CIRCUMCISION: For or Against? (NO BASHING!!!)

Much to the chagrin of circumcision advocates who spend endless hours trying to convince you that circumcision is a "non-issue," circumcision is highly controversial, and a guaranteed attention getter.

No parenting forum, webpage or Facebook group is complete without the obligatory circumcision thread, which always asks a question to the effect of "Are you pro or anti-circumcision?" Or "Circumcision: For or against?", and which is usually coupled with some sort of "NO BASHING!!!" warning.

These threads and the pages they're on are something of a paradox; asking for "no bashing," they posit a question that, because of its very nature, will elicit just that. Answering "no" or "anti" is going to be perceived as "bashing" by those who are "pro." Parents who circumcised their children invariably say "it's none of your business!" as they brag on a public parenting forum about having had their children circumcised.

But I digress, and I've already written a separate post about mommy pages and the "no bashing!!!" phenomenon.

"Do you support or oppose circumcision?" asks many a thread on public parenting forums, but this kind of bifurcation ignores many important factors that are relevant to the debate.

For example, is there a medical need? Are other alternatives available? Have they been tried? Shouldn't surgery be reserved as a very last resort?

As a thought experiment, let's replace "circumcision" with any other medical procedure.

Are you for or against appendectomies?

Do you support or oppose coronary bypasses?

Are you in favor of gall bladder removal?

Kidney transplants?

Suddenly, medical necessity becomes relevant, and whether you're "for or against" becomes a moot point, doesn't it.

Am I for or against circumcision?
I am against the forced circumcision of minors unless there is a legit medical need for it, and all other alternatives have failed.

This is standard medical practice governing all other medical procedures though.

If informed, conscientious adult males choose to be circumcised for non-medical reasons, I have no problem with this.


Bottom Line
The foreskin is not a birth defect. Neither is it a congenital deformity or genetic anomaly akin to a 6th finger or a cleft. Neither is it a medical condition like a ruptured appendix or diseased gall bladder. Neither is it a dead part of the body, like the umbilical cord, hair, or fingernails.

The foreskin is not "extra skin." The foreskin is normal, natural, healthy, functioning tissue, with which all boys are born; it is as intrinsic to male genitalia as labia are to female genitalia.

Unless there is a medical or clinical indication, the circumcision of a healthy, non-consenting individual is a deliberate wound; it is the destruction of normal, healthy tissue, the permanent disfigurement of normal, healthy organs, and by very definition, infant genital mutilation, and a violation of the most basic of human rights.

Without medical or clinical indication, doctors have absolutely no business performing surgery in healthy, non-consenting individual, much less be eliciting any kind of "decision" from parents.


Related Posts:

The "Mommy Page" Wars

REPOST: If You Can't Stand the Heat...

The Circumcision Blame Game

Germany "Protects" the Forced Genital Mutilation of Boys

"For the right to circumcise little boys."

Well, it appears that Germany chose to cave to political blackmail and pass a law to "protect" the so-called "religious right" to take a child and mutilate his genitals.

I've already commented on this before, so instead of repeating myself, I'm just going to dissect a Reuters' article reporting this turn of events, since they're not publishing comments.

"The ban - imposed on the grounds that circumcision amounted to "bodily harm" - triggered an emotional debate over the treatment of Jews and other religious minorities, a sensitive subject in a country still haunted by its Nazi past," begins the article.

The Cologne ruling was not mistaken; unless there are medical indications, circumcision DOES amount to bodily harm, and the boy involved in the ruling was one of many cases in point.

What's interesting is that one bodily harm, circumcision, is being defended by alluding to the bodily harm German Nazis imposed on Jews. A bit of an oxymoron. "Shame on Germany for wanting to protect children from bodily harm; remember what they did to Jews sixty years ago." (?)
 
"The outcry prompted Germany's centre-right government and opposition parties to draw up legislation confirming the practice was legal - overruling the decision by a court in the western city of Cologne."



As if the legality of forced genital mutilation on minors was something to confirm. I'm afraid German Common Law is rather clear on this, as are the laws of many other industrialized nations. Germany's government was faced between upholding its Common Law, and divorcing themselves from Nazi labels.

"The new law passed by an overwhelming majority in Bundestag lower house said the operation could be carried out, as long as parents were informed about the risks."

