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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.
by
Georganne Chapin, MPhil, JD
Intact America
March 14, 2019
The state of California has a pending child protection bill before its legislature. While we share the legislators’ condemnation of the activities this bill seeks to regulate, we also wish to point out the fact that the bill violates California’s state Constitution.
Senate Bill 201 seeks to “…prohibit a physician and surgeon from performing any treatment or intervention on the sex characteristics of an intersex minor if the treatment or intervention may be deferred until the intersex minor can provide informed consent…” The bill states: “‘Intersex minor’ means an individual born with atypical physical sex characteristics, including, but not limited to, chromosomes, genitals, or internal organs, and includes differences in sex development resulting from androgen insensitivity syndrome, congenital adrenal hyperplasia, and hypospadias.”
Because intersex surgery has been and remains the purview of the medical profession, the intersex bill contains extensive detail about the types of surgeries that have been traditionally performed upon children with anomalous genitalia in efforts to “normalize” the appearance of their sex organs toward either the male or female end of the spectrum of visible sex characteristics; it describes in similar detail measures that must be taken to prove medical necessity for such surgeries. The California intersex bill follows a 2018 resolution representing the first time a state set out to condemn and regulate “intersex surgery (the second was Connecticut and the third was Iowa, both in 2019)” and (b) includes extensive language about the rights of intersex people to “participate in decisions about surgery and other medical treatments or interventions on their physical sex characteristics, and to guarantee [them] the rights to bodily integrity, autonomy, and self-determination.” Bravo!
Since 1996, California has had a law on its books prohibiting female genital mutilation, also known as FGM. The law states: “‘Female genital mutilation’ means the excision or infibulation of the labia majora, labia minora, clitoris, or vulva, performed for nonmedical purposes.” The current intersex bill is similarly sweeping.
So, what is wrong with the anti-FGM law? What’s wrong with the proposed intersex law? Why are they unconstitutional?
California’s Constitution contains an “equal protection” clause which states: “A citizen or class of citizens may not be granted privileges or immunities not granted on the same terms to all citizens…” In other words, California’s laws should never favor, protect, or privilege one group over another.
While they rightfully protect girls and intersex children from medically unnecessary surgery on their genitalia, whether carried out in a “cultural” or medical context, they deny these protections to boys.
Should not boys also be protected from the medically unnecessary surgical modification of their genitals? Are not boys entitled to the same rights to bodily integrity, autonomy, and self-determination as girls and intersex minors?
“Routine” infant male circumcision – like “female genital mutilation” – entails the removal of a normal, natural part of a boy’s genitals in the absence of any medical necessity. Sometimes – as in the case of female genital mutilation – male circumcision is performed for “cultural” reasons (I purposely draw no distinction between “culture” and “religion,” as there is simply no justification to favor the practices of groups who can point to a written text over those with a long oral tradition.) And sometimes – just as with intersex surgery – male circumcision is performed simply as a social or cosmetic procedure, justified as in the child’s best interest, helping him to “fit in” or to “avoid problems in the future.”
“Intersex” is a condition estimated to characterize somewhere between two and three percent of the population. It is not known how many girls are subjected to FGM in the United States, but the number is certainly less than one percent.
Possession of a penile prepuce (male foreskin), on the other hand, characterizes nearly half of the population. Until the mid-19th century, surgical amputation of the foreskin was practiced only by Jewish and Muslim people, and by some tribal cultures. Victorian doctors introduced the practice in the United States and other Anglophone countries to stop boys from masturbating. By the mid-20th century, “routine” circumcision had become embedded in American medicine, and still today, the United States is the only non-Jewish, non-Muslim country in the world where doctors routinely remove baby boys’ foreskins (South Korea and the Philippines also have high circumcision rates because of the influence of U.S. military hospitals.) While in the United States the incidence of routine infant circumcision varies widely by region, California’s rate remains among the lowest in the nation, at about 23 percent.
Just as intersex individuals are speaking out loudly against a medical establishment that overlooks individual autonomy in favor of social norms, American men of all ages are expressing indignation about having undergone the removal of their normal, functional foreskins when they were too young to either consent or resist.
