fbpx

How COVID-19 Can Help Break the Circumcision Cycle

The United States is now the epicenter of the global coronavirus pandemic, and our medical resources are stretched thin. There is a shortage of health care professionals to care for the thousands of terribly ill COVID-19 patients who have flooded our hospitals, which is why the U.S. Surgeon General Jerome Adams asked health care providers to cancel or postpone all adult elective procedures to avoid overwhelming hospital systems. The Surgeon General warned that every elective surgery could spread this deadly virus within a facility. Unfortunately, though not surprisingly, after a few weeks’ realization that the pandemic is going to be with us for a long time, hospitals are resuming elective surgeries, with little discussion about the principles or priorities that underlay the Surgeon General’s recommendations.

That said, his guidance did not go far enough. In particular, it failed to address the fact that many elective procedures for minors could and should also be evaluated as to their need. A glaring example of a surgery that is not just a non-priority during a pandemic but utterly useless at any time is – ironically – also the most commonly performed pediatric surgery in America. Newborn circumcision treats no illness and could be completely abandoned with only positive benefits for children and for the nation’s health overall. Of course, this procedure is sold by physicians and nurses to parents, who “elect” to cut their baby boy’s genitals, and the patient is given no choice; if he were, I suspect he’d opt to forgo the surgery and remain intact. (One of my favorite bumper stickers of all times says: 10 Out of 10 Babies Say NO to Circumcision!)

Boys who are circumcised spend, on average, an extra six hours in the hospital, increasing the risk that they and their mothers will be exposed to COVID-19 and other infections. It is just appalling to me that doctors and hospitals engage in cutting the genitals of infants, even when the risks associated with the pandemic are so apparent.

Yet, it’s clear from the reports I have seen that doctors and nurses continue to press parents to circumcise their newborn boys, and that it even extends to cases where the mother is COVID-19-positive! In early April, the American Academy of Pediatrics published its “Initial Guidance: Management of Infants Born to Mothers with COVID-19,” which specifically states, “Well newborns should receive all indicated care, including circumcision if requested.”

What the guidance does not say, but should, is that the American Academy of Pediatrics itself has always stated that there is not sufficient scientific evidence to recommend routine newborn circumcision. To that, we add that circumcision is a harmful intervention that no professional medical society recommends, that it is performed on patients who are not sick, and that it robs babies of an essential erogenous part of their natural penis.

Intact America has launched a petition drive to demand that the Surgeon General tell hospitals to stop performing male child circumcisions at this critical time. Nationwide, doctors perform 3,000 newborn circumcisions each day, or more than one million unnecessary surgeries every year. Each day, the procedure consumes 6,000 surgical masks, 6,000 pairs of protective gloves, and other supplies that could be better used to protect frontline health care workers from COVID-19 and to treat sick patients.

We have also contacted nearly 20,000 administrators and clinicians from thousands of hospitals around the country requesting that they stop all newborn circumcisions. Health care professionals need to understand that cutting newborn genitals both wastes precious resources and increases the risk of exposure to COVID-19 by babies and their mothers.

COVID-19 has brought pain and suffering to millions in the United States, and the U.S. health care system will be forever changed by this pandemic. One would hope that both experts and the general public will begin to accept that it’s necessary to prioritize our overall use of medical resources to ensure that supplies, equipment and personnel are available – and equitably accessible – for when they are truly needed. Fortunately, more and more Americans are ready to accept the wisdom that intactivists have advocated for years: suspend routine newborn circumcisions and keep all children whole, as nature intended.

We can use this pandemic as an impetus to stop cutting boys’ genitals—just as we refuse to allow cutting the genitals of girls. We can break the circumcision habit, and thus move closer to a consensus that keeping a boy intact (“uncircumcised”) is the normal and desirable thing to do. In his book, “The Tipping Point,” Malcolm Gladwell, explains the concept: “The tipping point is that magic moment when an idea, trend, or social behavior crosses a threshold, tips, and spreads like wildfire.”

We look forward to watching the flames. Help us by signing our petition today.

