Monthly Archives: December 2013

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Pa. Rabbi facing lawsuit for botched circumcision

A couple filed a lawsuit against Pittsburgh rabbi Mordechai Rosenberg, alleging that he caused a “catastrophic and life-changing injury” to an 8-day-old infant during a circumcision ceremony on April 28 of this year (2013).

Mordechai Rosenberg

The baby had to be taken to a nearby hospital for emergency reconstructive surgery and leech therapy.

Leeches help a body accept reattached parts by promoting blood flow and tissue regeneration, so it is somewhat fair to assume that there was a partial or total amputation of the glans, an injury common to the Mogen clamp, the one commonly used by religious practitioners.

In 2000, the FDA warned about the potential for injuries from Mogen clamps. In 2010 the manufacturer went out of business due to millionaire lawsuits based on catastrophic injuries caused by the clamp. Yet the clamp is still commonly used (currently being part of a trial at the Good Samaritan Hospital in Ohio!).

Glans amputation with a mogen clamp

Rosenberg’s webpage says he’s a certified mohel, or ritual circumciser, who’s done the operations since 1990.

Mohels are not certified by a government agency because circumcision is considered a religious ceremony and not a medical procedure.

If circumcision is a medical procedure, then religious practitioners are performing unlicensed medicine and should be charged with a crime. If this is not a medical procedure, then how can we explain the use of scalpels on the body of a baby and the loss of tissue. And if this is not a medical procedure but just a religious ritual, then we need to consider this ritual abuse of a minor.

Laws against ritual abuse of minors often leave provisions for “activities, practices, and procedures otherwise allowed by law” (http://leg.mt.gov/bills/mca/45/5/45-5-627.htm) – a loophole no doubt enacted to allow cutting male babies’ genitals, while cutting female babies’ genitals is specifically prohibited and “In applying subsection (b)(1), no account shall be taken of the effect on the person on whom the operation is to be performed of any belief on the part of that person, or any other person, that the operation is required as a matter of custom or ritual.” (http://mgmbill.org/usfgmlaw.htm)

Read more: http://triblive.com/news/adminpage/5277845-74/child-mohel-circumcision#axzz2neRB9Skf

And  http://www.kansascity.com/2013/12/18/4700791/pa-rabbi-facing-circumcision-lawsuit.html

In November we found out about a similar injury suffered by a Memphis baby in the context of a medical circumcision, and days later we heard about an 18 day old baby in UAE who had his penis partially severed.

Memphis baby who suffered amputation of his penis during a circumcision in August, reported in November 2013
Saudi baby who had his penis partially cut off during circumcision, November 2013

Circumcision promoters such as Brian Morris boast how safe the procedure is. Yet here, in a matter of 2 months we learn of 3 babies who suffered this life changing injury – and all without medical necessity.

Regarding this risk, the AAP says in the technical report on circumcision:

The majority of severe or even catastrophic
injuries are so infrequent as
to be reported as case reports (and
were therefore excluded from this
literature review). These rare complications
include glans or penile amputation
[...]

Isn’t it time somebody started collecting these case reports? Or do we not care about these babies, Dr. Diekema?

Response to IBT “Brian Morris (author of circumcision study) denies link to Gilgal Society”

Dear Editor,
I see your apology and remarks that Brian Morris denies involvement with the Gilgal Society. I would like to point that the Publications page of the Gilgal Society, url: http://www.gilgalsoc.org/pubs.html
Has a link to the Reference Centre, url: http://www.circinfo.com/index.html which at the bottom specifies “Sponsored by The Gilgal Society“. This page includes a document, “Circumcision, a guide to the parents“, url: http://www.circinfo.com/parents_guide/gfp.html
At the bottom of this document you can clearly see: Copyright © 2006 Brian Morris and The Gilgal Society
I also want to point that Brian Morris website has a page on testimonials, url: http://www.circinfo.net/circumcision_testimonials_from_men.html, at the bottom of this page there is a link to a Next Section: Humor, which currently produces a page not found error. This page, however, can be found in the Internet Archive, at this url:
Points to notice:
  • Photo of a nude infant with a flip phone grasping the tip of his foreskin. Why did Mr. Morris ever consider this worth of publishing on his website, we can only guess.

  • Immediately following, a poem called “Decision“ 

Decision
Some people claim that foreskins are fun
And keep the ‘muzzle’ on the gun.
But many doctors do declare:
‘It’s healthier with the glans laid bare’
So, mum & dad, we say to you,
You must decide what’s best to do,
Your son will benefit throughout his life,
As, incidentally, will his wife;
If you make the choice that’s always wise
and do decide to circumcise.
Written
by Vernon Quantance


This poem is attributed to Vernon Quantance, the founder of the Gilgal Society (currently a convicted pedophile).
In internet comments, Mr. Morris has confirmed having previous contact with Mr. Quantance and having texts published under the Gilgal Society, which fell out of his favor with Quantance’s arrest last year. And while Mr. Morris objects to the Gilgal Society’s religious name, the Gilgal Society does not pretend to be a religious entity, but according to their home page “THE GILGAL SOCIETY is a not-for-profit publisher of medical educational material for the general public.” http://www.gilgalsoc.org/
While it is sad that Mr. Morris would feel offended by your article, truth is he has association to this group and previous cooperation that he has been quick to try to erase in face of Quantance’s misfortune.

