Sexual Surgery

Long before people rationalized sexual surgery on medical grounds, they rationalized it on religious grounds. Indeed, the idea that the sexual organs ought to be surgically altered runs through all of history. Because the genitals (as well as certain other body parts, especially the face) have symbolic meaning, and because culture rests on symbolic interactions, human beings are easily led to believe that, in their natural state, the sexual organs and powers are not in their proper form and hence ought to be enhanced or diminished by means of artifacts or surgical interventions.

The earliest historical example of sexual surgery is circumcision. According to the Old Testament, its origin and meaning are as follows:

And God said unto Abraham...That is my covenant, which you shall keep between me and you and thy seed after thee. Every man child among you shall be circumcised. And ye shall circumcise the flesh of your foreskin; and it shall be a token of the covenant betwixt me and you...And the uncircumcised man child whose flesh of his foreskin is not circumcised, that soul shall be cut off from his people; he hath broken my covenant.

The Bible thus tells the story of the ancient Israelites making a bargain with their god: the jews give Jehovah their foreskins, in return for which Jehovah gives them preferred nation status. Mutilation of the penis becomes a badge of identity--the mark, according to the Jews, of their being God's Chosen People. Since subsequently the Christians and the Muslims have also claimed, perhaps even more successfully, that they, and they alone, are God's favorite children, this operation must be deemed a failure.

The ancient Israelites seemed to have been decidedly preoccupied with foreskins--viewing the severed flesh of the penis as a trophy, much as headhunters view the severed head:

And Saul said, Thus shall ye say to David, the king desireth not any dowry, but a hundred foreskins of the Philistines...Wherefore David arose and went...and slew of the Philistines two hundred men; and David brought their foreskins, and they gave them in full tale to the king, that he might be the king's son in law.

Despite this biblical passage, most people--Jews and non-Jews alike--continue to believe that ritual circumcision is evidence of the ancient Hebrews' sophisticated concern with genital hygiene. However, such a view is inconsistent with the fact that Jewish law requires the circumcision of dead infants:

An infant who dies before circumcision, whether within the eight days or thereafter, must be circumcised at the grave, in order to remove the foreskin which is a disgrace to him...If he was buried without circumcision, and they (his parents) become aware of it immediately, when there is no likelihood that the body has already begun to decompose, the grave should be opened and the circumcision should be performed. But if they have become aware of it after some days, the grave should not be opened.

If Asclepius is the archetypal physician, then surely Abraham is the archetypal sex-surgeon. He is well enough known for having invented and popularized circumcision. (Actually, circumcision was practiced by the Egyptians, from whom the Jews had copied it. Routine post-natal circumcision remains the most widely performed surgery on American males, despite the fact that the procedure is hazardous and lacks any medical justification. If performed on infants under one year of age, there is significant bleeding in 15 percent of circumcisions, and serious bleeding, sometime requiring transfusion, in 2 percent. One neonatal circumcision in 6,000 results in the death of the infant. About 1,325,000 newborn American males are circumcised annually and about 230 of them die as a result of the operation. The annual cost to the consumer of this massive sexual-surgical mayhem is estimated to be around $54 million.)

Although the Christians gave up circumcision, their attitude toward the penis was decidedly less friendly than that of the Jews had been. Believing that sexual desire was itself an evil, the early Christians were ready to assist their aspirations toward asceticism by means of autocastration. In the Gospel according to Matthew, extravagant praise is heaped upon men who have made themselves eunuchs for the kingdom of heaven's sake. (Some biblical scholars interpret eunuch metaphorically, to mean simply a man who renounces marriage in favor of celibacy.).

So much for some early examples of sexual surgery. Let us now skip the next eighteen centuries--replete with such practices as castration, infibulation, clitoridectomy, and the use of the chastity belt--and turn to a review of modern sexual surgery.

Throughout the nineteenth century, the most common and most feared sexual disease was masturbatory insanity. According to Henry Maudsley, who was the foremost psychiatrist of his age, the prognosis for this disease was hopeless. The sooner he (the masturbator) sinks to his degraded rest, he wrote in 1867, the better for the world which is well rid of him. Since Maudsley believed that the disease was incurable, he offered no remedy for it. Many other physicians, however, thought that it was curable by means ofsexual surgery.

The treatment of masturbation by means of surgery reached its apogee, as might be expected, when the patient had only a clitoris. According to the conventional medical wisdom of the late nineteenth century, it was irrelevant to a woman's feelings whether she had sex organs or not. While (male) doctors could never quite convince themselves or the public that the proper treatment for male masturbation was penectomy, they did convince themselves and at least some women that the proper treatment for female masturbation was clitoridectomy. The credit for this discovery belongs to Isaac Baker Brown, a prominent London surgeon who later became the president of the Medical Society of London. He introduced the operation of clitoridectomy around 1858, because he believed that masturbation caused hysteria, epilepsy, and convulsive diseases. One woman who had been castrated for the sexual perversion of masturbation wrote back to her castrator to report: My condition is all I could desire. I know and feel that I am well; I never think of self-abuse; it is foreign and distasteful to me.

