from his past.
Ismail believes that the truth is verifiable and that disputes can be resolved by studying the facts. When we disagree, he often prefaces his strongest argument with the phrase “The bottom line is . . .” He says these four words with absolute confidence, as if he were standing on rock-solid ground. I find his certainty maddening, because to me the truth is not solid, but more of a liquid: it slips easily through my fingers, reflects the light in different ways, and takes the shape of the countless perspectives that try to contain it. Because he likes to back up his arguments with data, Ismail will often conclude with “I’ll send you some links.” The next day he’ll e-mail me his online sources, which are, to his mind, indisputable.
In my efforts to protect our unborn son’s penis, I borrowed his strategy and made Internet research my first line of defense. I printed stacks of articles about the drawbacks of circumcision for Ismail to read, confident that once I’d educated him, he would change his mind. He piled these articles by his bedside and read them one by one, his brow furrowed. Still he insisted that his son be circumcised. In his native language, circumcision is called tahara, which means “purification.” Muslims view the procedure as a way to follow in the footsteps of the Prophet Mohammed; it is both an honor and a rite of passage. No scientific study or public-health message could change Ismail’s mind. Neither could my argument that he was no longer a traditional Muslim, having discarded many other customs from his past. The best explanation he could provide was that circumcision is what men in his family did, and that he needed his son to be a part of that lineage. He made me feel that if I prevented the procedure, I would be breaking one of his last and most important connections to his heritage.
Part of me wanted to honor my husband’s wishes. Over the course of our marriage, Ismail had accepted many of my idiosyncrasies: my difficulty with apologies, my desire to sit down and write rather than clean house, my need to disappear alone into the woods to clear my head. He didn’t ask me to back up these behaviors with data. Instead he watched our daughter when I disappeared. He cleaned while I wrote. And when I returned, rather than waiting for the apologies he deserved, he broke the tension by reaching for my hand. He honored my most urgent and inexplicable desires, the ones I couldn’t dress up in tidy intellectual arguments. He accepted me in spite of the fact that I confounded him. I felt I should be able to do the same for him. But I also wanted to protect our son.
Ismail and I were in couple’s therapy at the time. One day, as we were walking out the door after a session in which we hadn’t discussed this topic, I offhandedly asked our secular Jewish therapist if he’d had his own sons circumcised. “Of course,” he said without hesitation. Like my husband, he could not provide a clear explanation for why he had done so, though he did offer that the circumcised penis was more “attractive.” He and my husband nodded knowingly at each other. Ismail and I had spent many hours in this therapist’s office trying to reduce the unnecessary suffering we brought on ourselves and those we loved. Now this man, so adept at analyzing the subtle ways in which we caused each other pain — our tone of voice, our choice of words, our avoidance — spoke as if cutting away the most sensitive part of a baby’s body made perfect sense and required no further consideration.
At the end of one of my last prenatal visits, just after my midwife had finished measuring my mountainous belly, I asked if she knew where I could get my son circumcised. I may as well have asked her for a cigarette. She stared at me long and hard, as if she suddenly didn’t recognize me. Then she began to tell me in slow, measured tones that the procedure was not medically necessary. She pointed out that it was no longer covered by some insurance policies, and that by the time my son was in high school, more than half of his peers would be uncut. She talked about hygiene and sexual satisfaction. She even told me about support groups for men who mourned the loss of their foreskins, and about kits men purchased on the Internet to help regrow them. She asked me to consider this decision very carefully.
Nothing could have prepared me for the sight of my newborn son naked, his penis curled like an inchworm on the bright red apple of his swollen scrotum. The skin of his genitals was glistening and raw and appeared so paper thin that I worried it would tear at the lightest touch. It seemed to me like a defect: such vulnerable organs exposed rather than shielded beneath muscle and bone. For the first few days I avoided touching these parts of him entirely.
But before long I became intimate with the male body in a way I never had been before. As a young woman I’d regarded men’s bodies as a dangerous neighborhood I rushed through in the dark, heart pounding, eyes closed tight. Once, in my early twenties, after I’d had a lover for several months, I’d caught sight of his penis in the morning light and gasped in alarm. “You’re not circumcised — I can’t believe it!” He’d replied with equal alarm, “And I can’t believe it took you so many months to discover that!”
