Sunday, September 30, 2012

Letter to AAP: Being honest about medical involvement that contravenes "first of all, do no harm", Susan Bewley

http://pediatrics.aappublications.org/content/130/3/585/reply#pediatrics_el_54495

Following the retraction of its policy on female genital mutilation in 2010 (1,2,3,4), the American Academy of Pediatrics (AAP) seems determined to court controversy again (5). What is puzzling is that apparently "new scientific evidence shows the health benefits of newborn male circumcision outweigh the risks of the procedure" - sufficient to justify third party payment and endorsement by the American College of Obstetricians and Gynaecologists - and yet "the benefits are not great enough to recommend routine circumcision for all newborn boys"(6).
The AAP dithers between envisioning neonatal circumcision as a benefit rather than 'the lesser of two [harms] evils' and cannot have it both ways: Either infant male circumcision is better for health and thus has a 'therapeutic' indication for all or it isn't - and has to be classified as 'cultural', 'religious', 'habitual', 'cosmetic' or 'mutilation'. Prophylactic pediatric surgery arguments are weak - we would not accept disease eradication via routine tonsillectomy or appendicectomy, for example, just because some children avoid problems later and certainly not without randomised trial evidence. There are no comprehensive and reliable statistics on the known, albeit rare, serious risks of death and damage (7, 8). The literature on circumcision complications is subject to underreporting and bias as it relies on case reports and is probably compounded for non-hospital procedures. If neonatal circumcision is beneficial, it should be recommended for all (accepting that parents do not have to take the advice). If it is not beneficial (or risky or harmful), then society can either (i) allow some leeway for parents to harm their infants (with or without medical collusion), or (ii) disallow it until boys are of an age to make their own decisions. The latter makes particular sense as most purported benefits relate to possibly preventing diseases and disorders, such as HIV acquisition, that will not occur until maturity.
The key question is whether the AAP brings the medical profession into disrepute when reading the scientific literature in an unsystematic way and legitimising non-therapeutic procedures by 'medicalisation'. Should we be suprised to find the practice supported by those with a cultural, religious or financial vested interest? The conflict of interest statements are not published with the policy. In the UK National Health Service, despite similar official equivocation (9,10) OB-GYNs do not perform neonatal circumcision and only 0.2% of newborn boys are circumcised (11). Female genital cutting or mutilation is illegal in the UK as well as the USA (12,13,14). Do newborn boys not deserve equal protection?
References
1. AAP Board of Directors Ritual Genital Cutting of Female Minors Pediatrics Vol. 126 ( 1) 191-192, July 1, 2010. 2. Strandjord SE. Opportunity for Education Plus Protection of Minors. Pediatrics eLetter published May 17 2010 http://pediatrics.aappublications.org/content/125/5/1088.short/reply#pediatrics_el_50347 3.Bewley S. Sincerity, retraction and apology. Pediatrics eLetter published June 1 2010. http://pediatrics.aappublications.org/content/125/5/1088.short/reply#pediatrics_el_50347 4.Bewley S. Female genital mutilation. BMJ 2010 Jun 2: 340:c2728. 5.AAP Task Force on Circumcision, Circumcision Policy Statement, Pediatrics 2012 Sept: 130:585-586 6. AAP Press Release August 27, 2012, http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/New-Benefits- Point-to-Greater-Benefits-of-Infant-Circumcision-But-Final-Say-is-Still-Up -to-parents-Says-AAP.aspx 7. Williams N. Complications of Circumcision. Br J Surg. 1993 Oct;80(10):1231 8. Circumcision Information and Resource Pages http://www.cirp.org/library/complications/ accessed September 6 2012 9. British Medical Association. The Law and ethics of male circumcision. Guidance for doctors. June 2006, http://bma.org.uk/practical-support-at- work/ethics/children accessed September 6 2012 10. British Association of Paediatric Surgeons, The Royal College of Nursing, The Royal College of Paediatrics and Child Health, The Royal College of Surgeons of England and The Royal College of Anaesthetists. Statement on Male Circumcision March 6, 2007 http://www.rcseng.ac.uk/media/medianews/statementonmalecircumcision 11. Cathcart P, Trends in paediatric circumcision and its complications in England between 1997 and 2003. Br J Surg. 2006 Jul;93(7):885-90 12. Ending female genital mutilation United Nations Resolution E/CN.6/208/L.2/Rev.1 http://www.un.org/womenwatch/daw/csw/csw52/AC_resolutions/Final%20L2%20ending%20female%20genital%20mutilation%20 -%20advance%20unedited.pdf accessed September 6 2012 13. Public Law No. 104-208, 30 September 1996 [Sections 579, 644, and 645]. 1995 Prevention
of Female Genital Mutilation Act, (USA) http://www.hsph.harvard.edu/population/fgm/usa.fgm.86.htm 14. Female Genital Mutilation Act 2003 (UK) http://www.legislation.gov.uk/ukpga/2003/31/contents
  • Susan BewleyProfessor of Obstetrics
  •  
  • Sarah Strandjord, Professor of Pediatrics
Kings College London

Letter to AAP: Circumcision Report is Flawed, Ronald Goldman


The American Academy of Pediatrics circumcision report has many serious deficiencies. It ignores effects of circumcision pain on infants, two dozen surgical risks including death, functions of the foreskin, connections between circumcision and erectile dysfunction, trauma of circumcision, psychological harm to men, using condoms to prevent STDs, conflicts with its own bioethics committee, lack of true informed consent, and unknown harms that have not been studied. Instead it continues the endless search for a medical "benefit" that started in the late 1800s. Circumcision is a solution in search of a problem.
The AAP report also conflicts with circumcision positions in other countries that recommend against circumcision or are discussing restricting it. Other countries recognize the inherent physical, sexual, and psychological harm of circumcision and that it violates medial ethics to cut off a natural, healthy, functioning body part. Ignore the report. Just watch a circumcision video and trust your feelings.
Circumcision Resource Center

Letter to AAP: Revised male infant circumcision policy: A disservice to Americans, Christopher Guest


