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Letter to an Unenlightened Urologist

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


Dear Dr. Mooreville:Georganne Chapin, Chairperson

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

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

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

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

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

Sincerely,
Georganne Chapin, MPhil, JD
Executive Director

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.   

American Academy of Pediatrics: End the Pain

The media overlooked an important story late last month that should dramatically change how doctors and hospitals treat newborn babies. On January 25, the American Academy of Pediatrics (AAP) announced a study updating its recommendations on avoiding, minimizing, or treating pain in infants. The AAP statement cites research showing that many “routine” interventions are extremely painful and that there are both short- and long-term consequences of babies’ exposure to painful stimuli.

Babies DO feel pain, and the pain from circumcision has lifelong consequences.

Now that the AAP is asking health facilities to implement “a pain-prevention program … minimizing the number of painful procedures performed” on newborns, we need to ask again why doctors continue to circumcise nearly a million baby boys a year in the United States. Unlike other painful stimuli the AAP cites, including heel punctures or IV insertion, circumcision is a protracted surgery that does not diagnose or treat any illness, but rather subjects tiny boys to extreme pain for a medically unnecessary procedure.

Until recently, circumcisions have been carried out with no pain relief at all. Instead, practitioners used only physical restraints. Even today, it’s estimated that as many as half of circumcising doctors do not employ analgesia, and that the methods used the rest of the time are only partially effective, if not outright dangerous. (“EMLA,” a topical anesthetic cream widely used in U.S. hospitals, is specifically contraindicated for use “on the genitals of children” in the United Kingdom.

Unfortunately, as the AAP statement acknowledges, it’s nearly impossible to manage pain in infants, given their small size and vulnerability to chemical interventions – even the questionably effective and widely used sugar pacifiers. Implicit throughout the AAP statement is the fact that the safer the analgesic, the less effective it is in eliminating pain.

The next step

Now that the AAP has gone on record to affirm that babies feel and suffer the consequences of pain, and should not be subjected to painful procedures if they can be avoided, the logical next step is for the AAP to call unequivocally for doctors to stop circumcising babies. In its 86-year history, the AAP has never recommended circumcision and has always held that it’s not medically necessary. But, recently, as more and more parents opt out of the procedure for their boys, the trade association’s enthusiasm for circumcision has only increased. In 2012, while admitting that the complications and risks of infant circumcision have never been studied systematically, the AAP took the regrettable position that the operation’s benefits outweigh the risks.

Medical experts from around the world disagree. In response to the AAP’s 2012 statement, a large group of European physicians and ethicists wrote, “Cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious, and the report’s conclusions are different from those reached by physicians in other parts of the Western world… [Their claims of] health benefits… are questionable, weak, and likely to have little public health relevance in a Western context.”

Notably, far fewer than 10% of adult men in Europe are circumcised, compared to 75% of the adult male population in the United States.

Now we have a systematic study about the short- and long-term risks of pain inflicted upon infants.  This is all we need to know in order for the AAP to stand up and say to its members: “Removing a boy’s foreskin is not medically necessary, it is painful, and the pain may compromise his neurological development for years hence. The AAP recommends that the circumcision of male infants cease.”

In my experience, the more you know about circumcision, the more you oppose it. One important fact is that the foreskin is not “extra skin,” but a natural, necessary part of the male anatomy that protects the head of the penis, provides natural lubrication, and enhances sexual pleasure for men and their partners. In 2011, a study published in the International Journal of Men’s Health found that circumcised men have a 4.5 times greater chance of suffering from erectile dysfunction than intact men.

As an activist, bioethicist, attorney and, most importantly, a mother, I feel a glimmer of hope when I read the AAP’s new policy statement. I see a medical organization increasingly boxed into a corner as it tries to escape the inevitable: infant circumcision is not medically necessary, it is unethical, and it has no place in legitimate medical practice.  The organization, which pledges its commitment to “the optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults,” thus has no legitimate path other than to tell its physician members to stop circumcising baby boys.

