Monday, August 27, 2012

The AAP 2012 Circumcision Policy Statement and What I Have Learned from a Decade of Intactivism

By Karen Glennon
Further reading on the 2012 AAP Policy Statement



I have long said that the medical community will not stop soliciting circumcision voluntarily. I have long said that the most effective way to significantly reduce circumcision in America is by educating the individual of child bearing age (or younger) because circumcision happens one parental consent, and one baby at a time.

Each parent that says no to circumcision will raise a child to whom the whole body is normal. I am on the 40 year plan with my intact education and advocacy. If I reach a young adult in their teen years now and they go on to have a whole child in a few years - then that child grows up with a normal whole body. In 20 years, that (1st generation) whole child will be an adult who may have a (2nd generation) whole child of their own. In 20 years that 2nd generation whole child may have one of their own and we’ve arrived at the 40 year mark with 2 generations of acceptance and appreciation and normalization of the natural male body.

How do we get young people to leave their future children whole? We educate them about the anatomy and function of the foreskin. In all my years of face to face demonstration/education on this issue, I have never failed to get a young person to listen to me talk to them about normal sexual development and function of the sexual organs. Young people do not get this information from their parents, from school, from text books, from porn, from their peers or from pop culture. I cannot tell you how many people (of all ages) have said to me “No one has ever told me this.” (I get this same response from older adults too!)

If you do not know what something is made of and how it works, it doesn’t have value to you. You never go to a yard sale, an antique shop, an auction and pick up an item you do not recognize, you know nothing about and say “Wow, this is so neat, I just have to buy it!” You cannot find value in something if you do not know what it is and what it does. The same is true for the foreskin. This is exactly why the prevailing myths in America of “oh, it’s gross” and “it’s dirty” and “it’s a useless flap of skin” thrive – people know nothing of its structure and function.

They do not know:
  • that the foreskin contains far more fine touch nerve receptors than the exterior parts of the female clitoris (over 20,000 verses about 8,000).
  • that the foreskin is a double layered skin system and is approximately 12-15 square inches in an adult. 
  • that the end of the penis is supposed to be mucosal tissue like the inside of the cheek or the inside of the eyelid.
  • that the foreskin slides and has a gliding action during intercourse, all the while providing exquisite sensations for the man that shape his orgasmic response.
  • that this gliding action maintains a woman’s vaginal lubrication and does not dry her vagina out, making for a more comfortable experience for both partners and eliminating the need for artificial lubricants. 
  • that having the foreskin increases the girth of the penis and that it allows a man to have enough skin to accommodate his whole penis – intact men are larger. 
  • that intact men often use shorter, gentler strokes, thus maintaining more contact between his pubic bone and hers, and her clitoris. 
  • that intact men do not need to pound and thrust like many circumcised men do to achieve orgasm.
When they learn this – suddenly the foreskin has value! Once a person sees it has function for the man and for his partner, it is much easier for them to allow into their minds the idea that a man shouldn’t be robbed of this function and value. All of a sudden his bodily integrity seems important. His right to choose seems important.

The fact that the medical community is performing amputative surgery on a baby with no deformity or disease seems important (and wrong). The fact that the American government enacted federal legislation to protect girls from genital cutting but doesn’t protect boys seems important (and wrong).

It’s easy to counter the myths when you believe the foreskin has some importance. All of a sudden hygiene is easy to explain with a shower and “retract, rinse, replace” is easily understood.

All of a sudden infection is easily explained by the fact that girls get genital infections and we medicate them, we do not amputate their genitals. We can do the same for men. (Also, if penile infections were really such an issue, we’d have a section in the drug store for penile infection creams. We certainly have a female genital infection medication section – full of creams and products to “freshen” our nether regions. Ever wondered why we don’t have these products for men? Perhaps these infected penises are truly a myth!)

All of a sudden it’s not just a little snip. It’s the elimination of what will ultimately become 50% or more of the penile skin. It is the destruction of an exquisite system designed to protect the glans in babyhood from the diaper environment, and from abrasion with clothing for the rest of life.

None of these facts sway people until they first establish a value for the foreskin. Until they understand and believe a value in it, circumcision will always be a valid 'parental choice' to protect a baby from disease and to conform to society (in America).

