We Asked a Mohel About Changing Attitudes Toward Circumcision

In 1979, two thirds of newborn boys in Western US states were circumcised, but rates of circumcision plunged in the ensuing years. In 2010, 58 percent of newborn boys underwent the procedure. That number might be on its way further down as well, because there's a whole grassroots movement aimed at changing what we (in the US, at least) consider normal.

Intact America is the group formed in 2008 by so-called "intactivists," aimed at shifting the norm away from the procedure. They were at perhaps their most active earlier this year when a woman in Florida named Heather Hironimus, took the case to save her son's foreskin all the way to Federal Court (and lost.)

But while the cultural consensus on circumcision is changing, there might be nothing more change-averse in the world than Jewish tradition. The Old Testament couldn't be clearer about what you do to a new baby boy: "On the eighth day the flesh of his foreskin shall be circumcised." So for 3,700 years or so that's been the Jewish way to go, with very few exceptions. Most Jews really aren't the people to talk to about shifting a norm, because we don't do it to be normal; we do it to be Jewish.

Still, tragic, circumcision-related deaths among certain Orthodox communities in the US have pulled Jews into the debate about foreskins. During the ceremony rabbis at the center of the debate put their mouths on babies penises, and risk giving them fatal herpes. Personally, I don't know any Jews who do that, or even approve of it, but upon reflection it's a little weird that we nonetheless let religious functionaries perform a life-changing medical procedure. Just what exactly are these non-doctors doing to all these baby penises? And where do they stand on intactivism?

To find out, I chatted with the popular Los Angeles-based Rabbi Meir Sultan, who works as a full-time mohel (which is the Hebrew word for "ceremonial foreskin-slicer.") Sultan, who has developed an impressive reputation for someone who is only 32-years-old, was kind enough to pull back the tallit and let us know how a modern bris goes down. Rabbi Sultan is a pretty colorful speaker, and when he wasn't sticking up for his very specific technique, he filled me in on what's been happening in the foreskin business lately. The conversation has been edited for brevity and clarity.

VICE: Hi Rabbi Sultan! How do you perform a circumcision?
Rabbi Meir Sultan: I happen to have a very different technique from other mohels in the city. What I do is that I have a special bandage which I call the "wonder bandage." It's a bandage which we wrap around the penis following the circumcision, and it clots the wound within a matter of two to three minutes.

How's that different from other methods?
Well, you see, there are a few different methods that you can go about getting a circumcision: You're either going to go through the clamping system—now there are clamping instruments that are used, whether it's the Mogen clamps, the Gomco clamp, or the plastibell. These are all types of clamps that grab on to the foreskin and clamp on it hard enough that it stops the blood circulation.

Oh my…
Until you get the blood circulation to stop. It takes a good couple of minutes. A couple of minutes for a baby is an eternity. So it's a cleaner job. There's a little less blood, which is why doctors like to use these types of instruments. That's one way of going at it. And then you close the wound up right away, you don't need much of a bandage. The other way of doing it is doing it the traditional way and, you know, using a shield. After you remove the foreskin, you place a bandage and then the mohel comes back 24 or 48 hours later and removes the bandage.

And that's not good?
The problem with that is that I've found, often times, babies who end up with a bandage for 24 to 48 hours are more susceptible to UTIs—urinary tract infections. If the bandage just sits there, it gets dirty, and it can attract bacteria, and that's an infection. So, you know, I've never liked the clamping system because I've found it too painful for the baby.

So what do you do?
I use this method where I actually apply some anesthetics to the area. Very strong topical anesthetics. I don't inject because injecting is a lot more painful. But I apply very strong topical anesthetics so the baby doesn't feel anything. I place a shield in between the foreskin and the penis, and I remove that which I feel is necessary to remove. Right after that, I apply pressure with my wonder bandage for a matter of two to three minutes, and when I remove my wonder bandage, the wound is completely closed up and there is no more bleeding anymore, miraculously.

What's your wonder bandage?
There are different types of bandages which can help. I usually leave it at "it's my wonder bandage." And when people ask me, I say, "Well listen. The chef never gives out his secret recipe!"

How'd you develop this method?
Well, I'll tell you what. I grew up in a family of circumcisers. My dad was a rabbi and a circumciser for 45 years. So I lived it and I breathed it. I saw the way my dad did circumcisions, and he used to use a clamp, and I was never a fan of it. So as soon as I found an alternative, I said "OK, let's go." I tried it, it worked, and boom, I went along with it.

Do you also have a medical background?
Well, I studied in Israel. I was a mohel in the hospital over there. And then I furthered my studies in England where I made sure to get a lot more exposure to botched circumcision, and adult circumcision. So that's where I furthered my studies. But am I a doctor per se? No, I am not a doctor.