With my newborn son, Khalil, I got to know the male body as something vulnerable and precious. In the soft sunlight that flooded his bedroom in the morning, I stripped him naked and gently cleaned him, lingering over the task, focused and deliberate. I was falling in love with his soft apricot ears; his tiny red toes; his sweet, milky scent; and, yes, his penis. Intoxicated by a mother’s love, I saw every part of him as perfect. One day, sitting in a cafe with Khalil curled against my chest, I had an epiphany. Each man in this room was once this small and pure, I thought. My eyes grew damp as I looked around: at the barista pouting over the espresso machine, his faded jeans slung low on his hips; at the elderly man in the corner hunched over a newspaper; at the gregarious college boys clustered at the next table. I felt a surge of tenderness toward them all, a desire to cradle each of them to my breast.
My arguments with Ismail about circumcision were the only dark shadow in the dazzling early weeks of Khalil’s life. Our discussions unsettled me; it was as if our ancestors had invaded our home with their unwelcome advice. Normally compassionate and open-minded, Ismail became like a stranger to me, a stubborn patriarch. When I offered what I thought were compelling reasons to forgo circumcision — the trauma, the risk, the unnecessary violation of our son’s body — he stared blankly at me, as if I were speaking a foreign language. Up against hundreds of years of Muslim tradition, my arguments felt flimsy and disposable, like cheap plastic up against concrete. I was being worn down. Inside my head I heard the voices of my own ancestors, especially the women in my family, whispering that there was no other option than to submit to his male authority, that it was my role as wife to honor his will.
One day a mother on the playground told me that her two sons had been circumcised by a wonderful Jewish doctor who had come to their home, used anesthesia, and allowed the father to hold their baby during the brief procedure. She said that he was very skillful. “In fact,” she added confidentially, with a touch of pride, “several doctors have commented to me about what a good job he did.” She wandered off to push her child on a swing, leaving me to wonder what an exceptionally well-circumcised penis looks like.
I was encouraged by the fact that the procedure could be done in our own home and that my son would not be strapped onto a “circumcision board,” a restraint I’d seen pictures of online that looked like a neonatal torture device. So I called the doctor the woman at the playground had recommended. With brisk professionalism, he asked whether my son was Jewish, then explained that he performed house calls only for Jewish babies. He transferred me to his receptionist so that she could schedule an office visit.
Sitting on hold, cradling the phone between my cheek and my shoulder, I looked at the baby nursing at my breast. Khalil was too young and soft and tender to belong to any religion. He was all of them. But I was exhausted by this conflict that had hovered over my marriage for months. I wanted to accept Ismail as he had always accepted me. And I needed to put this discord behind us. If this was going to be done, I wanted it done quickly. When I was connected with the receptionist, I made the first available appointment.
The doctor’s office was located in a complex that also housed a tax accountant and a real-estate broker. We arrived early, and I paced the waiting room, holding my newborn son to me. A receptionist with heavy pink lip gloss smiled sweetly and reassured me in a soft Southern accent that my baby would be “just faaahn.” On the wall behind her hung a framed picture of George W. Bush, along with an inscription thanking the doctor for his contributions to the Republican Party. In the movies, bad things happen in dark, shadowy places and are accompanied by ominous music and skewed camera angles, but in real life suffering is often perpetuated in comfortable locales like that quiet waiting room, with its plush, color-coordinated furniture and soft music.
When the nurse called my son’s name, I handed him to his father. I was able to give my permission for him to be cut, but not to be there with him while it happened. I sat on a small chair in the hallway, sobbing into my hands when I heard Khalil scream (in response to the injection of anesthetic, I later found out). I wanted to rip the pictures off the walls; to howl at the receptionist, who smiled blandly at me from her station; to claw my way through the door to the examining room. My heart pounded against my ribs, and I gasped raggedly for air. It felt as if I sat doubled over in that seat for a very long time, but the procedure lasted less than five minutes.
After it was over, when I heard my husband call my name, I rushed into the room — a histrionic and tardy savior — and grabbed my son from Ismail. I cradled Khalil in my arms and offered him my breast, wanting him to believe I was not responsible for his pain. For a brief time, my relationship with my son had consisted of an unadulterated flow of love and nourishment. With this first betrayal, I planted our relationship firmly on this earth; on the rich, dark soil of ambiguity, mystery, and loss. My husband and the doctor tried to reassure me that the procedure had gone well, but I pushed right past them. I didn’t hear what the receptionist said to me as I fled the office with Khalil, as if I could run fast enough to slip back into the past. My husband called out to me to wait for him at the elevator, but I was already halfway down the stairs.
