PORT HURON, MI: Intactivists picket hospital

"Nobody told me we didn't have to."


the Times Herald (Michigan)
March 30, 2013

Protesters decry infant circumcision

by Bob Gross

The people carrying signs Saturday in Pine Grove Park across from Port Huron Hospital were protesting cuts — but not to health care spending or state government.

Members of Intact Michigan were protesting infant circumcision.

“We believe that since girls are protected under the law from genital cutting, males also should be protected under the law from genital cutting until they’re old enough to decide,” said Kaitlyn Young, who organized the protest.

“We’re not against circumcision per se,” she said. “We’re against it being forced on infants.”

Mandi Owczarzak, of Sterling Heights, is one of the co-directors of Intact Michigan. She said the group picked Port Huron as a protest site, not because it’s a center of circumcision, but “it was a good place for all those who wanted to come.”

She has three children, two daughters and a son.

“This is important to me because nobody told me and I almost did it to my son,” she said. “Nobody told us we didn’t have to.”

Young said male infant circumcision is an American cultural tradition and usually is not done for religious reasons.

She said the group advocates religious circumcision be delayed until the male is old enough to make his own decision.

“It he wants to do it for religious decisions, it makes more sense for him to make that decision himself,” she said.

Young said the infant can suffer harm from the procedure, including death.

“A lot of people say it’s parental right or parental decision,” she said.

“It should be a son’s right whether or not he should have his foreskin.”

Young said the procedure is harmful.

“It did hurt the son, it did hurt the husband, it did hurt themselves if they are a man,” she said.

“We don’t need to perpetuate it on future generations.”

• For more information about Intact Michigan, go to www.facebook.com/IntactMI

LEXINGTON, KY: Circumcised men less likely to use condoms

PubMed
March 20, 2013

Intact men more likely to use condoms

This study shows circumcised men are less likely to use condoms at all, more likely to use them rarely, and lack confidence in using them.

Int J STD AIDS. 2013 Mar 20. [Epub ahead of print] A comparison of condom use perceptions and behaviours between circumcised and intact men attending sexually transmitted disease clinics in the United States. Crosby R, Charnigo RJ. Source College of Public Health at the University of Kentucky, Lexington, Kentucky, USA. Abstract This investigation compared circumcised and intact (uncircumcised) men attending sexually transmitted infection (STI) clinics on condom perceptions and frequencies of use. Men (N = 316) were recruited from public clinics in two US states. Circumcision status was self-reported through the aid of diagrams. Intact men were less likely to report unprotected vaginal sex (P < 0.001), infrequent condom use (P = 0.02) or lack of confidence to use condoms (P = 0.049). The bivariate association between circumcision status and unprotected sex was moderated by age (P < 0.001), recent STD acquisition (P < 0.001) and by confidence level for condom use (P < 0.001). The bivariate association between circumcision status and infrequent condom use was also moderated by age (P = 0.002), recent STI acquisition (P = 0.02) and confidence level (P = 0.01). Multivariate findings supported the conclusion that intact men may use condoms more frequently and that confidence predicts use, suggesting that intervention programmes should focus on building men's confidence to use condoms, especially for circumcised men. PMID: 23514832 [PubMed - as supplied by publisher]

Since condoms are so much more effective than circumcision at prevening HIV acquistion and transmission (assuming the RCTs are valid) this just underlines the risk of promoting circumcision.

LONDON: Two out of five would ban infant circumcision

Nearly two out of five support a ban on infant circumcision

Jewish Chronicle
March 27, 2013

Forty five per cent of Britons ready to ban shechita

by Simon Rocker

Almost half the population favour a ban on religious slaughter of animals for meat and nearly a third want a ban on male circumcision, according to the results of a YouGov poll for the JC.

Asked whether they support or oppose a ban on religious slaughter, 45 per cent back a ban, 27 per cent are against and 28 per cent say they do not know.

Opinion diverges less when respondents are asked about “male circumcision for religious reasons”, with 38 per cent [More like 2/5 than 1/3] supporting a ban, 35 per cent against and 27 per cent undecided.

Dayan Yisroel Lichtenstein, head of the Federation Beth Din, said: “It’s worrying and it shows we need to do a lot more public relations to put our case.”

...

Forty-one per cent of 18-24 year-olds would ban both shechita and circumcision.

...

The German government recently passed legislation to protect religious circumcision after a mohel was arrested last year. [No, not even detained, but convicted and discharged.]

...

But David Graham, senior research fellow of the Institute for Jewish Policy Research, cautioned against reading too much into the figures.

...

If people are asked are whether they support or oppose a ban on an issue, he said, “the seed of doubt is already sown in the respondent’s mind, before he or she has had a chance to consider what they are being asked. It is hardly surprising a majority opts for a ban.”

[Perhaps if the question had been,

"Do you think babies' genitals should

1. be left alone?
2. have part cut off?"

the proportion in favour of intactness would have been considerably higher.]


...

WASHINGTON, DC: Intactivists converge for Genital Integrity Awareness Week

DCist
March 27, 2013

Anti-Circumcision Protesters Cut Into Supreme Court Scene

by Benjamin R. Freed

While most of the thousands of demonstrators lined up outside the U.S. Supreme Court today were there to show their opposition to the Defense of Marriage Act, a handful of people were getting snippy about a completely different issue.

Circumcision.

This week marks the 20th annual Demonstration Against Infant Circumcision, a yearly protest in which hundreds of "intactivists" descent upon Washington to clamor for an end to the practice of doctors removing newborn infant boys' foreskin, whether for religious purposes or because it's a standard practice in American medicine.

"Forcing children to participate in blood rituals is wrong," says Jonathan Conte, a San Francisco resident holding a large sign reading "Equal Justice" above a large, graphic photo of a newborn being circumcised. "Religion of one's parents is not a reason to abuse."

Noting that the federal government adopted legislation in 1996 banning vaginal circumcision, Conte wants to see a similar measure adopted that protects penises. While the removal of the foreskin is an ages-old custom in Judaism, Conte says that accounts for only a fraction of circumcisions performed in the United States, where it was adopted as a standard medical procedure for newborns in the mid-19th century.

"That started 150 years ago as a way to curb masturbation," he says. Conte also argues that the reasons for circumcision continuing as a customary operation keep changing, such as AIDS prevention, despite what he says is a lack of evidence. It's also a practice he says is unique to American medicine.

"Most of the world's men have their whole penises, and they're not dropping dead," he says.

To his very open frustration, Conte does not have his whole penis either. He was snipped at birth, and he says he resents his parents for electing to have the operation conducted, as well as the doctor who performed it.

"Every one of my sexual partners has had sex with a mutilated man," he says.

Conte says that a circumcised man of is missing roughly 15 square inches of protective issues around the glans, or head, of his penis, an effect he displays by rolling up a small handbill preaching the ills of foreskin removal. "It permanently alters the form and function of the penis," he says. "The glans is mucosal tissue. It's meant to be covered."

Then there are the effects on the most important functions of the penis. Conte wants to assure people he speaks with that circumcised men—like himself—are still capable of sex and procreation, though in his opinion it can be a bit dodgy.

"I'm not saying cut men can't have sex," he says. "Or that they can't feel pleasure or get erections. Sex without a foreskin is much more abrasive and dry. It's the mechanics of it."