Georganne Chapin
February 13, 2016

 

 

 

 

 

 

IOTM – Amy Wright Glenn

MAY 2015:Intactivist of the Month is Amy Wright Glenn—author, educator, doula, and mother. Glenn connects with her audiences through the natural and nurturing elements of motherhood, and exemplifies the qualities of compassion, caring, and communication. Glenn earned her MA in Religion and Education from Teachers College, Columbia University. She then taught for eleven years in the Religion and Philosophy Department at The Lawrenceville School in New Jersey, earning the Dunbar Abston Jr. Chair for Teaching Excellence. She is a Kripalu Yoga teacher, Birthing Mama® Prenatal Yoga and Wellness Teacher Trainer, (CD) DONA birth doula, hospital chaplain, and founder of the Institute for the Study of Birth, Breath, and Death.

Glenn is a frequent contributor to PhillyVoice and draws upon her skillset as an ethicist in composing articles relating to the harms of routine infant circumcision.

Her recent article on the Hironimus v. Nebus case is a must-read: Circumcise your 4-year-old or go to jail.

Commenting on the honor of being named Intactivist of the Month, Glenn said, “Intact America represents the leading edge of a powerful and important shift in consciousness with regard to the involuntary genital cutting of children in America. The tide is turning. While it still may take decades of work, one day the practice of forcibly cutting the genitals of American boys will be condemned in the same way the cutting of a girl’s labia and/or clitoris is condemned.”

We’d like to dedicate this newsletter to mothers and other inspiring women like Amy Wright Glenn for their work to educate parents on the risks of circumcision and the beauty of the natural human body.

To learn more about Amy Wright Glenn, visit Birth Breath and Death, facebook.com/AmyWrightGlenn, and facebook.com/birthbreathanddeath.

Georganne Chapin, Intact America’s Executive Director, said, “Amy Wright Glenn’s writing is polished and forthright, and leaves no room for ambiguity. She is as certain as can be that circumcising children is morally unacceptable. We are so grateful for her ability to deliver that message with such clarity.”

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Lousy Sex

In a new “listicle” posted on its website this week, The Huffington Post outlines Eight Things America Gets Wrong About Sex. From health care to homophobia, the piece covers a range of historical and sociological reasons for America’s sexual dilemmas. It speaks to just about everything, except anatomy. And what’s one thing about American sexual organs that’s unique compared to much of the rest of the world? That’s right—routine male circumcision.

It astonishes me that in talking about sex, pretty much nobody mentions that most adult men in the United States today have been deprived of the most pleasurable, sensitive part of their penises. Without a foreskin and its sensory feedback, a man has difficulty controlling the timing of his orgasm. Also, because he’s missing the very organ that serves a gliding and lubricating function—and because he has a scar where his foreskin used to be—his penis is calloused and dry, when compared to that of an intact man; this creates a friction during intercourse and compromises the pleasure of both sexual partners.

Don’t believe me? Then explain the uniquely American proliferation of lubricants and masturbation creams, the existence of which many Europeans—most of whom are intact—find strange. CIRCUMserum is available for those who want to combat what it calls “Dullness Syndrome” by restoring “natural feeling for more intense sex”; Stroke 29, Wicked Cream, and others are designed to help circumcised men seeking solitary pleasure, who find the after-effects of circumcision to stand in the way of sensory pleasure.

Understandingcircumserum the history of American circumcision helps to explain all of this. In fact, when doctors began promoting circumcision in the Victorian era (late 1800s), the purpose was precisely to reduce pleasure and cause pain–to dissuade men from the “immoral” and “unhygienic” practice of masturbation. Among those who pushed the circumcision solution to masturbation were American physicians Abraham Jacobi (the organizer of the American Pediatric Society) and J.J. Moses (then-head of the New York State Medical Society and president of the Association of American Physicians).

Just as Jewish physician and philosopher Maimonides had recognized 800 years earlier, these fathers of American medicalized circumcision believed that its physiological and psychological effects–aversive pain memory and loss of sensory tissue–would help to diminish sexual gratification, whether self-sought or through genital contact with a partner.

Should we be surprised, then, with findings such as those from Denmark, published in the International Journal of Epidemiology in 2011, showing that circumcised men have greater difficulty reaching orgasm, and that female partners of circumcised men are less likely to feel sexually satisfied?

What is astonishing is that American doctors persist in a practice designed to ruin the natural pleasures of sex, and then deny that it in fact does so. Meanwhile, the vast majority of adult American men are living with scars instead of foreskins. Half of the couple is missing a most basic, sensual part of his anatomy, and we wonder why Americans find sex less than fulfilling.

Georganne Chapin