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Ask Marilyn—What’s the impact of intactivism conferences?

The penis advice columnDear Marilyn:

I’m looking forward to attending Intact 2022, the 16th International Symposium on Child Genital Cutting, in Atlanta this week. Can you tell me how child genital cutting symposia have impacted intactivism since you began organizing them in 1989?

—Larry, St. Louis, MO

Dear Larry:

I first witnessed a circumcision in 1979. I was horrified and immediately began researching the subject. Our local libraries, including those at the hospital and universities, had little or no relevant information. Then in 1980, Edward Wallerstein sent me a copy of his book, “Circumcision: An American Health Fallacy.” This book became the foundation of my work. I told everyone what I was learning and appeared on local radio and television shows. I was contacted by an attorney who wanted to file a lawsuit asking if parents have a right to consent to a child’s circumcision, or if the baby’s body belonged to the baby. I found a plaintiff, and our lawsuit got publicity.

The publicity likely prompted a couple of local doctors—urologist Aaron Fink and Edgar Schoen, a pediatrician—to join forces and begin their campaign to validate both cultural and religious circumcision, in the form of a pro-circumcision resolution that Fink introduced to the California Medical Association (CMA) and Schoen took to the American Academy of Pediatrics (AAP).

Fink introduced his resolution to the CMA at its yearly convention in 1987, but the Scientific Committee voted it down. Fink came back in 1988 with Arthur Dick, a urologist, who circumcised a banana in front of the CMA membership, and the resolution passed. This was followed by a counter-resolution from Dr. John Hardebeck, who planned to present it at the CMA convention the following year. I knew that meeting was being held at the Disneyland Hotel. So I booked a hotel across the street for our First International Symposium on Circumcision.

I invited Dr. Michel Odent, a French obstetrician and childbirth specialist, to give the keynote presentation. He asked if there would be other international presenters and, when I told him I didn’t have any, he said, “Well then, you need me.” I invited Fink and Schoen, but neither came or even responded to my invitation. But those who did were eager to share their work or their experiences. This was the first time that experts from various disciplines—religion, anthropology, psychology, medicine, law, and ethics—gathered around the subject of circumcision. We were all thrilled by what had transpired. Dr. Paul Fleiss, a popular Los Angeles pediatrician who was both a breastfeeding and anti-circumcision advocate, also attended, and—at the end of the symposium—declared: “Marilyn, now we need to take this show on the road.”

The second symposium was held in 1991 in San Francisco, and Dr. Ashley Montagu, anthropologist and humanist, gave the keynote address. Presenters and attendees alike were amazed at the quality, breadth, and depth of the presentations on this crucial human rights issue.

The joy of each symposium is the new material that has been presented, the medical research that has been done, and the focus on how we treat children at the beginning of life and how this affects society. Those who have attended our symposia have been enriched with important information about the issue and what’s being done to end an anachronistic blood ritual. By coming together, we learn from one another, and become secure in knowing we’re not alone. We have become Intactivists together and we have become a family.

In the following years, we held 13 more symposia around the world including Switzerland, England, Australia, Italy, and Finland; six books of the proceedings were published by Springer—the same company that published Wallerstein’s groundbreaking book decades earlier. Our books are now in universities worldwide and being used in classrooms.

The Atlanta symposium (August 2022) will be the first I will not attend in person. While I’m sorry for that, that’s life! And I’m thrilled to know these gatherings will continue—this time because of David Llewellyn and Georganne Chapin—as will the movement I initiated all those years ago just because I couldn’t keep my mouth shut. As you can see, I still can’t. Please, carry on…

—Marilyn Milos, RN

Opposition to Child Genital Cutting is Based on Human Rights, Not Anti-Religious Sentiments

Since Intact America’s founding in 2008, our organization’s stated goal has been to “change the way America thinks about circumcision.”

Our Vision statement says:

Intact America envisions a world where children are free
from medically unnecessary surgeries carried out on them without their consent
in the name of culture, religion, profit, parental preference, or false benefit.

The genital cutting of any child in the absence of life-threatening or seriously health-threatening pathology violates not only that child’s body, but also his/her/their autonomy over their own sexual future. This position is immutable.  No parent or guardian has the right to waive a child’s right to be protected from any type of tortious interference, or physical or sexual assault, with regard to genital cutting. The right that governs is that of the child.