The American Academy of Pediatrics (AAP) revised statement on male infant circumcision claims "the benefits of circumcision may exceed the risk of complications" but the AAP fails to recognize the sensory and mechanical function of the human foreskin. The foreskin is richly innervated, erogenous tissue which enhances sexual pleasure and it also provides a unique, linear gliding mechanism during sexual intercourse. In 2009, the College of Physicians and Surgeons of British Columbia stated "the foreskin is rich in specialized sensory nerve endings." In 2010, the Royal Australian College of Physicians stated "the foreskin is a primary sensory part of the penis, containing some of the most sensitive areas of the penis" and in the same year, the Royal Dutch Medical Association concluded "the foreskin is a complex erotogenic structure that plays an important role in the mechanical function of the penis during sexual acts." The AAP statement fails to consider the obstinate relationship between structure and function as it pertains to the foreskin; circumcision alters the structure of the penis which inevitably alters function. The long term harm and sexual side effects of circumcision have not been adequately studied.
The revised statement also claims "circumcision may decrease the risk of heterosexual HIV transmission" and is supported with selective evidence from randomized control trials from Kenya, Uganda and South Africa. These trials reveal a number of methodological weaknesses and they contradict larger demographic trends in global HIV prevalence. For instance, the United States has a high prevalence of circumcision, yet has a significantly higher rate of HIV infection compared with countries like Sweden and Japan where the prevalence of circumcision is very low. Behavioural factors greatly overshadow any potential protective effect of circumcision and should be the focus of effective and ethical prevention strategies. Even if the African trials were scientifically valid, the evidence can not be applied to justify infant circumcision in North America where the incidence of heterosexual HIV transmission is low.
The revised statement also claims "circumcision may decrease the risk of urinary tract infections" yet the AAP ignores the wealth of international medical evidence to the contrary. Even if circumcision provided complete protection against urinary tract infections, this practice could never be justified based on the ethical principle of proportionality - there are effective and less destructive therapies available for preventing and treating urinary tract infections which do not involve the prophylactic removal of healthy genital tissue.
The AAP's revised statement ignores the inherent conflict of circumcision with contemporary medical ethics. Infant circumcision violates the fundamental ethical principles of autonomy, beneficence and primum non nocere. Medical associations in the Netherlands, Finland, Sweden, Norway, Denmark, Germany and other countries have stated that there is no justification for performing the procedure without medical urgency. Medical associations in these countries are calling for the practice to stop due to ethical and human rights concerns. The AAP's new position statement does a disservice to American parents and children.
Respectfully, Christopher L. Guest M.D., F.R.C.P.C.


Children's Health & Human Rights Partnership

Thursday, September 27, 2012

Marty Klein, Criminalizing Circumcision: Self-Hatred As Public Policy

Marty Klein, from Sexual Intellingence (?), in an article called Criminalizing Circumcision: Self-Hatred As Public Policy, (an article published last year during the debate of San Francisco proposed bill), states that "Equating the removal of an infant’s foreskin with the “mutilation” of the testicles or penis is ignorance, willful distortion, or delusion. No one in the city has been accused of touching anyone’s testicles or penis"

Big imprecision there. The foreskin is the penis. There is no dotted line saying: penis to the left, foreskin to the right. Circumcision, as currently practiced, eliminates 30 to 50% of the skin of the penis. So YES, circumcision touches and hurts the penis.

He later states that circumcision "has no impact on later physical function". Of course, he admits to being circumcised. Well, I'm circumcised and now at 41 I know that it does affect physical function. I just never knew before because I was not comparing my sexual experience with that of my intact friends. The fact that I was most sensible in the underneath area of my penis, that I had to really concentrate and pump really fast when I wanted to achieve orgasm, that sex felt more like a stamina test than an intimate pleasure... it's all because of circumcision. Just because Mr. Klein is ignorant to those facts (even if he is a sex therapist) doesn't make them any less truth. In fact:

Sorrels et al, in 2007, found that "the glans of the circumcised penis is less sensitive to fine touch than the glans of the uncircumcised penis. The transitional region from the external to the internal prepuce is the most sensitive region of the uncircumcised penis and more sensitive than the most sensitive region of the circumcised penis. Circumcision ablates the most sensitive parts of the penis." (Fine-touch pressure thresholds in the adult penis)

J.R. Taylor, 2003, found that "Skin and mucosa sufficient to cover the penile shaft was frequently missing from the circumcised penis. Missing tissue included a band of ridged mucosa located at the junction of true penile skin with smooth preputial mucosa. This ridged band contains more Meissner's corpuscles than does the smooth mucosa and exhibits features of specialized sensory mucosa" and concluded that "Circumcision also ablates junctional mucosa that appears to be an important component of the overall sensory mechanism of the human penis." (The prepuce: specialized mucosa of the penis and its loss to circumcision)

The document "Neonatal Male circumcision global review" of UNAIDS (an institution that promotes circumcision in Africa) states that "some of the serious complications that can occur during the procedure include death from excess bleeding and amputation of the glans penis. Postoperative complications include the formation of skin bridges between the shaft and the glans, infection, urinary retention (this has caused deaths), meatal ulcer, impetigo, fistulas, loss of penile sensitivity, sexual dysfunction and oedema of the glans." - Sexual dysfunction IS one of the risks of circumcision.

Mr. Klein states that "In 31 years of talking with men about circumcision, I have never met a man who felt damaged, mutilated, or emasculated by his circumcision who did not have other emotional problems." This is sad. He's stating that if we are worried because we were FORCIBLY SUBJECTED TO AN AMPUTATION ON OUR MOST PRIVATE PART and we are upset with that, we must have some underlying emotional problem. Way to victimize the victims. How would you feel if your penis looked like some of this: http://www.circumcisionharm.org/gallery1.htm or this http://www.circumstitions.com/Botched1.html

"The pain they claim to remember from the brief procedure is impossible". Again Mr. Klein you fail. Many men have been left with so little skin in their shaft, that EVERY ERECTION is painful, sometimes resulting in skin rupturing and bleeding. This is a daily reminder of the damage of circumcision, not just the memory of the procedure itself.

