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A silver lining to the COVID-19 pandemic?

Nurse holding a smiling Newborn baby at the hospitalIn the face of the COVID-19 pandemic, the American College of Surgeons released an advisory recommending that that hospitals, health systems and surgeons “thoughtfully review all scheduled elective procedures with a plan to minimize, postpone, or cancel electively scheduled operations… or other invasive procedures.” In addition, the ACS called on facilities to “minimize use of essential items needed to care for patients,” among these “personal protective equipment” (e.g., sterile gloves and masks) and cleaning supplies.

Echoing the guidance from the ACS, U.S. Surgeon General Jerome Adams warned that every elective surgery could spread coronavirus within the facility, [and] use up protective medical gear as public officials worry about shortages and burden a hospital workforce who “may be needed” to respond to COVID-19.

On March 16, the American College of Obstetricians (ACOG) joined several other medical societies in issuing a similar statement, endorsing the Surgeon General’s warning.

If we applied the advice of the ACS, ACOG and the Surgeon General every day — not just in times of crises or pandemics — the “routine,” elective genital cutting of children would simply end.

Just like in the United States, during the 1930s and ’40s circumcision took hold in Commonwealth countries. Then World War II caused economic collapse in England, leading to the creation of the British National Health Service — a system where every procedure and every treatment was scrutinized for its cost and potential benefit. That’s how male circumcision there went by the wayside. Cutting out the funding of the risky, harmful and unnecessary amputation of baby boys’ foreskins ended up benefitting British boys and men for the rest of their lives, while saving resources for people with true medical needs.

It’s estimated that more than a billion dollars are squandered each year in the United States on amputating baby boys’ foreskins and repairing the most immediately obvious functional and cosmetic blunders. (If you’re thinking “only a billion,” note that this sum could buy 31,400 high-acuity ventilators or pay for 378,000 ventilator-dependent patient days.) Long-term costs of circumcision, physical and psychological, are of course much greater.

Whether in times of abundance or of scarcity, no state Medicaid program and no private insurer should be spending taxpayer or premium dollars on gratuitous medical interventions. If there is any silver lining to the COVID-19 pandemic it will be relegation to history of the nation’s most common and utterly unnecessary pediatric surgery.

 

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2 Comments

  • Dan Bollinger

    March 26, 2020 3:07 pm

    Sadly, some good may come from critically reviewing healthcare resources and necessities like permanently canceling hospital genital cutting for boys (aka circumcision).

  • PL

    April 1, 2020 4:28 am

    It is surprising that America´s most common surgery (infant circumcision) is not once mentioned in guidelines from the Surgeon General or the College of Surgeons. Probably because the procedure is very much ingrained in American Culture and Medicine. Providers reaping money from the procedure most certain have a desire to keep their doings under the radar. I hope that intacticists are numerous enough to monitor local OB-clinics and put some pressure on.

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Marilyn

Marilyn Fayre Milos, multiple award winner for her humanitarian work to end routine infant circumcision in the United States and advocating for the rights of infants and children to genital autonomy, has written a warm and compelling memoir of her path to becoming “the founding mother of the intactivist movement.” Needing to support her family as a single mother in the early sixties, Milos taught banjo—having learned to play from Jerry Garcia (later of The Grateful Dead)—and worked as an assistant to comedian and social critic Lenny Bruce, typing out the content of his shows and transcribing court proceedings of his trials for obscenity. After Lenny’s death, she found her voice as an activist as part of the counterculture revolution, living in Haight Ashbury in San Francisco during the 1967 Summer of Love, and honed her organizational skills by creating an alternative education open classroom (still operating) in Marin County. 

After witnessing the pain and trauma of the circumcision of a newborn baby boy when she was a nursing student at Marin College, Milos learned everything she could about why infants were subjected to such brutal surgery. The more she read and discovered, the more convinced she became that circumcision had no medical benefits. As a nurse on the obstetrical unit at Marin General Hospital, she committed to making sure parents understood what circumcision entailed before signing a consent form. Considered an agitator and forced to resign in 1985, she co-founded NOCIRC (National Organization of Circumcision Information Resource Centers) and began organizing international symposia on circumcision, genital autonomy, and human rights. Milos edited and published the proceedings from the above-mentioned symposia and has written numerous articles in her quest to end circumcision and protect children’s bodily integrity. She currently serves on the board of directors of Intact America.

Georganne

Georganne Chapin is a healthcare expert, attorney, social justice advocate, and founding executive director of Intact America, the nation’s most influential organization opposing the U.S. medical industry’s penchant for surgically altering the genitals of male children (“circumcision”). Under her leadership, Intact America has definitively documented tactics used by U.S. doctors and healthcare facilities to pathologize the male foreskin, pressure parents into circumcising their sons, and forcibly retract the foreskins of intact boys, creating potentially lifelong, iatrogenic harm. 

Chapin holds a BA in Anthropology from Barnard College, and a Master’s degree in Sociomedical Sciences from Columbia University. For 25 years, she served as president and chief executive officer of Hudson Health Plan, a nonprofit Medicaid insurer in New York’s Hudson Valley. Mid-career, she enrolled in an evening law program, where she explored the legal and ethical issues underlying routine male circumcision, a subject that had interested her since witnessing the aftermath of the surgery conducted on her younger brother. She received her Juris Doctor degree from Pace University School of Law in 2003, and was subsequently admitted to the New York Bar. As an adjunct professor, she taught Bioethics and Medicaid and Disability Law at Pace, and Bioethics in Dominican College’s doctoral program for advanced practice nurses.

In 2004, Chapin founded the nonprofit Hudson Center for Health Equity and Quality, a company that designs software and provides consulting services designed to reduce administrative complexities, streamline and integrate data collection and reporting, and enhance access to care for those in need. In 2008, she co-founded Intact America.

Chapin has published many articles and op-ed essays, and has been interviewed on local, national and international television, radio and podcasts about ways the U.S. healthcare system prioritizes profits over people’s basic needs. She cites routine (nontherapeutic) infant circumcision as a prime example of a practice that wastes money and harms boys and the men they will become. This Penis Business: A Memoir is her first book.