Legislators from California and every other state seeking to redress the ethically and medically unjustifiable practices of “normalizing” surgery performed on the genitalia of girls and intersex children need to take notice, to ensure that any new laws be consistent with the “equal protection” or “laws uniform” clauses of their constitutions, and to protect all children.
by
Georganne Chapin, MPhil, JD
Intact America
March 14, 2019
The state of Connecticut has two pending child protection bills before its legislature. While we share legislators’ condemnation of the activities these bills seek to regulate, we also wish to point out the fact that both bills violate the Constitution of the State of Connecticut.
The first bill, Senate Bill 505, forbids the practice of “female genital mutilation” or FGM – i.e., the culturally-based practice of pricking, incising, or cutting a minor girl’s genitals – and makes it a Class D felony. The bill arose in response to the dismissal by a federal court in Michigan of a case against a physician prosecuted under a similar federal law (18 U.S. Code § 116, also known as the Federal Prohibition Against Female Genital Mutilation Act of 1996) for operating on the genitals of three young girls. In dismissing the case, the judge said that despite the heinous actions of the physician (a woman from an Indian sect that practices female genital cutting), the federal law under which she was charged was unconstitutional because the behavior it proscribed falls under the rubric of “local criminal activity,” which is properly regulated by states.
The second bill in the Connecticut child protection pipeline attempts to regulate an activity that is only now becoming a topic of public discussion. Senate Bill 388 seeks to “…prohibit discrimination against a person on the basis of such person’s intersex status…” by banning “any licensed health care provider from engaging in medically unnecessary surgeries on an intersex person without such person’s consent.” Genital modification surgery of “intersex” minors refers to any surgical treatment to children born with atypical physical sex characteristics including but not limited to chromosomes, genitals, or internal organs.
Another related bill under consideration would bar discrimination against intersex individuals and provide a third option for gender designation on birth certificates, driver’s licenses and other legal documents. Taken together, the pending Connecticut intersex bills seek “to address the needs of [people in a] community who have suffered from discrimination, unnecessary surgery and inaccurate documentation of their gender, by providing relief from such issues.”
So, what is wrong with these bills prohibiting medically unnecessary genital surgery on girls and intersex children? Well, they’re unconstitutional!
Connecticut’s Constitution contains a “equal protection” clause which states: “No person shall be denied the equal protection of the law nor be subjected to segregation or discrimination in the exercise or enjoyment of his civil or political rights because of religion, race, color, ancestry or national origin.” In other words, Connecticut’s laws should never favor, protect, or privilege one group over another. While the anti-genital-mutilation laws summarized above rightfully protect girls and intersex children from medically unnecessary surgery on their genitalia, whether carried out in a “cultural” or medical context, they deny these protections to boys.
Should not boys also be protected from the medically unnecessary surgical modification of their genitals? Are not boys entitled to the same rights to bodily integrity, autonomy, and self-determination as girls and intersex minors?
“Routine” infant male circumcision – like “female genital mutilation” – entails the removal of a normal, natural part of a boy’s genitals in the absence of any medical necessity. Sometimes – as in the cases of female genital mutilation – male circumcision is performed for “cultural” reasons (I purposely draw no distinction between “culture” and “religion,” as there is simply no justification to favor the practices of groups who can point to a written text over those with a long oral tradition). And sometimes – just as with intersex surgery – male circumcision is performed simply as a social or cosmetic procedure, justified as in the child’s best interest, helping him to “fit in,” be normal,” or “avoid problems in the future.”
“Intersex” is a condition estimated to characterize somewhere between two and three percent of the population. It is not known how many girls are subjected to FGM in the United States, but the number is certainly less than one percent.
Possession of a penile prepuce (male foreskin), on the other hand, characterizes nearly half of the population. Until the mid-19th century, surgical amputation of the foreskin was practiced only by Jewish and Muslim people, and by some tribal cultures. Victorian doctors introduced the practice in the United States and other Anglophone countries to stop boys from masturbating. By the mid-20th century, “routine” circumcision had become embedded in American medicine, and still today, the United States is the only non-Jewish, non-Muslim country in the world where doctors routinely remove baby boys’ foreskins (South Korea and the Philippines also have high circumcision rates because of the influence of U.S. military hospitals.) In the United States, the incidence of routine infant circumcision varies widely by region. At approximately 70 percent, Connecticut’s newborn circumcision rate is well above the national average.
Just as intersex individuals are speaking out loudly against a medical establishment that overlooks individual autonomy in favor of social norms, American men of all ages are expressing indignation about having undergone the removal of their normal, functional foreskins when they were too young to either consent or resist.