"The sense of being incomplete a neurotic problem". Mr. Klein, when a woman loses a breast to mastectomy, usually one of the next steps is to offer reconstructive surgery. Because an amputation makes a person feel incomplete. Most men do not think of their circumcision as an amputation. But some have learned that they were subjected to it in quite traumatic forms. If you are a teenager or an adult and suddenly learn at school or in a locker room that you are missing a part of your body, you will feel incomplete. I've seen it happen. I've seen the confusion turn to anger and turn to sadness.

"But this is dramatically different than men who feel mutilated or disgusted with their penis, blaming all their life’s problems on an event they can’t possibly remember." Nobody said that ALL of our problems are blamed on circumcision. You are creating an unwarranted hyperbole there. We lost a part of our body. We are upset. Some of us experience sexual problems from that amputation. We don't want future generations to suffer the same fate. How is that blaming ALL of our problems on circumcision?

And when you say it's an event "they can't possibly remember", please tell me. Would raping a drugged person be okay because the person can't possibly remember it? Circumcision is not only a physical amputation, but also a violation of trust. Growing up to learn that your parents chose to trim part of your body, like clipping a dog's tail, hurts emotionally. Parents are not entitled to do anything that they want to their children (in fact in this country, pricking the clitoris of a daughter with a pin even without any removal of tissue, is a federal crime, yet the more invasive male circumcision is tolerated). Parents are trusted with the care of the child. They have a duty to protect the child, not the right to shape the child anyway they want. Whether the fact is remembered or not, is immoral.

"The sexual effects of circumcision are clear: there are none. Say what you want about foreskins protecting penile sensitivity—virtually no one complains that their penis isn’t sensitive enough." I commend you to visit the foreskin restoration forum (http://www.foreskin-restoration.net) and read with open mind and heart. If you don't find people suffering negative sexual effects from circumcision then you are simply ignoring the facts.

"The United Nations recognizes the health benefits of circumcision; the World Health Organization is now promoting a huge circumcision campaign in southern Africa." Yet, 2 African studies that show protective effects from FEMALE CIRCUMCISION are dismissed. Why? Because circumcision is being promoted because it's valued in the U.S. Not because it's the cure. Female circumcision is frowned upon in the West, so any found benefits are irrelevant, just like the damage from male circumcision is considered irrelevant. Let me remind you of the quote in a document from UNAIDS, the same organization promoting male circumcision: "some of the serious complications that can occur during the procedure include death from excess bleeding and amputation of the glans penis. Postoperative complications include the formation of skin bridges between the shaft and the glans, infection, urinary retention (this has caused deaths), meatal ulcer, impetigo, fistulas, loss of penile sensitivity, sexual dysfunction and oedema of the glans." The document also acknowledges that the frequency of complications is "underestimated because events occuring after the discharge are not captured [in the discharge sheet]" and sometimes are treated at a different hospital."

"Halfway around the world, the Phillipines recently offered free circumcisions for poor people, who lined up enthusiastically." Phillipines is a cutting culture, just like the U.S., the Jews, the Muslims and good part of Africa. People didn't line to get themselves circumcised. People lined to HAVE THEIR KIDS circumcised. The kids didn't go on their own. The article "Some boys cried in their mothers' arms while others bit their shirts to stifle sobs as doctors carried out the surgery on dozens of makeshift operating tables inside a sports stadium in Marikina city east of Manila". I've seen photos of those event. Newspapers were used as drapes. Yes, very sterile enviroment, very safe. Click here to see for yourself: http://4skinftw.blogspot.com/2010/12/operation-tuli.html what a wonderful party that was.

"Is rarely dangerous when done using simple public health guidelines". Yes. Any person using a Mogen clamp can amputate a glans or part of it. Any person using a mismatched Gomco clamp can injure the glans. Any Plastibell can cause urine retention (which can cause death) or denude the whole shaft of the penis or cause necrosis. That's even in medical settings. Look how safe the plastibell is: http://www.thewholenetwork.org/14/post/2012/08/the-dangers-of-plastibell-circumcisions-graphic.html

"There is absolutely no evidence that the sexual experiences of circumcised and uncircumcised men are different for them or their partners (outside of partners’ simple personal taste, of course)." For an answer to this, check http://www.sexasnatureintendedit.com/

"As a therapist, I am sworn to empathize with the pain of every man" -- You are failing.

"As a citizen, my sworn concern is to keep emotion out of public policy" -- Human rights is not emotion. Protecting women from rape is not emotion. Protecting girls from FGM is not emotion. Protecting children from Genital Alteration is not emotion.

"So I urge anyone feeling damaged by their circumcision to get as much therapy as necessary, as much good sex as possible—and to keep their self-admittedly damaged psyches away from public policy." You have chosen to maintain your cognitive dissonance. Whether you have suffered the effects or not of circumcision, is not for me to judge. But the fact that we can spare kids from a damaging and traumatic procedure, it's a worthy task. Are we less citizens because we have suffered psychological damage? Aren't always the victims of any unfair treatment the first ones to denounce it, the first ones to line up to bring change? Well, that's what we are doing and you are patronizing us.

"The ballot box is not the place to work out your self-loathing." Thinking that cutting a part of your most private part and others' most private parts is okay is self-loathing. "Medical" circumcision in the United States started out of self-loathing, out of a doctor (so he must have known what he was talking about right?) that thought that masturbation caused diseases like tuberculosis, blindness and others. He was the one who came with circumcision as a way to prevent masturbation, J.H. Kellogg. That is a self-loathing attitude. Maintaining this cultural custom is self-loathing, and doing it under the guise of medical benefits is cognitive dissonance, selective blindness and bad use of science. There are benefits to keeping your whole body, but nobody is talking about those. There is damage to getting the foreskin amputated, but nobody wants to hear about that either. You sheep keep repeating "it's okay, it's fine, I came out alright". Truth is, you don't know that.









Wednesday, September 26, 2012

I don't get USAID


I don't get USAID, I really don't.

