The Covenant and Health

A fundamental principle in Judaism is that the commandments of the Torah are intended solely for the benefit of the person, not for the sake of the Creator or His own benefit. For the Creator is complete in every perfection and does not need anything from the human He created. As it is brought in the Midrash on the verse, “The word of the Lord is pure; He is a shield to all who take refuge in Him,” that “The word of the Lord” refers to the commandments God has spoken, and their purpose is “pure”—to purify and elevate the person, enabling them to enjoy the Divine in the World to Come. But even in this world, the commandments serve as “a shield for all who take refuge in Him,” protecting from various troubles and diseases. This is in addition to the high spiritual benefit inherent in every commandment for the one who fulfills it and for their environment.

Here is the wording of the Midrash:

"And does it matter to the Holy One, blessed be He, whether a person slaughters an animal and eats it, or whether he steals and eats? Does it benefit Him or harm Him? Or does it matter to Him whether one eats pure food or unclean food?

Solomon said, ‘If you have been wise, it has been for yourself!’ The commandments were given only to purify the creatures, Israel, as it says, ‘The word of the Lord is pure.’

Why? So that it shall be a shield for you, as it says, ‘He is a shield to all who take refuge in Him.’”

At first glance, the commandment of circumcision appeared in the past as a senseless commandment: How is it possible that for a person to enter a covenant with his Creator, he must undergo surgery on his body? And how does this align with the fundamental principle in Judaism that in every commandment there is great benefit for a person even in this world? Is it possible that removing a part of the human body could provide a health benefit or any other benefit?

In those days, no one imagined that there would come days when millions of people in the world would register and line up to merit to undergo circumcision, for health reasons, as happens nowadays.

Let us begin with a general overview of the health benefits of this important commandment, apart from the merit of fulfilling the commandment itself from a Jewish perspective.

Circumcision Worldwide

In the medical world, there is a growing consensus that performing circumcision on infants benefits their health in several important areas, and the benefit lasts throughout the circumcised individual's life.

Because circumcision is a process known for many generations and is performed on large segments of the population worldwide, there is abundant and accessible information about it.

The World Health Organization (WHO) reports that one in every three men worldwide is circumcised. In the U.S., more than 56% of newborns are circumcised. A 2011 survey showed that 88% of parents in the U.S. agree to circumcise their sons, and 96% of African American parents strongly believe that circumcision contributes to the child’s health. In the U.S. and the U.K., it was found that families with higher socioeconomic status tend more to circumcise their children. Although non-Jewish parents are also aware of the pain involved, they still circumcise their sons—a noteworthy fact. According to a study conducted in California among non-Jewish teenagers, some of whom were circumcised as infants and some not, most circumcised individuals expressed satisfaction with this fact.

The Covenant and Health

Numerous medical studies enumerating the benefits of circumcision have been published in recent years. Recognized organizations such as the U.S. Department of Health and the American Academy of Pediatrics have issued official statements to the public about the advantages of circumcision.

We summarize below the noted benefits:

• Reduction of risk for various diseases in the genital area, including cancer, AIDS, herpes, human papillomavirus (HPV), syphilis, and phimosis. The risk reduction reaches tens of percent, and for some diseases up to 98-100%!

• Reduction of risk for urinary tract infections (UTIs) in the first year of life. An uncircumcised infant has ten times (!) the risk of developing such infections compared to a circumcised infant. The damage to the infant’s delicate, developing kidney can be severe.

• More effective hygiene in the area and reduced risk of infections.

• Circumcision benefits the wife as well, reducing her risk of contracting various serious diseases and pregnancy complications.

Circumcision is also notable for preventing these diseases for life, unlike other measures whose effectiveness diminishes or disappears over time.

Recommended Age for Circumcision

There is a clear recommendation from many doctors to perform circumcision during infancy for the following reasons: When circumcision is done during infancy, complications are rare and usually minimal. In infants, the skin has the ability to heal quickly and without scars or marks.

It was also found that about ten percent of males not circumcised in infancy will need to undergo circumcision as adults for medical reasons. Circumcision in adulthood is medically more complicated, more expensive, and involves lost days of school or work. A broad study of approximately 15,000 people found that performing circumcision later in life increases costs tenfold.

And of course, it is worth mentioning the findings of Dr. James Armand Quick from Marquette University in Milwaukee, USA, regarding the uniqueness of the eighth day after birth, which is the most suitable day for performing circumcision because it is the day when blood clotting factors reach maximum maturity, as expanded upon in the first part of "The Turnaround," chapter "Day of Maturity of Blood Coagulation Factors."

To Opponents of Infant Circumcision Due to Pain or Other Reasons, We Respond:

Everyone agrees that mild and temporary pain that brings great benefit in the future is worthwhile by any measure. This is aside from the Divine commandment of circumcision, clear to every believer in God and the Torah.

