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.

 

Voices — H Smith

I was born and raised on an isolated farm in East Africa, a descendant of a Boer War veteran who settled there in the early 20th century. My younger brother and I seldom saw other children. At the age of six, I was sent to boarding school. I can still remember the feeling of abandonment, knowing that it would be months before I would see my parents again, and the confusion of being with 150 other children in an atmosphere of military organization and discipline. But worse was to come. The first night, our whole dorm was marched into the communal shower room for our evening bath. I immediately saw that my penis did not resemble that of many of the other boys, and I was shocked and sickened to realize I was missing something. I intuitively knew it was something valuable. I wasn’t alone in my realization that something horrible had been done to me, for that night, I found myself and another boy standing in the dorm doorway in the light of the hall, pajama pants down, staring at our denuded penises and wondering why this had been done to us. There was absolutely no solace from the knowledge that there were other boys like us. Thereafter, every time I was in a library, I tried to find out more but in those days, there was no information to be had.

I remember at about age 9, my brother and I were in the tub, being watched by my mother and her cousin. I heard my mother say she thought the doctor had done a neater job on me than on my brother. I knew exactly what she was referring to (the doctor who circumcised me must have gotten paid by the square inch, or maybe the square millimeter!). Curiously, even though my mother was a very approachable and open person, I always felt too embarrassed to broach the topic of circumcision with her.

I was 13 and away at school when my youngest brother was born. I saw him for the first time when he was a month old. That evening, I was chatting to my Mum while she bathed him. She must have sensed that an explanation was in order and said that she’d had him…”oh, what ‘s it called?” “Circumcised?” I volunteered. “Yes, that’s it.” She went on to explain that her father, who had been born in Ireland, was circumcised at age 12 because “his foreskin got so tight that he couldn’t pee,” and he felt it better done in infancy “when there would be no memory” of the event. This explanation never made any sense to me. I wish my grandfather had said nothing, so that I might have remained whole. My dad was also circumcised, I surmise as a consequence of his mother’s upper-class English upbringing. I don’t blame my parents, though; they didn’t know anything. I place most of the blame on the doctor; had he told my mother it wasn’t necessary, I’m quite sure it would not have happened. Especially as Dr. Douglas Gairdner’s article “The Fate of the Foreskin” was published about the same time.

I frequently see both medical personnel and parents express the sentiment that boy’s penises should match those of their fathers. But how can any of them predict what the boy might want?

I believe that we all have the right to the body we were born with and that circumcision violates a child’s basic human rights from day one. As for religious circumcisions, these should wait until the child has reached an age to choose for himself.

It amazes me how many North American parents choose to circumcise their sons because they fear they’ll be teased in school. I have to say that in 12 years of grade school, I never witnessed a single case of teasing based on circumcision status, despite the fact that shower rooms were communal and everyone saw everyone else and knew their status. For a time in elementary school, games in off-time involved “armies”, with the “Roundheads” being the circumcised boys and the “Cavaliers” the intact boys.

When I finished high school, I moved to Canada to attend university. I was surprised at how many Canadian males were circumcised, and I began to resent my own circumcised status more and more. My feelings of violation and betrayal grew stronger, as did my desire to understand the history and rationale for this bizarre custom: the coerced amputation of the most sensitive part of a baby boy’s genitalia.

In the early ’80s, I came across an article by Kelly Servaas in The Saturday Evening Post. The piece confirmed my hunch that there was no good reason for circumcision. Some years later, I found Rosemary Romberg’s book “Circumcision, The Painful Dilemma,” and then the books by Thomas Ritter (Say No to Circumcision) and Jim Bigelow (“The Joy Of Uncircumcising”). I learned a whole lot about the form and function of a foreskin, what I was missing and how my sex life had been compromised.