Moreover, the circumcision opponents say the practice is one more example of the U.S. medical system's fee-for-service setup, in which doctors have a natural incentive to perform as many procedures as possible. Only, in the case of circumcision, Conte says doctors are being paid to lop a body part that "years of evolution" haven't discarded.

"Can you imagine if doctors were making money cutting off other parts of healthy baby boys?" he asks.

Conte and his fellow "intactivists" will be in town through the weekend, culminating with a march from the U.S. Capitol to the White House on Saturday. The demonstration will be "extremely diverse" he says. "We have both victims and intact people."

ROSTOCK, GERMANY: Metzitzah Rabbi sued; "Most Jews in Germany don't circumcise"

MOGiS un Freunde
March 23, 2013

Rabbi sued for circumcising his son

by Christian Bahls

Why I am sueing the orthodox Rabbi Yehuda Teichtal for having a circumcision performed on his son
I'd like to make one thing very clear right up front:

This lawsuit is not driven by any anti-Jewish resentments, but by the strong belief that all children bear the same inalienable rights.

With it I don't aim to attack the Jewish naming ceremony that involves amputation of the foreskin, that is an issue for an internal debate among the Jewish people.

I want to point out explicitly that I reject any ideology or action that is directed against a humane, tolerant, free and democratic value- and law-abiding society. I will refuse or quit any cooperation with persons or groups of whom I think would put a society based on democratic values, unconditional and at any time, in question.

In that spirit I also disapprove of any misuse of my efforts to further children's rights to bodily integrity by people that use the issue of circumcision to fuel their discriminating thoughts against minorities.

For now my aim is to shed some light on the circumstances of this particular circumcision. It clearly shows that some people are unwilling to abide to at least the minimum standards set forth by law, for example just obeying the rules for proper medical treatment.

In the video published on the website of the Berlin Tagesspiegel one can see how Mr. Menachem Fleischmann takes a mouthful of wine, then leans down over baby Mendel Teichtal to suck blood from his bleeding penis.

In §1631d BGB the law states that parents may only consent to a foreskin amputation if it is to be performed according to the rules of medical science, with the degree of skill and learning commonly applied under all the circumstances in the community by the average prudent reputable member of the profession.

...

The act of performing a Metzitzah B'peh in itself would be a violation of the demand for adherence to the rules for medical treatment to make the foreskin amputation legal according to §1631d BGB.

It is not to be assumed that the legislator intended to legalize the Metzitzah B'peh. During the hearing in the justice committee of the German Bundestag on Nov. 26th, 2012, Rabbi and urologist Dr. med. Antje Yael Deusel stated: "The most recent medical standards concerning surgical execution, including sterility and appropriate pain treatment, both during and after the operation, have to be met. A so-called Metzitzah B'peh - meaning a direct sucking of blood from the wound - is obsolete and has to be omitted unconditionally." (German protocoll from the hearing)

...

Another reason for me to file this lawsuit is to clarify the practice of "Periah". It can be assumed that the Mohel - when alone with the infant in an adjacent room - while do what he called "caring for the wound" - performed a radical foreskin amputation on the infant.

During a Periah, the remaining inner layer of the foreskin - which on newborns is fused to the glans, much like a fingernail to the nail bed - is scraped off all the way down to the corona glandis. (https://www.realeyz.tv/de/its-a-boy.html)

...

I believe it should be investigated whether the entire inner layer of the foreskin down to the corona glandis has been removed, and if, whether this can still be considered part of the naming ceremony or rather an infliction of bodily harm not covered by §1631d BGB.

...

In conclusion, as Mr. Teichtal - because his involvement in the german discussion 2012 - must know about the illegality of his acts. I see the way the ritual has been performed on March 3rd, 2013, as a deliberate provocation.

Also there is one thing I'm totally aware of: by far the most people of Jewish descent in Germany don't have their sons circumcised. Only a small minority has their sons circumcised, and of those only a few have it done to such an extent and following such an archaic rite like Mr. Teichtal had it done on his son on March 3rd.

BERKELEY/ILLINOIS: Dr and lawyer slam ethics of AAP circumcision policy / Task Force defence: "Respect!"

March 24, 2013

AAP Circumcision Task Force fails again

by Hugh Young

In the latest Journal of Medical Ethics, a paediatrician and a lawyer have demolished the ethics of the 2012 American Academy of Pediatrics circumcision policy. (pdf may require opening in a reader to show the comments.)

They say the policy suffers from several troubling deficiencies, including "...the exclusion of important topics and discussions, an incomplete and apparently partisan excursion through the medical literature, improper analysis of the available information, poorly documented and often inaccurate presentation of relevant findings, and conclusions that are not supported by the evidence given."

• Topics excluded:
  • Anatomy and function of the foreskin
  • Harm caused by its removal
  • Biomedical ethics
  • Human and children’s rights
• Incomplete and partisan survey of literature:
  • Case reports, case series, ecological studies, reviews and opinions excluded
  • Studies finding detriments from circumcision excluded
  • Cost/benefit analyses that fail to find benefit ignored
  • No North American STD or HIV studies (which consistently fail to find circumcision benefit)
  • Cherry-picking from within studies
• Improper analysis:
  • Internally contradictory statements
  • Conclusions that do not follow from data
  • No risk/benefit analysis (either of circumcision or intactness)
  • Move toward recommending based entirely on three African HIV studies
• Poorly documented and inaccurate presentation:
  • Ignores anti-circumcision findings within cited studies
  • Gets numbers wrong, e.g. in cancer risk
  • Discusses circumcision, but not Gardasil, to prevent HPV
  • Fails to apply cost/benefit to UTI, the only early-onset risk
  • Fails to consider cost of meatotomy
• Conclusions not supported by evidence:
  • Third-party payment called for, yet still "elective"
  • Doctors advised to be cultural brokers for parents

Accordingly, the critics say, the AAP should immediately replace its policy with one reflecting such critical concerns as the functions of the lost tissue, medical ethics and the importance of respecting non-consenting children’s rights.

---

This is followed by a reply by the Task Force (pdf may require opening in a reader to show the comments) that addresses none of the issues it raises, but just questions the tone of opposition to circumcision in general, asking four times that criticism to be "respectful".

This is essentially the fallacy of Appeal to Authority.

The most disrespectful word in the Svoboda-Van-Howe paper is "myopic".

This repeated demand for "respect" ignores one of the major realities of that case - that an increasing number of men are very angry that this was done to them, and they resent the lack of respect shown for the most intimate part of their bodies, for their individuality, their privacy, their religious freedom, their sexuality, their equality with women and for the security of their persons.

Nobody should be surprised when these men show disrespect toward those who stand by the ones who did that to them.

The Task Force claims to be "unbiased", unlike its critics, but it has an inherent bias to which it is blind: it treats cutting a normal, healthy, functional, non-renewing part of a baby's (and hence a man's) genitals off as if it were equal and opposite to just leaving the baby's body alone - when in fact it is is medically and ethically a different kind of activity, with a different kind of consequences.

The Task Force ends its reply "It is our fervent hope that, through the combined efforts of well-intentioned, open-minded researchers, we will achieve greater understanding so as to better serve our young patients."

The Task Force's melifluous, unctious tone belies its subject-matter, cutting parts off babies' genitals - "patients" who have nothing the matter with them. People from cultures where this is not a norm will be baffled by the disconnect between the Task Force's words and its actions.

