A deadly ritual

If you want to understand just how religious authoritarianism harms children, look no further than the actions of a powerful group of rabbis in New York known as Agudath Israel. AI is a Jewish communal organization that represents the most conservative Jewish believers, Haredi or ultra-Orthodox Jews.

These rabbis are seeking to sue the City of New York after the health department announced it would adopt a measure that requires parents to sign a written consent form warning them of the dangers of a circumcision ritual called metzitzah b’peh. (The policy was just passed.) If you have not heard of metzitzah b’peh, brace yourself: It involves the sucking of the bleeding penis by the circumcising rabbi or mohel.

The practice of metzitzah b’peh was added to the Jewish circumcision ritual known as brit milah around 500 CE. Originally, it was believed to prevent infection by drawing blood from the wound. Fast forward to today and you find that Haredim commonly practice metzitzah b’peh, and authorities allow it. This is confounding because in just about every other segment of society, such an act would be considered sexual abuse. What’s more, the ritual has led to babies dying or suffering brain damage after contracting the herpes simplex I virus.

Neonatal herpes infections of all kinds are nearly always fatal in infants. An investigation by the New York City Board of Health found that, in the last decade, an average of one baby per year who underwent metzitzah b’peh contracted the virus. Two of the infants died, and two suffered brain damage.

“This is a ritual. . . that’s come down through the ages, and now it has met modern science,” the chair of preventive medicine at Vanderbilt University told ABC News. “It’s certainly not something any of us recommend in the modern infection-control era,” he said.

Not surprisingly, AI proclaimed that, in passing the parental consent policy, New York health officials are impeding on religious freedom, indicating that the religious leaders know more about infectious diseases than doctors. In a statement signed by 200 haredi rabbis, the group accused the health department of “spreading lies” and that participating in the “evil plans” of the department is forbidden by the Torah.

Dr. Jonathan Zenilman

Most people would be shocked that religious leaders would support such a disgusting and potentially deadly practice. In a letter he wrote to Mayor Michael Bloomberg, Johns Hopkins Bayview Medical Center infectious disease specialist Dr. Jonathan Zenilman wrote that the AI is “doing a terrible disservice to the Jewish Community and the public at large.”

But as I have repeatedly pointed out, such disregard for children’s rights is part and parcel of religious authoritarian cultures like the Haredim. Members of this segment of the Jewish population consider their belief system to be the one, true faith, and they are convinced that all other believers, including other Jews, are spiritually inferior. In addition, the Haredim manifest the three perfect-storm characteristics of a religious authoritarian culture: They have a strict, social hierarchy; they are unusually fearful; and they are socially separatist.

As I continue to reiterate, the way religious authoritarianism harms children is through the parents—or, rather, through parental impotence. In religious authoritarian cultures, parents lack autonomy in how to raise their children. Instead, they rely on—or are forced to adopt—child-rearing practices that fail to attend to children’s physical and emotional needs. In fact, the New York health department has received numerous complaints from parents whose mohels went so far as to perform metzitzhah b’peh on their babies without their consent.

It stands to reason that the powerful rabbis of Agudath Israel don’t want parents to be informed about the dangers of metzitzah b’peh, even though it puts children at risk for death or being left permanently disabled. Instead, these men prefer to leave mothers and fathers in the dark, where they will remain powerless to make critical decisions in their children’s lives.


  1. Love the article but there’s one mistake: Metzitzah b’peh is not thousands of years old. It was added to the brit milah (Jewish circumcision ritual) in the Talmudic Period (500-650 AD). But I’m just appalled that these people have no respect for human life. They are willing to kill children because they don’t want to stop putting boys’ penises in their mouths for money.