This may actually be a light at the end of the tunnel for human rights activists; ultra-orthodox rabbis in New York are fighting to keep the City from passing a law that demands precisely this.

Still, Germany would never allow female circumcision "as long as parents were informed about the risks."

"Jewish groups welcomed the move."

In New York, Jewish groups are fighting to keep the city from requiring them to inform parents about the risks, as this is seen as an "infringement of  their religious freedoms."

"This vote and the strong commitment shown ... to protect this most integral practice of the Jewish religion is a strong message to our community for the continuation and flourishing of Jewish life in Germany," said Moshe Kantor, President of the European Jewish Congress.

 Jewish life, yes. Muslim life? Only if your child is male; some Muslims see female circumcision as "an integral practice of the Jewish religion." Take a look at what's happening in South East Asia;
 the Malaysian Health Ministry wants to medicalize female genital cutting.

Germany's Catholic Bishops Conference said it hoped the bill would help safeguard religious freedoms. No comment was immediately available from the country's Central Council of Muslims.



SOME religious freedoms. Actually, only this particular "religious freedom" as it applies to healthy, non-consenting boys.

Does the new law protect these "religious freedoms?"

A father slashes his child's head for the Holy Day of Ashura

Muslim women perform "sunat" (ritual genital cutting) on a girl

Child marriage in India

"PAIN MINIMISED
The May ruling centered on the case of a Muslim boy who bled after the procedure and the ban only applied to the area around Cologne."

But this forced lawmakers to consider a change in the law, as, actually, the Cologne ruling reinforces German Common Law.

"But some doctors in other parts of Germany started refusing to carry out circumcisions, saying it was unclear whether they would face prosecution."

Actually, they stopped because it was rather clear to THEM that they would.

"Under the new law, a doctor or trained expert must conduct the operation and children must endure as little pain as possible, which means an anesthetic should be used. The procedure cannot take place if there is any doubt about the child's health."

No such provisions and exceptions exist for female genital cutting.

Female genital cutting is always wrong, and it doesn't matter if a doctor or a "trained expert" conducts the ceremony, and that the children "endure as little pain as possible."

For most other surgery as performed by doctors and physicians, surgery is performed AS A RESULT of a doubt in the child's health. i.e., there is medical necessity that prompts it. This seems to be the only case where a child must be HEALTHY to undergo surgery.


"Justice Minister Sabine Leutheusser-Schnarrenberger said no other country in the world country had made the religious circumcision of boys an offence."

Plenty of laws to make religious circumcision of girls an offence though...

"In our modern and secular state, it is not the job of the state to interfere in children's' upbringing," she said.

Except if the child is a girl, I'm sure.

Child welfare group Deutsche Kinderhilfe disagreed, saying the government had "(pushed) through the legalization of the ritual of genital circumcision ... against the advice of child right campaigners and the medical profession."


And they are right.

This is purely a political move, and everybody knows it.

German Common Law is rather clear on this matter, and the Cologne Ruling serves to make it even clearer. German lawmakers are choosing to look the other way because they fear Nazi labels.

All double-standards, self-contradiction and beating around the bush. Let's see how this move plays out, as it flies in the face of Germany's Common Law. Special pleading. What's next? "Protecting" female circumcision? Sharia Law to appease the Muslims?

I've asked before; how far are "parental rights" and "religious freedoms" protected?

As long as doing so doesn't label you Nazi, it seems.

Closing Remarks
Most of what I have to say on this matter I've already done so on past post, but I wanted to copy and paste the closing remarks here.

Intactivists, do not despair; to those of you who do, you should have this coming. We shouldn't despair when politicians with agendas change the laws to appease voters and preserve popularity. Laws don't change anything. They never do. In a social movement, laws are the very last thing to change. What we need to work on is changing people's attitudes. Female circumcision was swimmingly outlawed because our country already viewed the practice with disdain. History shows us that laws reflect social change, not bring it about. And, it looks like, judging by news articles and reports, the fact that more and more people are openly talking about the practice, the very fact that it's being questioned in courts, change is already happening.

Do not despair, and keep educating. More and more people listen every day.