Legislators from Connecticut and every other state seeking to redress the ethically and medically unjustifiable practices of “normalizing” genital surgery performed on girls and intersex children need to take notice, to ensure that any new laws be consistent with the “equal protection” clauses of their constitutions, and to protect all children.
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.
“Born Complete”: International Hypocrisy Day 2019
by Georganne Chapin
On Wednesday, February 6, the United Nations Population Fund (UNFPA) rolled out — with much digital fanfare — International Zero Tolerance Day for Female Genital Mutilation.”
After scanning the promo, I’m inspired to suggest a few alternative monikers. How about International Zero Tolerance Day for Genital Mutilation (unless You’re a Boy, in which Case You’re Out of Luck)? Well, that’s probably too many words, so how about International Cultural Blindness Day? Or, better yet, International Hypocrisy Day? Let me explain.
On a polished new website for its “Born Complete” campaign, UNFPA decries the cultural practice of cutting girls as “reflect[ing] deep-rooted inequality between the sexes.” Really?
It’s good to hate FGM, and it’s essential to protect girls from the practice. It’s also irrefutable that many women around the world have less freedom and opportunity than their male counterparts. But to condemn FGM on the grounds that it constitutes sex discrimination is truly mystifying, given the nearly universal circumcision of boys in countries where FGM is practiced.
Particularly hypocritical and galling to me is the fact that my own country is the largest non-Muslim boy-cutting nation in the world: although the numbers are slowly falling, more than one million boys born each year in U.S. hospitals are sexually mutilated within a few days of their birth (and only a handful of those surgeries are carried out as religious rituals).
Yet, the United States of America is blithely and uncritically on board with the UN’s claim that FGM constitutes sexual discrimination. This is corroborated by the current push by (mostly female) state legislators to implement laws declaring it a crime to cut only the genitals of girl children for non-medical reasons. This trend has accelerated in the wake of a Michigan court dismissing charges against a female doctor who performed minor genital-altering surgery on three young girls whose immigrant parents solicited the procedure. Incidentally, the dismissal was based on the judge’s ruling that the federal anti-fgm law is unconstitutional – NOT because it implicitly exempts boys from protection, but because it attempts to regulate activities that properly belong under the jurisdiction of the states.
I do believe it’s only a matter of time before there will be a court challenge to the state FGM laws as discriminating against boys and intersex children. I’m less sure when the international human rights establishment will start to celebrate “Born Complete” and being “intact” (am I being petty to complain that the UN appropriated this term from the American intactivist movement?) as applying to all children.
But those are topics for another day. In the meantime, hypocrisy rules!
The Power of You
Happy New Year! When l look back on the progress we have made toward changing the way America thinks about circumcision, I am deeply moved and excited about the future.
Mostly, I am extremely grateful for YOU – for the generosity and compassion you showed in 2018. Because of you and our other donors, we were able to claim 100% of the generous $50,000 match put forward by a private philanthropist from Illinois. And to Intact America’s many new supporters: thank you for becoming part of this outspoken and uncompromisingly dedicated community.
Thank you for standing with Intact America to fight for the rights of baby boys to keep the bodies they’re born with.
Thank you for understanding the damage circumcision creates for boys, men and those who love them. And for your commitment to stopping this travesty.
Thank you for your support for this movement until true equality can be claimed – until all children can grow up knowing that their genitals and their rights to a healthy sexual future have been protected.
And thank you for sharing your passion for this cause with friends, family, and others. Every time you do, the wall of stigma surrounding a once-taboo topic crumbles a little bit more.
The national survey Intact America conducted in 2018, compared to the one we did four years earlier (the first of its kind), showed that the American public is increasingly accepting of the intact male body. We will survey again in 2019 to continue measuring the movement’s progress in reaching a tipping point.
The public response to American Circumcision, Brendon Marotta’s documentary, featuring interviews with many movement leaders including yours truly, has been nothing less than phenomenal. With the documentary now on Netflix, we have seen scores of individuals requesting Intact America’s e-newsletter, writing to ask questions about our organization, sharing their stories, and wanting to become more involved. This breakthrough film is a game-changer for our movement.
In the first quarter of this year, Intact America will launch a new mobile-friendly website – the leading source of information on intactivist issues. Stay tuned – we think you’ll love it.