    • Jai,
      I appreciate the correction and will alter the text so it’s accurate. But why is it that rabbis who support this ritual often refer to it as being thousands of years old? http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritual.html?_r=0 “The Orthodox Jewish community will continue the practice that has been practiced for over 5,000 years,” Rabbi David Niederman of the United Jewish Organization in Williamsburg, Brooklyn, said at the time. “‘We do not change. And we will not change.”
      Please set us straight on this and thank you again for your contribution,

      • I honestly have no idea why Rabbi Niederman is claiming any of the things he’s claiming in that statement. He either has no clue about Jewish history, which I find hard to believe considering he’s a rabbi, or he’s outright lying. First off, Judaism has not been practiced for over 5,000 years. Judaism rose out of combination of polytheistic Canaanite religion and Zoroastrianism and didn’t become monotheistic until much later. Unless you count the history of the Ancient Israelite faith prior to introduction of monotheism, it doesn’t come close to 5,000 years. He’s also wrong in claiming Judaism doesn’t change. The brit milah became the brit peri’ah around 140 CE, when Jews began removing all of the foreskin and the frenulum in an effort to prevent epispasm (foreskin restoration) among Jewish men. So, neither metzitzah b’peh nor the current brit milah are the original circumcision ritual mentioned in the Torah. Judaism also has the rule of “pikuach nefesh,” which allows a Jew to break any mitzvah in order to preserve human life. For example, if you are starving and all you have to eat is pork, you may eat pork to keep yourself alive. Metzitzah b’peh transmitting disease is nothing new; it was documented as transmitting tuberculosis from mohel to child as early as 1883 and by 1916, there were forty two such cases and at least sixteen resulted in the death of a child. Applying the logic of pikuach nefesh, it would be required to abandon the practice of metzitzah b’peh because it places both child and mohel at risk of death due to disease transmission. On a related note about circumcision and religion, the Quran does not mention circumcision, much less require it.

        • This is fascinating history. I talk about how circumcision became a more and more severe procedure over time in my book. Sadly, the blindly legalistic and pious will only want to see things their way, but there is a lot we can do to educate those who are willing to use critical thinking and recognize that children have the right to a body that is not permanently altered without their consent. Thanks again for this information.

  2. Why is no one referring to this as RAPE? If any other adult did this to a baby boy, one would hope Child Protective Services would be called and the offender would be arrested and put on a sex offender registry! Is it because it is a boy that people refuse to see the sexual trauma in this?

    • Laurie,
      It never fails to astound me what behaviors people accept if those behaviors are infused with religious belief and tradition.

    • It’s not the same thing, circumcision is far WORSE than rape. See, when you’re raped, people understand that it was wrong; they won’t mock you for complaining about being abused; no one will say that rape is a sacred tradition that must be respected; and, in the end, you usually still have a complete set of genitals.

      • Stormwatch,

        With all due respect, I don’t see how anyone can compare rape and circumcision in such a general way. Contrary to what you say, many rape victims still are “mocked” for what they have suffered. This is especially true for male victims. If anything, I see a similarity between how victims of rape and circumcision (male and female) feel. Both commonly describe it as a violation.


  3. Hi,

    I am pursuing a master’s degree in public administration and have been following this issue closely as I am writing my thesis about the practice as it relates to NYC’s recently passed proposal that parents sign a consent form prior to this procedure. As I understand metzitzah (suction), it is the third part of the three-part circumcision ritual. In the days before scientific understanding and infection control, it was believed that saliva was sterile and that metzitzah b’peh (suction by mouth) was of benefit to the infant. Obviously, that is not the case and all but the most ultra-Orthodox now use other methods for suction — either a glass pipette or gauze, both of which draw blood away from the wound without putting the baby at risk of infection.

    Hope this information is helpful.

    • Thanks for this contribution, Jane.