ILLINOIS: AAP exhibits cultural bias in its denial of it

March 21, 2013

AAP Task Force reveals cultural bias while denying it

by Hugh Young

Last August, the American Academy of Pediatrics released its new circumcision policy in a flurry of publicity. The policy claimed that "the benefits outweigh the risks" (without actually comparing them). It fell short of recommending universal infant circumcision, though it was widely reported as having done so, and it recommended that insurance pay for this "non-recommended " procedure.

This week, Pediatrics published a rebuttal from 38 heads or spokespeople for the paediatric associations of Austria, Britain, Denmark, England, Estonia, Finland, Germany, Iceland, Latvia, Lithuania, Norway, Sweden and the Netherlands, and senior paediatricians in Canada, the Czech Republic, France and Poland, accusing the AAP of cultural bias, and finding fault with its methodology, its conclusions, and its ethics.

The AAP has published their letter with a reply from its "Task Force on Circumcision" that just underlines the same cultural bias for which it was criticised. It basically says "You're another!" without noticing that leaving a child's genitals alone, doing nothing to them, is medically and ethically a different kind of thing from cutting part off.

They reveal their bias even while denying it: they refer to the whole penis as "uncircumcised" and discount the sexual value of the foreskin found by some studies because "the relevance to individuals undergoing circumcision during infancy was questionable." but with no consideration of their relevance to individuals not undergoing circumcision during infancy.

They falsely claim that "approximately half of US males are circumcised, and half are not." In fact, a chart in their own policy indicates the rate is more like 80%. This is in order that they can say "Although that [50:50 ratio] may lead to a more tolerant view toward circumcision in the United States than in Europe, the cultural “bias” in the United States is much more likely to be a neutral one than that found in Europe, where there is a clear bias against circumcision."

In fact, in Europe, the default position is to do nothing, simply to leave the child's body alone. No need for any "cultural bias" or any Task Forces on Leaving Children's Genitals Alone.

They go on "... a culture that is comfortable with both the circumcised penis and the uncircumcised penis would seem predisposed to a more dispassionate analysis of the scientific literature than a culture with a bias that is either strongly opposed to circumcision or strongly in favor of it."
In what mad world is the United States "a culture that is comfortable with" the whole penis when the Task Force won't even call it that? When a TV show can include nine negative references to foreskins and the men with them without exciting comment? (Positive references are virtually unknown.) To rebut the claim of the 38 that the foreskin has a sexual function, the Task Force says:

Members of the task force appreciate that the foreskin has nerve fibers: the task force clearly recommends adequate pain control for infants undergoing circumcision. However, the task force did not move beyond what these studies actually reveal (the foreskin has nerve bundles and pain fibers, the foreskin contains Meissner corpuscles, the inner surface of the foreskin resembles a mucous membrane) to speculate about the effect that circumcision might have on sexual function or pleasure.
The 38 European critics do not need to "speculate": its male members or their male partners will have foreskins. Of course the inner foreskin resembles a mucus membrane, because it is one - like the lips. The lips also "have nerve fibres". Whose first thought about those would be about how to minimise the pain of lip-removal? Who either doubts, or can find a study to prove, that the nerves of the lips are intimately involved in the pleasure of kissing? Who needs one?

The Task Force, both in its policy and this response to its critics, criticises the only study that actually attempted to measure the sensitivity of the foreskin itself by ignoring its main finding - that "male circumcision [removes] the most sensitive part of the penis."

They now admit that the critics' "argument about the basic right to physical integrity is an important one, ..." yet they ignored this important argument in their 2012 policy, and now they contrast it with a new, unmeasured and undocumented claim that "...it is also true that some males will be harmed by not being circumcised." By that reasoning, the man who had to cut his own arm off after it was trapped under a boulder in the desert was "harmed by not having had it previously amputated" but nobody would ever think that meant infant amputation should be given even a moment's consideration - yet this is just "to prevent zipper injury" writ large.

The Task Force says nothing about the critics' case, based on the AAP's own policy, that the diseases circumcision reduces are so rare, or of such late onset, or so readily prevented or treated, that circumcising infants to prevent them is a bad option compared to letting the child grow up to decide the fate of his own genitals.

Its claim that "the benefits outweigh the risks" is now nowhere to be seen, and goes undefended.

Earlier story

EUROPE: Thirty-eight top pediatricians slam AAP circumcision policy

Pediatrics
March 18, 2013

The following article is due to appear in the next issue of Pediatrics, the journal of the American Academy of Pediatrics.

It is signed by the 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.

It comprehensively dismantles the AAP's 2012 circumcision policy statement.