Even as late as 1900, masturbation was still considered to justify the following surgical procedure:

The prepuce is drawn well forward, the left forefinger inserted within it down to the root of the glans, and a nickelplated safety pin introduced from the outside through the skin and mucous membrane is passed horizontally for half an inch or so past the tip of the left finger and then brought out through the mucous membrane and skin so as to fasten from the outside. Another pin is similarly fixed on the opposite side of the prepuce. With the foreskin looped up, any attempt at erection causes painful dragging on the pins, and masturbation is effectually prevented. In about a week some ulceration of the mucous membrane will allow greater movement and will cause less pain; then the pins can, if needful, be introduced in a new place, but the patient is already convinced that masturbation is not necessary to his existence, and a moral as well as a material victory has been gained.

How docilely people then accepted such brutal medical interventions, and how docilely they still accept similar barbarities. Then, the quacks claimed that masturbation was pathological--and proved it by torturing the masturbator and calling it treatment. Now they insist that masturbation is healthful--and prove it by inventing the disease of masturbatory orgasmic inadequacy.

Since masturbation was principally a male disease, the fury of anti-masturbatory surgery was vented mainly on men. For women there awaited sexual operations undreamt of in medically less advanced times. The most important--because it was the most widely practiced--of these procedures was the removal of both normal ovaries, known eponymically as Battey's operation, so named after Robert Battey, the American surgeon who developed it in 1872. During the next three decades this procedure was performed on thousands of women, in the United States as well as in Europe.

Consistent with this intensely interpersonal (rather than individualistic) view of the sex act, Jewish law strictly forbids masturbation. The practice is condemned unequivocally both in the Talmud and in extra-Talmudic literature. The Zohar calls masturbation a sin more serious than all the sins of the Torah. jewish exegetes interpret the act as murder and say that the guilty person deserves death. Although this was rhetorical hyperbole rather than an actual demand for execution, it is nevertheless indicative of the Jewish condemnation of sexual self-gratification. This prohibition rests, of course, on the view that the masturbator destroys his generative seed and thus commits an act not unlike murder.

Jewish law went further still. It regarded even involuntary (nocturnal) emissions as partly sinful, because it did not consider the man a helpless, innocent victim in every case. Taking into account the obvious connection between sexual stimulation during the day and subsequent seminal emission at night, the Jewish law commanded men to avoid such stimulation--a prohibition that went so far as to forbid touching one's penis: The law definitely prohibits touching one's genitals--the unmarried man never, and the married man only in connection with urination. This is why, among orthodox Jews, one of the most important aspects of bladder training is to admonish the boy not to finger his penis: Without hands! is the admonitory cry of a parent seeing his or her son attempting to pass water with digital aid. Better a bad aim than a bad habit!

Psychologically, the Jewish religious prohibition against touching one's penis symbolizes that the male sexual organ belongs to the Jewish God. Theologically, the Jewish religious prescription of circumcision symbolizes the covenant between Yahveh and Abraham (and all Jews). These two sets of practices are clearly connected: only the circumcised male can urinate without touching his penis--the uncircumcised male having to pull back the foreskin. Jewish ritual circumcision is a necessary complement to the Jewish religious prohibition against touching one'spenis.

The Christian moral premise--that chastity is the supreme sexual- ethical virtue, and that all sexual pleasure is wicked--entailed a significant downgrading of marriage from the position it occupied in Judaism. Although marriage later became a Christian sacrament, the early Christians ranked matrimony far below celibacy, as Roman Catholics still do (hence the required celibacy of their priests and nuns). The most novel feature of Christianity lay, indeed, in identifying chastity--that is, abstinence from sexual acts and pleasure of all kinds--as a virtue, and in elevating it above all other virtues. In fact, the Greeks, like all primitive (non-Christian) people, had no special word for chastity. When the Church Fathers, who wrote in Greek, spoke of the new Christian virtue, they employed the term agneia--which means a rite of aversion or mourning--and extended it to cover this new idea.

The religious requirement of chastity set a moral standard to which few, if any, human beings could adhere; and that failure in turn served admirably to confirm the image of mankind as innately wicked. Since sex was considered sinful, how did the early Christians accept and then even sanctify marriage? By an ingenious chain of rationalizations: they maintained that the pleasurable satisfaction of lust was a grave sin, even in marriage, but argued that marriage was a permissible arrangement because it was a remedy against sin that led to producing more virgins to worship Jesus. Thus, they remained hostile to matrimony, viewing it in terms that resemble the language of contemporary critics of this institution. In his classic study, Sexual Relations in Christian Thought, Derrick Bailey documents how the Church Fathers continued to regard matrimony as a concession to the inordinate desires of fallen humanity, calling marriage a sad tragedy and a galling burden, servitude and an oppressive bondage.

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