We’re also launching the advocacy phase of “Made to Stick,” our Foreskin Protection Campaign, with a letter to the American Academy of Pediatrics (AAP). It cites our survey findings – that 43% of American boys under 7 years old have had their foreskins forcibly retracted – mostly at the hands of pediatricians. In the letter, and in our follow-up actions, we’re calling upon the AAP to educate its members about foreskin anatomy and the harms of forcible retraction. And we’ll offer working with them to ensure that this practice comes to an end. We’ll also continue to collect more stories/cases to our national foreskin retraction registry.
This summer, once again, we’ll be a big, loud presence at New York City PrideFest, where record crowds are expected for WorldPride and the 50th anniversary of the Stonewall Uprising. Pride represents a totally unique opportunity to spread the intactivist message to millions of attendees. The LGBTQ community knows all too well the discrimination and stigma attached to threatening the status quo by simply being oneself. We are deeply grateful for this community’s alliance with intactivism.
I am proud to report that Intact America is alive and vibrant, and on track to reach the tipping point – where a critical mass of Americans believe that the intact male body is natural and normal – and that cutting a baby’s genitals is NOT an option.
In the meantime, we will continue to protect boys from harm and to serve as a safe space for men and families – to tell their stories, to feel acknowledged and validated. None of this would be possible without your support.
I want to close with a New Year’s toast to you. Join me in raising a glass – to your courage and your leadership to stand for justice in the face of so much fear and shame. To your vision that has shaped this transformative human rights movement over the last decade. And to your continuing partnership in 2019 with Intact America to achieve our collective goals.
Best wishes for a healthy and joyful New Year,
Georganne Chapin
Founding Executive Director
Parents, Beware! Medical Professionals Want to Forcibly Retract Your Son’s Foreskin!
Georganne Chapin, MPhil, JD
Increasingly, new parents are questioning the peculiarly American practice of “routine” infant circumcision. They’re heeding their own instincts, doing their research, and choosing to protect their sons’ bodies and right to keep the genitals nature gave them.
Unfortunately, many of these parents and their sons now face a new worry – an iatrogenic[1] epidemic of forced foreskin retraction, the result of ignorance and bias among U.S. healthcare professionals.
A new lawsuit shines a bright light on this insidious practice. On January 10, 2018, Atlanta attorney David Llewellyn filed a Complaint against a major pediatric hospital in that city, describing its disregard for current pediatric care guidelines, and its nursing staff’s systematic violation of patient rights.
Alleging battery; nursing malpractice; intentional infliction of emotional distress; willful, wanton and reckless misconduct; and negligent failure to protect the patient, Park v. Children’s Healthcare of Atlanta catalogs the actions by a nurse who – without conversation or warning – ripped away the foreskin of an intact 2-month old baby named Jude Parks, causing him severe pain, bleeding and emotional anguish. The Complaint also describes the defiant attitude taken by the nursing supervisor and other hospital staff, who insisted – contrary to fact – that the hospital’s protocol calling for the forced retraction of all intact boys’ foreskins was derived from current established medical recommendations.
Some Background
Starting in the late 1800s, Victorian-era doctors began promoting foreskin-removal as a way to make boys stop pleasuring themselves. (It didn’t work) By the mid-20th century, routine medical (i.e., non-religious) amputation of baby boys’ foreskins had become a peculiarly American phenomenon – fueled, no doubt, by the fact that health insurers paid for it. Today, an estimated 80 million adult American men are missing a palm-sized area from their penises. Even with increased parental awareness – still, over half of all baby boys born in the U.S. are victims of a medical system that makes money from the procedure. But with the voices of aggrieved men becoming louder, and parents questioning the bogus medical claims that there’s something inherently unhealthy about the natural penis, circumcision rates continue to fall.
Most Americans, though, remain surprisingly unfamiliar with the intact penis. Parents who choose to keep their sons intact get little or – worse – the wrong information about how to care for their sons’ genitals. They don’t know that a tight or adherent foreskin (called physiologic phimosis) is normal in babies and boys, and that over time, the foreskin will loosen and separate naturally from the head of the penis. They don’t know that the average age of spontaneous foreskin retraction is actually around ten years of age, and that nobody should but the boy himself should try to hasten this process along.
