Sunday, September 29, 2013

How American medical school books normalize genital mutilation (circumcision)

The book "Biology of Humans: Concepts, Applications and Uses", by Judith Goodenough and Betty A. McGuire, ISBN-10: 0321821718 | ISBN-13: 978-0321821713, used by college students, just like many other medical textbooks, normalizes circumcision.

As mentioned by a fellow activist, all of the drawings of males depict males with exposed glans,  "circumcision" is in the glossary but foreskin is not (labia is though)."

The other day I stopped at a bookstore, and I stopped to take a look at "The illustrated atlas of the human body" by Beverly McMillan. In page 233 it has its only mention of the foreskin. "The tip of the penis is covered with a loosely folding prepuce or foreskin. Circumcision removes the foreskin"

Notice the impersonal form. "Circumcision removes the foreskin". But what is circumcision and how does it get there? How does it manage to remove the foreskin? Do you see the disconnect. Why is there a mention of circumcision? Why is it that the mention of foreskin is even followed by removal and by circumcision? When I looked at the page about the breasts, the second sentence didn't read "mastectomy removes the breast".

What about the anatomy of the foreskin? What about the functions?

Circumcision advocates often call us "foreskin fetishists", but how to understand that a part of the body is intentionally omitted, and when mentioned, no discussion of its value, functions or anatomy is allowed, only the fact that it is removed by a procedure, no mention of who performs the procedure or why or whether it is elective or not...

How can students learn about the normal human body when parts of it are intentionally omitted?

Thursday, September 19, 2013

My response to Jill on "How intactivists are ruining the debate on circumcision"

Jill in declares that intactivists are ruining the debate on circumcision - while acknowledging some important points about the fight for genital integrity of minors.

I appreciate that you admit that there should be a discussion over male circumcision. In fact, my belief is that there should be an integral debate on the issue of genital cutting of minors (males, females, intersex). Genital cutting is not a matter of gender, it's a matter of control, it's a children's issue.

Mark Joseph Stern says in the text you quoted: "None of intactivists’ cornerstone beliefs are based in reality or science". I'll give you facts that he can't deny:

* Circumcision damages or completely removes the frenulum. This is important because circumcised males who still retain their frenulum, and even intact males, consider it to be their "g spot". Those males who had it damaged or removed have lost their "g spot".

* Circumcision removes the ridged band. The ridged band was described by John Taylor, Canadian Pathologist, as a "intensely vascular" and "richly innervated" which "appears to be an important component of the overall sensory mechanism of the human penis".

* Circumcision restricts the skin mobility of the penis. This has been noted by circumcision promoters as well. This is important because the mobility serves a mechanical function, that is to allow the foreskin to glide over the glans during sex.

* Circumcision allows for gradual keratinization of the glans. This has been noted by circumcision promoters and opponents and is documented in encyclopedias. Whether the keratinization (hardening and drying) of the surface of the glans has an effect or not on sexuality is a different matter, but the phenomenon itself is objectively verifiable.

These are facts that are rarely discussed by circumcision promoters and apologists, such as Mark Joseph Stern, who appears to have a personal bias for circumcision. One clear demonstration is that you won't find the words "frenulum", "ridged band", "mobility", "keratinization", "Meissner" and not even the word "condom" in reference to HIV prevention, in the totality of the AAP's Technical Report on Circumcision.

A response to Nancy Ripton's "When to circumcise" in Canadian Family

Nancy Ripton learned that there is a different protocol for newborn circumcision and late circumcision during childhood. One reason Dr. Martin gave her is that "babies tend to bleed less and fuss less during a circumcision".

A problem with newborn circumcisions is the risk of bleeding, because babies have less blood. In fact, this happen to Ryleigh McWillis from the British Columbia in 2002. The parents were told to look for bleeding but they didn't know how much bleeding was too much, and this caused the dead of their dear baby.

Less blood may also mean higher risk for cardiac arrest. A baby died in Israel in May of this year after a Jewish bris. The baby appeared to stop breathing shortly after the procedure, but the media refuses to acknowledge the role of the circumcision, citing instead a possible unknown pre-existing condition.

The use of anesthetic may be debated, but the pain of circumcision is not subject of debate. Listen to the cries, observe the face of a baby, and you won't have any doubt.

You say delaying brings up the question of whether the child should be circumcised at all, and Michael says he is circumcised and he wants his son to be as well. The actual question is why should a baby be circumcised in absence of any disease, condition or abnormality?

Is there a logic to subjecting a baby to amputation of healthy normal tissue that does not represent a threat to the baby's well being?

Isn't it obvious that cutting a part of the penis affects the sexual experience and reduces pleasure? It was obvious for Jewish philosophers and physicians in the 1st century (Philo), and later in the 12th century (Maimonides), and it was obvious for the American and British physicians that advocated circumcision (and clitoridectomy) to punish and discourage masturbation (of boys and girls) in the late 19th century and early 20th (see J.H. Kellogg).