In 2007 they stated in a report: Clinical trials have now confirmed the efficacy of male circumcision (MC) in reducing female-to-male HIV transmission. (Document: COSTING MALE CIRCUMCISION IN SWAZILAND AND IMPLICATIONS FOR THE COST-EFFECTIVENESS OF CIRCUMCISION AS AN HIV INTERVENTION http://pdf.usaid.gov/pdf_docs/PNADP247.pdf)

In 2009, they stated: There appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher. (Document: Levels and Spread of HIV Seroprevalence and Associated Factors: Evidence from National Household Surveys http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf)

In a blog entry from 2010, ("Fighting HIV with circumcision") they say: "Dr. Emanuel, from the White House Office of Management and Budget, blogged extensively during a recent two-week trip through Africa.  In this installment he discusses the potential for using male circumcision to prevent HIV transmission. 'Three separate randomized trials have shown that male circumcision is among the most effective interventions against HIV/AIDS, reducing transmission by about 60 percent. This is a huge impact. As one AIDS researcher has said to me, if we had a vaccine that effective, we would be sparing no effort to distribute and administer it.  But widespread deployment of male circumcision has not yet occurred.'" http://blog.usaid.gov/2010/12/fighting-hiv-with-circumcision/

The Barefoot Intactivist commented: "USAID researchers found circumcision does NOT prevent HIV. From a February 2009 report: “In 10 of 18 countries with data, HIV prevalence was HIGHER among circumcised men.” [Emphasis added.] Source: http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf Why is USAID supporting the quack science of genital cutting as HIV prevention, even after their own researchers found it to be bogus?"

The blog administrator responded: "In March 2007, the Joint United Nations Program on HIV/AIDS/World Health Organization (UNAIDS/WHO) issued normative guidance [PDF] stating that Voluntary Medical Male Circumcision (VMMC) should be recognized as an additional important intervention to reduce the risk of male heterosexually acquired HIV infection and that VMMC should always be implemented as part of a comprehensive HIV prevention package. This package includes the provision of HIV testing and counseling services; treatment for sexually transmitted infections; the promotion of safer sex practices, such as abstinence from penetrative sex, reduction in the number of sex partners, and delay in the onset of sexual relations; and the provision of male and female condoms, and promotion of their correct and consistent use. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) looks to UNAIDS/WHO to set global norms and standards, provide policy and program guidance for the provision of safe and efficient VMMC services, and conduct high-level advocacy."

How does this make sense? How do they find that there is no pattern of association (in contradiction to the infamous 3 randomized trials) and yet ignore their own finding because it's the UNAIDS/WHO who sets the global norms and standards?

Cognitive dissonance much?

Georganne Chapin - Intact America


Intact America

MGM vs. FGM Male and female circumcision

From http://www.circumstitions.com/FGMvsMGM.html

This article includes a comparison table of FGM vs. MGM, and quotes among others, these words from anthropologist Kristen Bell:

Ultimately, the message is clear: genital mutilation is gendered. These male and female genital operations are not merely seen to differ in degree, they are seen to differ in kind. Thus, despite the heterogeneous voices speaking out against female circumcision, a common thread unites many: all forms of female genital cutting are seen to constitute a sexual mutilation and violation of bodily integrity, and male genital operations are dismissed as benign.
 And while we are in this topic, from http://www.noharmm.org/anatsim.htm take a look at the anatomical similarities in the development of the male and female genitalia.


From: http://www.drmomma.org/2009/09/history-of-female-circumcision-in.html



From: http://www.drmomma.org/2008/01/mgmfgm-visual-comparison.html

A visual comparison between male and female circumsion:



From: http://www.drmomma.org/2011/04/male-and-female-circumcision.html


From http://www.drmomma.org/2010/04/circumcision-already-illegal.html, Is male infant circumcision already illegal?

I often come across parents who do not agree that circumcision should be illegal. They usually argue by saying it is a parental decision like vaccination, homebirth, etc. Here is my response:

Vaccines cannot be compared to a cosmetic surgery that removes healthy organs for non-therapeutic purposes. This is like comparing apples to oranges. Let's stick with comparing other actions that are considered bodily
modifications of non-consenting minors when contemplating the legality of circumcision.

Piercing is a body modification, but because it does not alter the function of a body part, nor does it remove any tissue or organs, it is generally accepted within reason (earlobes, for example).


Tattooing is much more extreme in that it is permanent, yet it still does not remove any organ or alter the functions of any healthy body parts. However, most people agree that parents should not be able to tattoo their infants or children. In fact, a Florida family was recently charged with cruelty to children for tattooing their 6 kids.


And then you have circumcision - a genital surgery which
does alter the function of the primary sex organ, does remove otherwise healthy tissue and the prepuce organ, does alter appearance forever more and is permanent. If you aren't allowed to tattoo your children, why on earth would you be legally able to remove healthy, functioning tissue from your son's genitals?

....

Circumcision violates our human rights laws, which are designed to protect the bodies of minor children.

Circumcision violates our medical ethics laws that state a doctor can only perform procedures on a minor when there is clear medical need and a more conservative treatment has failed.


Circumcision is not good preventative medicine because amputation is always a last resort to conservative treatments.


Circumcision on babies cannot be considered a good prophylactic measure against sexually transmitted infections.


And last but not least, because baby girls
are protected from even the most minor genital surgery (even a pin prick), circumcision is a violation of the equal protection clause of the Constitution of the United States which states that, "all persons shall receive equal protection under the law" regardless of sex.

Case closed, circumcision is technically already illegal. The question is not then whether or not it is legal to circumcise a child - we have already established that the male foreskin and its removal exists outside our legal and medical norms. The real question is, when will our government recognize that they have failed to apply the law accordingly and, in doing so, they have failed to protect our most innocent and most fragile of citizens?

Germany outlines new law allowing circumcision

Unfortunately Germany is going back after the Cologne's ruling:

From http://uk.reuters.com/article/2012/09/25/uk-germany-circumcision-idUKBRE88O18120120925

The ruling in June by a district court in Cologne outraged Muslims and Jews and sparked an emotional debate in the country, leaving an embarrassed government to promise legislation by the autumn protecting the right to circumcise.