Though ignorance and misinformation are widespread, the pediatric literature itself (including guidelines from the American Academy of Pediatrics) actually is clear: a baby’s foreskin should NEVER be forcibly retracted. Using force to pull back a boy’s foreskin is painful, and can cause swelling, bleeding and infection.
What Happened to Baby Jude?
According to the above-mentioned lawsuit, Jude Parks was referred by his primary doctor to Children’s Healthcare “because he had been vomiting often and the vomit was of a disturbing color.” He was accompanied by his mother Ms. Parks and his maternal grandmother. The Children’s Healthcare physician who examined Jude ordered tests for blood and urine. Nurse Sorrells (a named Defendant in the lawsuit) “took off Jude’s diaper, apparently to obtain a urine specimen, and, without comment and without asking permission to do so, forcibly tore and retracted his foreskin all the way back off of his glans, to which it was naturally attached… caus[ing] the end of Jude’s penis to become bloody. Jude started screaming. Neither his mother nor [his grandmother] had ever hear him scream like that before. Neither has heard him scream that way since.”
When Jude’s mother told Defendant Sorrells that no one is supposed to retract and tear an intact boy’s foreskin, the nurse insisted that what she’d done was proper, and that Ms. Parks herself should be retracting Jude’s foreskin at every diaper change. A nursing supervisor subsequently appeared and told Ms. Parks it was hospital protocol to retract intact boys’ foreskins – that they did so in every case. She also said that Jude not being circumcised “leaves him open for infection.”
For weeks after the incident, the Complaint states, Jude manifested pain, and anxiety whenever his diaper was changed. The Complaint further alleges that Jude’s foreskin is scarred, and he may need surgery later on in order to be able to retract it.
The Complaint provides exhaustive evidence that the actions performed upon Jude, and the hospital protocol supporting those actions, violate current medical standards and guidelines, including those from the American Academy of Pediatrics. It further alleges that Children’s Healthcare was aware or should have been aware of these standards and guidelines. Finally, it provides a reference to a contemporary article by Adrienne Carmack, MD and Marilyln Milos, RN confirming that it is not necessary to retract a boy’s attached foreskin to insert a catheter.
While it’s too late to protect Baby Jude from this harm, it is possible to protect the thousands of intact boys like him.
If you are the parent of an intact boy:
- Do not allow a doctor, nurse or anybody else to forcibly retract your son’s foreskin. Make a point of telling your pediatrician this up-front, and providing this information in his medical chart. If you do take your intact boy to an emergency room, let the provider(s) know that foreskin retraction is off-limits.
If your baby has been subjected to forced retraction:
- The soreness and swelling will likely resolve on its own. Watchful waiting, and bathing him in plain warm water (no soap or bubble baths), are the best recourse for healing. If he does not improve, or if there is pus or smelly discharge, seek medical help – preferably from a foreskin-knowledgeable physician. Let the new doctor know that you will not tolerate further tampering with your son’s foreskin.
- You are entitled (and we encourage you) to complain in writing to the doctor who performed the retraction and the facility where this battery took place. At a minimum, you should provide them with factual information, such as the Carmack and Milos article referenced aboveand this information sheet. You may also file a complaint with your state’s medical board or office of professional discipline. Finally, you may wish to explore filing a lawsuit. Should you choose to do so, Intact America can help you or your attorney with the pertinent resources. Contact us at info@intactamerica.org or write to me directly at gchapin@intactamerica.org.
Over time, as the ranks of intact American men increase, medical professionals will learn the facts and foreskin bias will subside. Until that time, it’s not simply enough to keep your son intact. Ongoing education and vigilance will remain necessary until Americans realize that nature put the foreskin there for a reason – and that it’s something we should value, rather than fear.
[1] I.e., caused by the medical system. Iatrogenesis refers to any effect on a person, resulting from any activity of a person or persons acting as healthcare professionals or promoting products or services as beneficial to health that does not support a goal of the person affected.
Slightly edited version of essay published in Huffington Post 05/03/2017 01:26 pm ET
By: Georganne Chapin, MPhil, JD, Executive Director, Intact America
On April 13th, a Detroit doctor was arrested and charged with the Federal offense of removing parts of the genitals of two young girls. Meanwhile, doctors across the United States remove part of the genitals of 3,000 baby boys every single day.
How is that different?
