On February 7, the New York Times printed two responses, one of them mine. Under the heading, Business of Circumcision, my letter reads:

To the Editor:

Re “AIDS Prevention Inspires Ways to Make Circumcisions Easier” (Jan. 31): With 20 million men targeted to undergo “assembly-line” circumcisions, it’s no surprise that medical equipment manufacturers are rushing to cash in. It appears, though, there’s no money to be made from informed consent; that issue didn’t figure anywhere in this enthusiastic report on the plans of researchers and organizations dominated by white, circumcised Westerners to surgically reduce the penises of poor, non-English-speaking Africans.

The male foreskin comprises 15 square inches of erogenous tissue. Its removal results in an open wound and permanent reduction of sexual sensation.

Georganne Chapin

The second letter extols the virtues of the Shang ring, one of the two circumcision devices mentioned. The authors of this letter are physicians affiliated with the questionable research and HIV “prevention” agenda for Africa.

The plan to circumcise 20 million African men is a sinister combination of cultural/medical imperialism and the big business of international health. The researchers who have made their careers by promoting mass (and even universal) circumcision are almost all Americans. Several were known for their pro-circumcision agenda before they ever became involved in the African “trials”—which were, from the onset, really circumcision campaigns. Participants were randomized into two groups, “circumcise now” and “circumcise later,” rather than “circumcised” and “not circumcised,” which would have been the proper way to study objectively whether circumcision status truly affects HIV transmission. (See, e.g., Gray RH, Kigozi G, Serwadda D, et al., Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial, Lancet 2007; 369: 657–66.)

Promoters of circumcision as HIV prevention, and the press reporting on these efforts, both fail to acknowledge the methodological problems with the African studies. These same researchers’ own subsequent work has shown that male circumcision actually increases women’s risk of contracting HIV from their circumcised partners. The research subjects have become victims of the intentionally promoted fallacy that circumcision is a “vaccine” against HIV. A recent investigation in Zambia showed that many men circumcised as part of a mass circumcision effort there resumed unprotected sex before their incisions healed, jeopardizing their wives or girlfriends—women who will find it very difficult to negotiate “safe sex” with men who believe they’ve just received a surgical “vaccine.”

Inextricably intertwined with the bad science is the utter disregard for ethical and public health issues begging to be acknowledged in any report on the African circumcision campaign.

For example:

How do you ensure informed consent in a population of poor, non-English-speaking men, who are being lined up, hundreds in a day, to have part of their genitals removed?

How do you ensure partner education, when men who do not know or wish to know their HIV status are being circumcised anyway, without being tested—leading them to believe that they are now “safe” from AIDS?

How, despite the promotion of single-use surgical devices, do you ensure that there is no re-use of contaminated medical instruments—syringes, scalpels, scissors, etc.—and how do you ensure safe disposal of medical waste in countries with inadequate sanitation and an underdeveloped health care infrastructure?

How do you ensure that men who develop serious complications—not to mention circumcised men and their female partners who still contract HIV—are appropriately treated and even compensated for what they have lost, due to our peculiar fixation on altering the male anatomy?

Mostly, how do we get the mainstream American press to ask these obvious questions? Why is getting the truth out dependent on me managing to get a 100-word letter printed in the New York Times?

—Georganne Chapin

Even while, by now, I truly have no problem talking about the foreskin, penises, circumcision, sexual dysfunction, female genital cutting, or any related topic, I do remember how difficult it was at the beginning when somebody would challenge me with arguments I knew were wrong, but to which I hadn’t yet formulated a cogent response.

I know that other intactivists have the same problem. So I thought it might be useful to lay out some talking points, or simple answers to questions or arguments I commonly hear. Here’s part one. First you’ll see the question (or argument) in italics, and then my counterpoint.

There are so many more important causes. Why are you wasting your time on this? I see infant circumcision as a human rights issue, and wouldn’t you agree that human rights should top the list of worthy causes? Furthermore, protecting babies and children ranks among the highest of human rights causes because they are unable to speak out or advocate on their own behalf.

You people are really weird.  It’s strange to me that you think my position is weird. Frankly, when I first starting thinking about circumcision, I thought it just didn’t make sense that half of the human race “needs” surgical correction after being born. To me, it seems weird to chop off any normal, healthy body part – let alone, the end of someone’s penis.

You are obsessed with penises. Actually, I think it’s the people who want to cut off foreskins who are obsessed with penises. My belief is simply that baby boys should be left in peace. As a pediatrician I know says, “Don’t just do something – stand there!” In other words, leave that baby’s body the way God – or nature – made it.