....


The speed with which national lawmakers agreed in July to pass a new law underscored sensitivity to charges of intolerance in a country haunted by its Nazi past. German Chancellor Angela Merkel said Germany risked becoming a laughing stock if Jews were not allowed to practise their rituals.

About 120,000 Jews are registered as living in Germany along with around 4 million Muslims, many of whom are from Turkey.

The Cologne court, ruling in the case of a Muslim boy who suffered bleeding after circumcision, said the practice inflicted bodily harm and should not be carried out on young boys, although it could be practised on older males with consent.

A mutilator’s question


From: http://web.archive.org/web/20080521184624/www.genitalintegrity.net/blouch/2007/04/28/a-circumcisers-question/

Many years ago, I witnessed an infant circumcision in person at the invitation of a mutilator. He invited me to attend, to prove to me that there is nothing wrong with mutilating babies. He also decided and told me that he would not do a complete circumcision, just a little dorsal slit, to minimize trauma, damage, injury, and blood loss. “I will cut on the center line. There are no blood vessels there.” (Right.)

I decided to go. White mutilator, black baby, southern USA, 1972 or so. With the first probe under the foreskin the baby screams a blood curdling scream and keeps screaming.
...


I have since learned from a reformed circumciser, who did scores of circumcisions, that he didn’t hear the babies he circumcised screaming. He was so intent on doing his work “correctly” that he literally, as hard as it is to believe, did not hear the screaming. Then, one day—why, he didn’t know—he heard it. He heard the baby and knew what the screaming meant. He was injuring the baby, deeply. He’s never done another one.

The mystery of how people can do this to babies and allow it to be done and think it normal gets deeper for me every day.

Source: http://web.archive.org/web/20080521184624/www.genitalintegrity.net/blouch/2007/04/28/a-circumcisers-question/

Female Circumcision & Health Benefits

From: http://mondofown.blogspot.com.au/


One of the arguments you will hear trying to justify male circumcision and denounce female circumcision is that "Male circumcision has health benefits but Female Circumcision has no health benefits".

My opinion is that human rights supercede health benefits, and the Western Scientific Community appears to agree with me but only where female circumcision is concerned.

There are 2 issues here.

1 Cultural values. Some western cultures value male circumcision, but most do not.  All western cultures view female circumcision as a human rights violation.

2 Availability of data.  The truth is there is no reliable or valid data about the health benefits of female circumcision because no-one is interested if there are any benefits.  The few correlational studies that do exist indictae there could indeed be health benefits similar to male circumcision.

.....

At least this is some PROOF that there are some higher values than Health Benefits from genital surgery, and YES Human Rights are considered more important!!!!!!  Unfortunately when it comes to circumcision though, only the human rights of females are considered important.  SADLY!!!!!!


Read more:  http://mondofown.blogspot.com.au/2012/06/female-circumcision-health-benefits.html

Source: http://mondofown.blogspot.com.au/2012/06/female-circumcision-health-benefits.html

In Kenya: Circumcision Protects All From HIV, Except Luos...and Women

From: http://hivinkenya.blogspot.jp

There are many anomalies in arguments claiming that mass male circumcision can be used to reduce HIV transmission. But in Kenya, the biggest anomaly relates to the Luo tribe; over 20% of Luos are already circumcised, yet HIV prevalence is almost the same among circumcised (16.4%) and uncircumcised men (17.3%). These figures were available to those who have been promoting the current Voluntary Medical Male Circumcision (VMMC) program, which has been going on for 4 years and reports that 450,000 men (though most of them are said to be boys) out of a target of 850,000 have already been circumcised, and the program has another 6 years to run.

....

Those promoting VMMC are not just feeding people the convenient bits of data, they are papering over the gaps in the data with hot air.

Even the randomized controlled trials did not exclude from their figures the people who were infected non-sexually. This is crucial, because VMMC assumes that almost every HIV positive person in Kenya was infected sexually and that the main risks HIV negative people face are sexual. The trials did not establish this, they simply assumed it. Therefore, proponents of VMMC are not in any position to make promises about protection against sexual HIV transmission; they don't even know what proportion of HIV transmission among participants in the randomized controlled trial were infected sexually, let alone in the population as a whole.

Far from being an shining beacon to the uncircumcised populations of high HIV prevalence African countries, the VMMC program in Kenya should serve as a horrific example of what can result from public health programs that are based on selective use of data and lies. There are billions of dollars behind this program, but the Luo people should not be participants in an experiment to which they did not give their consent, and for which the outcome was already known before the program started.

Source: http://hivinkenya.blogspot.jp/2012/09/circumcision-protects-all-from-hiv.html

Tuesday, September 25, 2012

A guide to convincing parents to circumcise their babies

by Intactivists of Australasia

To convince otherwise well-meaning parents to take their precious, perfectly formed baby boy and amputate one of the most intimate, sensitive parts of his body would take a compelling argument. While cultural and religous influences can be strong, certain pro-circumcision individuals and groups have devised a formula to help parents go against their instincts and have their baby circumcised. We reveal the secrets to their formula to help Australian and New Zealand parents identify when they are about to be conned:

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Men Speak Out

https://www.facebook.com/events/418506468212559/


The Intactivist movement suffers from the public not seeing just how many men really are opposed to the practice. We’ve started the “Men Speak Out” photo project as a way to change that by showing that a lot of men DO complain. We hope you’ll take a moment to snap a close-up photo of yourself, holding your baby picture next to your face. This will visually unite the infant with the man he will become; something that doctors need to learn.

Will you share a picture of yourself with us? It’s easy – just
upload your high-resolution photo and send it to info@intactamerica.org. Large files are sometimes difficult to send by email, so you might want to use YouSendIt.com. It is easy to use, just enter your email address, our email address info@intactamerica.org, and attach the photo. Also, please post the photo you’ve taken here on this event page. (For additional photo tips, refer to instructions below.) 
Photo Tips:
• Use the best digital camera you have. Set it at its highest resolution. The width needs to be 2000 pixels or more.
• Use a plain background.
• Place the baby picture touching your cheekbone.
• Zoom until all of your head and your baby picture are framed, with as little background showing as possible.
• Use even, bright lighting such as inside near a large indow, our outside in broken shade or on an overcast day so that the light falls onto your face.
• Take many photographs and choose the best one.
• Please, no text or words on your photo.
• Please, no PhotoShop collages. Hold the baby picture next to your cheekbone.
• This is one time you DON’T SMILE! (unless you are intact!)

