Last year, 21 boys bled to death after a botched circumcision ceremony in the Eastern Cape. They were members of the Xhosa ethnic group, where circumcision is performed as part of an elaborate ritual marking the coming of age of young men. The boys are removed from the general population and stay in specially made tents, where they are covered in white clay as a sign of separation from childhood. And the pain is intended to test the courage of the boys. In his autobiography Long Walk to Freedom Nelson Mandela recalls his own Xhosa initiation as he stood in line waiting for his turn, then came face to face with the circumciser:

“Without a word, he took my foreskin, pulled it forward, and then, in a single motion, brought down his assegai. I felt a if fire was shooting through my veins; the pain was so intense that I buried my chin in my chest… Then I recovered and called out, ‘Ndiyindoda!’ [I am a man]”

The operation is designed to be terrifying, according to anthropologist Nigel Barley, who spent months in Cameroon investigating the circumcision rites of the Dowayo tribe. “The boys are stripped naked at the crossroads and led to the riverside grove where the cutting is to be performed. On the way they are leapt upon by the circumcisers who are growling like hunting leopards and threatening them with knives.” Similarly gory ceremonies take place among the Merino of Madagascar as well as many Australian aboriginal tribes.

Since the Xhosa ceremony went so tragically wrong, demands have grown in South Africa for tighter regulations to control these initiation practices.

Rationalists, of course, tend to dismiss all forms of circumcison as yet another appalling cruelty enacted in the name of religion. But rather than merely shudder in disgust at the seemingly meaningless ritual cruelty, we need to understand why it remains such a persistent and universal phenomenon. Each year, approximately 100 thousand Jews are circumcised and 10 million Muslims. In parts of Africa where circumcision is a tribal custom, the number is around nine million. But there is no plausible explanation for its ubiquity.

“Circumcision is the oldest enigma in the history of surgery,” writes David L Gollaher in his exhaustive history of the subject. “It is far easier to imagine the impulse behind Neolithic cave painting than to guess what inspired the ancients to cut their genitals or the genitals of their young. Yet millennia ago, long before medicine and religion branched into separate streams of wisdom . . . cutting the foreskin of the penis was invented as a symbolic wound; thus circumcision became a ritual of extraordinary power.”

And what appears to be consistent among those who perform circumcision for religious or tribal reasons is that it is associated with the most profound human preoccupations: life and death; the relationship with nature and the supernatural; sex and procreation; survival and belonging.

Unlike African and aboriginal peoples, for whom it’s primarily an initiation into manhood, Jews regard it as a confirmation of identity. Babies are circumcised on the eighth day of life to seal the ancient covenant with God. Even so, as with many other tribal cultures, the spilling of blood and the excising of human flesh recall more radical forms of human sacrifice. Abraham’s circumcising of his son, after all, could be interpreted as a substitute for the infanticide he very nearly enacted.

Circumcision is also associated with fecundity. In many tribal cultures the foreskin itself is seen as a talisman of good fortune. Sometimes it is eaten by a relative, or even by its owner. Some aboriginal tribes would hide dried foreskins in secret spots invested with sacred energy. Among the Ait Yusi of Morocco it is given to the boy’s mother to hang in her tent. Persian women would swallow their sons’ foreskins to ensure fertility.

And the true nature of the Jewish contract with God, according to a number of Talmudic interpretations, is that circumcision will ensure plentiful progeny. There are several references in the Bible to the pruning of trees to make them more fruitful. The fruit of immature trees are even described as “foreskins”, and the trees themselves as “uncircumcised”.

It’s all very well to be fruitful and multiply, but that doesn’t mean you should enjoy the experience too much. Jewish commentators like the mediaeval scholar Maimonides thought that circumcision was also intended to reduce sexual pleasure so that men could be released from their physical selves into a more spiritual one-ness with God.

The sacred text, the Midrash, agreed that “the covenant of circumcision was therefore placed on the genitals so that the fear of God would restrain them from sin.”

While the Jewish tradition sees circumcision as the perfecting of man, making him whole in relation to God, early Christians believed that the removal of any part of the body must make it less than whole. At the same time, the new creed needed to justify abandoning the ritual, since Jesus himself was circumcised and his own foreskin held in awe as a holy relic.