Khalil fell into a deep sleep as soon as we pulled out of the parking lot, and we drove home in silence. Our son’s foreskin was wrapped in a piece of gauze and tucked into Ismail’s shirt pocket. Though I had felt angry on the way to the clinic, I felt only raw on the way home, overwhelmed with grief and a crazy desire to somehow fold my baby back into my body. At home I curled around him in bed while my husband knelt beneath the young fig tree in our garden, said a prayer, and buried the foreskin in the earth.
Two years later, thumbing through a magazine while Khalil stacked Legos next to me, I came across a short article condemning circumcision. The author explained that by tickling both circumcised and uncircumcised infants on the penis and gauging the intensity of their laughter, scientists had determined that the circumcised penis is less sensitive than the uncircumcised one. As I read this, my chest began to tighten. Later that evening, after our children were in bed, I showed the article to my husband. We sat out on our porch in silence, watching the night fall and cloak our home in shadows. After a while he told me he wished he had approached the decision in a more rational way; he wished he had been able to listen to me better.
I didn’t respond. Instead I sat looking out into the darkness and thinking of all the parents who’d come before us, the ones who’d done the best they could, never knowing which choices would come back to haunt them: The mothers who’d smoked and drunk during their pregnancies, not knowing the risks involved. The fathers who’d encouraged their sons to join the army, not knowing that a war was already brewing. The parents who’d stayed in bad marriages for the sake of their children, only to have the children later resent them for having done so. We do the best we can, never knowing which choices our children will find most unfathomable, most difficult to forgive.
I imagined the scientists who had conducted the circumcision study saying with conviction, “The bottom line is . . . circumcision diminishes sensitivity in the penis.” Science stakes such a confident claim on the truth, like the proverbial blind man who gropes the elephant’s trunk and concludes that the animal resembles a snake. I thought about how much I’d hated being tickled as a child, even as I’d laughed uncontrollably. I thought about my own sensitivities, which have brought me equal measures of joy and pain. I thought about the way my circumcised husband’s face crumples with pleasure during lovemaking, and the warm tears of joy I sometimes feel on his cheeks afterward. Can the quality of our sexual experiences really be reduced to the number of neurons that fire when our genitals are stimulated? Lovemaking doesn’t conform well to scientific research. It is a churning storm of sensuality and spirit that defies our attempts to categorize or contain it.
My instinct tells me that my son’s circumcision was painful and unnecessary — and I have learned that, in the unique culture of our family, my instincts are worth at least as much as hundreds of years of tradition. But I don’t believe those who would claim my son was permanently scarred by his circumcision any more than I believe those who say he is profoundly bonded to me because I gave birth to him naturally. I don’t believe that he’ll have a less fulfilling sex life because of his circumcision any more than I believe, as some claim, that he will have an educational advantage because he was breast-fed for two years.
As a mother I have become intimate with paradox. I know that there is nothing I can do to guarantee my children’s security, even though the desire to do so shapes so many of my decisions. So I try to let go of the past and trust in the human capacity for resilience. I watch my son run through our house, laughter bubbling out of him like a fast-running creek, and I know that he is intact. He has lost a part of himself, and yet he is whole.
Krista Bremer’s essay on circumcision, “The First Cut” [February 2008], resonated strongly with me. I gave birth to my only child, a son, in the winter of 2000. I had done extensive research on circumcision and learned that, from a medical standpoint, it’s rarely necessary, and that uncircumcised penises are as unhygienic as ears and feet. My ex preferred to have it done, but with seven months of pregnancy hormones coursing through my veins, I put my index finger to his nose and said sharply, “If you even think of cutting my baby, your throat will be next.”
Needless to say, my son, who is now almost eight, remains uncut. He is not an oddity. His pediatrician informed me that he sees more and more uncut boys these days.
Ironically, my staunchest supporter turned out to be my former mother-in-law. On most fronts, she and I never saw eye to eye, so I was shocked when she said she’d felt circumcision was wrong ever since my ex had been taken from her for the procedure and she’d heard him screaming down the hall. She’d wanted to leave her other boys uncircumcised, but it hadn’t been an option in her day. “Good for you for saying no,” she told me.