You’re not a man. Why do you care so much about this? You don’t have to be a man to know that babies – all babies – deserve protection from forced surgery on their genitals. You don’t have to be Jewish or Cambodian or Sudanese to care about genocide, or African-American to care about racial equality. It is everybody’s business to stand up for people whose rights are being violated.

I’ll let my husband decide; he’s the one with the penis.  If you accept that a child cannot legally consent to a surgery that is unnecessary, then you must agree that the child’s right to be protected cannot be suspended on a whim by a Father, or anyone else. If your husband were missing a finger, would you let him make the decision to cut off your child’s finger, or would you step in to protect your baby?

What about religion? Circumcision is a Jewish thing. You must be anti-Semitic. Most people don’t realize boys from Jewish families represent a very small fraction (a few thousand) of the one million infant circumcisions that occur in the U.S. each year. In turn, only a few of those circumcisions are performed in keeping with religious ritual. The rest are carried out mostly by doctors in medical settings, even though the surgery is not medically indicated and violates the rights of the babies who undergo it. I believe all children have a right to bodily integrity, girls and boys, from families of any religious or cultural affiliation. Finally and not surprisingly, growing numbers of Jewish parents are choosing to forego the painful practice of circumcision and are leaving their sons intact.

Why are you telling other people what to do? Circumcision should be a personal choice.    You’re right! Circumcision should be a personal choice, and the person making that choice should be the person whose body will be permanently altered – and who will have to live with the consequences of the surgery.

A boy should look like his father.  You wouldn’t abandon your baby if his eye color was different from his father’s (or mother’s) eye color. You wouldn’t seek to surgically alter any other body part of your child’s to make it conform to his parent’s looks. So why would you be concerned that a baby’s “private” parts (with an emphasis on “private”) should match his father’s?

My next post will deal with some of the “hygiene” and “disease” arguments. Do you have suggestions for other questions or objections that you’ve found challenging and that have left you wishing you had a more compelling response? Let me know.

BY GEORGANNE CHAPIN

Rabbi Uri Makley, a member of the Knesset Immigration, Absorption and Diaspora Committee, is reported to take issue with the claim that shechita is cruel to animals, pointing out that the same authority that declared it a mitzvah to eat kosher meat also said cruelty to animals was a sin.

Rabbi Moshe Friedman, representing the European Rabbinical Council, is quoted as calling laws banning ritual slaughter (such laws are already in effect in Luxembourg, Norway, Switzerland and Sweden) “anti-Semitism disguised as animal rights.” He goes on to say that “the message European citizens have received is that Judaism is a religion that is cruel to animals, and the path from this to prohibiting circumcision is very short.”

I haven’t thought much about the relative cruelty of ritual slaughter as compared to the mass, mechanized slaughter of animals in the commercial meat industry.

I have, however, thought a lot about circumcision. What I find revealing in this article is a religious authority acknowledging the parallels between the ritual killing of animals—a one-on-one blood encounter that pits a knife-wielding human being against a helpless and unsuspecting animal—and a ritual that involves a knife-wielding adult inflicting a painful, invasive, and permanent wound on a helpless and non-consenting child.

The rabbis’ comments clearly imply that it is the perpetrator’s motive—not the victim’s experience—that determines whether a practice is cruel or not.  No matter how bloody or barbaric the custom, if we can get others to buy the rationale, the motive, it’s ok.

Of course, American culture and our legal system also support that construct. We give a pass to doctors because they circumcise baby boys for “health benefits” or “hygiene” or cultural conformity.  We give a pass to parents and faith practitioners who cut babies “for religious reasons” when, otherwise, bringing a stranger with no medical license into your home to cut off part of your son’s penis would clearly meet the definition of assault, battery, and child abuse. Our hypocrisy on this matter becomes even more apparent when we consider how the gender of a child turns the world I just described upside down: If it’s a girl whose genitals are being cut, suddenly there are no excuses—not even religion—that will keep you out of jail.

Interestingly, people who deplore female genital “mutilation” while defending male “circumcision” often explain the difference in terms of motive—that FGM discriminates against women, and represses their sexuality, while circumcision is a modern, clean thing.

Our poor sons.

—Georganne Chapin

Thank you for making me understand why I should leave my son intact. This is my first baby and I didn’t know which way to go, but after doing a lot of research and reading all of your comments, I have decided not circumcise my baby. Thank You!!!!

At this time of year, with all the emphasis on seeking happiness through material possessions, this message wafted across my face like a warm tropical breeze. For me, a dream gift — another intact baby, and a mom willing to take the time to share the news!

