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California’s Pending Child Protection Legislation: Unconstitutional!

by
Georganne Chapin, MPhil, JD
Intact America
March 14, 2019

The state of California has a pending child protection bill before its legislature. While we share the legislators’ condemnation of the activities this bill seeks to regulate, we also wish to point out the fact that the bill violates California’s state Constitution.

Senate Bill 201 seeks to “…prohibit a physician and surgeon from performing any treatment or intervention on the sex characteristics of an intersex minor if the treatment or intervention may be deferred until the intersex minor can provide informed consent…” The bill states: “‘Intersex minor’ means an individual born with atypical physical sex characteristics, including, but not limited to, chromosomes, genitals, or internal organs, and includes differences in sex development resulting from androgen insensitivity syndrome, congenital adrenal hyperplasia, and hypospadias.”

Because intersex surgery has been and remains the purview of the medical profession, the intersex bill contains extensive detail about the types of surgeries that have been traditionally performed upon children with anomalous genitalia in efforts to “normalize” the appearance of their sex organs toward either the male or female end of the spectrum of visible sex characteristics; it describes in similar detail measures that must be taken to prove medical necessity for such surgeries. The California intersex bill follows a 2018 resolution representing the first time a state set out to condemn and regulate “intersex surgery (the second was Connecticut and the third was Iowa, both in 2019)” and (b) includes extensive language about the rights of intersex people to “participate in decisions about surgery and other medical treatments or interventions on their physical sex characteristics, and to guarantee [them] the rights to bodily integrity, autonomy, and self-determination.” Bravo!

Since 1996, California has had a law on its books prohibiting female genital mutilation, also known as FGM. The law states: “‘Female genital mutilation’ means the excision or infibulation of the labia majora, labia minora, clitoris, or vulva, performed for nonmedical purposes.”  The current intersex bill is similarly sweeping.

So, what is wrong with the anti-FGM law? What’s wrong with the proposed intersex law? Why are they unconstitutional?

California’s Constitution contains an “equal protection” clause which states: “A citizen or class of citizens may not be granted privileges or immunities not granted on the same terms to all citizens…” In other words, California’s laws should never favor, protect, or privilege one group over another.

While they rightfully protect girls and intersex children from medically unnecessary surgery on their genitalia, whether carried out in a “cultural” or medical context, they deny these protections to boys.

Should not boys also be protected from the medically unnecessary surgical modification of their genitals? Are not boys entitled to the same rights to bodily integrity, autonomy, and self-determination as girls and intersex minors?

“Routine” infant male circumcision – like “female genital mutilation” – entails the removal of a normal, natural part of a boy’s genitals in the absence of any medical necessity. Sometimes – as in the case of female genital mutilation – male circumcision is performed for “cultural” reasons (I purposely draw no distinction between “culture” and “religion,” as there is simply no justification to favor the practices of groups who can point to a written text over those with a long oral tradition.) And sometimes – just as with intersex surgery – male circumcision is performed simply as a social or cosmetic procedure, justified as in the child’s best interest, helping him to “fit in” or to “avoid problems in the future.”

“Intersex” is a condition estimated to characterize somewhere between two and three percent of the population. It is not known how many girls are subjected to FGM in the United States, but the number is certainly less than one percent.

Possession of a penile prepuce (male foreskin), on the other hand, characterizes nearly half of the population. Until the mid-19th century, surgical amputation of the foreskin was practiced only by Jewish and Muslim people, and by some tribal cultures. Victorian doctors introduced the practice in the United States and other Anglophone countries to stop boys from masturbating. By the mid-20th century, “routine” circumcision had become embedded in American medicine, and still today, the United States is the only non-Jewish, non-Muslim country in the world where doctors routinely remove baby boys’ foreskins (South Korea and the Philippines also have high circumcision rates because of the influence of U.S. military hospitals.) While in the United States the incidence of routine infant circumcision varies widely by region, California’s rate remains among the lowest in the nation, at about 23 percent.

Just as intersex individuals are speaking out loudly against a medical establishment that overlooks individual autonomy in favor of social norms, American men of all ages are expressing indignation about having undergone the removal of their normal, functional foreskins when they were too young to either consent or resist.

Legislators from California and every other state seeking to redress the ethically and medically unjustifiable practices of “normalizing” surgery performed on the genitalia of girls and intersex children need to take notice, to ensure that any new laws be consistent with the “equal protection” or “laws uniform” clauses of their constitutions, and to protect all children.

 

Author

3 Comments

  • eshu21

    March 14, 2019 4:10 pm

    Thank you! Boys by the millions have been mutilated without their consent; when will states recognize that culture, esthetics or parental religion are no excuse for mutilating the body of an unconsenting third party?

    • Laird Ehlert

      March 14, 2019 4:22 pm

      I couldn’t agree with you more! Infant circumcision had such a negative impact on my life. I know what it’s like and there was not one good thing about it. Protect ALL children.

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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.