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.

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!

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.

Petition to American Academy of Pediatrics: Please Sign to END THE PAIN!

Petition to American Academy of Pediatrics: Please Sign to END THE PAIN!

Last week, Intact America launched a petition to the American Academy of Pediatrics (AAP). The petition demands that the AAP follow the recommendations from its own research about infant pain, and  tell its doctors to END THE PAIN and stop circumcising baby boys. Our goal is 29,000 signatures by February 29. We need your help! Please sign this petition, and share it with your friends. Ask them to sign and share it, too!

AAP told to cut their hypocrisy, not baby boy penises.

Intact America insists that the American Academy of Pediatrics issue a new circumcision policy—one that honors and protects baby boys from harm.

The American Academy of Pediatrics (AAP) recently said that babies shouldn’t be subjected to unnecessary pain. But the AAP continues to promote “routine” infant circumcision, a painful, medically unnecessary surgery that removes a normal part of a baby’s penis.

Last month, the AAP published research showing that common medical procedures carried out on newborn babies are very painful, and that the effects of the pain can last many years. The procedures mentioned included heel sticks, insertion of IV needles, and circumcision. The AAP report also found that commonly used pain relievers are neither effective nor safe.

Infant circumcision differs from the other procedures discussed in the report in that it is an invasive surgery that neither tests for nor treats any illness, and permanently removes a natural and valuable part of a boy’s sexual anatomy – the foreskin. The pain from circumcision is intense and continues for days or weeks after the surgery.

Circumcision, originally promoted in the 19th century as a way to prevent masturbation, has become part of American medical culture. Every year, a million baby boys in the United States are subjected to this surgery, although no medical association in the world recommends it.

Some of the falsehoods currently used to support circumcision include hygiene, disease prevention, and aesthetics.

The truth is:

  • The intact penis is easily cleaned throughout a boy’s and man’s lifetime.
  • Circumcision does NOT prevent sexually transmitted diseases, including HIV. European countries where fewer than ten percent of all men are circumcised have about the same STD rates as the United States, where circumcision is common.
  • Any preference expressed by men or women for the circumcised penis is a result of cultural conditioning. Besides, as the U.S. circumcision rate declines, and the number of intact boys and men grow, the intact penis will no longer seem strange or unattractive.

Many Americans also believe that circumcision is “just a snip” – a minor, brief, and painless procedure that babies will not remember. This is FALSE, and the new AAP article on pain proves it.

Because circumcision is NOT medically necessary, and because the pain it causes is unmanageable and harmful over the long term, Intact America demands that the American Academy of Pediatrics tell its doctors to end the pain and stop circumcising baby boys.  

Help us reach 29,000 signatures by February 29, 2016.  

Please sign our petition TODAY.   

IOTM – David Grant

JULY 2015: This July we honor David Grant, intactivist and volunteer extraordinaire, whose on-the-ground organizing made Intact America’s presence at the 2015 NYC Pride March a rousing success.

David was born in South Carolina in June 1969 – just weeks before the Stonewall Riot and one year before the first Gay Pride March. “I always felt great inspiration about being born in a year that shook the world,” he says, “and in times of self-doubt and fear, I use that to pull me out.”

“I knew as early as I have memories that I was gay, and though I had loving parents, I knew my answers lay elsewhere.” So at the age of 17, David jumped on a Trailways bus to New York City.

His intactivism started years later with a tiny mention of Intact America in Next magazine, a popular weekly that covers NYC gay nightlife. In a small column, it briefly mentioned actor Alan Cumming’s appearance at a local club, where he “suddenly” brought up the subject of foreskin and talked about his support for a group called Intact America.

“Alan talked about the way the foreskin enhances sexual pleasure, things I didn’t know,” says David. “I immediately got on my computer and found Intact America’s website. My life would never be the same. I refer to it as the deeply personal, ‘Killing Me Softly With His Song,’ effect. When I read about the harm from circumcision, it was my own story. All the complications… I knew them well because I lived them, and still do.”

From that time, David joined intactivist campaigns, demonstrations, and protests. “You name it, I do it. Online and on the street. I strike from all angles with my own money, my time and – believe me – my own blood, sweat, and tears.”

NYC Pride Parade 2015

NYC Pride Parade 2015

“For the most part the gay community is very open to the intactivist message. What we have in common is questioning social norms and religious bigotry, and we fight for the same cause: Neither our parents, nor our culture, nor any religion owns our bodies, and only we can decide what to do with them. So, as they say, we are family. Also, gays have always been parents, but today it’s openly and legally accepted. Tragically, though, it’s still quite legal to cut children’s genitals if they are male. LGBT American parents, just like ’straight‘ American parents, are faced with the same question of keeping their boys whole or taking a knife to them.”

Protest Group
In 2006, a small group of Intactivists were approved to enter the New York City Gay Pride parade – among them, Julia and Emily Legutko, who later took up the Intact America banner. This year’s march, on the heels of the Supreme Court decision on same-sex marriage, was the largest ever. David’s organizing skills and passion were much in evidence, as this former kid from South Carolina directed Intact America’s demonstrators, float drivers, disc jockeys, parade assistants, demonstrators, and dancers through the complexities of an event attended by more than a million people. The resonance of Intact America’s message was abundantly clear, and the sparkle in David’s eyes – as he danced and twirled and strutted his banner – was priceless.

“When I came to New York, all my dreams were here, just waiting for me,” says David. “The greatest of them was Gregory, my boyfriend of 23 years, who supports my intactivism, and whose love is as constant as the North Star.”

“The moment I heard Alan Cumming’s words and discovered Intact America, there was a realization inside of me that would reshape my future. I knew I had been treated like cattle, put through a slaughter house, carved up and branded with a scar I will carry to my grave. But I will not go quietly to the grave with this indignation. I will do everything in my power to stop another child from being sent to the meat factory. And one day we will prevail.”

“The day David Grant discovered intactivism was the day our burden became easier to carry,” says Georganne Chapin, Intact America’s Executive Director. “With friends and supporters like David, we simply cannot lose.”

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