 "Truth suppress'd, whether by courts or crooks, will find an avenue to be told"

~Sheila Steele

 "Do nothing secretly; for Time sees and hears all things, and discloses all"

~Sophocles

DISCLAIMER:
The views I express in this blog are my own individual opinion, and they do not necessarily reflect the views of all intactivists. I am but an individual with one opinion, and I do not pretend to speak for the intactivist movement as a whole, thank you.
~Joseph4GI




Related Post:
The Cologne Ruling and the Limitations of Religious Freedom

AAP: Around the Bush and Closer to Nowhere

The eminent AAP position statement on circumcision had been much hyped by the media and circumcision enthusiasts. The new statement has been leaked, and I've read it, but it leaves a lot to be desired. More than a clear and direct statement, the statement creates more confusion than clarity.

Actually, there is one thing clear; the new statement was carefully drafted by rabid circumcision advocates wanting to keep waters muddy.

Actually, there have been two PDFs that have are bouncing about on the internet; an abridged summary, and a much longer version which often reads like a broken record, repeating the same thing over and over like a mantra. Additionally, the longer version leaves a few key points out that appear in the summary. They're essentially the same, though, continuing to ignore the crux of the argument, going on and on about questions nobody asked, and appealing to endorsement from non-related medical organizations.

I repeat again; what I criticize here is an abridged summary; this isn't the detailed statement released in its entirety. There is so much bullshit I already tackle on my blog.

From the released summary:

The Abstract
"Male circumcision is a common procedure, generally performed during the newborn period in the United States. In 2007, the American Academy of Pediatrics (AAP) formed a multidisciplinary task force of AAP members and other stakeholders to evaluate the recent evidence on male circumcision and update the Academy’s 1999 recommendations in this area. Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it. Specific benefits identified included prevention of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV. The American College of Obstetricians and Gynecologists has endorsed this statement."

We must know what "recent/current evidence" means. Did they evaluate all of it, or just the evidence that attempts to justify this pathetic update? Notice we hear alleged "benefits," but so far, we don't hear about a single risk. And notice the part in red; this will be important later. (The "benefits," are discussed in the more detailed statement. Readers will be able to see for themselves exactly what data they used; the same old crap.)

It must be asked, what in the world does the American College of Obstetricians and Gynecologists (ACOG) matter in any of this? The American Academy of Pediatrics (AAP) is concerned, at least ostensibly, with the health and well-being of children. ACOG is concerned with the health and well-being of WOMEN. Why does it matter that ACOG approves of this statement or not, when the circumcision of infant MALES should not even be in their purview?

The answer: It is because the majority of circumcisions in the US are carried by OB/GYNs, and a negative statement by the AAP would affect their business, that's why.

A little hint; ACOG isn't the only organization that has blessed this statement; other organizations are mentioned in the more detailed statement, and understandably so, as there would be physicians in other trade unions who perform circumcisions, but ACOG is key, because OB/GYNs are the ones who have a bigger slice of the pie.

Let's move on.

The Policy Statement
"Systematic evaluation of English-language peer-reviewed literature from 1995 through 2010 indicates that preventive health benefits of elective circumcision of male newborns outweigh the risks of the procedure."

What is the literature that was evaluated? Was it a comprehensive analysis? Or was it cherry-picked data? Was the data obtained from experiments and research conducted in adult males, or children? What is the reason that no other medical organization in the world has come to this conclusion using this same "data?"

Readers will be able to read what "research" was used in the creation of this document once it is released in its entirety.

"Benefits include significant reductions in the risk of urinary tract infection in the first year of life and, subsequently, in the risk of heterosexual acquisition of HIV and the transmission of other sexually transmitted infections."

What data was used to come to this conclusion? Were other methods of prevention considered? And, again, why have other medical organizations in the world come to this conclusion?

I have read the entire thing, and I can already tell readers, it focuses myopically on how to necessitate circumcision. Not a word on alternatives. Worse than that, it fearmongers by insisting over and over again that parents should be encouraged to circumcise in infancy "because it is when they can benefit more from it." (Nevermind countries that do well without it.) They also skim over the fact that older men would be less than likely to buy this crap and refuse to undergo circumcision in adulthood, but instead of respecting older men's decisions, trampling over their basic human rights to choice over their own bodies seems to be a REASON to recommend circumcision in children, and it is ignored as the very crux of the ethical debate. Basically, a blatant endorsement of abuse, where I define it as taking advantage of those smaller, and weaker and unable to fend for themselves.

