We may make allowances for the orgies of stupidity and cruelty that were indulged in before humanity had a clear concept of the germ theory of disease. Most of the «miracles» of the New Testament have to do with healing, which was of such great importance in a time when even minor illness was often the end. (Saint Augustine himself said that he would not have believed in Christianity if it were not for the miracles.) Scientific critics of religion such as Daniel Dennett have been generous enough to point out that apparently useless healing rituals may even have helped people get better, in that we know how important morale can be in aiding the body to fight injury and infection. But that would be an excuse only available in retrospect. By the time Dr. Jenner had discovered that a cowpox vaccine could ward off smallpox, this excuse had become void. Yet Timothy Dwight, a president of Yale University and to this day one of America’s most respected «divines», was opposed to the smallpox vaccination because he regarded it as an interference with god’s design. And this mentality is still heavily present, long after its pretext and justification in human ignorance has vanished.

It is interesting, and suggestive, that the archbishop of Rio makes his analogy with dogs. They do not trouble to roll on a condom: who are we to quarrel with their fidelity to «nature»? In the recent division in the Anglican Church over homosexuality and ordination, several bishops made the fatuous point that homosexuality is «unnatural» because it does not occur in other species. Leave aside the fundamental absurdity of this observation: are humans part of «nature» or not? Or, if they chance to be homosexual, are they created in god’s image or not? Leave aside the well-attested fact that numberless kinds of birds and mammals and primates do engage in homosexual play. Who are the clerics to interpret nature? They have shown themselves quite unable to do so. A condom is, quite simply, a necessary but not a sufficient condition for avoiding the transmission of AIDS. All qualified authorities, including those who state that abstinence is even better, are agreed on this. Homosexuality is present in all societies, and its incidence would appear to be part of human «design». We must perforce confront these facts as we find them. We now know that the bubonic plague was spread not by sin or moral backsliding but by rats and fleas. Archbishop Lancelot Andrewes, during the celebrated «Black Death» in London in 1665, noticed uneasily that the horror fell upon those who prayed and kept the faith as well as upon those who did not. He came perilously close to stumbling upon a real point. As I was writing this chapter, an argument broke out in my hometown of Washington, D.C. The human papillomavirus (HPV) has long been known as a sexually transmitted infection that, at its worst, can cause cervical cancer in women. A vaccine is now available — these days, vaccines are increasingly swiftly developed — not to cure this malady but to immunize women against it. But there are forces in the administration who oppose the adoption of this measure on the grounds that it fails to discourage premarital sex. To accept the spread of cervical cancer in the name of god is no different, morally or intellectually, from sacrificing these women on a stone altar and thanking the deity for giving us the sexual impulse and then condemning it.

We do not know how many people in Africa have died or will die because of the AIDS virus, which was isolated and became treatable, in a great feat of humane scientific research, very soon after it made its lethal appearance. On the other hand, we do know that having sex with a virgin — one of the more popular local «cures» — does not in fact prevent or banish the infection. And we also know that the use of condoms can at least contribute, as a form of prophylaxis, to the limitation and containment of the virus. We are not dealing, as early missionaries might have liked to believe, with witch doctors and savages who resist the boons that the missionaries bring. We are instead dealing with the Bush administration, which, in a supposedly secular republic in the twenty-first century, refuses to share its foreign aid budget with charities and clinics that offer advice on family planning. At least two major and established religions, with millions of adherents in Africa, believe that the cure is much worse than the disease. They also harbor the belief that the AIDS plague is in some sense a verdict from heaven upon sexual deviance — in particular upon homosexuality. A single stroke of Ockham’s potent razor eviscerates this half-baked savagery: female homosexuals not only do not contract AIDS (except if they are unlucky with a transfusion or a needle), they are also much freer of all venereal infection than even heterosexuals. Yet clerical authorities persistently refuse to be honest about even the existence of the lesbian. In doing so, they further demonstrate that religion continues to pose an urgent threat to public health.

I pose a hypothetical question. As a man of some fifty-seven years of age, I am discovered sucking the penis of a baby boy. I ask you to picture your own outrage and revulsion. Ah, but I have my explanation all ready. I am a mohel: an appointed circumciser and foreskin remover. My authority comes from an ancient text, which commands me to take a baby boy’s penis in my hand, cut around the prepuce, and complete the action by taking his penis in my mouth, sucking off the foreskin, and spitting out the amputated flap along with a mouthful of blood and saliva. This practice has been abandoned by most Jews, either because of its unhygienic nature or its disturbing associations, but it still persists among the sort of Hasidic fundamentalists who hope for the Second Temple to be rebuilt in Jerusalem. To them, the primitive rite of the peri’ah metsitsah is part of the original and unbreakable covenant with god. In New York City in the year 2005, the ritual, as performed by a fifty-seven-year-old mohel, was found to have given genital herpes to several small boys, and to have caused the deaths of at least two of them. In normal circumstances, the disclosure would have led the public health department to forbid the practice and the mayor to denounce it. But in the capital of the modern world, in the first decade of the twenty-first century, such was not the case. Instead, Mayor Bloomberg overrode the reports by distinguished Jewish physicians who had warned of the danger of the custom, and told his health care bureaucracy to postpone any verdict. The crucial thing, he said, was to be sure that the free exercise of religion was not being infringed. In a public debate with Peter Steinfels, the liberal Catholic «religion editor» of the New York Times, I was told the same thing.

It happened to be election year in New York for the mayor, which often explains a lot. But this pattern recurs in other denominations and other states and cities, as well as in other countries. Across a wide swath of animist and Muslim Africa, young girls are subjected to the hell of circumcision and infibulation, which involves the slicing off of the labia and the clitoris, often with a sharp stone, and then the stitching up of the vaginal opening with strong twine, not to be removed until it is broken by male force on the bridal night. Compassion and biology allow for a small aperture to be left, meanwhile, for the passage of menstrual blood. The resulting stench, pain, humiliation, and misery exceed anything that can be easily imagined, and inevitably result in infection, sterility, shame, and the death of many women and babies in childbirth. No society would tolerate such an insult to its womanhood and therefore to its survival if the foul practice was not holy and sanctified. But then, no New Yorker would permit atrocities against infants if not for the same consideration. Parents professing to believe the nonsensical claims of «Christian Science» have been accused, but not always convicted, of denying urgent medical care to their offspring. Parents who imagine themselves to be «Jehovah’s Witnesses» have refused permission for their children to receive blood transfusions. Parents who imagine that a man named Joseph Smith was led to a set of buried golden tablets have married their underage «Mormon» daughters to favored uncles and brothers-in-law, who sometimes have older wives already. The Shia fundamentalists in Iran lowered the age of «consent» to nine, perhaps in admiring emulation of the age of the youngest «wife» of the «Prophet» Muhammad. Hindu child brides in India are flogged, and sometimes burned alive, if the pathetic dowry they bring is judged to be too small. The Vatican, and its vast network of dioceses, has in the past decade alone been forced to admit complicity in a huge racket of child rape and child torture, mainly but by no means exclusively homosexual, in which known pederasts and sadists were shielded from the law and reassigned to parishes where the pickings of the innocent and defenseless were often richer. In Ireland alone — once an unquestioning disciple of Holy Mother Church — it is now estimated that the unmolested children of religious schools were very probably the minority.