The preferred explanation was that the traditional excision of the foreskin was made theologically redundant by the death of Christ. After the crucifixion, no more physical sacrifice would be necessary. These views were voiced most eloquently by Paul the Apostle, who called for circumcision “of the heart” rather than the flesh. Proselytising for the new religion, he was keenly aware of the significance of reversing the custom most associated with the Old Testament.

Inevitably, revulsion against circumcision became conflated with revulsion against those who practised it. For centuries, anti-semitism has been characterised by disgust at this most Jewish of rituals. Fear and hatred of them over centuries was directed at what the historian Frank Felsenstein described as “the perpetual stigma of the Jewish people in their self-inflicted Otherness”.

Throughout Europe, Jews were labelled as castrators, circumcisers and crucifiers. Indeed, Freud, who saw circumcision as a symbolic castration, suggested that it was at the root of anti-semitism, “for even in the nursery little boys hear that a Jew has something cut off his penis ... and this gives them to right to despise Jews.” And also, he argued, a reason to fear that the Jews may do the same to them.

Despite the centuries of pogroms and persecutions, Jews have tenaciously continued to circumcise. As Sartre pointed out in his celebrated essay on anti-semitism, they are defined by those around them and so must ensure their very existence by emphasising their difference. It was this insistence that made circumcision the ultimate sign of Jewish identity.

While there are millions more circumcised Muslims than Jews in the world, it’s not considered a crucial mark of Islamic belonging. They are instructed to do it by Mohammed but there are no set rituals. In the West, the operation is usually performed in hospital, and male converts to Islam are not expected to undergo the procedure as a test of their sincerity.

For Jews, though, it remains fundamental. The bris, the ceremony, is an occasion for feasting, the welcoming of a new recruit to the tribe. And that is why oppressive regimes seeking to convert or eliminate the Jews have systematically denied them the right to circumcise.

But with the dawning of the Enlightenment, a new perspective emerged. If Jews are oppressed because of their differences, then to abandon these ritual practices would liberate them. The 17th-century liberal philosopher Spinoza, who had been formally excommunicated from the Jewish community of Amsterdam for his anticipation of “the gradual and steady substitution of reason for superstition and science for religion”, thought that Jews should dispense with circumcision so that they could be integrated into an enlightened Europe where prejudice would be eradicated.

A century later, the French Revolution offered the opportunity and the rationale for the assimilation Spinoza proposed. In his study of circumcision, Marked in Your Flesh, Leonard B. Glick describes how radically this period of turmoil affected the position of Jews. The new State proclaimed that individual citizens were entitled to the same duties and privileges as everyone else. But there was no place for those who wished to maintain a separate identity.

The Jewish Reform movement which emerged in 1849 in Germany was a response to this questioning of established rituals and assumptions. Its leaders believed that circumcision was no longer needed and recommended that Jews should embrace the new secular world in order to flourish in it.

But it made little difference. Circumcision is just too deep-rooted for even the most unbelieving Jew to relinquish. Secularist Jews like me may gorge happily on a roasted hog, relish the forbidden sea taste of lobster and shrimp, eschew any thoughts of synagogue or godliness, marry out, enjoy football, buy retail... and yet still cling to that one final recognition of tribal heritage.

And, searching for a rational explanation for this most atavistic of choices, we will usually cite reasons of hygiene and health. Back in the mid-19th century we would have found support from the medical establishment, who began to recommend circumcision to cure or prevent every possible ailment from syphilis to bed-wetting. And they were so successful that it became accepted as standard procedure. In the 1960s more than 80 per cent of American men were circumcised. It’s still 60 per cent today. In Britain it was widely practised until the 1950s.

In his book A Surgical Temptation Robert Darby argues that the real motive of doctors who urged parents to circumcise their son was to curb the frowned-upon habit of masturbation in boys by removing the presumed cause.

Playing on fears of moral turpitude to convince parents of the efficacy of removing the “useless bit of flesh”, these physicians pointed to the example of the Jewish community, where, allegedly, masturbation was uncommon. Which may have come as a surprise to literature’s most celebrated onanist, Alexander Portnoy; and, by implication, to countless women who have not found a man’s sexual enjoyment to be impaired by the lack of a foreskin. Nor his performance.