"The procedure is well tolerated when performed by trained professionals under sterile conditions with appropriate pain management."

This isn't news; most surgery is "well tolerated when performed by trained professionals under sterile conditions with appropriate pain management." The question is, is it necessary in healthy newborns? What are the risks, and it is it conscionable to cause a healthy, non-consenting child to undergo them? Are the "benefits" not obtainable using less invasive modes of prevention? What are they? Or is circumcision supposed to be the only option?

The full article rambles on about "the best way to perform the surgery."  Basically, it hopes readers will look past the important question of medical or clinical need of surgery in a healthy, non-consenting infant, and the validity of the so-called "benefits."

"Complications are infrequent; most are minor, and severe complications are rare. Male circumcision performed during the newborn period has considerably lower complication rates than when performed later in life."

What complications exist, "minor" and "severe?" In children and adult males?

Not mentioned here; MRSA infection, infection with herpes, the development of gangrene, a botched procedure resulting in unpleasant cosmetic results, partial or complete ablation of the glans, hemorrhaging, and even death.

These are actually mentioned in the more detailed article, albeit heavily minimized and not given their deserved attention. They choose only to look at, of course, only the evidence that suits them.

They actually go into other important issues like sensitivity and sexuality, but, again, only quoting the "evidence" they choose, predictably, the so-called "trials" in Africa. They even admit that the data is rather shoddy and poorly obtained but consider this the best they've got. Not included in here was the Sorrells sensitivity study. Nor the Danish study. Nor other studies that show adverse effects. (And they wouldn't because it would jeopardize the position of members who profit from circumcision; who wants to cause adverse effects to their children as grown adults?)

"Although health benefits are not great enough to recommend routine circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns."

Note here, and this is important, we see nothing more than a repetition of the doublethink in their last position statement, which they were hesitant to update.

Here is where the AAP shirks its professional responsibility, and pawns it off on naive parents, most of whom are not versed in, nor interested in, medical literature. (The red part is what ACOG likes, because it absolves OB/GYNs from profiting from procedures which aren't even in their purview.)

Note here the self-contradiction in this statement. What was said earlier in the abstract? Here it is again:

"...the health benefits of newborn male circumcision outweigh the risks..."

But then, here is:

"... not great enough to recommend routine circumcision for all male newborns..."

And again:

"...sufficient to justify access to this procedure for families choosing it..."

If the so-called "benefits" weren't enough for what has been up until now, a well-respected health organization, to recommend circumcision, why would naive parents be expected to weigh the same exact evidence and reach a favorable conclusion?

 

In short, the weasel words are "yes, no, but maybe."

The statement concludes:
"It is important that clinicians routinely inform parents of the health benefits and risks of male newborn circumcision in an unbiased and accurate manner."

And we can trust a clinician who sees a price tag at the end of every foreskin to do just that, right?

"Parents ultimately should decide whether circumcision is in the best interests of their male child."

Medical necessity and the ethics of cutting off part of the genitals of a healthy, non-consenting child be damned...

"They will need to weigh medical information in the context of their own religious, ethical, and
cultural beliefs and practices." (As opposed to medical need?)

Once again, the self-same "medical information" that this piss-poor excuse for a health organization could not use to clearly come out and endorse this practice. And once again, the onus of responsibility is pawned off on parents and whatever crazy beliefs they might have. This is the one instance in medicine where "religious, cultural beliefs and practices" trump medical or clinical need. I intentionally leave out the word "ethical" from the quotes because the ethics of performing amputative surgery on a healthy, non-consenting child is being completely thrown out the window.

"The medical benefits alone may not outweigh these other considerations for individual families."

But they already said they weren't "great enough to recommend routine circumcision for all male newborns." Why should should it even be a "consideration" for families in the first place?

Maybe I'm blind?
As Michael Brady was quoted saying, the AAP statement does indeed say  "...the health benefits of newborn male circumcision outweigh the risks." This is actually a key element in this "statement." It is repeated numerous times like the hook in a really crappy pop-song. You know the kind, those silly pop-songs where it's the same song over and over again with only slightly changed lyrics and they expect you to believe it's a new release.


But this part, the important part, is only found in the summary:

"... not great enough to recommend routine circumcision for all male newborns..."