    • You’re mistaken about the reason for metzitzah and/or metzitzah b’peh (suction and/or oral suction). First of all, because there was no understanding of germs or disease transmission essentially until the beginning of the 19th century, the reason for metzitzah b’peh had absolutely nothing to do with saliva being sterile. If you look at what was state-of-the art Greco-Roman medicine 1800 years ago, you’ll see that it was based on a theory of bodily “humors.” One of those humours was blood. Based on Hippocrates, Galen, the preeminent physician of his time, believed that the blood of a wound that was allowed to stagnate could turn into pus as a result. To prevent that, suction of some kind had to used in order to draw blood from the furthest areas of the body to the wound. That is the reason for metzitzah. Read Shlomo Sprecher’s paper on metzitzah b’peh for source citations, etc. You can also see the material I’ve published ( http://failedmessiah.typepad.com/failed_messiahcom/circumcision_controversy/ ), which includes a history of disease transmitted by metzitzah b’peh and a history of metzitzah in Jewish law and practice,

  4. Christopher Fletcher MD says:

    In the late 19th and early 20th century there were attempts to ban metzitzah b’peh in NYC because of the transmission of syphilis and tuberculosis from dirty mouths from oral sucking by mohelim. Substituting a glass tube for the lips/mouth/tongue of the mohel was apparently an acceptable alternnative. To more modern folks it would be obvious that oral hygiene back then was not close to that of today in terms of dental infections, gum disease, etc. Did people even go to dentists? Today those diseases are extremely rarely transmitted to infants but neonatal herpes is a disaster waiting to happen since the infant’s immune system is not primed to be able to fight that infection. Any kind of behaviour like that performed by a physician would be an automatic ticket to de-licensing and an unwinnable malpractice case. What gives these ultra-orthodox believers rights that no one else has?

    It seems incredulous that anyone, outside of the insulated descendants of some backwards villagers in eastern Europe, would consider sucking a newborn’s penis until it stops bleeding to be anything other than disgusting, perverted, neonatal rape, etc. Would anyone tolerate similar behaviour practiced on a newborn female?
    The American Academy of Pediatrics, in its recently revised statement and irrational zeal to have every American male circumcised, should be front and center defending their clients (babies) from these archaic and sickening rituals.

    With the recent stories on PBS and other media of hundreds of young Jewish men “coming out” in New York and openly accusing their rabbinical mentors of secret sexual molestation during their religious upbringing and training, it does not take a genius to see the close connections between the potentially deadly ritual of metzitzah b’peh on an unwilling and innocent baby boy and eventual full-scale molestation of those babies as they mature into teenagers and young men. If similar rituals existed in Islam or Christianity there would certainly have been much stronger legal actions by the general public, much less the health authorities. The ultra-orthodox sexual abuse scandals are beginning to look too much like the Catholic Church sexual abuse scandals.

  5. If America continues to engage in RIC, we at least need to acknowledge that it’s a medical procedure to be performed in a sterile environment. A man’s mouth has no place on an infant’s genitals. I don’t care if the tradition is five hundred or thousands of years old. And if we can agree that this part of the tradition is outdated, maybe one day we’ll agree that the entire tradition of circumcision is outdated. Fingers crossed.

  6. While metzitzah or metzitzah b’peh is terrible enough, I’m alarmed that we are still referring to male genital mutilation as acceptable – without metzitzah or metzitzah b’peh. We like to sanitize it with the more acceptable term “circumcision.” And some like to give it an air of legitimacy by claiming we are attacking religion by attacking this practice. But the bottom line is that it mutilates a male’s genitals without his consent. I believe the same practice on females is outlawed in most civilized countries.

    • Thank you for sharing this, Brian. As those who have read my book know, I believe it is hypocritical and irrational for Americans to be horrified by female genital cutting while finding male genital cutting to be acceptable, even healthy. This perception exists despite the fact that proponents of the female procedure give many of the same reasons to justify that practice as do proponents of the male procedure and that some female procedures are more mild than the complete removal of the foreskin, such as in cases where the clitoral hood is pricked. I believe that, even though many Americans vociferously want to continue cutting male infants, the practice will wane along with the physical punishment of children.

      Despite all the justifications given for male genital cutting, the most common reason people do it is for the simple reason that it is customary, just as Chinese girls had their feet painfully broken for hundreds of years and African boys continue to undergo painful initiation rites. But the reverse is also true: As more people refuse to carry out the ritual of MGC, the easier it will be for others to do the same.

      Best regards,

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