I began working on restoring my foreskin. At least I would feel “whole”, even if I was still missing the specialized nerves. Unfortunately, my wife who had been ambivalent about circumcision, became opposed to my efforts, and between her extreme lack of support and the constraints of my work, I eventually gave up — something I resent to this day because I believe restoration might have mitigated the problems I now face. The fact that thousands of circumcised North American men are undertaking the arduous process of stretching what penile skin they have left and restoring some semblance of what was taken from them should be a glaring signal to the medical establishment.

When my father died, I flew overseas to be with my Mum for a few weeks. One night I got up the courage to ask her why she had had her sons circumcised. I got the exact same answer as the explanation a couple of decades earlier. Not wanting her to feel badly about her decision, I merely stated that it was falling out of favor. She asked if my son had been circumcised, and I said “no.” In hindsight, I wish I had pursued the conversation, because I would really like to know the history in my family. I’m guessing that my paternal grandfather was intact. I will forever wonder what my Dad’s views were. Did they really think that nature made a mistake? Did they not consider it weird that only one human body part was being amputated for prophylactic reasons?

I have always been terrified of doctors. I can’t even visit someone in a hospital without my blood pressure increasing by a factor of 50%. Because I could count my childhood doctor visits on one hand, this puzzled me until I learned there are two types of memory, and that explicit (recallable) memory does not develop until around 3 years of age. No wonder few children “remember” the horror of being circumcised. However, implicit memory begins in the mother’s womb, and everything the baby is exposed to leaves a trace on its brain. Too little research has been done on the psychological effects of neonatal circumcision; Dr. Ron Goldman’s illuminating work is an exception. I find it very sad that so few doctors will admit – let alone warn parents – that there may be psychological sequelae to cutting the genitals of babies.

Some years ago, I read an article by Dan Bollinger showing that circumcised boys are far more likely than their intact counterparts to suffer from Alexithymia – the inability to express feelings. That’s me. In fact, I think it goes further. Circumcision inhibits close relationships. It is well known that babies withdraw after being circumcised and many have difficulty breast feeding. This makes perfect sense: they have just endured what is probably be the most traumatic event of their lives and no one protected them. I don’t doubt that these feelings of helplessness and abandonment and the resulting sense of distrust all carry forward into adulthood.

As I reached my sixties, I began having sensitivity issues and achieving ejaculation was becoming more difficult. I won’t use the word orgasm because what I felt was far from the exquisite, almost out of body experience that I have observed in my female partners. I believe there is a marked difference between what an intact man experiences versus his circumcised counterpart. A few years later, I began having ED issues as well. I am fortunate that unlike my previous doctors, my current doctor – a lovely English woman – has tried very hard to find solutions for my issues and to refer me to others who may be better able to help.

I am not a true intactivist in that I can’t participate publicly. However, I speak to expectant parents privately when the opportunity presents itself, and I frequent parenting boards to provide information and encourage parents to leave their sons intact. I don’t want anybody to experience the same grief that I have, so when I can persuade a parent who is thinking of circumcising their son to leave him whole, it is positively uplifting. I also make my discontent known to medical personnel; when I have to fill in a form listing previous surgeries, I always start the list with “1949 – totally unwarranted circumcision.” And, when I visit a doctor and my blood pressure shoots up, I explain why I think that occurs.

To those who claim that they’ve never heard from a man who was unhappy about being circumcised: You have now!

On behalf of little boys in previous and future generations, I want to thank the people and organizations who have exposed the myths and misconceptions propagated by the medical community for 150 years. To name just a few in addition to those named above: Edward Wallerstein and his book “Circumcision, an American Health Fallacy”; Dr. John Taylor for his research into the structure of a foreskin; Marilyn Milos and NOCIRC (now Genital Autonomy – America); and of course, Georganne Chapin and Intact America.

H Smith, Alberta Canada

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Voices — Amanda Bunch

Amanda Bunch
I believe strongly that baby boys should not be circumcised. For me this is an issue of personal choice, a basic human right that a baby can’t claim for himself.