I couldn't find this anywhere in the large article. Did they forget to put it in? Maybe they hoped no one noticed?

I guess "...the health benefits of newborn male circumcision outweigh the risks..." and "...sufficient to justify access to this procedure for families choosing it..." were the more important take-home messages for charlatans who profit from this procedure, and the naive parents they give themselves permission to take advantage of.

But again, perhaps maybe I read this new piece of fiction in a hurry and I may have missed it.

I want to pray that this isn't so, and that sometime in the near future someone will correct me on it.

Medicaid, PAY for it...

Another key point in this new statement, which is only very lightly touched upon in this summary, but well expanded in the full version, is the encouragement of public funding for the procedure. Spoken like the money-driven charlatans they are. In the summary, it is found in the clause that reads "[T]he benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns."

Translated, this statement reads that (again, keeping in mind they said earlier that  the "benefits" were "not great enough to recommend routine circumcision for all male newborns...") that, while they can't come out and endorse the practice (which actually, this is what they are trying to get away with doing), funding should still be provided for it. (Because otherwise families couldn't pay for them, and the charlatans lose out.) It's what this "access" is referring to, and the detailed article goes into much further detail than it does here.

There is now no doubt in my mind the release of this statement was carefully orchestrated with the circumcision liberation brigade at Johns Hopkins and others who have been raving at state medicaid programs that have dropped coverage. The AAP has been hijacked by the likes of Tobian, Leibowitz, Gray and Wawer who, if they don't have cultural or religious convictions to defend circumcision, at the very least are trying to make themselves necessary by insisting medical organizations use the data and only their data to shape public health policy. Remember; if their work is worthless, then so are the millions in grants and funding they receive.

What is it about these "researchers" and their obsession with male genital mutilation? What drives their knives?

Is it cognitive dissonance? Sour grapes? Is it a hidden agenda to preserve what is a cherished and heavily defended religious blood ritual? (No conflicts of interest are declared, but look to their religious affiliations. Keep in mind the recent ruling in Cologne, Germany.) Is it the drive to keep their meal ticket from grants and the prestige of Johns Hopkins? Or is it all of the above?

To close:
I'm not sure what would be worse; if the AAP actually came straight out and said all US males should be forcibly circumcised, or wishy-washy weasel words like these aimed to preserve confusion and continue to allow charlatans taking advantage of parental naivete off the hook.

In short, the statement is just what I predicted it would be, parading around all the "benefits," minimizing or ignoring the risks, and again (at least in their summarized version of the statement), never coming to a direct conclusion. Regardless of the conclusion they fail to arrive, it is more important that circumcision is publicly funded, and the medical value judgement be made by naive parents, not doctors who supposedly went to school for 10 years.

All I can say is, this is nothing but a one-sided statement carefully concocted by people who couldn't be  less interested in the health and well-being of children. This is a piece of work that has had 6 years in the making, beginning with the so-called "trials" in Africa. This was the goal of those who wrote the work. This is the culmination. The ultimate goal was to vindicate what has been a historically problematic religious procedure for Jews and Muslims. The ultimate goal was to emancipate the countless mutilators who hide behind the title of "physician" to profit from infant genital mutilation. The ultimate goal was to clothe a cherished belief, money-maker and violation of basic human rights in science.

But calling a dog's tail a leg doesn't make it one:
It is mistaken, idea that the right amount of “science” can be used to legitimize the deliberate violation of basic human rights.

There would never be enough "research" or "benefits," no matter how "compelling," that would ever convince us to endorse female genital cutting of any kind. Not even a "ritual nick." Not even if it were performed "the right way."

Genital mutilation, whether it be wrapped in culture, religion or “research” is still genital mutilation.

It will be interesting how all of this is going to play out.

How will other health organizations across the globe who have not reached the same conclusion as the AAP react? How is the AAP going to be viewed after basically going against the overwhelmingly negative trend of opinion on routine male circumcision in industrialized nations? Will it be business as usual, or will there be statements from other medical organizations calling the AAP and its accomplices on their bullshit?

You can read my last post on the upcoming AAP policy statement here.

DISCLAIMER:
 The views I express in this blog are my own individual opinion, and they do not necessarily reflect the views of all intactivists. I am but an individual with one opinion, and I do not pretend to speak for the intactivist movement as a whole, thank you.