Intact America was founded in 2008 by a coalition of individuals and intactivist organizations who wished to see the intactivist movement grow into a mainstream human rights cause. The new organization, as well as its founders, were guided by widely-accepted secular bioethical principles adopted in Western human rights and political discourse in response to atrocities committed against persons of many religions, races, and cultures during World War II. Our position is also supported by common law and the objective fact that having normal genitals, including a foreskin, is not a condition requiring surgical intervention. Furthermore, intactivism places no inherent value in following a particular common or traditional practice nor in capitulating to the current (but always-evolving) status quo, if those traditions and practices compromise the physical integrity and sexual wellbeing of children and the adults they will become.

Thus, neither religion nor “culture” should ever be invoked to support child genital cutting. At the same time, opposition to child genital cutting is not rooted in anti-religious sentiments. To tie ourselves up in such accusations is to lose focus on the true intent of the intactivist movement, as expressed in the fundamental goal and vision of Intact America, restated from above: a world where children are free from medically unnecessary surgeries carried out on them without their consent.

As a human rights organization that respects all persons regardless of their race, religious or cultural affiliation, it is also our duty to refute expressions of bigotry when expressed by people outside or within the intactivist movement. To leave no doubt, in 2022 Intact America’s adopted a new position statement against bigotry and hate speech:

Intact America rejects all forms of ethnic, racial, and religious stereotypes and bigotry. We condemn any form of hate speech based on ethnicity, race, national origin, gender, sexual orientation, religion, or irreligion. The incorporation of anti-Semitic or anti-Muslim expressions into criticism of male (or female) circumcision only serves to undermine our movement and potentially derail our work to protect all children from genital cutting.

I fervently believe that adherence to the logic and principles outlined above will ensure our success in protecting future children and the adults they will become.

–Georganne Chapin

Letter to an Unenlightened Urologist

On October 11, 2021, the New Yorker magazine published an essay by popular writer Gary Shteyngart, recounting how being circumcised when he was seven years old resulted in decades of misery and complications. On November 1, the magazine published three comments in response, mine, one from a rabbi, and one from a urologist. The post below is the follow-up letter I wrote to the urologist, Dr. Michael Mooreville.


Dear Dr. Mooreville:Georganne Chapin, Chairperson

I am writing about your letter to the New Yorker, which appeared after my own among the responses to Gary Shteyngart’s essay about his decades of suffering because of a botched circumcision. Thank you, in advance, for taking the time to read my comments below.

First, you suggest that Shteyngart’s problems occurred because he was circumcised too late, and then say that it’s easier (somehow) for a physician to know how much foreskin to remove from a baby than from an older male. My decades of working to end unconsented-to, medically unnecessary circumcision suggest this is not true. Men who have spoken or written to me, or who have spoken out publicly about their circumcision-induced penile deformities, overwhelmingly were circumcised as newborns by doctors in American hospitals. Some of them have undergone one or more additional surgeries to correct cosmetic or functional problems; others, out of parental ignorance or shame, instead have learned to live with the harm just as Shteyngart did. In none of these cases did any of these surgeries result in a better, healthier penis than the penises of men who were fortunate enough to have grown up with their natural, unaltered genitalia. As a practicing American urologist, your caseload is likely similar to that of other urologists who have told me that more than one-quarter of their medical practice involves addressing circumcision-related damage, including meatal stenosis (which occurs nearly exclusively in circumcised males), skin bridges (such as Shteyngart’s), and degloved penile shafts.

Second, I am curious about your comment that amputating a baby’s foreskin will allow his penis to “grow into a fully mature look…” (emphasis mine). Are you suggesting that the penises of men with foreskins (comprising around 75% of the world’s males) are somehow “immature”; this makes no sense. How can a penis shorn of its natural protective covering, with its nerves, muscles and blood supply be superior to the natural, unaltered penis that evolved over hundreds of thousands of years? Frankly, I’m astonished that the New Yorker’s rigorous fact-checking protocol didn’t eliminate this nonsensical statement from your letter.

Finally, I wonder if there are other healthy body parts you would suggest removing from babies or children because they “can be the source of multiple (?) medical problems in older men” (or women). The appendix (1.1 cases of appendicitis per 1000)? Teeth (prone to infection-causing decay)? Breasts (1 case per 1000 of breast cancer among American women aged 40, increasing over time), while the rate of penile cancer (which occurs in both intact and circumcised men) in the United States is 1 per 100,000. I might add here that genital hygiene is not complicated. If a boy can learn to become a teacher or chef or woodworker or tennis player or truck driver or urologist, he should be able to learn how to wash his penis.