I first thought seriously about this in my twenties when I read an article in a body modification e-zine. The writer listed all the reasons circumcision is wrong. Up until then I’d considered circumcision to be the right thing to do because it was so common. I’d barely given it a thought. But what she wrote re-ally resonated with me; for the first time I saw how circumcision went against everything I believed about the right to one’s own body.

That planted a seed, and I started researching the topic. When I saw what ba-bies when through—having no choice—I changed my mind. What solidified it for me was seeing the table baby boys are strapped to for the circumcision. How could I believe in the right to bodily self-expression and still condone a practice that imposed mutilation on an innocent child? When I had my son nine years ago, my husband and I agreed without hesitation that we would not subject him to that.

Society wants to assert its control over people, and circumcision is a good ex-ample of this. “You need to look this way; you need to be this way.” If you’re not this way, it doesn’t reaffirm what they feel about themselves. They need their validation. They need you need to fall in line.

My sister Ellen and I own BodyArtForms, a body-piercing jewelry online store. We opened in 2001, one of just a couple of similar e-commerce sites operating before the boom of online retail. We believe people should be able to express themselves and adults should be able to do whatever they want to their bodies. Back then I had implants in my arms and lots of piercings. I express myself a little differently now, but I believe strongly in the freedom of individuals to express themselves this way.

Our business supports the important work Intact America is doing on the front lines. I don’t tend to speak out about circumcision, but opportunities to share do come up. I was taking a pole fitness class and the teacher asked us to do a dance to release something that upset us, an emotion we wanted to get out. I found myself releasing my feelings about circumcision on behalf of all those baby boys. I thought, “I can’t believe I’m doing this.” Some people asked me about it afterwards. They wanted to know why I was so passionate about it, and we talked. Maybe I planted the seed that time. I like to think that maybe I did.

Amanda Bunch

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Voices — David Arnold

David ArnoldI am 77 years old. It has taken me a lifetime to deal with the consequences of the trauma of my circumcision as a newborn infant in 1942. For most of my life, the earliest memory I had of my mother was when we were traveling on a railroad train across the western plains  from Louisville, Kentucky to the coast of Oregon to visit my father who was serving in the Coast Guard during WWII. I was two years old.  As the train sped over the prairie, we needed to move from one car to another. The shaky and narrow walkways between the cars were open, windy and scary.  My mother wanted to carry me, but I fought against her and insisted on walking on my own. I felt I had to do it myself because I could not trust my mother. This feeling hindered a close relationship between us for most of our lives. I was afraid of her. Fortunately, I had great attention and care from close relatives who were always available to and engaged with me for the first three years of my life while my father was absent, and my mother and I lived with her parents and older sister. I am forever grateful for their attention to me.

My first career was as an officer in the Coast Guard.  However, in 1985 I turned down a significant promotion and many appeals and inducements by senior officers to remain in the Service.  I had begun to pursue my interests in depth psychology and experiential approaches to self-individuation. I had become increasingly concerned about the Coast Guard and the competence and authoritarian style of its leadership, and I no longer wanted to be a part of it.

I decided to pursue a second career in clinical psychology. I recognized that I was suffering from PTSD and moral wounding, and that I was unable to trust or take in the satisfactions and further opportunities offered to me as the result of my accomplishments. I sought to avoid further injury and to obtain personal healing for myself.  During my career change, I obtained effective, ongoing personal therapy that enabled me to communicate and heal my relationship with  my mother. I was very glad to be able to express to her my love, understanding and appreciation of her while she was still alive.

As I explored academic programs in clinical psychology and counseling, I decided to take a self-indulgent year off and enroll in a new massage therapy school in Connecticut that was integrating aspects of experiential and body-centered psychotherapy. During this time, while receiving massage and while deeply relaxed and mindfully observing, I had body memories of my infancy.  I felt hunger and the impulse to nurse along with the beginning of a penile erection. This rapidly turned into intolerable pain in my genitals.  I realized I must have had some experience as a nursing infant that had required me to turn off feeling in order take in nourishment and survive, and that resulted in my associating the pleasure-seeking fulfillment of my needs with unbearable pain.  I had developed an ability to strive, to accept and tolerate dangerous and painful circumstances.  I became increasingly curious about my vivid body memory and its possible effects on all aspects of my life.  I wondered if my mother, while holding and nursing me, had perhaps checked my diaper and accidentally stuck me in the genitals with a diaper pin.