This event was created by Intact America:


Men Speak Out
What was taken from the child, the child within will always grief for.

Circumcision is just a surgery, that's all, and on its own it's not good or bad. It's how we use it that is bad. If circumcision was just done when therapeutically necessary, we wouldn't be here making all this noise. But because someone made it into a religious ritual and then someone made it into a social custom and then another person tried to justify it as prophylaxis or prevention or inherited aesthetic forced upon those who did not request it and could not remove themselves from the situation, that's why we are here, and that's why we are not leaving and shutting up. Because it's not fair for those who are coming after us, to go through what we went. To grow up and then one day find out in the most strange way that a part of their body was discarded with the permission (or not) from their parents, as if it was some sort of biological waste. It's not fair for them.

It's great for those who like their private parts the way they are altered. There are equally real human beings that don't like what was done to them, to us. Babies can't give informed consent, and parents have no way of knowing how things are going to go, which is why we have to be conservative in the treatment of our children and respect their bodies and their souls. Conservative: to conserve, to keep, to maintain. Not to excise and discard. We are given the privilege of caring for them, not the right to shape them as we see fit.


AAP Brochure for parents and an excellent response

AAP Brochure

Response

In summary, the brochure makes it seem like having a foreskin is a birth condition that needs to be surgically fixed.

It minimizes the risks (never mentioning the possibility of death or damage to the genitalia)

It dismisses every reason to not circumcise as a fear or a belief.

It makes it seem like every "uncircumcised" (intact) male will have phimosis.

It justifies social reasons (baby has to look like daddy, he will be teased in the locker room).

It refers to the foreskin as skin that covers the "end" of the penis. The foreskin is not an addition. The foreskin IS the end of the penis. They also seem to have a hard time referring to the glans as glans. They just say the "tip", the "end of the penis". One would think these guys were doctors and would call things by their names.

Anyway... go read both links and make your own opinion.

Also... learn a little bit about the doctors responsible for this brochure. http://circleaks.org/index.php?title=AAP_Circumcision_Task_Force_2012


Friday, September 21, 2012

Please, Not this Week: A Thank You.

http://www.ourmuddyboots.com/please-not-this-week-a-thank-you/

But what devastated me this week is this question:  where did this part of Owen’s body go?  What did the surgical staff do with it?  Did they throw it away?  Was it put in a Bio-Hazard container? Was it incinerated?  A part of my baby?

Please do not provide me the answer.  Not this week.

Because a God-given and important part of Owen’s body was discarded thoughtlessly and routinely.  Along with countless other foreskins that once belonged to other precious baby boys.

Me But Not My Son: A Young Jewish Man Breaks Rank on Circumcision

http://www.beyondthebris.com/2012/03/me-but-not-my-son-young-jewish-man.html

When I found out I was circumcised, I was horrified.

I was in second grade when I first heard about circumcision. A group of boys at school were talking about it. I walked into the middle of the conversation. At this point, I knew some penises looked different than others, but had assumed it was just one more way people were naturally different, like hair or eye color. One of the boys accused the Jews of circumcising their babies. I was the only Jew at my school so I felt I had to defend my people. How could a religion of tikun olam do something destructive to their newborns?

The scariest part for me, then, was thinking this might have been done to me. I couldn’t believe my parents would have done this, so I told the other boys there was no way Jews did this to their newborns and that I wasn’t circumcised. I didn’t find out I was wrong until some time later. One day, my dad pointed to the table in my house where it had happened to me and talked about it. He seemed proud but he might have been joking. After he told me, I ran to my room crying. My mom comforted me. Before this, I had felt proud of being perfect, unaltered. Now I knew I had been changed.

A bioethicist speaks about his personal reaction to circumcision

Dan O’Connor, PhD, bioethicist at Johns Hopkins wrote "A Piece I Didn’t Really Want to Write On Circumcision" with some good points about how, when a foreigner (like him or like me) comes to the U.S. and find the prevalence and normalization of male circumcision. He says his article is about: "the look I get on my face when you tell me you’ve circumcised your child, and the look you get on your face when you realize I think it’s wrong".

He makes a point of not being judgmental and concludes that "the thing with circumcision is that, like your best friend’s family’s weirdo ways with food, it doesn’t actually indicate anything deeper".

I posted a comment asking why does he think that the medical community has ignored the men who feel that they were physically and psychologically damaged by their circumcision. Five days later my comment has not been approved.


Circumcision and its benefits

"A common error made by those who want to justify infant male circumcision on the basis of medical benefits is that they believe that as long as some such benefits are present, circumcision can be justified as therapeutic, in the sense of preventive health care. This is not correct. A medical-benefits or "therapeutic" justification requires that overall the medical benefits should outweigh the risks and harms of the procedure required to obtain them, that this procedure is the only reasonable way to obtain these benefits, and that these benefits are necessary to the well-being of the child. None of these conditions is fulfilled for routine infant male circumcision. If we view a child's foreskin as having a valid function, we are no more justified in amputating it than any other part of the child's body unless the operation is medically required treatment and the least harmful way to provide that treatment."