We know that, in the past couple of years alone, in the time since Intact America was founded, the intact rate among newborns in the United States has risen to well above 50 percent. (The exact rate is hard to determine; a Centers for Disease Control study last year said that only 33 percent of infant boys are circumcised before leaving the hospital, but that didn’t include circumcisions paid “out-of-pocket.”) This means that thousands upon thousands of helpless babies have been spared the trauma and betrayal of trust that circumcision entails.

A  Jewish friend of mine recently said, “The greatest mitzvah (act of human kindness) you can bestow upon an infant boy is to leave him intact!”

My first blog post, the one referred to above by the mother who wrote to thank Intact America, said how fortunate I feel to have left my own son — now 31 years old — intact. Similar to my friend’s concept of mitzvah, I used the metaphor of “gift,” saying that my awareness at the time gave both my son and me “the gift of not having to say ‘I’m sorry’ to each other” about circumcision.

So as I spend time this season with my family, I find myself feeling gratified that the work of Intact America has inspired so many parents to give a gift, bestow a mitzvah — by protecting the rights of their infant sons to an intact body. Every person who has saved a baby by spreading the word, every parent who has considered circumcision and decided against it, can bask in the light of knowing he or she has contributed in this way to the peaceful beginning of a new life — and thus to Peace on Earth.

Thank you all for caring, and happy holidays to all!

– Georganne

P.S. If you’d like to help Intact America keep up the momentum we’ve gained over the last year, please consider making a donation. Future intact babies will thank you for it!

The backlash against the ballot measure brought together an interesting coalition of doctors and religious rights organizations. The former claimed the measure would interfere with their right to practice medicine (actually, there was a state preemption issue which alone would have probably killed the municipal law). The latter claimed that the proposed bill was the equivalent of “hate speech,” driven by anti-Semitism, and so deeply divisive that to allow San Franciscans to vote on it would be “dangerous.” They also claimed that interfering with infant circumcision would interfere with the religious freedom of Muslims and Jews.

As a result of the backlash, some intactivists expressed the opinion that perhaps any future proposed legislation should contain a “religious exemption.” I could not disagree more.

For one thing, nobody arguing for their religious freedom to cut babies is saying that they would support a ban on medical circumcision of minors so long as it provided a religious exemption.

Additionally, there are practical considerations. Who, exactly, would be entitled to the religious exemption? Only Jews and Muslims? How “Jewish” would parents have to be?  Would they have to observe Jewish dietary laws? Attend synagogue regularly? Or just say – as a Jewish friend of mine, married to a Greek Orthodox man, did – “If I had a son, I would have to circumcise him, because otherwise my mother would freak out when she changed his diaper.” Would Christians also be allowed the religious exemption if they took the position, as I have heard often from callers when I do radio interviews, “It’s in the Bible”?

The real issue, dwarfing the practical and legal problems of defining and setting the boundaries of a religious exemption, is that we cannot bargain away the rights of a child – any child.  If we believe – as I do – that to circumcise a child is to violate his most fundamental personal right to autonomy and to an open future, if we believe that circumcision is an assault and battery when conducted on a person who did not and cannot consent, then how can “we” through legal means or a policy statement, grant an exemption allowing certain children to be assaulted?  How can we say, “Circumcision is a brutal violation on a child who cannot consent,” and then say, “but it’s ok to cut some babies, if their parents’ religion recommends it”?

For those who accuse intactivists of anti-Semitism, I have this to say. Roughly two percent of the U.S. population is Jewish, and the birth rate among American Jews is reportedly low. Increasing numbers of Jews are choosing not to circumcise, and among those who do, many have their sons circumcised by doctors in hospitals, a practice that carries no religious significance. So the number of ritual circumcisions carried out in this country is no more than a few thousand each year. Isn’t it rather absurd to suggest that an entire movement to protect children’s rights is based on the hatred of a religious group responsible for a fraction of one percent of the one million infant circumcisions performed in the United States each year? The intactivist movement has nothing to do with religion, and everything to do with protecting children – all children –  from harm.

The real issue is, whose rights – to autonomy, to religious freedom, to bodily integrity, to safety and security of person – does child circumcision violate? The baby’s rights, of course.

Babies have no religious opinions, and to allow somebody else – parent, mohel, doctor – to remove part of their genitals, to mark their bodies with a permanent scar where that normal, natural body part used to be, precludes their own rights to make a choice in the future.

Georganne Chapin

Events that occurred earlier this year in San Francisco, however,  made me think seriously about whether I believed “circumcision should be outlawed” – in other words, whether I would support a legislative ban on “routine” (medically unnecessary) circumcision of male infants and children. While most Americans abhor the very thought of female genital mutilation, many simply don’t know that there is a federal law that already prohibits even the most minor cutting of the genitals of a girl under the age of 18. The proposed San Francisco ban was modeled exactly on that “anti-FGM” legislation.