When I was 43 years old, I asked my mother if she could recall any accident or difficulty when she was nursing me in infancy. I was shocked by her immediate explosion of emotion and the specific details. She named and swore at the obstetrician, telling me how he had nearly cut off the end of my penis and then sewn it back on with five stitches. She exclaimed how the doctor had insisted that newborns did not feel pain, that the circumcision process did not hurt and could not be the cause of my distress in her frantic attempts to feed me. She told me how the doctor said that her difficulties in comforting and nursing me were due to her breasts being too small and her milk inadequate,  She told me how agitated and terrified she was in her attempts to care for me. Her powerful feelings of inadequacy, regret, helplessness, guilt and rage were evident as she told me things she had never before spoken about.

My mother’s account clarified and furthered my understanding of my early injury and its consequences.  It increased my confidence in trusting in the power, depth and consequences of “body” memory” existing before “conscious” memory and the subsequent physical and psychological consequences.

I decided to train and became a body-centered psychotherapist, and had a second career in  private practice with self-paying clients for over two decades until I became severely physically disabled due to compression fractures in my thoracic spine and, resulting spinal cord injuries resulting from a rare cancer throughout my spine, liver, and lungs. The cancer was caused by exposure to Agent Orange while I was skippering patrol boats in Vietnam in 1967-68.

My mother’s revelations to me about my circumcision confirmed my body memory and explained the basis of a vast number other beliefs and behaviors resulting from the experience. This understanding helped not only in my personal healing journey, but also in working successfully with clients suffering from severe physical and psychological issues that not had not been successfully treated with conventional medical treatments or talk therapies.

The answers to basic questions such as “Am I lovable?” “Can I trust others?”. “Can I get my needs met?” and “Is this world safe for me?” are fundamental in the development of individuals and cultures.  The increasing incidence of adverse childhood experiences (ACE) resulting from our rapidly changing culture and the deep feelings of betrayal arising from the actions of authorities upon whom we rely are critical issues we face  as individuals and as a nation.

The trust in the power and depth of the body memory of each individual and the use of body-centered psychotherapy and many wholistic practices have been of life-saving value to me, as well as to many of my clients. I am grateful that the complexities and difficulties in the paths of possibilities in my life journey are ongoing.  I attempt to share what I believe might be beneficial to others.

Many find the topic of “circumcision” too painful to discuss, or even consider. I believe that the present conflicts between systems of human authority, privilege and control (including religion, politics, economics, science, and communication systems) are causing great harm, carried out by individuals attempting unsuccessfully to overcome their own deep personal insecurity and developmental traumas.

I am grateful for the critical work that Intact America is doing to recognize and end the trauma of genital mutilation of infant males.

David Arnold

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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.

Voices – Marilyn Milos, RN

Since her days as a hospital floor nurse more than 35 years ago, Marilyn Milos, RN, has been at the front of the fight to end forced circumcision in the U.S. She founded the National Organization of Circumcision Resource Centers (NOCIRC), now Genital Autonomy – America, and is a co-founder of Intact America, a member of its Steering Committee, and also serves as its Clinical Consultant.

When I began my work in 1979, I naively thought it would take a couple of years to stop routine infant circumcision. It seemed so obviously wrong, and I’m outspoken and pretty determined. So, I figured if someone put a spotlight on it, rational people would see the truth.

I witnessed a circumcision for the first time when I was a nursing student, and it changed me forever. Before the doctor came into the nursery, the baby was lying on a molded plastic board, struggling against the restraints that held his arms and legs down. I asked the nurse if I could comfort the baby and she said to wait until the doctor arrived. I asked the doctor when he came in, and he said to put my finger in the baby’s mouth. The baby began to suck on my finger. I stroked his little head and told him what my doctor had said to me before my own three sons were circumcised — it wouldn’t hurt, just took a minute, and would protect him throughout life. As the doctor began, the baby let out a scream I’d never heard come out of a human before. It wasn’t like a baby’s cry when he’s hungry or needs his diaper changed. It was primal. He screamed for the next 15 minutes.

