Doctors Weigh In as Voters Mull Circumcision Ban

Bay Area medical professionals and clerics have mobilized against attempts by a local anti-circumcision group to enact a citywide ban against the practice. If activists have their way in municipal elections this November, when voters will be asked to vote on the measure, circumcision of a boy under the age of 18 years of age for religious reasons would be classified as a misdemeanor and punishable by up to a year in jail and a $1,000 fine.

On Wednesday, S. Francisco’s Board of Elections approved a petition to place the issue on the ballot. Rabbi Yosef Langer, director of Chabad-Lubavitch of S. Francisco, expressed dismay that there’s even a question as to the propriety of what for many is a central religious requirement.

“This is a tradition not only practiced by Jews, but by Muslims and members of secular society,” stated Langer. “The Jewish people and spiritually conscious people all over the world will certainly – and have always – risen to the occasion so that justice, and the will of the Almighty, will prevail.”

Legal experts have weighed in on the case, with many asserting the ban, if passed, would infringe upon parents’ First Amendment rights guaranteeing freedom of religion. Ritual circumcision of an eight-day-old boy, known in Hebrew as brit milah, is an essential tenet of Jewish law.

But by criminalizing the procedure, the ban could also have far-reaching medical consequences: Urologists point to decreased rates of urinary tract infections among circumcised infant and toddler boys, penile cancer, and some sexually transmitted infections, such as gonorrhea, herpes, HPV and HIV.

Consequently, the local Jewish Community Relations Council and Anti-Defamation League have joined with other religious groups and doctors in combating the proposed ban.

“One of the big issues is that S. Francisco is supposed to be a bastion of tolerance,” said Dr. Brian McBeth, Assistant Clinical Professor of Emergency Medicine at the University of California, S. Francisco. “[A ban on circumcision] will likely send a negative message to advocates of religious freedom.”

“The JCRC and the entire Jewish community is united in this fight,” said Rabbi Shlomo Zarchi, rabbi at Congregation Chevra Thilim, the oldest Orthodox synagogue in S. Francisco, and a member of the committee spearheading the grassroots campaign against the ban. “We’re looking at this in a multi-pronged and mobilizing the entire faith-based community.”

One overarching concern of area doctors is that the initiative would undermine a parent’s right to consult a physician prior to making a decision on behalf of his or her child’s health.

“Newborn circumcision is something that should be decided between the parent and physician after a clear discussion of medical benefits,” asserted Dr. Stephen Harris, chairman of the department of pediatrics at the S. Clara Valley Medical Center and president of the local chapter of the American Academy of Pediatrics. “Writing legislation to interfere with the doctor patient relationship runs counter to the American Academy of Pediatrics policy statement which states that ‘existing scientific evidence demonstrates potential medical benefits of newborn male circumcision.’ ”

According to Harris, the reduced risk of urinary tract infections makes the strongest case for newborn circumcision, where the risk dwindles from about 1 in 100 boys to 1 in 1000 boys during the first year of life.

And a report by the federal Centers for Disease Control determined that “male circumcision significantly reduces the risk of HIV acquisition,” while the World Health Organization backed the procedure as an important tool in the fight against HIV.

“Given the overwhelming medical and public health evidence in favor of male circumcision,” said Dr. Mark Glasser, retired chief of obstetrics and gynecology at the Kaiser Permanente Medical Center in S. Rafel, Calif., “I find it hard to believe that the medically-sophisticated S. Francisco community would believe the nonsense that [anti-circumcision groups] have been spouting for the past 25 years.”

The goal is not to advocate circumcision for everyone, Harris pointed out, but to uphold the rights of those who do make a conscientious choice to circumcise their newborn sons.

“People who are doing it for ritual reasons are doing it with a clear mind about why they are doing it,” said Harris. “The point is not to recommend universal circumcision, but the bottom line is there are medical benefits to the practice.”