Intact America has not advocated for a legislative ban on circumcision – yet.  I believe that before we can reasonably expect routine infant male circumcision to be outlawed, we need greater social and political consensus that it is harmful, and the political power to overcome interest groups who promote their right to carry out the procedure. In the meantime, Intact America and the intactivist movement in general are moving public opinion and parents’ awareness, in the direction of more and more boys being left intact. As this occurs, and as knowledge of the harms of circumcision spreads, we will come closer to the conditions needed to achieve a gender-neutral approach to the genital cutting of children.

However, this doesn’t mean that I wasn’t really impressed and really excited when Lloyd Schofield and others gathered enough signatures in San Francisco to get a limited circumcision ban onto the ballot in that city.  Predictable media comments on “those kooky San Franciscans” aside, I thought it was awesome that this local initiative raised the visibility of the circumcision problem to national – and actually international – prominence.

Was there backlash? Of course!  And some intactivists have said that the opposition by physicians and religious groups, which ultimately resulted in the measure being stricken from the ballot, means that the initiative was “premature” or – worse – a setback to the progress we have made in recent years.

But I see it differently. I think the backlash is a mark of our progress. The other side is afraid, because they know we are winning, and that their professed right to cut the genitals of babies is being challenged as never before.

Abolitionists didn’t wait for the slaveholders’ permission to call for an end to slavery. Suffragists didn’t wait for women to be recognized as men’s equals before advocating for the right to vote. Dr. Martin Luther King, Jr., didn’t ask if it was ok for him to have a dream of racial equality.

Intactivists do not need anybody’s permission to talk about the American promise of equal protection guaranteed by the 14^th Amendment, and why permitting the genital cutting of boys belies that promise.

In a future post, I will talk about challenges that arise in crafting a ban on male child circumcision – in particular, the charge that such a ban would conflict with another American principle: the right to religious freedom.

Stay tuned!

Georganne Chapin

On the one hand, I find it incomprehensible that there are those – parents, doctors, religious practitioners – who decree it their right to inflict this barbarity on a child. On the other hand, I find it not only gratifying but inevitable that, as a society, we are moving toward a greater appreciation of what is right:

•  Basic common sense (“you want to cut off what?!?)”
•  Non-intervention when nothing is wrong in the first place (“Don’t just do something; stand there!”).
•  Acknowledgment of and respect for the rights and wishes of children (“10 out of 10 babies say NO to circumcision.”)

I am grateful to know and work with some of the finest people in the world, in our efforts to end infant and childhood circumcision. The list is long (and growing), but I will mention just a few. First, Marilyn Milos, who is my daily inspiration as well as a fount of infinite knowledge, support, humor and kindness; and Dean Pisani, who believed in us and saw the potential for a new kind of organization –  one in which the dissemination of ideas could occur at an unprecedented range and speed due to the exploding phenomenon of social networking.  Second, the people I work with each day – Amy Callan, Jennifer Konig and  Ted Herman – to craft the message behind Intact America’s work and keep things moving along. Third, to every single person who has taken action on an Intact America page, speaking out and donating to the cause. Finally, to all of my intactivist colleagues who offer their support (and criticism), who respond instantly when their help is needed, who write every day to keep each other posted, who volunteer, and who remain intensely interested and involved because of their confidence in our collective mission.

I am grateful that, together, we are making the world a better place.

Georganne Chapin

Then and there, I decided to take the plunge. After all, I am almost 60 years old. Who in the world, other than me and my “boyfriend” (still looking for a better term), really cares about my sex life? And I grew up in the 60’s, graduated from high school in (tee-hee) 1969. So I’m supposed to be able to talk about this without blushing, right? Right.

“All other things being equal,” I said, “yes, sex is better with a man who has a normal, complete penis.”

Love (and lust) can conquer a lot. You can love a circumcised man with all your heart, you can make it work, and what you do together is nobody’s business but your own. But a man who has been robbed of his foreskin is missing something. (Actually, he’s missing a lot – 15 square inches of specialized skin, muscle, and nerve endings, designed to protect the glans (head of the penis) and keep it moist and sensitive, easing intercourse and enhancing pleasure.) And so is his sex partner.

Scientific studies (a recent Danish article reports the results from interviews with 5500 men and their female partners) are emerging that show what many of us know from experience but may have been unable to “prove”: male sexual problems like trouble reaching orgasm, and women’s problems such as pain during intercourse, are more common when the man’s foreskin has been removed. It’s no wonder that many men who were forcibly circumcised as babies are angry and grief-stricken when they begin to realize the profound consequences of the assault and their loss.