The medical community will not stop soliciting circumcision until the liability of risk outweighs the profits to be gained. This will only happen when lawsuits for damage are greater than profits. While there have been many gross injuries and even deaths, they don’t get the attention they deserve because we don’t value the foreskin more than the risks of cutting babies. The uneducated public is willing to ignore the few horrible mishaps for the greater myth of a cleaner, prettier penis because they don’t know the value of the foreskin.

The general public will say NO to circumcision when the medical community solicits it - IF they know the value of the foreskin, the truth of the procedure and what their son loses forever. It is my commitment that they be informed and that they know the value and that they make the right decision for their son and the man he will become.

I know that so many of us are disheartened by the AAP’s new policy statement, but we have to realize that the AAP is a professional trade organization and it exists for the promotion of its members – pediatric doctors. It is not, and never will be, a patient advocacy group. They have a profit line to maintain and a drop in circumcision rates is not beneficial to them.

They will not stop soliciting circumcision until one of two things happens (or both):
1) The financial risk of performing this unethical surgery outweigh the profit to be made: lawsuits for botched circumcisions or bodily integrity violations cost too much.  
2) The majority of parents staunchly refuse, forcing them to do an internal evaluation of the procedure. I suspect it would take 75% or so refusing before this happens.
Don’t lose faith. The truth has its own longevity. The human body is genetically programmed to form a foreskin. It will always do this. All we need to do is understand its function to give it value. That which we value, we care for. It’s all about education.







~~~~

11 comments:

  1. Thank you for your words of wisdom. This is indeed a sad day for our sons and our society. I am, however, encouraged because there is a "whole" generation growing up that will rail against this atrocity called circumcision. I have no doubts that these young people will use their voices on the internet and in person to stop a profound violation of human rights. My children are taking the lead and they have no intention of going quietly.

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    1. It is amazing how easily young people understand that circumcision is WRONG! I am quite hopeful that if they become aware of it and educated, they will indeed not do it to their own children and will speak out for others.

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  2. I can't believe they did that!!

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  3. This article gives a fresh perspective on the issue. Comparing an unknown body part (foreskin) with unrecognized items at a garage sale puts this into terms many can understand.

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  4. I agree wholeheartedly. I do have a question that keeps coming up in debates I often have. Why has no one outside of the intactivist circle done research on the functions of the foreskin? I keep searching for articles on its function that do not have an intactivist leading the study, someone more neutral that avid pro-circers are willing to listen to, but I can't find a thing. Why wouldn't there be research on the foreskin to, at least, prove its "lack of necessity"?

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  5. roger desmoulinsAugust 30, 2012 6:46 AM

    Aura, here's what the pro-circ camp calls research. They put together a self-selected sample of 100 odd cut and uncut men, tickle their glanses, claim that there is no statistical difference in sensitivity by circ status, jump to the conclusion that circ doesn't matter for sexual pleasure, and then call it a day. Notice that the sensitivity and functioning of the foreskin are completely left out of the picture.

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  6. Thank you for this! As always, you have expressed this so eloquently. My question is about your awesome 40-year plan; how you find opportunities to educate young people? What type of materials do you use? I would love to do exactly what you describe in my community but finding the chance to talk to young people about intercourse and normal sexual function seems difficult. Cruise the mall and movie theater? it seems like many parents would be unhappy about a stranger giving their child (or teen, even) drawings of penises and descriptions of sex. I'd love more info about how to spread the word.

    also, I would love to see someone do more research into alternatives to circ for foreskin problems in intact adult males. Seems like every urologist in the world wants to circ for every little problem. And a reason people give for circ is the underlying assumption that it will have to be done later in life anyway so might as well do it while the baby won't remember. (which, I think they do remember, but anyway...) Personally I think forced retraction causes most of the problems that "require" circ in adults. we don't retract baby girls and somehow it all works out with no adhesions or whatever.

    My little brother was circed at 34 for phimosis - and I happen to know that he was forcibly retracted from infancy because our pediatrician told my mom that she had to keep his penis clean or he'd circ the baby with or without her consent. Anyway, so as an adult he had some painful bouts with phimosis and finally went to the urologist, who offered him no medical treatments, no second opinion, just - amputate it. I tried to give him info on steroid creams and other less radical treatments but he said it was already scheduled and he was already mentally resigned to it. Not that it really matters to me personally but I hated to see him do it and then regret it later. I wonder how many urologists recommend circ as a way of justifying their own circumcisions. :(