It’s not. Too many people who object to cutting little girls have no qualms about cutting baby boys. The simple truth is that no child born with healthy genitalia should have any part of them cut, permanently altered, or painfully removed—no matter what gender they are.
I remember the first time I heard about female genital mutilation, or FGM as it’s often labeled. I was in my 20s, and not yet married or a mother. I immediately thought, “But we do the same thing to boys…, and call it by its euphemism — ‘circumcision’.”
Maybe if we called it male genital mutilation, more people would understand what it actually entails—binding the arms and feet of a newborn boy, using a metal probe to forcibly tear his foreskin from his glans penis, clamping that foreskin, and then cutting it off with scissors or a scalpel. Sometimes doctors cut off too much (causing complications too gruesome to mention here); sometimes they cut unevenly. Follow-up surgeries to correct errors and functional impairments are common. That’s no surprise. Surely, it is hard to operate on the genitals of a bucking, screaming child.
‘I Heard the Most Terrible Cries.’
Read what Elise Carin Wicklund, a mother in Parrish, Florida, wrote after she was told by her baby’s pediatrician that her weeks-old son would feel only a few seconds of discomfort.
“I heard the most terrible cries. The nurse brought me my screaming baby. They hadn’t even been able to put his onesie on all the way. He wouldn’t look at me. He wouldn’t nurse. For a long time, when I changed his diaper, he screamed.”
Without a doubt, that doctor is still out there cutting little boys. Compare this to the case of Jumana Nagarwala, a Johns Hopkins-trained female physician, charged with genital cutting of minor girls.
“Despite her oath to care for her patients, [Dr. Nagarwala] is alleged to have performed horrifying acts of brutality on the most vulnerable victims,” said Acting Assistant Attorney General Kenneth A. Blanco in a news release announcing the arrest.
Nagarwala’s case, the first to be filed under 18 U.S.C. 116, the Federal law that criminalizes female genital mutilation, has opened the eyes of many Americans, who are shocked that FGM is practiced on our soil. Perhaps it’s time they think more about what doctors routinely do to little boys.
As for the alleged health benefits of male circumcision, suffice to say that Great Britain, Europe, Australia, and other Western countries do not circumcise their boys or men, and their rates of AIDS/HIV, cervical cancer and penile cancer are comparable to or lower than ours.
The truth is that Americans circumcise their boys for the same reason other cultures circumcise their girls. We need to recognize that only tradition, bias and politics make the one okay, and the other abhorrent. Let’s acknowledge that all children deserve equal justice.
Dear Dr. Remley
| CALLING THE AMERICAN ACADEMY OF PEDIATRICS (AAP) TO ACCOUNT |
| by Georganne Chapin |
Just about a year ago, after an article published in the journal Pediatrics called for minimizing painful medical procedures in children, Intact America launched a petition. As of last week, more than 12,000 people had signed that petition, demanding that the AAP tell its member pediatricians to “End the Pain,” and stop circumcising baby boys.
The petition and our demand were further bolstered by an odd piece published in the April 2016 issue of that same journal, Pediatrics, by pediatric urologist Andrew Freedman. If his name sounds familiar to you, perhaps it’s because Freedman, in addition to being a member of the AAP’s Circumcision Task Force that in 2012 published the Academy’s revised policy on the subject of foreskin removal, made headlines by openly talking about circumcising his own son on his parents’ (the boy’s grandparents’) kitchen table.
Freedman’s April 2016 statement sought to “clarify” the meaning of the 2012 Report’s “benefits outweigh the risks” position. According to Freedman, the report wasn’t really talking about the medical benefits of forced foreskin removal from babies who cannot consent, but rather the overall benefits, “given the role of the phallus in our culture….” What’s important, he says, is that parents who choose circumcision for their boys should have “access” to the procedure, in the form of third-party (Medicaid or private insurance) payment (to doctors and hospitals, of course).
Clearly, there’s a lot more we could say here. But for now, we want to thank those of you who signed the petition and tell you that, together with the 12,160 signatures, it’s been forwarded to Dr. Karen Remley, Chief Executive Officer of the AAP. You can see my letter to Dr. Remley below. We will keep you posted on the AAP’s response.
