Mar 18, 2019
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.
Mar 14, 2019
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.
Feb 21, 2016
Last week, Intact America launched a petition to the American Academy of Pediatrics (AAP). The petition demands that the AAP follow the recommendations from its own research about infant pain, and tell its doctors to END THE PAIN and stop circumcising baby boys. Our goal is 29,000 signatures by February 29. We need your help! Please sign this petition, and share it with your friends. Ask them to sign and share it, too!
Intact America insists that the American Academy of Pediatrics issue a new circumcision policy—one that honors and protects baby boys from harm.
The American Academy of Pediatrics (AAP) recently said that babies shouldn’t be subjected to unnecessary pain. But the AAP continues to promote “routine” infant circumcision, a painful, medically unnecessary surgery that removes a normal part of a baby’s penis.
Last month, the AAP published research showing that common medical procedures carried out on newborn babies are very painful, and that the effects of the pain can last many years. The procedures mentioned included heel sticks, insertion of IV needles, and circumcision. The AAP report also found that commonly used pain relievers are neither effective nor safe.
Infant circumcision differs from the other procedures discussed in the report in that it is an invasive surgery that neither tests for nor treats any illness, and permanently removes a natural and valuable part of a boy’s sexual anatomy – the foreskin. The pain from circumcision is intense and continues for days or weeks after the surgery.
Circumcision, originally promoted in the 19th century as a way to prevent masturbation, has become part of American medical culture. Every year, a million baby boys in the United States are subjected to this surgery, although no medical association in the world recommends it.
Some of the falsehoods currently used to support circumcision include hygiene, disease prevention, and aesthetics.
The truth is:
- The intact penis is easily cleaned throughout a boy’s and man’s lifetime.
- Circumcision does NOT prevent sexually transmitted diseases, including HIV. European countries where fewer than ten percent of all men are circumcised have about the same STD rates as the United States, where circumcision is common.
- Any preference expressed by men or women for the circumcised penis is a result of cultural conditioning. Besides, as the U.S. circumcision rate declines, and the number of intact boys and men grow, the intact penis will no longer seem strange or unattractive.
Many Americans also believe that circumcision is “just a snip” – a minor, brief, and painless procedure that babies will not remember. This is FALSE, and the new AAP article on pain proves it.
Because circumcision is NOT medically necessary, and because the pain it causes is unmanageable and harmful over the long term, Intact America demands that the American Academy of Pediatrics tell its doctors to end the pain and stop circumcising baby boys.
Help us reach 29,000 signatures by February 29, 2016.
Please sign our petition TODAY.
Feb 13, 2016
The media overlooked an important story late last month that should dramatically change how doctors and hospitals treat newborn babies. On January 25, the American Academy of Pediatrics (AAP) announced a study updating its recommendations on avoiding, minimizing, or treating pain in infants. The AAP statement cites research showing that many “routine” interventions are extremely painful and that there are both short- and long-term consequences of babies’ exposure to painful stimuli.
Now that the AAP is asking health facilities to implement “a pain-prevention program … minimizing the number of painful procedures performed” on newborns, we need to ask again why doctors continue to circumcise nearly a million baby boys a year in the United States. Unlike other painful stimuli the AAP cites, including heel punctures or IV insertion, circumcision is a protracted surgery that does not diagnose or treat any illness, but rather subjects tiny boys to extreme pain for a medically unnecessary procedure.
Until recently, circumcisions have been carried out with no pain relief at all. Instead, practitioners used only physical restraints. Even today, it’s estimated that as many as half of circumcising doctors do not employ analgesia, and that the methods used the rest of the time are only partially effective, if not outright dangerous. (“EMLA,” a topical anesthetic cream widely used in U.S. hospitals, is specifically contraindicated for use “on the genitals of children” in the United Kingdom.
Unfortunately, as the AAP statement acknowledges, it’s nearly impossible to manage pain in infants, given their small size and vulnerability to chemical interventions – even the questionably effective and widely used sugar pacifiers. Implicit throughout the AAP statement is the fact that the safer the analgesic, the less effective it is in eliminating pain.
The next step
Now that the AAP has gone on record to affirm that babies feel and suffer the consequences of pain, and should not be subjected to painful procedures if they can be avoided, the logical next step is for the AAP to call unequivocally for doctors to stop circumcising babies. In its 86-year history, the AAP has never recommended circumcision and has always held that it’s not medically necessary. But, recently, as more and more parents opt out of the procedure for their boys, the trade association’s enthusiasm for circumcision has only increased. In 2012, while admitting that the complications and risks of infant circumcision have never been studied systematically, the AAP took the regrettable position that the operation’s benefits outweigh the risks.