The $200-$2000 cost of circumcision can be incredibly increased if your son happens to be the unlucky one to develop a complication requiring corrective surgery. Penile denudation, buried penis, penile adhesions, skin bridges, lacerations and partial amputation of the glans (specially with the method favored by Dr. Pollock and his disciples, the Mogen clamp). Or the possibility of too much skin removed, resulting in painful erections and sex as an adult.

Phimosis is not an indication for infant circumcision. Most babies are born with physiological phimosis, it's a natural condition for that age, because the foreskin and the glans have not separated completely. Separation takes years, and retraction often becomes possible in the 10-17 years range. Operating for phimosis before adulthood is like giving a baby a denture because he is toothless.

Urinary backflow is not cured by circumcision. Those babies often need surgical correction of the ACTUAL problem.

Penile cancer hardly qualifies as prevention, given the low incidence of the disease. The AAP estimates that 909 to 322,000 circumcisions are needed to prevent a single event, and that comes at the cost of 2 to 909 complications, some of which can be severe and life long. It's in the AAP's Technical Report on Circumcision, the one people don't bother to read before repeating the marketing propaganda.

Circumcision as HIV prevention doesn't measure as well, as has been found out by Zimbabwe and Nyanza in recent days. Safe sex, abstinence, monogamy and low promiscuity are important measures. Circumcision is a distraction.

A group of international physicians, including Canadians, has published an article criticizing the AAP's Policy Statement as culturally biased and scientifically unsound.

What is the price of self-determination and bodily integrity? How many studies are needed to override the empowerment to decide over one's own body? Self-ownership?

Forced infant circumcision (prepucectomy) is an unethical, unnecessary and risky residual of the Victorian era, justified with overinflated health benefits and overlooked risks and harm.

The foreskin has sexual functions. It's removal permanently alters the sexual experience, by damaging the frenulum, removing the ridged band, limiting the skin mobility and subjecting the glans to gradual keratinization. But those interested in promoting the procedure won't discuss the anatomy and functions of the foreskin, or the harms that I just mentioned.

One thing I will give Nancy. The graphic chosen to represent circumcision is quite fitting. English speaking countries practice of circumcision: cutting the edge of the sexual experience of your children for over 150 years.

To circ or not to circ - A response to Dr. Mike Patrick blogging at iTriageHealth

Doctor Mike Patrick, an  emergency medicine physician and Medical Director of InteractiveMedia for Nationwide Children’s Hospital, blogging on, misrepresents the AAP's Policy Statement on circumcision and decrees the intactivist movement as fear-provoking and unscientific.

This is my response to Doctor Mike Patrick, which I submitted as comment on the blog entry - and assume will never pass moderation, as the almost one year article has 0 comments:

 The AAP did not say that the benefits CLEARLY outweigh the risks. In fact they said (copy and paste from their technical report):

"Parents should weigh the health
benefits and risks in light of their
own religious, cultural, and personal
preferences, as the medical
benefits alone may not outweigh
these other considerations for individual

Circumcision rates in Europe did not decline. They have NEVER been high except among Muslims and Jews.

The Johns Hopkins report by Aaron Tobian is a computer simulation applying African data to the U.S. population. One would have to wonder why Tobian did not apply European or Latin American data instead. Perhaps because that would not support the desired conclusion.

The result of his report is to put a price tag of about $400 on a foreskin. That is unethical thing to do. What is the worth of a body part? An eye? A leg? A hand?

Furthermore, the conclusion is not supported in real life. His premise is that healthcare cost would rise if circumcision rates were the same as in Europe; so why isn't healthcare cost as elevated in Europe?

Other international pediatric and medical associations contradict the AAP's position. The Royal Dutch Medical Association indicates that the risks outweigh the benefits. 38 international physicians and heads of medical associations presented an article denouncing the AAP's cultural bias towards circumcision.

The AAP's report makes no mention of prostrate cancer.

Intact penis - something you almost never see in American medical textbooks!

Regarding penile cancer the AAP says (again, copy and paste from technical report):

"The clinical value
of the modest risk reduction from circumcision
for a rare cancer is difficult
to measure against the potential for
complications from the procedure. In
addition, these findings are likely to
decrease with increasing rates of HPV
vaccination in the United States."

And it estimates 909 to 322,000 circumcisions required to prevent a single case of penile cancer, at the cost of 2 to 909 complications suffered by real babies - who will have to carry the consequences for life.

Severe complications of newborn
circumcisions affecting adults
 Common risks that you did not mention include adhesions (which can become skin bridges and cause pain during sex to the adult that the baby will become), too much skin removed (very common in the U.S. and a cause of pain, sore skin and even bleeding during sex - normally not even considered to be a complication!) and even penile denudation. In recent years the rate of circumcision revisions has increased 119% according to the AAP - this means children subjected to additional genital surgeries, at additional expense and emotional cost.

The AAP Policy Statement did not acknowledge the main problem with newborn circumcision, one that the World Health Organization recognizes: the problem of consent.