March 2, 2017
Karen Remley, MD, MBA, MPH, FAAP
CEO/Executive Director
The American Academy of Pediatrics
141 Northwest Point Boulevard
Elk Grove Village, IL 60007-1098
Dear Dr. Remley:
A year ago, the American Academy of Pediatrics Committee on Fetus and Newborn and Section on Anesthesiology and Pain Medicine published “Prevention and Management of Procedural Pain in the Neonate: An Update” in the February 2016 issue of Pediatrics. The study prompted the AAP to call for hospitals to minimize the number of painful procedures performed on newborns.
Unfortunately, the AAP did not take the next logical step: acknowledging that the painful and medically unnecessary circumcision of baby boys should cease.
Today, Intact America is submitting to you a petition, signed by more than 11,000 men and women, asking the AAP to take that step and call for your members to stop circumcising baby boys.
For every signature we received, we know there are dozens of other Americans who believe that circumcision needlessly subjects our baby boys to excruciating pain and robs them of a part of their anatomy that is important to their future sexual health.
As the AAP itself acknowledges, routine circumcision is not medically necessary. (Source: “Should the Baby Be Circumcised?,” on the AAP’s HealthyChildren.org website.) Yet, the public perception persists that the AAP recommends the procedure—a perception refuted in a 2016 commentary by Andrew Freedman, MD, pediatric urologist and a member of the Circumcision Task Force that formulated the Academy’s 2012 statement.
“To many, especially in the lay press, [the 2012 AAP statement] was interpreted as moving the needle from a neutral stance… to being pro-circumcision,” Dr. Freedman wrote in, “The Circumcision Debate: Beyond Benefits and Risks,” published in the April 2016 Pediatrics. However, Dr. Freedman explained, the statement’s actual point was that “the procedure’s benefits justify access to this procedure for families who choose it.” (Emphasis added.)
Regarding infant circumcision, parental choice is determined more by culture than health concerns, Dr. Freedman further noted. “Most circumcisions are done due to religious and cultural tradition. In the West, although parents may use the conflicting medical literature to buttress their own beliefs and desires, for the most part, parents choose what they want for a wide variety of nonmedical reasons.”
The AAP should not be complicit in encouraging parents to make a cultural decision under the pretense of science. The AAP must publicly recognize, in an official communication, that an erroneous perception exists and that the AAP does not and has never recommended circumcision as a medical necessity. The AAP also must ask pediatricians to inform parents accordingly. We urge you to take such action.
We also ask that the AAP educate its member pediatricians about the role of the foreskin in (1) protecting the glans, and (2) sexual pleasure—two major benefits not acknowledged in the 2012 assessment of benefits and risks.
In addition, we ask that you correct the mistaken assertion in the 2012 Task Force Report that a boy’s foreskin will usually separate from the glans by 2-4 months of age; while expert opinion on the average age of spontaneous foreskin retraction varies wildly around the world, the AAP’s own HealthyChildren.org says, “Most boys will be able to retract their foreskins by the time they are 5 years old, yet others will not be able to until the teen years.”[1] (The Pediatric Society of New Zealand says “by age 18”[2]; the British Association of Urological Surgeons says “by age 10.”[3] A Danish medical survey found the mean age of first foreskin retraction to be 10.4 years.[4])
We believe that your members should be advised that forcible retraction of a boy’s foreskin is never indicated, because the age of spontaneous retraction is variable and might not occur until late adolescence. It is important that the AAP correct the record, because many American health professionals are unfamiliar with the normal intact male penis, and believe that it is necessary to force separation of the foreskin from the glans —potentially causing boys extreme pain and—potentially—lasting physical damage.
Finally, as our enclosed petition demonstrates, we continue to ask you to tell pediatricians to end the pain, and stop circumcising baby boys.
Both the American Academy of Pediatrics and Intact America share a common goal – protecting the health and wellbeing of children. We can and should work together toward that goal.
Sincerely,
Georganne Chapin, MPhil, JD
Executive Director
[1] https://www.healthychildren.org/English/ages-stages/baby/bathing-skin-care/Pages/Care-for-an-Uncircumcised-Penis.aspx
[2] http://www.kidshealth.org.nz/foreskin-care
[3] http://www.baus.org.uk/patients/conditions/13/tight_foreskin_phimosis
[4] Thorvaldsen MA, Meyhoff H. Patologisk eller fysiologisk fimose? [Phimosis: Pathological or physiological?] Ugeskr Læger. 2005;167(17):1858- 62.
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