Cultural Bias in AAP's 2012 Technical Report and Policy Statement on Male Circumcision Abstract The American Academy of Pediatrics (AAP) recently released its new technical report and policy statement on male circumcision, concluding that current evidence indicates that the health benefits of newborn male circumcision outweigh the risks. The technical report is based on the scrutiny of a large number of complex scientific articles. Therefore, while striving for objectivity, the conclusions drawn by the eight task force members reflect what these individual doctors perceived as trustworthy evidence. Seen from the outside, cultural bias reflecting the normality of non-therapeutic male circumcision in the US seems obvious, and the report’s conclusions are different from those reached by doctors in other parts of the Western world, including Europe, Canada, and Australia. In this commentary, a quite different view is presented by non-US-based doctors and representatives of general medical associations and societies for pediatrics, pediatric surgery and pediatric urology in Northern Europe. To these authors, there is but one of the arguments put forward by the AAP that has some theoretical relevance in relation to infant male circumcision, namely the possible protection against urinary tract infections in infant boys, which can be easily treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts and penile cancer, are questionable, weak and likely to have little public health relevance in a Western context, and do not represent compelling reasons for surgery before boys are old enough to decide for themselves. Authors and Affiliations (38 people) Morten Frisch, MD, PhD: Consultant, Statens Serum Institut, Copenhagen, and Adjunct Professor of Sexual Health Epidemiology, Faculty of Medicine, Aalborg University, Aalborg, Denmark Yves Aigrain, MD, PhD: Professor of Pediatric Surgery, Hôpital Necker Enfants Malades, Université Paris Descartes, Paris, France Vidmantas Barauskas, MD, PhD: Professor and President of the Lithuanian Society of Paediatric Surgeons, Lithuania Ragnar Bjarnason, MD, PhD: Professor of Pediatrics, Landspitali University Hospital, Reykjavik, Iceland Su-Anna Boddy, MD: Consultant in Pediatric Surgery and Chairman of the Children’s Surgical Forum of the Royal College of Surgeons of England, UK Piotr Czauderna, MD, PhD: Professor of Pediatric Surgery, Medical University of Gdansk, Gdansk, Poland Robert P. E. de Gier, MD: Consultant in Pediatric Urology and Chairman of Working Group for Pediatric Urology, Dutch Urological Association, The Netherlands Tom P. V. M. de Jong, MD, PhD: Professor of Pediatric Urology, University Children's Hospitals UMC Utrecht and AMC Amsterdam, The Netherlands Günter Fasching, MD: Professor and President of the Austrian Society of Pediatric and Adolescent Surgery, Austria Willem Fetter, MD, PhD: Professor and President of the Paediatric Association of the Netherlands, The Netherlands Manfred Gahr, MD: Professor and General Secretary of the German Academy of Paediatrics and Adolescent Medicine, Germany Christian Graugaard, MD, PhD: Professor of Sexology, Aalborg University, Faculty of Medicine, Denmark Gorm Greisen, MD, PhD: Professor of Pediatrics, Rigshospitalet, Copenhagen, Denmark Anna Gunnarsdottir, MD, PhD: Consultant in Pediatric Surgery, Landspitali University Hospital, Reykjavik, Iceland, and Karolinska University Hospital, Stockholm, Sweden Wolfram Hartmann, MD: President of the German Association of Pediatricians, Germany Petr Havranek, MD, PhD: Professor of Pediatric Surgery, Thomayer Hospital, Charles University, Prague, Czech Republic Rowena Hitchcock, MD: Professor and President of the British Association of Paediatric Urologists, UK Simon Huddart, MD: Professor and Honorary Secretary of the British Association of Paediatric Surgeons, UK Staffan Janson, MD, PhD: Professor and Chairman of Committee on Ethics and Children’s Rights, Swedish Paediatric Society, Sweden Poul Jaszczak, MD, PhD: Vice President and Chairman of the Ethics Committee of the Danish Medical Association, Denmark Christoph Kupferschmid, MD: Practicing Pediatrician and Member of Ethics Committee of the German Academy of Pediatrics, Germany Tuija Lahdes-Vasama MD: Consultant in Pediatric Surgery and President of The Finnish Association of Pediatric Surgeons, Finland Harry Lindahl, MD, PhD: Associate Professor of Pediatric Surgery, Helsinki University Children's Hospital, Helsinki, Finland Noni MacDonald, MD: Professor of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, Canada Trond Markestad, MD: Professor of Pediatrics, Chairman of the Ethics Committee of the Norwegian Medical Association, Oslo, Norway Matis Märtson, MD, PhD: Consultant in Pediatric Surgery and President of the Estonian Society of Paediatric Surgeons, Tallinn, Estonia Solveig Marianne Nordhov, MD, PhD: Consultant in Pediatrics and President of The Norwegian Paediatric Association, Norway Heikki Pälve, MD, PhD: Chief Executive Officer of the Finnish Medical Association, Finland Aigars Petersons, MD, PhD: Professor and President of the Latvian Association of Pediatric Surgeons, Latvia Feargal Quinn, MD: Consultant in Pediatric Surgery, Our Lady's Children's Hospital, Dublin, Ireland Niels Qvist, MD, PhD: Professor of Pediatric Surgery, Odense University Hospital, Odense, Denmark Thrainn Rosmundsson, MD: Chief of Pediatric Surgery, Landspitali University Hospital, Reykjavik, Iceland Harri Saxen, MD, PhD: Associate Professor of Pediatrics, Helsinki University Children’s Hospital, Helsinki, Finland Olle Söder, MD, PhD: Professor and President of the Swedish Pediatric Society, Stockholm, Sweden Maximilian Stehr, MD, PhD: Professor of Pediatric Surgery, Dr. v. Haunersches Kinderspital, Ludwig-Maximilians Universität, Munich, Germany Volker C.H. von Loewenich, MD: Professor and Chairman of the Commission for Ethical Questions, German Academy of Pediatrics, Frankfurt, Germany Johan Wallander, MD, PhD: Professor and Chairman of the Swedish Society of Pediatric Surgery, Sweden Rene Wijnen, MD, PhD: Professor and Chairman of the Dutch Society of Pediatric Surgery, The Netherlands

Earlier story

BERKELEY: AAP circumcision policy rebutted in Journal of Medical Ethics

the Journal of Medical Ethics
March, 2013

Lawyer and pediatrician dismantle the AAP policy

An article in the Journal of Medical Ethics comprehensively takes down the American Academy of Pediatrics' 2012 circumcision policy.

Written by Michigan State University Clinical Professor Robert Van Howe and Berkeley lawyer J Steven Svoboda, it focuses on the ethical issues rather than the medical issues that concern the European pediatricians whose rebuttal is released today.

“The AAP ignores so many important topics that it is hard to know where to begin," Svoboda says. "For example, the anatomy and function of the foreskin are not mentioned. The AAP’s circumcision recommendations contradict its own bioethics policy statement, which requires pediatric care to be based only on the needs of the patient. Non-therapeutic circumcision is incompatible with widely accepted ground rules for surgical intervention in minors.”

“When physicians decide whether to do a procedure, they must, and normally do, exclude from their medical decisions non-medical factors regarding the parents’ culture. Contrary to what the AAP suggests, doctors are not cultural brokers. Their duty is promoting and protecting the health of their patients, not following practices lacking a solid ethical and medical foundation.”

Van Howe and Svoboda accuse the AAP of cherry-picking articles that support circumcision, and of taking passages out of context from within articles that do not support it.

They conclude that male circumcision should be neither recommended to parents nor funded by government insurance systems.

A few months ago, the Royal Dutch Medical Association favorably cited an earlier version of Svoboda’s and Van Howe’s article, noting that even if benefits do exist, the procedure can safely be delayed until the boy himself can make the decision.

Out of step: fatal flaws in the latest AAP policy report on neonatal circumcision by J Steven Svoboda, Attorneys for the Rights of the Child, Berkeley, California, USA Robert S Van Howe, Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, Marquette, Michigan ABSTRACT The American Academy of Pediatrics recently released a policy statement and technical report on circumcision, in both of which the organisation suggests that the health benefits conferred by the surgical removal of the foreskin in infancy definitively outweigh the risks and complications associated with the procedure. While these new documents do not positively recommend neonatal circumcision, they do paradoxically conclude that its purported benefits ‘justify access to this procedure for families who choose it,’ claiming that whenever and for whatever reason it is performed, it should be covered by government health insurance. The policy statement and technical report suffer from several troubling deficiencies, ultimately undermining their credibility. These deficiencies include the exclusion of important topics and discussions, an incomplete and apparently partisan excursion through the medical literature, improper analysis of the available information, poorly documented and often inaccurate presentation of relevant findings, and conclusions that are not supported by the evidence given.

OAKLAND: More than $80 million paid out for botched circumcisions

Attorneys for the Rights of the Child
March 16, 2013

More than $80,000,000 paid out for botched circumcisions

by Hugh Young

More than 80 million dollars have been paid out in settlements for botched and wrongful circumcisions since 1985, according to Attorneys for the Rights of the Child.

It has been compiling a list of cases since 1997 and first published it today.

They range from $22.8 million to a boy in Atlanta, Georgia who was severely burnt, down to $30,000 to a Palm Beach, California, boy who lost more than his foreskin to a mohel.

Two of the cases, totalling $18.3 million, were won against Mogen Circumcision Instruments Ltd, makers of the Mogen clamp. The company has gone out of business, but the Mogen clamp is still being used.

The number of botched circumcision cases that were settled out of court is unknown. The number that were successfully blamed on something else, such as an undiagnosed pre-condition or poor aftercare, is also, of course, unknown.

In its 2012 circumcision policy, the American Academy of Pediatrics said, "The majority of severe or even catastrophic injuries are so infrequent as to be reported as case reports (and were therefore excluded from this literature review)" before concluding (without actually weighing them) that "the benefits outweigh the risks".