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    1. My greatest opportunity to interact with young people has come on the west lawn of the nations's Capitol every spring for the past 6 years when I have attended the Genital Integrity Awareness Week demonstration, held at the end of March. The event is held at this time as it is the anniversary of the signing of the federal female genital mutilation law that gives girls genital integrity in America but fails to do the same for boys. Busloads and busloads of young people come through the area on tours. They are very interested in our signs and anything to do with sex organs and sexual function - because they are adolescents and young adults full of sexual hormones in a culture that exploits sex to market and sell anything but won't speak honestly to our children without weird shame and angst. As for talking with minors, when kids who are part of bus tours are minors, it's generally very obvious because the chaparones often rush them by and refuse to let them take any literature hand outs. That's not really a worry though because they all have cell phones and our signs have websites printed on them. We just smile and say "Go to the website". Otherwise, kids tend to be with parents and I will ask how old they are. I don't engage in sexual discussion with them in public unless I get permission from a parent or an adult that is with them but I will talk about the laws and lack of equal protection!
      As to getting access to young adults to talk with, I think one of the best places would be on public property next to a college campus. It's important to respect private property rules and exercise your right of free speech on public protety - not private. A simple sign to draw attention, some info cards (you can make your own or get some from any intactivist group like Peaceful Parenting, NOCIRC, 4ERIC etc) and a simple line drawing to use as a teaching aid. Sign ideas "Circumcision Harms, Ask Me How" will get people talking to you. It's the perfect place to start with teaching about the sexual function and the anatomy of the foreskin. I have copied and laminated two line drawings from the book Circumcision Exposed: Rethinking a Medical and Cultural Tradition. They show a circumcised and intact penis flacid and erect. The inner foreskin is shaded light grey and it's easy to see how much of the shaft it covers. With these pictures, it's easy for people to get an understanding of the function. I also do the hand touch test to give them an idea of the sensation. I have them put out their hand, palm down, then I run my finger over the back of it. I have them turn their hand and I do the same to the palm and I ask them if the sensation is different and they say "OH YES!" and I explain the Meisners corpuscles, fine touch nerve receptors. We have them in the lips, nipples, hands, genitals and soles of the feet. And then they begin to "get it"!

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    2. I speculate that the rush to circumcise by American urologists is solely based upon their lack of education on the structure and function of the foreskin. They do not learn this in medical school, therefore, they don't know. I am guessing that in an intact culture, this wouldn't be the case at all and doctors would have a much more conservative approach than sending him to the operating room to go under the knife. Does he regret having the circumcision performed?

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  7. I agree with you, but I don't think it is every urologist in the world, just in the U.S. I have many European relatives, and when the subject of circumcision came up with them, they were shocked and horrified that we do this for non-therapeutic reasons. None of them had ever heard of anyone ever having a foreskin problem. I think we have created these problems in the U.S. by giving the incorrect advice on proper care (forced retraction and excessive cleaning) and not educating doctors on the normal anatomy and less invasive treatment methods. Unfortunately with this nonsense from the AAP, it does not look like it will improve any time soon.

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  8. To the preceding commenter.

    Scholars noticed as far back as the 1980s that the frequency with which conditions are diagnosed varies widely by nation. Certain things are diagnosed in one or a few cultures, and never in others. This is very true of mental illness.
    "Phimosis" and "serious foreskin problems" are diagnosed more often in the UK than on the continent, and more often in the USA than in the UK.
    In Latin America, I bet foreskin problems are diagnosed more often in private clinics than in the public system. Doctors in private clinics have often done residencies in the USA. I have heard a Venezuelan mother describe the natural penis as a "poor boy's penis."
    Circumcision is spreading in urban China, where surgeons can charge privately for every operation they perform.

    The USA has fallen into the trap of jumping to the conclusion that the foreskin is the cause of a variety of medical "problems" that are fairly rare in Europe and Japan. This is aided and abetted by American medicine's ignorance of the foreskin's sexual value, a value summarized in the bullet list in the post above.

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