Medical experts from around the world disagree. In response to the AAP’s 2012 statement, a large group of European physicians and ethicists wrote, “Cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious, and the report’s conclusions are different from those reached by physicians in other parts of the Western world… [Their claims of] health benefits… are questionable, weak, and likely to have little public health relevance in a Western context.”
Notably, far fewer than 10% of adult men in Europe are circumcised, compared to 75% of the adult male population in the United States.
Now we have a systematic study about the short- and long-term risks of pain inflicted upon infants. This is all we need to know in order for the AAP to stand up and say to its members: “Removing a boy’s foreskin is not medically necessary, it is painful, and the pain may compromise his neurological development for years hence. The AAP recommends that the circumcision of male infants cease.”
In my experience, the more you know about circumcision, the more you oppose it. One important fact is that the foreskin is not “extra skin,” but a natural, necessary part of the male anatomy that protects the head of the penis, provides natural lubrication, and enhances sexual pleasure for men and their partners. In 2011, a study published in the International Journal of Men’s Health found that circumcised men have a 4.5 times greater chance of suffering from erectile dysfunction than intact men.
As an activist, bioethicist, attorney and, most importantly, a mother, I feel a glimmer of hope when I read the AAP’s new policy statement. I see a medical organization increasingly boxed into a corner as it tries to escape the inevitable: infant circumcision is not medically necessary, it is unethical, and it has no place in legitimate medical practice. The organization, which pledges its commitment to “the optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults,” thus has no legitimate path other than to tell its physician members to stop circumcising baby boys.
Georganne Chapin
February 13, 2016
Jul 25, 2015
JULY 2015: This July we honor David Grant, intactivist and volunteer extraordinaire, whose on-the-ground organizing made Intact America’s presence at the 2015 NYC Pride March a rousing success.
David was born in South Carolina in June 1969 – just weeks before the Stonewall Riot and one year before the first Gay Pride March. “I always felt great inspiration about being born in a year that shook the world,” he says, “and in times of self-doubt and fear, I use that to pull me out.”
“I knew as early as I have memories that I was gay, and though I had loving parents, I knew my answers lay elsewhere.” So at the age of 17, David jumped on a Trailways bus to New York City.
His intactivism started years later with a tiny mention of Intact America in Next magazine, a popular weekly that covers NYC gay nightlife. In a small column, it briefly mentioned actor Alan Cumming’s appearance at a local club, where he “suddenly” brought up the subject of foreskin and talked about his support for a group called Intact America.
“Alan talked about the way the foreskin enhances sexual pleasure, things I didn’t know,” says David. “I immediately got on my computer and found Intact America’s website. My life would never be the same. I refer to it as the deeply personal, ‘Killing Me Softly With His Song,’ effect. When I read about the harm from circumcision, it was my own story. All the complications… I knew them well because I lived them, and still do.”
From that time, David joined intactivist campaigns, demonstrations, and protests. “You name it, I do it. Online and on the street. I strike from all angles with my own money, my time and – believe me – my own blood, sweat, and tears.”
NYC Pride Parade 2015
“For the most part the gay community is very open to the intactivist message. What we have in common is questioning social norms and religious bigotry, and we fight for the same cause: Neither our parents, nor our culture, nor any religion owns our bodies, and only we can decide what to do with them. So, as they say, we are family. Also, gays have always been parents, but today it’s openly and legally accepted. Tragically, though, it’s still quite legal to cut children’s genitals if they are male. LGBT American parents, just like ’straight‘ American parents, are faced with the same question of keeping their boys whole or taking a knife to them.”
Protest Group
In 2006, a small group of Intactivists were approved to enter the New York City Gay Pride parade – among them, Julia and Emily Legutko, who later took up the Intact America banner. This year’s march, on the heels of the Supreme Court decision on same-sex marriage, was the largest ever. David’s organizing skills and passion were much in evidence, as this former kid from South Carolina directed Intact America’s demonstrators, float drivers, disc jockeys, parade assistants, demonstrators, and dancers through the complexities of an event attended by more than a million people. The resonance of Intact America’s message was abundantly clear, and the sparkle in David’s eyes – as he danced and twirled and strutted his banner – was priceless.
“When I came to New York, all my dreams were here, just waiting for me,” says David. “The greatest of them was Gregory, my boyfriend of 23 years, who supports my intactivism, and whose love is as constant as the North Star.”
“The moment I heard Alan Cumming’s words and discovered Intact America, there was a realization inside of me that would reshape my future. I knew I had been treated like cattle, put through a slaughter house, carved up and branded with a scar I will carry to my grave. But I will not go quietly to the grave with this indignation. I will do everything in my power to stop another child from being sent to the meat factory. And one day we will prevail.”
“The day David Grant discovered intactivism was the day our burden became easier to carry,” says Georganne Chapin, Intact America’s Executive Director. “With friends and supporters like David, we simply cannot lose.”
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