I hope you will think about my questions, and dare to think in a more common-sense way about a forced bodily alteration that does nothing to make American boys or men healthier than their counterparts in countries where males retain the genitals they are born with.

Sincerely,
Georganne Chapin, MPhil, JD
Executive Director

Genital Autonomy-America Merges with Intact America

Marilyn Milos, Regarded as ‘The Mother of the Intactivist Movement,’ Merges Her Organization, Genital Autonomy-America, with Intact America, the Nation’s Largest Professional Anti-Circumcision Advocacy Group

Says Milos: “It’s an auspicious time to join forces and further public awareness of the direct correlation between circumcision solicitation in hospitals and the high rate of medically unnecessary circumcision in the United States.”

(Tarrytown, New York—October 30, 2021)   Georganne Chapin, MPhil, JD, founding executive director of Intact America, and Marilyn Milos, RN, founding executive director of Genital Autonomy-America, announced today that their two organizations have officially merged. Ms. Milos will continue her intactivist work at Intact America, the largest national, professional advocacy group that is changing the way America thinks about circumcision.

The newly merged entity, a 501(c)(3) not-for-profit organization, will retain the name Intact America. Ms. Milos will sit on Intact America’s Board of Directors and continue her intactivist work as Intact America’s clinical consultant.

“It’s a tremendous honor that Marilyn Milos and the Board of Directors of GA-America have entrusted their organization’s mission and vision to us,” said Ms. Chapin. “Thanks to her work, male genital cutting emerged from the shadows and became a human rights issue. I and many other intactivists consider Marilyn to be the mother of our movement.”

The Evolution of Organized Intactivism

It was a watershed event in intactivism when, in 1985, Marilyn Milos launched the National Organization of Circumcision Resource Centers (NOCIRC). (The organization was renamed Genital Autonomy-America [GA-America] in 2016.) The group was the first clearinghouse of circumcision information for doctors, nurses, parents, and the public. Over the years, NOCIRC succeeded in raising awareness among tens of thousands of people that male child genital cutting (circumcision) is physically painful and traumatic to a baby, medically unnecessary, and amputates the most erogenous part of the adult male genitalia.

Under Ms. Milos’ leadership, NOCIRC gained attention for organizing biennial International Symposia on Circumcision, beginning in 1989. Experts in medicine, academia, ethics, law, and other disciplines flocked to the symposia, whose proceedings were published and shared worldwide. These highly influential publications advanced the field of male and female genital cutting research and shed new light on the ill effects of routine male circumcision.

A Next Step for Intactivism

Although Ms. Milos broke the taboo about speaking publicly about circumcision, more work was needed to strategically change America’s systemic circumcision culture. In 2008, Ms. Milos and other leading intactivists helped to form Intact America, a professional advocacy group funded by philanthropist Dean Pisani and managed by the experienced health care executive and attorney Georganne Chapin. Intact America’s work includes conducting national research and generating public awareness by mounting campaigns against routine male child genital cutting and forced foreskin retraction of intact boys.

Ms. Chapin noted, “We’re shifting the public’s perception of circumcision. In our most recent opinion poll, conducted this year, we found that more than 22.5% of respondents favor keeping boys intact, up from 16.8% in 2019. That’s an increase of 25% in just two years. We’re making big progress.”

Ms. Milos said the merger comes at an auspicious time. “I’ve worked relentlessly to save baby boys from the horror of routine circumcision and help adults and families to overcome the physical and psychological consequences of unnecessary circumcisions,” Ms. Milos said. “Now, it’s time for me to step back from the day-to-day responsibility of running GA-America. Since it was founded, Intact America has taken intactivism to the next level. I feel that the movement’s future success could not be in better hands.”

About Intact America

Intact America is the largest national advocacy group working to end involuntary child genital cutting in America and to ensure healthy sexual futures for all people. It does this by challenging social and sexual norms and empowering supporters and volunteers through advocacy and education. To learn more about the issues involved in the current conversation about newborn male circumcision, visit IntactAmerica.org and CircumcisionDebate.org, and follow us on Facebook, Twitter, and Instagram.

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.