Moreover, why do abortion supporters ignore that the fetus feels pain during abortion (at least in later stages)?

And to those who claim that infant circumcision denies ‘free choice’—how many adults would agree to undergo the painful birth process if it were left to their choice?

As is known, it is accepted worldwide that even invasive procedures such as vaccinations and dental treatments, which cause pain but are done for the health and welfare of infants and children, are not considered violations of the infant’s rights but rather benefits for them. Indeed, a parent who prevents these would be considered to harm the child’s right to health.

For a Jew, the primary consideration is, of course, fulfilling the Creator’s commandment in the Torah.

Health Benefits in Preventing AIDS

A particularly significant health benefit of circumcision has recently gained widespread publicity due to its effectiveness in preventing AIDS, a serious infectious disease that can cause death.

In a statement published by the WHO in 2007, it was reported that two comprehensive studies conducted in Kenya and Uganda showed that removal of the foreskin reduces the risk of HIV infection by at least 51-53%. (HIV = Human Immunodeficiency Virus, which causes the dreadful disease AIDS.)

Subsequent studies found even higher reductions—up to 73%—in infection rates among circumcised men, with protective effects increasing over time. It was found that the virus mainly resides in cells inside the foreskin, so its removal is a crucial factor in significantly lowering infection chances.

Based on these studies, the WHO and the UN AIDS program recommended that “male circumcision should be recognized as an effective tool to reduce HIV infection.”

Consequently, the WHO set a goal that by 2015, twenty million men would undergo circumcision. To achieve this, a media and educational campaign was launched, especially in African countries severely affected by the disease, urging boys and men to undergo circumcision surgery to reduce infection risk. Ministries of health in various countries, supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), UN agencies, the Bill and Melinda Gates Foundation, and many other organizations, joined the effort.

Immediately after the studies were published, international bodies reached out to the Israeli government and the Jerusalem AIDS Project Association for assistance. As part of the operation named “Operation Abraham,” nine Israeli delegations traveled to African and other countries to circumcise residents and train local medical teams. Each delegation was composed of mohelim (ritual circumcisers), doctors, and nurses, who gained extensive experience with adult circumcision during the large immigration wave from the former Soviet Union, as noted by Hannah Rosenberg, Chairwoman of the Jerusalem AIDS Project Association.

In a press interview, Rosenberg praised the King of Swaziland for his extensive awareness campaign, noting, “The population came in droves and stood in line. They were not afraid and understood it was important.” In Zimbabwe, 44 members of parliament underwent circumcision voluntarily in June 2012 to set an example for their countrymen about the importance of circumcision for disease prevention. At the International AIDS Conference in Washington in July 2012, then U.S. Secretary of State Hillary Clinton declared that combining male circumcision with proper medical treatment advances the vision of an AIDS-free generation.

The interviewer thus notes: “In the portion Lech Lecha in Genesis, God commanded Abraham, age 99, to perform the covenant of circumcision for the first time to symbolize the connection between the Jewish people and their God. Thousands of years later, the World Health Organization declares that male circumcision is also a medical tool effective in combating AIDS, one of the most severe diseases challenging humanity in recent decades.”

The Deeper Meaning

It is worth noting that contrary to the shallow understanding that circumcision detracts from the completeness of the human body, it actually restores it to completeness. As long as a person lives with the foreskin, he is considered an incomplete being—a vessel whose creation is not yet complete. Conceptually, this can be compared to food containers today that are not suitable for use unless the plastic seal connecting the lid to the container is removed. Once the seal is removed, the vessel becomes whole and suitable for use.

This is the depth of the debate between the great Tanna Rabbi Akiva and the Roman Turnosaropus, as brought in the Midrash:

"Turnosaropus the wicked asked Rabbi Akiva: Which deeds are more beautiful, those of the Holy One, blessed be He, or of flesh and blood? He answered: Those of flesh and blood are more beautiful...

He asked: Why do you perform circumcision?

He answered: I knew you would say that, so I first said that the deeds of flesh and blood are more beautiful than those of the Holy One.

[Rabbi Akiva wished to illustrate:] Bring me ears of grain and pastries.

He said: These are the deeds of the Holy One, and those are the deeds of flesh and blood. Are they not beautiful?

Bring me flax fibers and garments from Beit She’an.

He said: These are the deeds of the Holy One, and those are the deeds of flesh and blood. Are they not beautiful?

Turnosaropus said: Since He desires circumcision, why is a newborn not born circumcised?

Rabbi Akiva replied: Why is the umbilical cord left attached? According to your reasoning, you wouldn’t cut the umbilical cord!

Why is he not born circumcised? Because the Holy One, blessed be He, gave the commandments not to the purpose of punishment but to purify. Therefore David said, ‘The word of the Lord is pure; He is a shield to all who take refuge in Him.’”