I read with dismay the heartfelt but clearly slanted article by Krista Bremer about circumcising her infant son. As a Jewish mother of a boy, I too was very anxious about circumcision. All the male relatives in our family were circumcised, so my husband and I were pretty much committed to the procedure. Yet I read everything I could about it.
Here are some important facts Bremer did not mention: Boys who are not circumcised have a 400 percent greater risk of recurrent bladder and kidney infections in early childhood. Eighty-five percent of women surveyed said they would not have oral sex with a man who is not circumcised. Circumcision is a first defense against the transmission of several STDs, most notably human papillomavirus and other viruses — including HIV — that have serious long-term effects. Women who sleep exclusively with circumcised men have uterine-cancer rates almost as low as celibate nuns. And only uncircumcised men can develop penile cancer.
My own son cried for only a few seconds after the surgery. It was a quick procedure that appeared much less frightening for him than the prick of his heel for a blood test earlier that week. I’m surprised that in her “thorough search of the Internet” Bremer did not turn up a more balanced picture of male circumcision.
As a family physician, I am disappointed that you chose to publish the letter by Ruth Lambert [Correspondence, June 2008] in response to Krista Bremer’s essay about the decision to circumcise her son [“The First Cut,” February 2008]. Lambert made numerous inaccurate, unsupported, or controversial medical claims about circumcision.
Regarding urinary-tract infections: Circumcision does reduce the rate of UTIs in newborn boys, but approximately two hundred circumcisions are needed to prevent one UTI, which is almost always a benign and easily treated infection; more than 2,500 circumcisions are needed to prevent one case affecting the kidneys.
Regarding STDs: It is wildly inappropriate to claim that “Circumcision is a first defense against the transmission of several STDs.” The first defenses are safe-sex practices, such as using condoms and limiting one’s number of partners. Most studies that suggest a protective effect of circumcision were done in high-risk populations. There has never been a well-designed study proving that newborn circumcision in average-risk populations provides significant benefit, and some studies suggest an increased risk of certain STDs, such as chlamydia, with circumcision.
Regarding uterine cancer: There is no connection between uterine cancer and circumcision. There have been several studies of cervical cancer and circumcision, which is probably what Lambert intended to say. But women who sleep with only circumcised men are not at all immune to cervical cancer, as the significant rate of cervical cancer in the U.S. demonstrates.
Regarding penile cancer: It is a myth that only intact men get the disease, which is exceedingly rare even in countries where circumcision is not practiced. Penile cancer is even rarer in circumcised men, but it’s nonsensical to amputate healthy genital tissue in newborns to prevent a rare cancer in elderly men.
Regarding the pain and risks of the procedure: Having now performed or witnessed more than a hundred circumcisions, I can report that, even with the use of local anesthesia (which has only recently become routine), it is often traumatic. Studies show newborns have marked physiological changes after circumcision, including abnormal sleep-wave patterns, increased levels of cortisol (a stress hormone), and abnormal vital signs. And circumcision trauma interferes with breast-feeding in some cases.
As a physician I don’t believe circumcision should be performed on infants when it is not medically indicated. Adult men can choose to be circumcised if they are concerned about the preferences of women, are planning to be sexually promiscuous in an HIV-endemic country, or feel it is necessary for their religious beliefs.
It was difficult for me to write about my son’s circumcision — and equally difficult to read some of the letters I received in response. My intention for this essay was not to rationalize the decision my husband and I made, nor to advance an argument. Rather, I wanted to explore the dynamics of my marriage, the role of ancient tradition in a modern context, and the ways our histories haunt our present. Parents face countless hard choices — whether to immunize their children, whom to entrust with their care, when to grant them freedom — and I’m interested in how we find peace with the choices we’ve made and with our fallibility as parents.
I was surprised by the normally levelheaded Krista Bremer’s misleading attempt to justify her husband Ismail’s circumcision of their son. Contrary to Bremer’s suggestion, her son, having lost his foreskin, is by definition no longer “intact.”
Why did Ismail, who rejected virtually all other trappings of his Muslim religion, nevertheless insist on cutting his newborn son? Why forcibly mark his boy with a sign of his religion when the son may turn out to be as freethinking as his father and move even farther away from Islam?
Circumcision amputates functional tissue serving three critical functions: immunological (helps defend the body against infection), protective (safeguards the glans and the rest of the penis), and erogenous. Yet circumcision continues to be the most common surgical operation performed on males in this country, and the only procedure performed on children without medical justification.