My chin began to quiver, and I knew I was going to lose it. I started to cry uncontrollably. The doctor looked at me and said, “There is no medical reason for doing this!” This baby was being tortured, and I was just realizing what had been done to my sons and that my own doctor had lied to me.

After witnessing a circumcision, I began learning everything I could about it. How could I have let this happen to my precious boys? I shared what I learned with other nurses working on the obstetrical unit. I thought, “We’re all learning together. We’ll be educating parents and changing things.”

But in the end, I was forced to resign. That was 1985, and that same year I started NOCIRC. It was the desperate screams of those babies that have driven me all these years. It was in my 30th year that a generous donor asked if his contributions were being as effective as they might be. I had learned that, after three decades, grassroots movements typically step it up a notch, and I suggested to him that I put together a group of the movers and shakers for this discussion. I invited Georganne Chapin to be part of that group.

Our conference call included the leaders of other organizations that formed after I founded NOCIRC — including Attorneys for the Rights of the Child, Doctors Opposing Circumcision and Nurses for the Rights of the Child. This phone call was the beginning of the formation of our new organization, Intact America. Georganne was the perfect person to lead this new level of intactivism. She ran a health care company and knew how to get things done. She was an attorney, a respected expert in the healthcare field and had a network of colleagues and media connections she could tap.

A core group of us continued to plan this new phase of activism in person with support from our donor. The third time we got together we met in Tarrytown, New York at Georganne’s Hudson Health Plan office. During one of our meetings that weekend, the consultants hired to help us organize went over the budget with us. It was based on more money than any intactivist organization had ever had or that I could even imagine having.

So when the donor offered that he planned to donate a million dollars, I burst into tears and cried for 15 minutes. I’d been challenged and discredited for more than 30 years, and suddenly I was being told the thing I hold so dear is worthy. It was overwhelming. And Georganne, bless her heart, was willing to step up and make it happen.

Intact America is the organization that is fighting on a level that none of us ever had been able to fight before.

In the early days of the work, we focused on getting accurate information about the normal penis and the harm of non-therapeutic genital cutting into the hands of parents, childbirth educators, midwives, doctors, lawyers, and concerned individuals. Today, with information readily available, we’re working to challenge those who profit from genital cutting and refuse to put their scalpels down, those who provide misinformation and disinformation to promote genital cutting, and those who advocate for the circumcision-to-prevent-HIV/AIDS agenda, which undermines the programs that truly will end the spread of the disease (for example, education about safe sex and condom use). Education continues to be key and the Internet has helped immeasurably. Intact America’s Internet outreach has been large, productive, and effective. And, now with more intact boys in the United States, our work includes educating parents and their sons’ doctors about proper care of the intact penis, about letting each boy be the first person to retract his own foreskin, and about treating foreskin problems medically instead of amputating them. Our work also includes helping men who have penile problems and dysfunctions resulting from their circumcision years before.

Medical organizations have to be very careful now. The American Academy of Pediatrics, the Centers for Disease Control, hospitals and academics who are making their career from the bogus and unethical “African HIV studies” — Intact America is taking on all of them. Georganne has stood up to the powers that be — with strength, dignity, and experience. She is not afraid to ask the tough questions about ethics and human rights, and the medical organizations and the doctors who head them are unable to provide answers that would put them on solid ground.

This is not surprising. No excuse is good enough to allow cutting off parts of the normal genitals of minors. It is time for American medical organizations to join with Intact America, other intactivist organizations, and medical and ethics organizations in Europe — and elsewhere in protecting the bodily integrity and genital autonomy rights of infants and children.

Marilyn Milos, RN

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