SACRAMENTO: Hospital denies death was circumcision-related

March 13, 2013

Hospital denies circumcision caused death

by Hugh Young

UC Davis Children's Hospital has posted on its Facebook page:

The comments being posted regarding a patient who allegedly died because of circumcision at UC Davis are entirely false and misleading. The patient was not circumcised at UC Davis and the cause of the patient’s death was not circumcision, nor was it hemophilia or a clotting disorder. UC Davis did all it could to save the patient’s life, and we are deeply sorry for this family’s loss. UC Davis has a deep respect for the privacy of its patients and does not use patient names in social media without their express consent and does not permit posting of patient names by third parties.

The baby was circumcised at Lodi, two days before he died. The coronor's report into his death has not yet been released. The hospital is pre-empting the court in determining the cause of death.

Earlier story

VANCOUVER: Doctors should revisit circumcision policy

Vancouver Sun
March 13, 2013

Pediatricians should revisit their circumcision policy

by Christopher L. Guest Co-Founder, Children's Health and Human Rights Partnership

Re: Pediatricians update circumcision policy; new statement from Canadian doctors offers parents a more neutral position on loaded issue, March 4

Most physicians are sadly ignorant of the sexual and mechanical function of the human prepuce.

The prepuce is richly innervated, erogenous tissue, containing thousands of sensory neuroreceptors such as Meissner's corpuscles. Many of the most sensitive regions of the penis are located along the inner prepuce and are needlessly amputated by circumcision.

The prepuce also acts as a linear bearing mechanism, providing a unique gliding motion during sexual intercourse.

Removing healthy, functional genital tissue from powerless infants is medically unethical and Canadian physicians should refuse to participate in this disgraceful practice. Parental preferences and cultural traditions should never trump contemporary medical ethics and the fundamental human right to bodily integrity.

When will the Canadian Paediatric Society (CPS) recognize that the boy is the patient, not the parents? Let him decide for himself, when he is older, and able to consent.

TUNISIA: Women slam MP for pro-circumcision stance

Egypt Independent
March 11, 2013

Tunisian representatives rejects pro-circumcision remarks

A secular-leaning member of Tunisia’s Constituent Assembly demanded that a representative of the ruling Islamist Ennahda movement apologize or resign for remarks he had made in support of female circumcision.

“It is unreasonable that a representative values a crime like this committed against women in several states,” Nadia Shaaban, from the Modernist Democratic Pole, said during an assembly session on Monday, commenting on remarks made by Habib Louz.

Louz, a hawkish figure in Ennahda, had told Al Maghreb newspaper on Sunday that female circumcision is an act of “beautification of women, and does not affect her (sexual) appetite.” Louz added that circumcision is “non-mandatory,” citing religious edicts by Egyptian preacher Wagdy Ghoneim.

In areas of high temperature, people practice female circumcision for sanitary and medical reasons, Louz also claimed.

Shaaban described the remarks, aired live by state television, represent an insult to Tunisian women and a coup against the Tunisian revolution. “Instead of pushing society forward, Louz wants to push us backwards,” she said.

...

---

Alarabiya - AFP
March 11, 2013

Tunisian MP stirs row after female circumcision remarks

Lawmakers from Tunisia's secular opposition Monday denounced remarks attributed to an MP from the Islamist Ennahda party that female circumcisions in Africa are carried out for “aesthetic' reasons.

“It is unacceptable that a member promotes crimes against women,” lawmaker Nadia Shaaban said in the National Constituent Assembly, referring to remarks purportedly made by Habib Ellouze, an MP from the ruling Ennahda.

“In the (African) regions where it is hot, people are forced to circumcise girls ... because in these regions clitorises are too big which affects the spouses,” Ellouze was quoted in an interview published in the Sunday edition of Maghreb newspaper as saying.

“There are more circumcisions but it is not true that circumcision removes the pleasure for women. It is the West that has exaggerated the issue. Circumcision is an aesthetic surgery for women,” he was quoted as saying.

Ellouze on Monday accused the newspaper of distorting his quotes, saying the journalist “attributed remarks to me that I have not said.”

“She insisted that I respond to the question and I told her that it is a tradition in other countries,” Ellouze said in the assembly.

LONDON: Doctors slam MP for pro-circumcision stance

Secular Medical Forum
March 11, 2013

Secular Medical Forum challenges Ed Miliband's support for religious circumcision

by

The Secular Medical Forum has condemned Ed Miliband's recent support for the ritual genital cutting of children and called on the labour leader to rethink his stance on the issue.

On 7 March Ed Miliband told an audience in London that he supports the practices of brit milah – a Jewish religious male circumcision ceremony performed on 8-day-old male infants. In reference to ritual circumcision and kosher animal slaughter, the leader of the Labour party said: "These are important traditions … ways of life must be preserved".

The removal of a young boy's foreskin is commonly practised in the UK for religious reasons. The Secular Medical Forum (SMF) argues that the operation disregards autonomy and exposes the child to significant risks, including bleeding, infection and death. In a statement, the SMF said it questioned Mr Miliband's support for the "ethically flawed and medically dangerous" procedure.

Anthony Lempert, Chair of the Secular Medical Forum, said; "The first principle of healthcare is 'primum non nocere – first do no harm'. This guidance is disregarded by supporters of ritual circumcision.

"The Secular Medical Forum calls on Mr Miliband to focus squarely on the rights of vulnerable infants and children. Mr Miliband should prioritise the rights of children rather than harmful religious traditions. Mr Miliband should defend the weak, rather than preserve abusive traditions. He should not be misled by misplaced allegations of anti-semitism against those striving to protect children from harm."

In 2012, a German court caused international controversy when it found that parental consent to religious circumcision was in conflict with the best interests of the child, and ruled that parents do not have the right to circumcise their children without a medical reason. Following the court ruling, the government of Angela Merkel introduced legislation permitting the tradition.

A full statement from the Secular Medical Form can be found here.

SACRAMENTO: Another circumcision death

March 8, 2013

Another circumcision death

An 11-day-old boy has died died at UC Davis Children's Hospital in Sacramento, California, two days after being circumcised in the nearby town of Lodi.

According to his grandfather, Brayden Tyler Frazier had been taken to the doctor when he was a week old because he had been sleeping constantly and not eating. His parents had also noticed that his neonatal sticks and pricks had not healed quickly, and had to stay bandaged for two days or more.

The doctor in Lodi sent them home with instructions to monitor his condition and after two days, he was circumcised. It was later discovered that the wound had continued to bleed. He was taken back to the doctor, then to Urgent Care, then to the ER, and then transferred to UC Davis Medical.
He had "generalized bleeding" and an unidentified infection.

Over the two days after his circumcision, he went into seizures and a coma, and died.

A paediatric haematologist/oncologist comments:

Coagulation studies are not routinely done before many types of surgeries, including circumcisions. ... Also coagulation studies are not a part of routine newborn screening tests. Coagulation is complex, and involves the platelet cell and a couple dozen chemicals / proteins, to clot when needed but also not to clot in inappropriate locations, or excessively, and to additionally reabsorb clots after they have done their jobs. Plus hemophilia isn't a single disorder; there are two main types of "hemophilia" (deficiency of Factor 8 or Factor 9 ). But there are many other reasons to bleed excessively. However, a combination of several functional tests can narrow down the list of specific aspects of the coagulation system that need testing, in a given individual whose screening functional tests are abnormal, in order to identify what needs to be done to treat that individual's bleeding/risk. However it is more complicated in newborns: 1) Of the couple dozen chemicals, many are in different levels in newborns. For several reasons, some aspects of the newborn's system are hypo-coagulable [blood won't clot] while others are hyper-coagulable [blood clots very easily] and it generally balances out. So there are different normal ranges for results in infants. 2) Most tests of the coagulation system involve drawing blood from a vein or artery and simultaneously mixing it with anticoagulants (different anticoagulants for different tests). These tests also involve a relatively large amount of blood. Additionally the tissue factors, that trigger the initiation of the clotting system in injuries, are released from a heel stick and affect clotting studies. 3) It is however easy to do extensive or specific coagulation tests in newborns. When planned, the blood is correctly drawn at delivery from the umbilical cord, taking the blood otherwise left in the placenta... This can be planned when a family history [of haemophila] is present or there are other reasons to test. Surgeries / procedures that have no medical necessity, [such as] circumcision, should not be done.

