A Surgical Temptation: The Demonization of the Foreskin and the Rise of Circumcision in Britain (review)

Four years ago, the US Agency for International Development released a report indicating that circumcised men were less likely than uncircumcised men to get HIV/AIDS. Three years later, another report indicated that circumcision significantly reduced female to male transmission of the virus.

These recent assessments of circumcision by scientists make the publication of Robert Darby’s work especially timely. In A Surgical Temptation: The Demonization of the Foreskin and the Rise of Circumcision in Britain, Darby traces the rise and decline of circumcision in the United Kingdom and other Anglophone nations. Arguing that routine circumcision developed from “a general emphasis on sanitary, preventive and surgical approaches to disease control and health maximization,” (317). Darby asserts that both old Galenic theories of medicine and newer theories which prioritized surgery merged to cause what he calls “the sudden vogue for male circumcision in Victorian Britain,” (1). Additional factors shaping this new surgical trend were the emergence of stricter codes of sexual morality, a growing interest in preventative medicine, and, even, a decline in anti-Semitism.

A Surgical Temptation is a well-researched book, with Darby delving deeply into the medical and social literature on this subject and presenting this material in a concise and clear manner. The book is best as a survey of secondary literature on the topic of Victorian views of sexuality. Darby’s own research into this subject is, as he himself admits, weakened by his reliance on printed sources.

The book is organized thematically with the first three chapters exploring pre-Victorian notions of male sexuality and rising concerns regarding masturbation. Chapters four and five explore the ways in which changes in sexual morality, attitudes toward the body, and understanding of disease led to a growing acceptance of circumcision. According to Darby, many Victorians came to view circumcision favorably because they believed that the practice served as preventative against various diseases. However, the widespread belief that circumcision limited masturbation provided advocates of the practice with a much needed supplemental argument for their belief that circumcision should be widely adopted. In chapters six through twelve, Darby discusses the pathologization of male sexuality and the medical profession’s promotion of circumcision as a form of behavior modification as well as a means of disease prevention and health promotion.

Throughout A Surgical Temptation, Darby makes no secret of his own views on circumcision, claiming that while he seeks to understand the Victorian doctors who advocated this procedure, he also intends to “judge them...[as there must be] a moral accounting,” (21). Unfortunately, in making this work an activist history, Darby unintentionally undermines some of his own excellent research. References to “loony doctors” and claims that surgeons declared “open season on” male genitals, (142) for example, indirectly weaken his argument by making his work appear less balanced. While criticisms of Victorian doctors are valid and to be expected, these criticisms should be couched in more nuanced tones.

Also lacking in balance is Darby’s discussion of female circumcision. Darby does state that male and female circumcision are quite different. However, by including a discussion of female circumcision within his study of male circumcision, he often veers dangerously close to equating the two practices.

These problems aside, Darby’s discussion of the failure of circumcision to become universal in Britain (in contrast to the United States) is provocative. Pointing out that circumcision was often limited to the upper and professional classes, Darby makes a convincing argument that this practice never became as widespread in Britain as physicians and moralists may have hoped. The reasons for this are varied. However, the contrast between the circumcised and uncircumcised and the fact that the circumcised were always a minority in British society undoubtedly led to a dislike of this procedure.

By the 1950s, as concerns about masturbation began to lessen, physicians ceased to advocate circumcision. This, combined with medical experts’ growing understanding of...