It's no longer just a medical debate. A small but growing number of Jewish parents are questioning why they should circumcise their sons - and are deciding to reject a fundamental tenet of their faith

Toronto - Growing up in Victoria, Alana Moon went to Jewish school, attended synagogue most Saturdays and celebrated the Sabbath.

But when her son, Amani, was born, Ms. Moon couldn't rationalize the idea of making her newborn go through elective surgery. She refused to have him circumcised - and joined a small but growing number of Jews who are rejecting an ancient, fundamental tenet of their faith.

In recent decades, circumcision rates have plummeted in hospitals across Canada, largely because of the medical consensus that the practice doesn't have the health benefits once believed. Increasingly vocal members of the anti-circumcision lobby, who say the process is unnecessary and barbaric, have also played a role.

Now, a Jewish wing has joined their ranks, including a small number of scholars and rabbis, support groups and websites. They point out that a circumcised penis isn't required to make someone Jewish, even according to Orthodox law. An alternative bris ceremony, minus the surgery, is gaining ground among Jews opposed to circumcision.

A small pocket of Jewish boys are now growing up with their foreskins intact - a trend many Jews find troubling. Parents who make the radical choice not to circumcise face such huge social and familial pressure, many refuse to talk about it or tell their friends.

"There's that whole thing, are you loyal to the faith? Are you loyal to the tribe?" says a Toronto mother who, like many contacted for this story, asked to remain anonymous.

For more than 3,000 years, eight-day-old Jewish boys have been circumcised in brit milah ceremonies (also known as a bris). The practice, according to Jewish law, symbolizes their connection to God. Opting out plays into a broader concern: that the Judaic religion is disappearing because of the rise in interfaith marriages and assimilation into North American culture.

"Circumcision is important for Jews not just of the past, but of the future," says Aubie Diamond, a Toronto family doctor and mohel (a Jewish person trained to perform ritual circumcisions) for the past 25 years. "Without it, I think we would eventually disappear. It's a tie that binds, literally, worldwide."

Pressure from family and the Jewish community to circumcise can be immense, says Eva Goldfinger, a Toronto humanistic rabbi, part of a progressive strain of Judaism that claims 50,000 members worldwide.

Parents fear that their uncircumcised sons will be outed, so to speak, at camp or in the school locker room - and then shunned or ridiculed.

Ms. Goldfinger says more couples have sought out her counselling in recent years over whether or not to circumcise their sons.

"Some people are just investigating the idea of it," she says. "Some feel strongly about it. Then, they tell their parents and their parents have a hissy fit."

Like many Jewish parents, Ms. Moon's mother, Sharon Kobrinsky, hoped to see her grandson circumcised - in her case, for health reasons. But she didn't try to dissuade her daughter, who had already made the unconventional decision to give birth to her two children at home.

"My daughter is a really strong-minded individual," says Ms. Kobrinsky, a Jewish leader in Victoria.

Her grandson, Amani, is now 7. "I think he's going to thank me when he's older," Ms. Moon says.

Others are more conflicted when making their decision. The Toronto mother who requested anonymity and said the issue is often framed as one of loyalty to the tribe says that when she was pregnant she and her non-Jewish husband consulted five rabbis, two mohels, a family therapist and many books in an attempt to decide whether to circumcise.

She says she was raised as a reform Jew and felt torn between her faith and her gut, which told her not to circumcise her son, now 3.

"It was an alienating experience, definitely, as a Jew," she says.

In the end she chose not to, basing her decision on medical evidence.

That made her part of a larger Canadian trend. In the 1950s, 60s and 70s, almost every Canadian boy was circumcised for the perceived health and hygiene benefits. Since then, those health benefits have been mostly debunked and the pendulum has swung the other way.

In the past 10 years, the rate of circumcision performed on boys born in Canadian hospitals has dropped to 6.7 per cent from 14 per cent, according to the Canadian Institute for Health Information. Routine circumcisions are now discouraged by both the Canadian Paediatric Society and its U.S. equivalent, the American Academy of Pediatrics, because they say it's not medically necessary.

Both organizations have maintained that position despite major studies released earlier this year showing that circumcision lowers the risk of HIV infection.

This medical debate influences Jewish couples with newborn sons, says Jacob Langer, head of pediatric general surgery at the Hospital for Sick Children in Toronto, who also performs 30 circumcisions annually as a mohel. "When faith and belief and ritual collide with modern medicine and popular thought, you always end up with these ripples."

One of the main objections to circumcision - pain - has played a role in the rise of an alternative ceremony (even though most circumcisions today are performed using anesthetic). Brit shalom is practised among Jews primarily in the United States. It allows parents to give their sons children their Hebrew name - an important part of the traditional bris - but without the snip.

Each year, Ms. Goldfinger performs a similar ceremony for about a dozen families, most in the Greater Toronto Area.

"The belief among Jews that all Jews are circumcised has been shattered," says Ronald Goldman, the executive director of the Jewish Circumcision Resource Center, an anti-circumcision lobby group in Boston.

Mr. Goldman says that in the past decade, more than 400 U.S. parents have called his organization to say they've opted out of the procedure.

Still, the vast majority of Jewish boys will continue to be circumcised at bris ceremonies, as their male relatives have been for thousands of years.

"Once in a blue moon, someone's in the back going 'this is barbaric,'" Dr. Diamond says. "It's so rare."