WORLD: NGO Council flags circumcision as human rights violation

Child's Rights International Network
October 21, 2012

International NGO Council raises human rights questions

The International NGO Council on Violence against Children published a report on harmful traditional practices in October 2012. On male circumcision, it says:

Male circumcision

Male circumcision has been largely neglected in mainstream debates on harmful practices because of its strong religious connections, particularly with Judaism and Islam, and its general acceptance in many societies. ...

Until recently, male circumcision has generally been challenged only when carried out by non-medical personal in unhygienic settings without pain relief. But a children’s rights analysis suggests that non-consensual, non-therapeutic circumcision of boys, whatever the circumstances, constitutes a gross violation of their rights, including the right to physical integrity, to freedom of thought and religion and to protection from physical and mental violence. When extreme complications arise, it may violate the right to life. It is reported that male circumcision can result in numerous physical, psychological, and sexual health problems during the surgery, afterwards, and throughout adulthood, including haemorrhage, panic attacks, erectile dysfunction, infection (in severe forms leading to partial or complete loss of the penis), urinary infections, necrosis, permanent injury or loss of the glans, excessive penile skin loss, external deformity, and in some cases even death.

There are now substantial established campaigns against non-therapeutic, non-consensual circumcision of boys and growing support to end it, particularly within the medical community. For example, the Royal Dutch Medical Association (KNMG) has publicly taken a children’s rights position that: “children must not be subjected to medical proceedings that have no therapeutic or preventative value.” In addition, in 2011 the then Ombudsman for Children in Norway advocated that boys should not be circumcised for non-therapeutic reasons until they are old enough to give their informed consent and that parents should not be able to consent on behalf of their children. Most recently, in 2012 a German court ruled that male circumcision constitutes a violation of physical integrity as a child is “permanently and irreparably changed by the circumcision” and that the practice is also in conflict with the child’s [and the future adult's] right to religious freedom.

The WHO review quoted three randomized controlled trials suggesting that circumcision reduces the risk of acquiring HIV infection in males. But this potential health benefit does not over-ride a child’s [and hence a man's] right to give [or withhold] informed consent to the practice. The decision to undertake circumcision for these reasons can be deferred to a time where the risk is relevant and the child is old enough to choose and consent for himself.

- International NGO Council on Violence against Children. (Oct 2012).
"Violating children’s rights: Harmful practices based on tradition, culture, religion or superstition"
p 21-22

CANADA: Ethicist plays down circumcision policy change

Canadian Medical Association Bulletin
February 5, 2013

ETHICS CORNER: CIRCUMCISION

by Dr. Jeff Blackmer, Director of Ethics, CMA

What advice should a physician give to parents considering whether or not to have their baby circumcised?

For some parents, the decision is easy because of religious tenets or family tradition. For others, it involves a struggle to balance competing evidence. In Canada this evidence is evaluated and the medical standard is set by the Canadian Paediatric Society (CPS), which since 1996 has held that “circumcision of newborns should not be routinely performed.”

However, in August the American Academy of Pediatrics (AAP) updated its 1999 policy on circumcision and cited evidence showing that the procedure offers some potential benefits, including lower risk of urinary tract infection (UTI), penile cancer and sexually transmitted disease (STD) infection.

There are, of course, provisos. For instance, most UTIs occur in the first year of life and can be avoided with proper hygiene, and the lower STD rates appear applicable only to certain populations, such as gay men. As well, most of the studies that were consulted by the AAP did not involve North American men. So what should doctors do when parents seek their advice? I would point out that the AAP guidelines do not advocate circumcision as standard practice and state that the final decision should be left up to the parents, as is currently the case. The CPS is currently reviewing the evidence and expects to release an updated statement of its own. Until then, its current advice stands.

So, despite all the recent publicity related to the AAP, not much has changed. Some parents will always choose circumcision, some will always reject it, and some will decide based solely on the evidence. The role of physicians in this decision-making process is simply to remain up to date on the evidence and do all they can to help parents make an informed decision.

Earlier story

NEW YORK: Father sues over botched circumcision

DNAinfo.com (New York)
March 5, 2013

Queens Infant Disfigured in Botched Bris, Lawsuit Charges

by James Fanelli

FOREST HILLS — A Queens rabbi botched the bris of an 8-day-old boy, then told the dad that he did an acceptable job, even though the infant needed corrective surgery, a new lawsuit charges.

Gavriel Barukh, the father of the boy, is suing Rabbi Mordechai Rachminov, claiming he sliced off part of his son's corona glandis during the religious ceremony on Oct. 16, 2011, at the Bukharian Jewish Community Center in Forest Hills, according to the lawsuit filed last week in Queens Civil Supreme Court.

After the ritual, Rachminov, 69, misled Barukh by claiming the circumcision was "performed appropriately and that his conduct was within the standard of care and skill required of Jewish mohelim and circumcisers," the lawsuit says.

He also allegedly told Barukh that a physician wasn't necessary. Even after it became apparent that the bris went awry, Rachminov and the community center failed to call a doctor, the suit says.

Barukh claims that the delay in medical treatment resulted in greater permanent damage to his son. The boy had to undergo corrective surgery with general anesthesia and may need even more procedures, the lawsuit says.

A woman who answered the phone at Rachminov's home said the allegations weren't true.

"I didn't hear any of this," she said.

The Bukharian Jewish Community Center was also named in the lawsuit. A woman who answered the phone at the center said Rachminov no longer works there. She declined to comment about the lawsuit.

Barukh's lawyer did not return a call for comment.

The practice of performing a bris became a hotly debated topic in September after an infant died from contracting herpes ...

NEW YORK: Intactivists confront Clinton over African circumcision: Intaction's statement

Broward Palm Beach New Times
March 5, 2013

President Clinton's Event Disrupted by Anti-Circumcision Activists

by Deirdra Funcheon

Surely, President Clinton was a little freaked out last night when in the middle of his event -- a Clinton Foundation Millennium Network talk in New York featuring the former president, Chelsea Clinton, and actor Ed Norton -- a whistle blew and a group of men stood up, held hands, and chanted, "Stop exploiting Africans; circumcision does not stop AIDS!"

The protesters were self-described "intactivists" -- those who believe that circumcision is actually a mutilation of the genitals.

Although circumcision is routinely performed on infants in the United States, it is not in other developed countries. Germans even moved to outlaw the practice last year (though Jews stopped the law on religious grounds), and it is banned in some Australian hospitals. Circumcision became widely popular as a means to prevent males from masturbating. Today's medical establishment generally supports circumcision, arguing that it has preventive effects for penile cancer and other diseases, though some studies say it leads to erectile dysfunction and other problems.