Can you tell me about studying botched circumcision?
I get probably, every week, one to two phone calls about botched circumcision. Now what is a botched circumcision? Basically, usually the phone calls I get is that the doctor or the OB did not remove enough foreskin—that's usually what I end up getting. Then you have just circumcisions that just don't look nice. They're circumcised, but they don't look nice. Just aesthetically, they're very ugly. And I explain to the parents…I say, "Listen, your child is circumcised. He very much is, but, you know, it's an art, and you have to know how to cut right and measure right. And there needs [to be] just a little bit of trimming because there's thick skin," or whatever it is. I mean, you know, you've got to do this job but you've got to do it right. Often times, you'll have a lot of medical professionals who will just do the job very quickly—very, very quickly. And that's the result. If you do it very quickly and you're not a perfectionist, chances are it's not going to come out so nice.

What were the botched circumcisions you studied in England like?
For example, we got this call when I was studying there. It was this child whose penis hole closed up. No, not completely, because that's obviously dangerous. But it had closed up a fair amount. It was minutely open. And that was an interesting experience, learning how to open up the pee-hole, which really has nothing to do with the circumcision whatsoever. But usually, for a child who's circumcised, they'll always come back to the one who circumcised them, and anything that's wrong in that area of the body, they'll always return to the mohel or to the doctor.

How would that happen?
Now, that baby in particular… The way that his penis was sitting on his diaper or the position, it sort of put two skins together for a long time and held those two skins together so that it eventually closed a nice part of the penile hole. So we had to open it up a little bit.

Has anything ever gone wrong with your circumcisions?
I tell parents that it's really important—as part of my aftercare instructions—to make sure to change the baby's diaper every two hours, which is when you pee, is why. Because when you pee, the diaper gets heavy and gets tighter, and around the frenulum area, it's a lot more sensitive. So if his penis is going to rub against a tight diaper, it'll create a blister—a big, fat, ugly blister. And I tell them, "Be very careful." […] And when they see that blister, they're not looking at a blister. They're looking at, in their eyes, a circumcision which went completely wrong.

Do you study the attributes of each penis in advance?
No, everything is a surprise. I see the baby for the first time when I'm going to circumcise him. There has been times that I've shown up to a circumcision and the baby was completely circumcised, and I don't know why the parents never told me. But, you know, I told them, "Listen, there isn't much work for me." There have been times where I've showed up and the baby was half-circumcised already, which is a little more complicated—but you know, you've got to do it.

Why would a child be half-circumcised?
Well that's how they're born. You know, babies are born in many different shapes and forms. Big penises, small penises, a lot of foreskin, and maybe not that much foreskin. It just depends on the baby.

So, size of the penis manifests itself that early in the life of the infant?Absolutely. You never know how much it'll grow. But definitely at that age, small, big, absolutely.

Is there misinformation out there?
I asked [a group of intactivists in Venice Beach], "Well, what is it about circumcision that bothers you so much?" And all they could really say was the following two things. Number one: you're taking away from their sexual pleasure—which, by the way, is arguable. There are many adults who will tell me after you circumcise them that their sexual life is actually a lot better now that they're circumcised. (Note: The Intact America website provides a longer list of reasons)

And the second reason?
The second reason [they gave] is trauma. It causes trauma to the baby. You know, long-lasting, psychological repercussions […] What I said back to them at the time was, "You know, there's so much child sex slavery happening right now, trafficking in third world countries. There are people who are adults who are suffering as we speak […] Do you not think that that is a lot more of a serious issue to address than to assume and presume that there are psychological repercussions to people getting circumcised?" So I say back, "You know, why don't you do your studies as well to women who have gotten their ears pierced? Maybe they are also traumatized from that and it leads to psychological trauma as well later on in life." [Note: Baby ear piercing is also controversial.]

Is it something that you recommend necessarily across the board?
Oh, absolutely not! I'll tell you what. I once met this cop [who] asked me what did I do for a living and I told him that I'm a mohel. He asked what is that, and I told him. He said "That's so funny," because he actually had this argument with his wife—one believes that their child, which they're going to be having in a few months, should be circumcised, and the other one believes he shouldn't be.

Were they Jewish?
Both this cop and his wife are not Jewish. He asked me, "What do you think?" I said, "although the CDC came out with that official diagnosis, so to speak, that the positives override the negatives (Note: The CDC issued a proposal for a possible recommendation late last year), […] if you ask me my personal opinion, I say absolutely not." I'm Jewish. The reason why we circumcise—and there are a lot of medical advantages to circumcising—but the reason why we circumcise is not because of that. The reason why Jewish people have been circumcising at 3,700 years and continue to circumcise is because of this real deep relationship that we have with God that sets us apart.

What would you say to Heather Hironimus? Her boyfriend took her all the way to Federal court over their son's circumcision.
In these types of things, who am I to recommend? I'll tell you personally what I told this cop: "If this is what you're fighting with your wife over, let go!" There are plenty of people who are not circumcised and live a very fine, long life, and are just as healthy as people who are circumcised. I don't think that a medical study is a reason to fight over it. A deep religious reason? I can see why there would be so much tension.

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Note: In a previous version, the introductory statistic about Western US states incorrectly referred to Western countries.