 A concern about early infant male circumcision is that the child cannot give informed consent for the procedure. Moreover, some of the health benefits, including reducing the risk of HIV infection, will not be realized until many years later when the person becomes sexually active. If circumcision is postponed until an older age the patient can evaluate the risks and benefits and consent to the procedure himself. - World Health Organization

Circumcision is a permanent body modification that the baby will have to live with for the rest of his life, whether he agrees with it or not as an adult.

You don't do your readers any favor by misrepresenting the AAP's position with your personal bias.

Wednesday, September 18, 2013

My response to Mark Joseph Stern - How Circumcision Broke the Internet - Slate

Mark Joseph Stern published in Slate an article called "How Circumcision Broke the Internet"

Mark Joseph Stern

This is my response:

Mark, you are wrong in your appreciation of intactivism and its timeline.

Intactivism can be traced at least to 1900 when AP Morgan Vance, M.D. from Louisville, KY, wrote an article on "Surgical Fanaticism".  Joseph Lewis, American freethinker and author, published "In the name of humanity" in 1949. William Keith C. Morgan, MD, wrote an article called "The rape of the phallus" in 1965. Douglas Gairdner, DM, MRCP, published "The fate of the foreskin" in 1949. American Jewish scientist and Nobel Prize award George Wald wrote an essay on circumcision in 1975 (but could not get it published during his life). Jewish author Edward Wallerstein published in 1980 a book called "Circumcision: An American Health Fallacy".

More recently a group of 38 non-U.S. physicians, heads or spokespeople for the paediatric associations of Austria, Britain, Denmark, England, Estonia, Finland, Germany, Iceland, Latvia, Lithuania, Norway, Sweden, and the Netherlands, and by senior paediatricians in Canada, the Czech Republic, France and Poland, published an article denouncing the Cultural Bias in the AAP's Policy statement on circumcision.

Circumcisions used to be funded in England, Canada and Australia, but England stopped funding it in 1949 due to lack of consensus over its benefits and growing awareness of morbidity and mortality. Canada and Australia also stopped funding infant circumcisions. The only country where infant circumcisions are performed with a pretense of health benefits is the U.S.

Activism from lay people against circumcision in the United States has occurred at least since 1970 with Van and Benjamin Lewis in Florida. Citizens Against Ritual Violence (CARV) in California in 1980. 1986 saw the appearance of NOCIRC, funded by Marilyn Milos. Tim Hammond and Wayne Griffiths funded NORM - National Organization of Restoring Men, in 1989.

Intact America was founded in 2008 and is presently the most well known intactivist organization with a strong presence in the media.

I wouldn't qualify those groups and individuals as being fringe groups. Foreigners coming to the U.S. (as myself) are usually shocked to learn about the practice of infant circumcision, which we find cruel and barbaric.

Circumcision has subsisted in the U.S. due to that veil of secrecy and taboo. People do it and don't speak about it. Males often grow up ignorant to their own circumcision status. Yet, when objectively evaluated, infant circumcision is nothing but a residual of the Victorian era.

The San Francisco initiative to vote on age-restriction of circumcision did not collapse due to its own weirdness, like you said. Reality is even stranger: it collapsed because a judge used a law that was originally created to allow veterinarians to declaw cats without intervention of municipalities! But the threat of this initiative was scary enough for religious groups that an "urgent" bill was presented (without public vote) to protect circumcision from municipal rulings in the state of California by Democrat Mike Gatto (A.B. 768)

Those interested in perpetuating circumcision because of their personal bias or financial greed seem more desperate nowadays to try to find elusive "health benefits" to justify the billion-dollar-year industry which  provides supplies for biomedical research and makeup manufacturing, fresh newborn foreskins used for fibroblasts, collagen and stem cells.

Absent from the debate is the fact that circumcision has verifiable harms which the benefits and risks fail to balance. But the AAP and other promoters do not mention these harms - or even discuss the anatomy and functions of the foreskin. Shouldn't it be a red flag to advocate the excision of normal tissue without discussing its functions?

A person subjected to surgery to remove a finger knows that there is a loss of the functions of that finger, that is an obvious fact and needs no study to prove it. The loss of the foreskin to circumcision also implies the loss of its functions and structures: loss or damage to the frenulum, loss of the ridged band, restriction of the skin mobility and progressive keratinization of the glans.

Regarding HIV, recent news have shown that new infections during 2010-2011 in Zimbabwe were more prevalent among circumcised males, and that the increasing rate of circumcision in Nyanza has failed to curb the new HIV infections, further proving that the presence or absence of foreskin has nothing to do with HIV infection, and behavior and safe sex practices have everything to do with it.

Foreskin restoration can be done for a price like you said - and the price of the common devices is less than the cost of an infant circumcision at the local hospital, and there are no doctors involved in the process. But foreskin restoration can also be done at no cost, through manual tugging or using Do It Yourself methods involving common household items. After all, shouldn't we males be entitled to our own bodies? Isn't it true that many women procure breast reconstruction after mastectomies? So why do we have to agree with a forced prepucectomy that we never wanted in the first place?