~Margaret A. Somerville

MARGARET SOMERVILLE is the founding director of the Centre for Medicine, Ethics and Law at McGill University, where she holds the Samuel Gale Chair in the Faculty of Law and is a professor in the Faculty of Medicine. As a consultant to numerous government and non-governmental bodies, she has worked with the World Health Organization, the United Nations High Commissioner for Human Rights and UNESCO. She Has received a number of honorary doctorates in law and is the recipient of many awards, including the Order of Australia. She lives in Montreal.

http://www.circinfosite.com/47.html

Wishing They Were Left Intact: Adult Men Discuss Their Circumcisions

http://www.everythingbirthblog.com/2012/09/wishing-they-were-left-intact/

The author of the article starts:

When I write a piece on circumcision in any forum, including here on Everything Birth Blog, inevitably, someone will explain that if circumcision were such a big deal, men would be speaking up, not just “crazy moms.”  I know men in real life that wish they hadn’t been circumcised, but speaking out about it can be embarrassing, humiliating or just plain difficult. Sure, some men don’t realize the impact their circumcision has had on their lives. Others, like my husband, do understand but choose not to discuss it. As my friend, Jon Stevenson, from Michigan said, “I wish I was uncut, but don’t feel like there’s much else I can say about that…”

Yet, there are other circumcised men who are as vocal as the Intactivist women I know. There are men who are able to tell their stories. It took me all of a few hours and a single “internet shout-out” to find them.

On learning that you were circumcised:
Men expressed a variety of reactions to learning they were cut. Generally, they had to figure it out on their own, which saddens me even more, that boys seem to not even be entitled to an explanation that they were born with protective skin and nerve endings that they no longer have. I wonder how strange it must be to feel that you know your body only to discover it had been altered shortly after birth. Jeff Hodapp from California discovered he was circumcised when he was about 8 or 9 years old. He recalled his initial confusion, “I was looking at an anatomy book and it showed an intact penis and a circumcised penis. I immediately identified with the circumcised one. I didn’t read the page, I put the book down and walked away thinking that there were two types of penises.” I learned that often, men realized what was done to them in school. Imagine learning something so profound about such a significant part of yourself, while surrounded by peers in a classroom…

INTERSEXION TRAILER

Trailer for feature documentary Intersexion. An award winning exploration into the world of intersex people. The 1 in 2000 of us who don't fit neatly into the male or female categories http://www.intersexionfilm.com/

Thursday, September 20, 2012

2 resources in Spanish

Circuncisión como ofensa ética y legal del varon 


Circunsición ¿Cuestión de rutina?

Torture room for a baby




http://www.facebook.com/photo.php?fbid=332812673481521&set=a.159418667487590.34880.159118167517640&type=1&theater

"Mary Conant, a Registered Nurse, comments:

"One of the doctors cautioned us against saying, 'Poor baby'. That it was upsetting to the mothers if you brought a baby back to her after having been circumcised and were going 'poor baby...' You know- patting the baby, saying
'Poor baby...' which is a normal thing to do to a baby that's crying. If a baby has labwork done, you pick it up and say, 'Oh poor baby'. The baby has any other painful thing that happens, you pick it up and comfort the baby and say 'Poor baby...' or something like that. So, its okay to do that with anything else that hurts the baby, but you can't do it with a circumcised baby because that will make the mother feel guilty and upset her. So, I don't know what you're supposed to say- 'You're a man now'? 'This is for your own good'? 'You're cleaner now'?""

The circumstraint

In less than 30 seconds, a nurse can immobilize the struggling infant securely in the correct position with Circumstraint. The immobilizer works on a proven principle of positive 4-point restraint. Soft wide Velcro® brand fastener straps encircle the infant's elbows and knees, depriving him/her of leverage. The child is held safely and securely without danger of escape. Circumstraint's comfortable contoured shape positions the infant, hips elevated, perfectly presenting the genitalia. The platform between the infant's legs provides support for a circumcision clamp.  

The Circumstraint permits a nurse to quickly immobilize an infant in the proper position, speeding procedures and saving valuable time for doctors. Exceptionally durable, Circumstraint gives long service, even with the heaviest use. Proven over many years, Circumstraint has become the infant immobilization standard for modern nurseries.



http://www.facebook.com/photo.php?fbid=312440778852044&set=a.159418667487590.34880.159118167517640&type=3&theater

Mini-Documentary about human rights and infant circumcision

Please note: at around 5 minutes, there is footage of an actual circumcision taking place overlaid with the speech. The cries of the baby caught me off guard. Just be aware of it. It's heartbreaking.
A mini-documentary based on the testimony of Anthony Losquadro during the MGM Bill Hearings. The hearings were held in Boston Mass, USA, on March 2, 2010.

Every action has a reaction. This trampling of human rights in abuses has given rise to the intactivists. Someone who supports genital integrity and self determination. I am proud to stand here as one along with my fellow colleges. Do we have some personality disorder? No we just want to protect the human rights of infants. And we wanted our bodies left alone, as nature and creation intended. But the medical community wouldn't leave us alone. They callously modified our bodies without our consent. We didn't ask for this. It is through no fault of our own. And we won't be embarrassed or ashamed to speak about what was done to us.

The intention of the intactivists is not to outlaw circumcision but we believe that each person has the infallible right to choose for himself, as a consenting adult of 18 years or older of self determination over the status of his sexual organs.

You wouldn't be able to [circumcise the adult] me today,. Yet I am an adult who has been circumcised against his will

Oh, I was probably about maybe 6 [years old] or something like that—I saw a little boy who was not circumcised, and I asked my parents, you know: "What's going on with this kid? Why does he look different?" They explained that I had been circumcised—that I had undergone an operation; [the explanation] was very brief and I didn't press any more questions.

....

So, that made me very indignant—that this is something [about which] people are lied to. People think of it as a "trivial" matter when really it's not; you wouldn't be able to [circumcise the adult] me today, for instance—it would be recognized as illegal, and in violation of my autonomy. Yet, essentially, I am an adult who has been circumcised against his will, and for some reason it's viewed in a different light, and I don't see how it's different at all, actually.  - David Pinckney

http://infocirc.blogspot.com/2012/09/david-pinckney-wheres-my-foreskin.html

Female circumcision: orgasm still possible?

http://www.rnw.nl/africa/article/female-circumcision-orgasm-still-possible


“Help the victims, but condemn the practice,” says Hussein Ghanem.
“You have real victims, women who suffer all their lives,” says Sara Johnsdotter. “But you also have many women who live very well with it. A respectful treatment would talk to both kinds of women, with all kinds of experiences.”
“Don’t start by telling people they’re barbarous and that they torture their own daughters,” she argues. Focus on “bodily integrity and human rights”. A woman’s right to keep her genitals in one piece.