In a contentious episode of Sex and The City – “Old Dogs, New Dicks” – Charlotte is so repulsed by her new lover’s foreskin that she refuses to have sex with him until he’s circumcised. After the operation he’s so delighted with his new sexual identity that he realises why women prefer it – and promptly leaves Charlotte for a life of opportunity.

There was a furious reaction from American men who felt that the male body was being objectified and trivialised. Most vocal of all were members of groups like The National Organisation of Restoring Men (NORM), “for men who have concerns about being circumcised, are considering foreskin restoration, or are in the process of restoring their foreskins”.

You can do this with a number of devices ranging from the very popular tape method, which stretches the skin to cover the glans, to more radical procedures like “tugging”, and the use of weights such as steel balls. This, apparently, helps to make men feel whole again.

But those testifying to the magical transformations wreaked by their false foreskins, not to mention their desolate sense of wretchedness at the loss of the real ones, do seem to make somewhat exaggerated claims, like this typical testimony from the NORM website:

“I can only describe the restoration process as a METAMORPHOSIS of body, mind, heart and soul. The changes to me as a person have been dramatic – I am not the same person as I was when I began this process. I have been given the opportunity to heal probably the largest wound in my life, a wound that up until a few months ago I never knew existed.” A recent contributor to BBC Radio 4’s “Beyond Belief” claimed that not a day went by when he did not mourn the loss of his foreskin, which he saw as the central agony of his life.

Militant members of the backlash brigade see their own sense of outrage and violation as no different from that of victims of female circumcision. But even those men who have participated in horrific mass rituals rarely suffer the debilitating symptoms of circumcised women, who after severely invasive cutting will for years afterwards experience chronic disorders: infection of the urinary tract, cysts, incontinence and pain during intercourse. To claim equal victimhood is as irrational as the practice the anti-circumcision campaigners so vociferously condemn.

Extremists are also keen to demolish any scientific or medical evidence which might challenge their beliefs. Over the past 50 years a series of studies has investigated the connections between circumcision and penile cancer, cervical cancer and more recently HIV. Most have been inconclusive, usually because the researchers have failed to take sufficient account of religious and cultural differences between the groups surveyed. And whenever a new piece of evidence is published, it is greeted by detractors with instant, vitriolic scorn.

But recent research has produced such overwhelming new evidence for the preventative benefits of circumcision that objections to earlier, similar findings are no longer viable. Two trials in Uganda and Kenya, whose results were published at the end of last year, showed that circumcision can cut the rate of HIV infection in heterosexual men by 50 per cent. Similar conclusions were reached in another recent report which evaluated the relationship between male circumcision and infectious diseases in 118 developing countries.

Unlike previous studies, this one did take into account religious and cultural behavioural differences. It demonstrated that male circumcision was strongly associated not only with a significant reduction in HIV cases among heterosexuals, but also with lower cervical cancer rates in women.

Nonetheless, these findings don’t offer much comfort for secularist circumcisers searching for reasons for our unreason. Despite the benefits, it is still perverse to use such an intrusive and brutal procedure as a preventative measure.

Perhaps we should instead accept Philip Roth’s explanation. In The Counterlife he argues that the purpose of the ritual is to introduce the newborn child to the harsh realities of an instinct-suppressing society. It is, says Roth, the first mark of belonging, a brutal awakening into necessary repression.

“Circumcision is everything that the pastoral is not and, to my mind, reinforces what the world is about, which isn’t strifeless unity. Quite convincingly, circumcision gives the lie to the womb-dream of life in the beautiful state of innocent prehistory, the appealing idyll of living “naturally”, unencumbered by man-made ritual.

“To be born is to lose all that. The heavy hand of human values falls upon you right at the start, marking your genitals as its own. Inasmuch as one invents one’s meanings, along with impersonating one’s selves, this is the meaning I propose for that rite.”

Circumcision is ultimately, as Roth says, “the very cornerstone of human irrationality, showing how little scepticism is worth up against a tribal taboo”. And yet, it also represents a savage kind of reality, repudiating romantic and misleading notions of childhood as a state of innocence in favour of a bleak but truthful fatalism.

It may be anachronistic, unnecessary and often cruel. But it is a massively powerful symbol of difference, heritage and tribal belonging, announcing the onset of the many knocks, betrayals, losses and cruelties which define the human condition. ■