By Elizabeth Reis

The previously obscure ultra-Orthodox Jewish rite of metzitzah b’peh (oral suction) has burst into the news lately and raised critical questions about genital surgery, consent, First Amendment rights, tradition, and the representation of Jews.

I would guess that most Americans, even Jewish-Americans, had never heard of metzitzah b’peh (oral suction) until the recent controversy between ultra-Orthodox Jews and the New York City Department of Health and Mental Hygiene. It refers to a custom performed after a circumcision in which a mohel (ritual circumciser) orally sucks the blood away from the baby boy’s penis. To insure the requirement that blood be shed and then hygienically removed (sucking was deemed the best means of achieving this hygiene anciently), metzitzah b’peh became part of circumcisions in the 2ndcentury, according to scholars. Most Jews, even observant Modern Orthodox Jews, have abandoned the practice. But a small minority adheres to and defends it, based on the First Amendment – somewhat surprisingly now on free speech grounds in addition to its religious liberty provisions.