Myths and facts about circumcision

Wednesday, September 19, 2012

Well, read them Dr. Freedman!

From http://www.thejewishweek.com/features/new-york-minute/fleshing-out-change-circumcision

Dr Anthony Freedman, a member of the AAP task force on circumcision:

"q: Do you have a son and, if so, did you have him circumcised?

a: Yes, I do. I circumcised him myself on my parents’ kitchen table on the eighth day of his life. But I did it for religious, not medical reasons."
"On my parents’ kitchen table"!!!! That guy is too much. Not only breaks the specifications of the committee of bioethics, but treats his own child like it's a chicken from the fridge???

Pediatricians, when providing medical care for their own children, are more likely to lack objectivity, function with incomplete information, and have difficulty setting physician-patient boundaries. Significant confidentiality issues could arise when caring for minor relatives and the children of close friends. By providing potentially less-than-optimal care for these children, pediatricians violate a fundamental professional obligation. Exceptions to the general prohibition are limited to minor treatments and decisions (often similar to those handled by nonphysician parents) or clear emergencies and disasters and for pediatricians who practice in underserved areas in which there are no other physicians capable of providing pediatric care. (
http://pediatrics.aappublications.org/content/124/6/1685.full )  But I guess he wasn't giving his son medical attention, he was performing a religious ceremony.

 "Why is there such negative sentiment against circumcision?

"I can’t really say. However, I can tell you that I’ve received thousands of e-mails over the years from parents..."
Well, read the letters! That's how you will be able to say!

Intact America, a New York nonprofit against infant circumcision, is demanding that the AAP retract its report “on the basis that it is inaccurate, biased and misleading,” among other charges.

Dr. Freedman said such backlash was expected. He said the AAP task force went out of its way in the technical report “to be inclusive, comprehensive and transparent as to the quality of the evidence.”

“As a practicing pediatric urologist, 20% of the patients I will see today are here because of something related to their circumcision,” Dr. Freedman said. “The procedure has some modest benefits and some modest risks.”

Families shouldn’t “feel like they’re harming their child no matter what they decide to do.
 The AAP encourages physicians to ensure that families understand that infant male circumcision is an elective procedure. The updated statement also accounts for the fact that male circumcision is not purely a medical decision, but includes aesthetic, cultural and religious factors [... my note: just like female cutting!] as well, Dr. Freedman said.

“We recognize our ethical obligation is in the best interest of the child, and we don’t have the ability to judge the best interest of the child across all those paradigms, []” said
...my note: your job was to judge best interest in medical terms, not religious, not cultural, not "aesthetic" for the pleasure of all the circumfetishists and acucullophiles out thereDr. Freedman, a pediatric urologist at Cedars-Sinai Medical Center in Los Angeles. “If [families] want the procedure, they can justify getting it. If they don’t want it, they don’t have to have it.”

The American Medical Association says the decision for neonatal circumcision should be determined by parents in circumstances in which the procedure is not essential to the child’s well-being.
Well Dr. Freedman, the guys in the photos in circumcision harm (click here) are a clear example of what this policy can achieve. Please look at them and  tell me if they received a modest benefit or a modest risk. Please tell me if they lives were not simply ruined by a guy just like you. Please look at them and tell me again how you don't understand why there is such a negative sentiment against circumcision.

Please tell me again why you had the right to be a part of the Task Force on Forced Male Genital Cutting, because I really don't understand that.

From: Rationalising circumcision: from tradition to fashion, from public health to individual freedom

From

    SYMPOSIUM ON CIRCUMCISION   
Rationalising circumcision: from tradition to fashion, from public health to individual freedom—critical notes on cultural persistence of the practice of genital mutilation

S K Hellsten

.....

From a human rights perspective both male and female genital mutilation, particularly when performed on infants or defenceless small children,and for non-therapeutic reasons can be clearly condemned as a violation of children's rights whether or not they cause direct pain. Parents' rights cannot override children's rights.

.....

 The studies by Fletcher,14 and Fleiss18 show how in the United States, where the routine circumcision of newborn males has been common until rather recently, because of the widespread diffusion of the scientific myths about its benefits, the medical data with counter results were deliberately ignored or misinterpreted in order to maintain the practice. For instance, the latest reports from European medical research on the issue were neglected in order to maintain the practice in the USA even when it was already rapidly disappearing in Europe, as also noted by Hutson.1 Behind the disguise of alleged medical benefits we can find more gruesome reasons for the maintenance of the practice. In a modern, American, market oriented society male circumcision became a form of commercial exploitation of children when physicians, in cooperation with transnational biotechnology corporations, looked for the sales of marketable and economically profitable products made from harvested human foreskins that could further be used in the pharmaceutical industry (Fletcher,14 pp 259–71), (Sorrells,15 pp 331–7).17

.....


Human sexuality and the attempts to control it, particularly to reduce or add sexual pleasure, have been, in one way or another, a part of all known cultures and civilisations. While sometimes this fact is acknowledged openly as the main purpose for genital mutilation, in most cases other rationalisations are put forward for the practice. These false reasons have varied from religious and cultural demands to a number of medical ``explanations'', depending on the wider cultural tradition within which the practice has appeared. These different rationalisations for the maintenance of the practices in various cultures show that no matter what the cultural differences are in beliefs and lifestyles, genital mutilation is a universal sign of human civilisation—or maybe the lack of it. All societies have found the arguments that best fit their local cultural traditions and environments in order to introduce or maintain genital mutilation in its various forms. In the Western, rather individualist tradition, these rationalisations are based on benefit to the individual and/or autonomy; in the Southern and Eastern cultures their support is drawn more directly from social values and ties, or from the need to protect one's unique cultural identity against Western cultural imperialism. Thus, in this regard one cultural tradition cannot be said to be better than another. Rather, with further education and knowledge the cultural smokescreen around the real reasons for the maintenance of the practice can be overcome in all societies no matter what their cultural background.