On the other hand, understanding that many of the sexual problems stereotypically attributed to men’s “selfishness” are actually a consequence of circumcision, can go a long way toward easing couples’ relationships and – I fervently hope – making the case for leaving future generations of men intact.

Georganne Chapin

The AMA’s president, Peter W. Carmel, M.D., was quoted as saying, “There is strong evidence documenting the health benefits of male circumcision, and it is a low-risk procedure….  [T]he AMA … will oppose any attempts to intrude into legitimate medical practice and the informed choices of patients.”

Strong evidence? Presumably, he’s talking about evidence from flawed studies conducted among adults in parts of Africa with high HIV prevalence? Even these studies show that while female to male sexual transmission of HIV might be lessened when the male is circumcised, male to female transmission actually increases. And it’s not clear what any of this has to do with newborn babies, who don’t have unprotected sex.

Health benefits? Compared to what?  The foreskin is there to protect the penis, keep the glans moist, and enhance sexual pleasure throughout a man’s lifetime. Do the AMA doctors know about recent studies showing higher rates of erectile dysfunction in circumcised men than in intact men? Do they know anything about the benefits of the foreskin?

Low risk? Do Dr. Carmel and the AMA know that more than 100 babies die each year in the United States from circumcision? Do they know about the $2.3 million award made earlier this year to the family of a Georgia baby whose penis was severed and thrown into the trash after a botched circumcision? Or about Jamaal Coleson, Jr., who died in New York City this spring, following a “routine circumcision?” Or about little Eric Keefe, who bled to death following his circumcision in a South Dakota Indian Health Service hospital in 2009?  Certainly, they don’t know that just this week, the blogosphere was ringing with the discussion of another post-circumcision infant death, this one allegedly from a heart attack. 

Legitimate medical practice? Do the AMA members who voted to keep the United States safe for circumcisers know that most of their European colleagues believe “routine” circumcision is not legitimate – but, instead, barbaric? Have they read the call by the Royal Dutch Medical Association for doctors to refuse to surgically remove part of the genitals of babies and children, on the grounds that there is no medical reason for it, and it violates children’s rights?

Informed choices of patients? Did the AMA stop to think about WHO IS THE PATIENT who supposedly is making an “informed choice?” Answer: the BABY is the patient – not the parents – and the baby cannot consent. On the contrary, only someone with a vested interest in denying the truth can assert that babies react with anything other than terrorized, panicked protest to the ripping, crushing and severing of their tender foreskins.

In the United States and most of the modern world, cutting a normal, healthy body part from the genitals of a girl is “genital mutilation” and it’s illegal. No ethical, moral or legal rationale distinguishes boys from girls in this regard.

Shame on you, Dr. Carmel. And shame on the AMA.

Georganne Chapin

If this doctor stops now, what will he tell the repeat “customers,” young parents asking him to circumcise their second or third son?  What will he tell his colleagues?

If he stops, what will he tell the boys he cut who later learn that he – indeed – did put down the knife?

If he stops, and one day a young man in the small community where he practices sues him for injuries, or for lack of consent (the statute of limitations on a malpractice claim typically re-opens for a time when an individual turns 18), what defense will he offer?

On the other hand, if he doesn’t stop, how will this doctor live with his conscience – or with the consciousness that made him come to talk with us? What will he do if he botches terribly a surgery, and a baby loses half of his penis, or dies, after he knew he should stop circumcising, but didn’t?

Since the AAP conference, I’ve lost hours of sleep pondering this conversation, unable to imagine the magnitude of the suffering – one or two babies a day, week after week, month after month, year after year, strapped down and mutilated – caused by this man who took an oath to do no harm. I went online and learned that the small northeastern city where he practices has only 16,000 people. This means – again, if his numbers are correct – he has circumcised pretty much every male under the age of 25 in the community and the surrounding area.

Except his own son, that is. And by the way, what does he tell his intact son?

Let’s say your postman one day stopped by to tell you that he’d touched the genitals of all the neighborhood children, and all the children in his son’s school (though not his own child), as well as the children in the surrounding towns, over the past 25 years; and then he told you he wanted to know your point of view about that. You’d reach for the phone, and call the police.

Yet there I was, in this huge exhibit hall in Boston, standing under the bright lights of the infant formula, baby lotion, and drug companies, talking politely with a man who had cut the penises of 5000-6000 babies, but was “open-minded” and wanted to understand Intact America’s point of view.

by Georganne Chapin