Last night's protest was led by a group called Intaction and promoted by "The Barefoot Intactivist" -- a University of Florida graduate who gives his name as Kevin and who runs barefoot to promote awareness of the anti-circumcision cause.

Protesters targeted Clinton because he has been a huge supporter of programs that seek to circumcise hundreds of thousands of African men in an attempt to slow the spread of AIDS.

Protesters say this is misguided -- that the research is flawed -- and that Africans are being used as pawns in science experiments.

Anthony Losquadro, executive director of Intaction, said that he and seven other activists had been planning the protest for a month. They each bought $100 tickets to the event, and had actually intended to put on white suits with bloodstains on the crotches before standing up, but the rows were packed too closely together to maneuver without sending the audience into a panic.

Losquadro said it was about midway through the program, when Norton was interviewing the Clintons about their foundation's initiatives, that his group interrupted. Clinton coolly said, "OK, you guys had your chance to speak, now its my turn" and "attempted engage us in a little bit of a dialogue. He mentioned the three studies in African countries that show circumcision results in a 60 percent reduction in the transmission of AIDS."

These three studies are the basis upon which millions of dollars are funneled into circumcision campaigns, though anti-circumcision activists say they research is flawed. "But it's kind of difficult to do a dialogue [about such a complicated subject] in the middle of the event," Losquadro said, "so we changed out chant to 'Condoms, no cutting' because we believe that condoms, education, and antiretrovirals are much more effective [in stopping the transmission of AIDS/HIV]. Then Chelsea Clinton interjected and said, 'The two are not mutually exclusive,' and we were escorted out of the building and the Secret Service questioned us."

Losquadro says he became an activist because "I see circumcision as the wrong thing to do to babies because they can't consent," he said. "It's just a matter of right and wrong, and we believe we're on the right side of this issue."

A statement by Intaction called African circumcision campaigns "exploitative and racist health policies," explaining:

The U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Clinton Foundation, and the Gates Foundation jumped on the circumcision bandwagon to demonstrate their effectiveness to their stakeholders and their donors. However, these organizations were either misguided or blinded by their quest to increase goodwill and donations by hyping circumcision. Male circumcision is a dangerous mistake in the fight against HIV, and it endangers both men and women. Recent studies examining circumcision rates and HIV prevalence found that circumcision did not significantly the reduce rate of infection in Africa, Europe, the Caribbean, and America.
See the full statement by Intaction here.

HeraldOnline March 4, 2013 Human Rights Activists Demand Clinton Foundation End Exploitation Of Africans By Intaction.org BROOKLYN, N.Y., March 4, 2013 — /PRNewswire-USNewswire/ -- During tonight's Clinton Foundation Millennium Network event featuring a dialogue with President Bill Clinton, Chelsea Clinton, and Hollywood actor Ed Norton, protesters from the human rights organization INTACTION disrupted the show wearing bloodstained white suits to protest the exploitative and racist health policies involving the circumcision of African men.   The concept of HIV prevention through circumcision began with biased medical researchers searching for a solution to the AIDS pandemic that could be marketed to government agencies and philanthropic organizations. The research teams that could develop a marketable solution, regardless of efficacy, would be richly rewarded with grants, research money, and tenure at their institution.   The U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Clinton Foundation, and the Gates Foundation jumped on the circumcision bandwagon to demonstrate their effectiveness to their stakeholders and their donors. However, these organizations were either misguided or blinded by their quest to increase goodwill and donations by hyping circumcision.   Male circumcision is a dangerous mistake in the fight against HIV, and it endangers both men and women. Recent studies examining circumcision rates and HIV prevalence found that circumcision did not significantly the reduce rate of infection in Africa, Europe, the Caribbean, and America.   U.S government medical authorities and U.S. academic researchers have a checkered history over human rights, ethics, and outright racism with STD experiments. From the Tuskegee experiments done to American black men to the disastrous STD experiments conducted in Guatemala, American researchers are now inflicting the same racist theories and pseudo-scientific experiments on Africans.   African men and women are being duped into the belief that circumcision offers effective protection from HIV. These organizations can tout their achievements to keep their revenue streams flowing, while poor Africans suffer from the continued spread of HIV and the trauma from the loss of their foreskins.   Further detailed information on these issues with citations can be viewed at http://www.intaction.org/circumcision-a-dangerous-mistake-for-hiv-prevention/   Video footage and photos of the event available for publication Press Contact: Anthony Losquadro Executive Director Intaction.org A 501 (c)(3) Non-profit organization 222 Varick Ave Brooklyn, NY, 11237, USA 877-CARE-103 tony@intaction.org

CANADA: Paediatricians foreshadow circumcision policy change

O Canada
March 3, 2013

Canada's pediatricians set to reveal new policy on circumcision

The Canadian Paediatric Society is preparing to revise its position on circumcision.

Canada’s pediatricians are about to update their advice on whether baby boys should be circumcised, revising their stand for the first time in 17 years.

Their review comes as new Canadian research suggests half of expectant parents would consider circumcision if they had a son — and that the single most important factor is the circumcision “status” of the father.

The Canadian Paediatric Society’s old policy, issued in 1996, opposed routine circumcision of newborns.

The new statement is expected to be more neutral.

“There isn’t going to be a ‘prescription’ for Canadian males in terms of circumcision,” society president Dr. Richard Stanwick, chief medical health officer for the Vancouver Island Health Authority, told Postmedia News.

The organization has been struggling to put forward a balanced position “that captures the risks, and the benefits, but is also respectful of personal preferences [whose?], religious issues and many other things that dictate this decision,” Stanwick said.

The issue is so loaded with emotion and controversy that the new statement has been three years in the making. “There are very strong opinions on both sides of this issue,” Stanwick said.

“We know that we’re wading into something that, no matter what we write, will not be strong enough for probably either side.”

Last year, the American Academy of Pediatrics announced that the health benefits of newborn male circumcision outweigh the risks, a move that provoked demonstrations by anti-circumcision activists who view the procedure as genital mutilation of newborns. [No, who view it as unethical.]

The old policy deemed circumcision medically unnecessary for the “well-being of the child.”

But after a special task force reviewed more than 1,000 studies published over the past 15 years, the American doctors’ group now says that circumcision provides protection against urinary tract infections, penile cancer and the transmission of some sexually transmitted infections, including HIV.

The organization isn’t recommending universal circumcision. Instead, it says the final decision should be left to parents.

Circumcision involves the surgical remove of some, or all, of the foreskin from the penis. It is one of the most common surgical procedures performed worldwide. In hospitals, the procedure is usually performed by obstetricians soon after birth.

“Clearly there has been a lot of literature around the potential role of the avoidance of infection,” Stanwick said.

“But this also has to be balanced off against the fact that this is still a surgical procedure, and it is not without risk.”

Those risks can include bleeding and hemorrhage, infection, inflammation and tightening at the end of the penis [and major complications, loss of the penis and death.]

Any shift in policy would have to ensure, “are there enough skilled professionals around to do this, so that we don’t have a complication rate that is unacceptable and so that we’re not seeing males being significantly harmed by not having the properly trained people to do it,” Stanwick said. [Not any shift, only a shift towards recommending it. Sounds like he's gearing up for a major increase, and needing to recruit!]

The new policy statement is expected to be released before the pediatric group’s annual meeting in June.

“It would be great if we had absolute answers, but on this one, I don’t think we will,” Stanwick said.