Redesigned website

Intact America is proud to announce that we have launched our new website! It took a long time, but it looks FANTASTIC! We are grateful to all who made it happen: Stephen Patterson, Intact America’s Director of Constituent Outreach; Erica DeJoannis, a Washington-based consultant who helped us to conceive of the site’s look and feel, and to organize the content; Dan Bollinger, IA’s stalwart volunteer, content contributor, and strategic consultant; and Adam Zeldis, also a volunteer who so generously helped with both content and technical issues. And most of all, We are grateful to YOU—Intact America’s followers and donors, who inspire us every day to do our best work.

The new website has all your favorite features and more. You’ll find links to IA’s Voices essays and our “Do You Know” series; you’ll find Intact America’s Statement of Principles, and our well-thought-out positions on the bioethics of genital cutting; and you can read about our various campaigns and ways you can take action and spread the word. Finally, you’ll find the site offers great resources for educating yourself and your community. So check it out — the new IntactAmerica.org — and tell us what you think.

Washington’s Pending Child Protection Legislation: Unconstitutional!

by
Georganne Chapin, MPhil, JD
Intact America
March 17, 2019

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

Senate Bill 5257, introduced January 15, 2019, would prohibit the practice of “female genital mutilation” or FGM – i.e., the culturally-based practice of pricking, incising, or cutting a minor girl’s genitals. The bill arose, in part, as a response to the November 2018 dismissal by a federal court in Michigan of a case against a physician prosecuted under a similar federal law (18 U.S. Code § 116, also known as the Federal Prohibition Against Female Genital Mutilation Act of 1996) for operating on the genitals of three young girls. In dismissing that case, the judge said that despite the heinous actions of the physician (a woman from an Indian sect that practices female genital cutting), the federal law under which she was charged was unconstitutional because the behavior it proscribed falls under the rubric of “local criminal activity,” which is properly regulated by states.

So, what is wrong with this Washington State bill prohibiting medically unnecessary genital surgery on girls? In three words: it is unconstitutional!

Washington’s Constitution contains a “equal protection” clause which states: “No law shall be passed granting to any citizen, class of citizens, or corporation other than municipal, privileges or immunities which upon the same terms shall not equally belong to all citizens, or corporations.” In other words, Washington’s laws should never favor, protect, or privilege one group over another. While the anti-genital-mutilation law summarized above rightfully protects girls from medically unnecessary surgery on their genitalia, whether carried out in a “cultural” or medical context, it denies through omission such protection to boys.

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

“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 with 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,” “be normal,” or “avoid problems in the future.”

It is not known how many girls are subjected to FGM in the United States, but the number is certainly less than one percent. By contrast, more than half of U.S.-born boys – more than one million babies each year – are subjected to the brutal removal of their their healthy, normal foreskins within a few hours of days of their birth.

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.) In the United States, the incidence of routine infant circumcision varies widely by region. At approximately 10 percent for in-hospital circumcisions, Washington’s current circumcision rate is well below the national average.

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 Washington and every other state seeking to redress the ethically and medically unjustifiable practices of genital surgery performed on girls must take notice, to ensure that any new laws be consistent with the “equal protection” clauses of their constitutions, and to protect all children.

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.

 

Connecticut’s Pending Child Protection Legislation: Unconstitutional!

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

The state of Connecticut has two pending child protection bills before its legislature. While we share legislators’ condemnation of the activities these bills seek to regulate, we also wish to point out the fact that both bills violate the Constitution of the State of Connecticut.

The first bill, Senate Bill 505, forbids the practice of “female genital mutilation” or FGM – i.e., the culturally-based practice of pricking, incising, or cutting a minor girl’s genitals – and makes it a Class D felony. The bill arose in response to the dismissal by a federal court in Michigan of a case against a physician prosecuted under a similar federal law (18 U.S. Code § 116, also known as the Federal Prohibition Against Female Genital Mutilation Act of 1996) for operating on the genitals of three young girls. In dismissing the case, the judge said that despite the heinous actions of the physician (a woman from an Indian sect that practices female genital cutting), the federal law under which she was charged was unconstitutional because the behavior it proscribed falls under the rubric of “local criminal activity,” which is properly regulated by states.