“At the end of the day . . . it will very much be influenced by dad’s status, as well as the cultural and religious issues.” [What other surgical procedures are influenced by the father's status, cultural or religious issues?]

A new study found that the circumcision rates are heavily influenced by whether or not the father is circumcised.

University of Saskatchewan researchers, in a study published in the journal Canadian Family Physician, surveyed 230 parents attending prenatal classes in Saskatoon.

Overall, half — 56 per cent — said they would consider pursuing circumcision if they had a son. In cases where the father of the expected baby was circumcised, 82 per cent were in favour of circumcision, versus 15 per cent when the father wasn’t circumcised.

According to the researchers, Canada’s current circumcision rate is 32 per cent. In the U.S., rates are increasing, to 61 per cent of men, they said. [No, it is slowly falling,and 61% is approximately the rate at which babies are being circumcised.]

ZIMBABWE: Hookers charge circumcised men more: "They take longer"

Zimdiaspora
March 2, 2013

Harare circumcised men forced to pay US$30 extra

UNAIDS and the World Health Organisation (WHO) recommended circumcision as an important new element of HIV Prevention.

As such, local health authorities have since embarked on a massive campaign encouraging men to get circumcised. The campaign has seen prominent musicians like Winky D and high profile politicians such as Mines Minister Orbert Mpofu being circumcised too.

Scientific trials have shown that male circumcision can reduce a man's risk of becoming infected with HIV during sexual intercourse by up to 60% hence the call for this campaign dubbed 'Pinda MuSmart'.

[Yet more circumcised Zimbabwean men have HIV than non-circumcised - just as they did before the circumcision campaign began:


Click to enlarge]
However, despite the health and hygienic advantages of circumcision, it has since been established that circumcision also BOOSTS revenue for a large quota of prostitutes. In a random survey conducted by this publication, siphoning information from sex workers, circumcised men pay more for sex. Revelations made by hookers operating around the Avenues, Harare's unrivalled red light district, show that prices for sex vary depending on the potential client's "circumcision status".

Their argument was that since the process of circumcision involved the removal of foreskin which contains sensory nerve receptors, that diminishes the man's sensitivity thereby increasing the period of sex sessions. An increase in time in the sex session, they argued, meant a loss of other potential clients in that period because they thrive on 'pushing volumes'.

"You see the problem with circumcised clients is they take too long to complete a single round. I might risk losing revenue from other clients and waste time on one guy for the same price, so we therefore push our charges upwards if one is circumcised," said a self proclaimed prostitute. [So it hardly "BOOSTS" their revenue, just brings it back up to par.]

Several other sex workers corroborated with her stating that there is a slight increase of US$20 to about US$30 if their client is circumcised. [So that's only $10 more.]

[Clearly the prostitutes don't believe circumcision protects them from HIV. Much more important is whether they accept sex without condoms.]

JAKARTA: Mother kills son after circumcision shrinks penis

Brisbane Times
February 28, 2013

Indonesian mum kills son over penis size

An Indonesian woman has drowned her nine-year-old son in the bath, claiming she was worried that his "small penis" would affect his prospects for the future, police say.

The 38-year-old woman from Jakarta told police her son had had a small penis prior to being circumcised, but that it appeared to shrink further after the operation, police spokesman Rikwanto told AFP. [This can happen when a tight circumcision causes a "buried penis"]

"She told police investigators that she killed him as he would have a bleak future with his small penis," Rikwanto said.

"She drowned her son in a bathtub filled with water. She then dressed him and laid him on a bed. After that, she went to a nearby police office to report her crime."

Rikwanto said the woman was fully conscious of what she had done, but police ordered a psychological test to assess her mental condition.

SPOKANE, WASH: Bloodstained man targets clinic after gung-ho Facebook post

Inlander (Spokane, Wash)
February 27, 2013

Circumcision protester targets South Hill pediatrics clinic

by Leah Sottile

At around 3 pm today, a bearded man dressed from head to toe in white clothing stood in the crosswalk at Wall and Riverside Avenue in downtown Spokane. Above his head he thrusted a sign that read "CIRCUMCISION CRUELTY TO BOYS."

But it wasn't his sign that every passing car or pedestrian was staring at. It was the giant red stain at the crotch of his pants.

The man, whose legal name is Brother K ("K stands for kind," he says), drove here from Sacramento, Calif., to lead an anti-circumcision demonstration at Grand Pediatrics, a South Hill children's clinic, tomorrow morning. Brother K, 65, says he first became aware of the Spokane clinic after seeing a Facebook post from a nurse practitioner there that read, "Did my first circumcision on Friday … watch out boys … here I come."


Brother K says that post went viral — attracting ire from anti-circumcision activists from around the globe — before it was removed.

"It’s like she’s gloating. She’s enjoying it," he says. "She has no appreciation that she’s ripping open a human penis."

Brother K says he fundamentally objects to circumcision practices — a practice that is becoming more and more controversial among new parents.

"Right now if you did to a girl what you did to a boy, it would be a major, major felony. You would go to jail."

Brother K has been part of the long-running anti-circumcision movement since the 1970s. And after seeing the Spokane nurse's post, he felt impassioned to travel here to demonstrate at the clinic tomorrow. He says the nurse's post enraged him because of "the fact that we see a woman who is preparing a lengthy career in circumcising boys."

Though Brother K was holding his sign silently and only standing in the crosswalk when the light was red, he was certainly getting attention. Drivers slowed to take photos. As we talked, a tall young man walked up and said, frankly, "I kind of agree with you!"

He says he will attend a large-scale protest of circumcision practices in late March for Genital Integrity Awareness Week. Outfits like his — all white with just a red spot at the crotch — are what he and his fellow protestors wear, he says.

For now, it looks like he and 11 others have RSVP'd to the Facebook event for tomorrow's protest.

The Inlander contacted Grand Pediatrics to speak with the nurse, who they say is currently on vacation. An office manager says she was aware of the original posting, which has since been removed. The clinic was not aware of any demonstration plans.

As we wrapped up our conversation with Brother K, a girl with pink hair walked past, muttering "your dick's red, by the way."

He shrugged her off.

"We’re gonna hold the circumcisers' feet to the fire," he says. "People are outraged."

PERTH: Couple to stand trial after trying to take girl, 1, for cutting

AAP
February 27, 2013

Parents accused of taking baby girl, 1, to Bali for 'circumcision'

A PERTH couple accused of arranging the illegal genital mutilation of their baby daughter will stand trial in the WA District Court.

The couple aged in their 40s, who cannot be named for legal reasons, are alleged to have taken [no, attempted to take] their one-year-old daughter to Bali to have her circumcised.
...
Their bail was renewed and they are due to make their first appearance in the District Court on May 24.

Earlier story

BERLIN: Intersex babies need not be assigned a sex

West-Info
February 26, 2013

A victory for intersex babies in Germany

by Mattia Rosini

There has been a small revolution for intersex babies in Germany. Born with a genetic [or other] condition that means they cannot be defined exclusively as male or female, because they have characteristics of both sexes, a new law allows their gender to remain unspecified on the birth certificate. The German government unanimously approved the amendment to the law on recording personal data at birth. Previously, the baby’s parents could choose which gender would appear on the birth certificate. However, the amendment doesn’t go far enough, according to the Ethical Council of Germany. It believes that parents of intersex children need more support and that gender reassignment surgery should be avoided.