The second bill in the Connecticut child protection pipeline attempts to regulate an activity that is only now becoming a topic of public discussion. Senate Bill 388 seeks to “…prohibit discrimination against a person on the basis of such person’s intersex status…” by banning “any licensed health care provider from engaging in medically unnecessary surgeries on an intersex person without such person’s consent.” Genital modification surgery of “intersex” minors refers to any surgical treatment to children born with atypical physical sex characteristics including but not limited to chromosomes, genitals, or internal organs.

Another related bill under consideration would bar discrimination against intersex individuals and provide a third option for gender designation on birth certificates, driver’s licenses and other legal documents. Taken together, the pending Connecticut intersex bills seek “to address the needs of [people in a] community who have suffered from discrimination, unnecessary surgery and inaccurate documentation of their gender, by providing relief from such issues.”

So, what is wrong with these bills prohibiting medically unnecessary genital surgery on girls and intersex children? Well, they’re unconstitutional!

Connecticut’s Constitution contains a “equal protection” clause which states: “No person shall be denied the equal protection of the law nor be subjected to segregation or discrimination in the exercise or enjoyment of his civil or political rights because of religion, race, color, ancestry or national origin.” In other words, Connecticut’s laws should never favor, protect, or privilege one group over another. While the anti-genital-mutilation laws summarized above 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 cases 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,” be normal,” or “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.) In the United States, the incidence of routine infant circumcision varies widely by region. At approximately 70 percent, Connecticut’s newborn circumcision rate is well above the national average.

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

 

Iowa’s Pending Child Protection Legislation: Unconstitutional!

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

The state of Iowa has two pending child protection bills before its legislature. While we share the legislators’ condemnation of the activities these bills seek to regulate, we also wish to point out the fact that both bills violate Iowa’s state Constitution.

The first bill, House File 299 (together with the related House Study Bill 115) forbids the practice of “female genital mutilation” or FGM – i.e., the culturally-based practice of pricking, incising, or cutting a minor girl’s genitals – and makes it a Class D felony. The legislation arose in response to the dismissal by a federal court in Michigan of a case against a physician prosecuted under a similar 1996 federal law (18 U.S. Code § 116, also known as the Federal Prohibition Against Female Genital Mutilation Act of 1996) for operating on the genitals of three young girls. In dismissing the case, the judge said that despite the heinous actions of the doctor (a woman from an Indian sect that practices female genital modification), the federal law under which she was charged was unconstitutional because the behavior it proscribed falls under the rubric of “local criminal activity,” which is properly regulated by states. It is safe to say that – from the perspective of public opinion – the proposed Iowa law and similar legislative activity taking place in other states are unlikely to meet with much pushback; Americans are rather unified in their revulsion toward “female genital mutilation,” sharing a presumption – even if they are not particularly well-informed about the issue – that this practice is indefensible from either a cultural or a medical standpoint.

The second bill in the Iowa child protection pipeline is more unusual in that it attempts to regulate an activity that is only now becoming a topic of public discussion. House File 576 seeks to prohibit genital modification surgery or “treatment or intervention on the [physical] sex characteristics” of “intersex” minors – defined as children “born with atypical physical sex characteristics including but not limited to chromosomes, genitals, or internal organs….” 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 Iowa intersex bill is also noteworthy because it (a) represents only the second time a state has set out to regulate “intersex surgery (the first was California, earlier this year)” 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!

So, what is wrong with these bills? Why are they unconstitutional?

Iowa’s Constitution contains a “laws uniform” clause (similar to an equal rights amendment) which states: “…the general assembly shall not grant to any citizen, or class of citizens, privileges or immunities, which, upon the same terms shall not equally belong to all citizens.” In other words, Iowa’s laws should never favor, protect, or privilege one group over another. While the two laws summarized above 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.

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, Iowa’s rate remains among the highest in the nation, at well above 70 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 Iowa 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.