Does your OB/Gyn require a “circumcision deposit”?

Does your OB/Gyn require a “circumcision deposit”?

We were alerted about this (apparently not so new) trend, by a post on The Whole Network:

Fan Question: I am pregnant with my second child and my regular OB (who delivered my daughter) started a new policy that forces patients to pay a “circ deposit” before their first prenatal visit. Apparently this is a growing trend among doctors.. Whether or not you are having a boy or if you want to keep him intact you have to pay and if you don’t use it the money will be refunded after you are discharged from the hospital. I tried fighting it but they told me it won’t be done unless I sign a consent form at the hospital. Since it is a new policy I am worried that the staff at the hospital will see that I paid and do it anyway assuming I wanted it done. I just found out that I am having a boy so I need to decide what to do now. Even though they are promising that I will have a say in the end, it makes me really uncomfortable and I’m not sure how safe my son will really be. I am thinking about switching to a new OB over this but I have medicaid so my options are limited. Would it be worth switching over? I am also not sure how to find an intact friendly OB so i was wondering if you could help point me in the right direction. I didn’t search for a doctor with my daughter because he was my regular GYN. I’m in Melbourne FL. There are no birthing centers around here..

But a quick search for “circumcision deposit” allowed us to find that this has been reported at least since 2009, with questions about the legality and ethical value of this practice. It is likely that this practice will increase as Medicare stops funding newborn circumcision in more states. In this particular case, the original poster is located in Florida, where newborn circumcisions are not covered.

More reports here, here.

Some relevant comments:

I would change doctors immediately, if that is an option.  I would worry that my paying a deposit would be construed as consenting to circumcision and would be afraid that it would be done without my knowledge.

I wonder how many mothers assume they don’t have a choice in the matter because they have to pay for it anyway!

The fact that parents who express their refusal to circumcise, and parents who are expecting girls, are being forced to pay this “deposit”  - even if it’s refunded later or applied to other outstanding balances- is outrageous. This is nothing but a way to reinforce the status quo of newborn circumcision, making it look like the default treatment is circumcision, effectively pushing it onto families from non-circumcising cultures. Forget the multiculturalism, forget the respect for the parents and the child. It’s all about collecting that fee and cutting that foreskin.

Circleaks is interested in exposing this practice and helping bring it to an end. But in order to do so we need your help. Please, help us identify entities and doctors with these policies. Your personal information will be strictly confidential.

Please email circleaks {at} gmail.com

hodgekiss

It’s official: Brian Morris is desperate

Back in August, the “Daily Telegraph” in Australia, reported on a new study by Morris and Krieger published on the “Journal of Sexual Medicine” called “Does Male Circumcision Affect Sexual Function, Sensitivity, or Satisfaction?-A Systematic Review.“. Back then, we replied: “No Morris, it doesn’t work that way

Anna Hodgekiss


For some reason, the Daily Mail in England has, just today, published a review of the same study, called: “It’s official: Circumcision DOESN’T affect sexual pleasure, according to biggest ever study of the issue“, authored by Anna Hodgekiss. This is interesting to the vigilant reader, as just in February 15th of this year the same newspaper published another article, this one by Claire Bates, titled: “Circumcision DOES reduce sexual pleasure by making manhood less sensitive

Have the male genitals adapted so much in a few months, that early this year circumcision reduced sexual pleasure, but now by December it doesn’t anymore?

No, of course not. But stay with us reader, so you can see through the words of Emeritus Professor Brian Morris, who -we never get tired of repeating it- is not a medical doctor, a sexologist, an epidemiologist, a pediatrician, an urologist or anything similar, but a molecular biologist and a circumcision enthusiast, one who, apparently, manages to convince naïve or biased reporters every few months.

The one concern I have is, why is a newspaper now in December reporting about a study that was published in August? Is it just that Mrs. Hodgekiss suddenly stumbled upon it and decided to talk about it? Or is Morris trying to get his study to do a second round, perhaps frustrated about recent developments regarding his beloved mutilating surgery?

Brian Morris


Because, unlike what Mr. Morris would like you to believe dear reader, circumcision is a multidimensional problem that can’t be simply resolved with an “evidence based appraisal”.

Circumcision, when performed for non-therapeutic reasons on non-consenting patients, becomes a human rights issue. Morris would like to cover this truth with his finger, but truth outshines him. Even the World Health Organization in its Manual for early infant male circumcision under local anaesthesia“, an extremely pro-circ document related to the intent of circumcising 20 million African males, recognizes that:


A concern about early infant male circumcision is that the child cannot give informed consent for the procedure. Moreover, some of the health benefits, including reducing the risk of HIV infection, will not be realized until many years later when the person becomes sexually active. If circumcision is postponed until an older age the patient can evaluate the risks and benefits and consent to the procedure himself.


More important, just two months ago (October 1st) the Parliamentary Assembly of the Council of Europe voted on and approved a resolution that declares that:


Despite the committed legislative and policy measures which have been taken by Council of Europe member States to protect children from physical, sexual and mental violence, they continue to be harmed in many different contexts. One category is particularly worrisome, namely violations of the physical integrity of children which supporters tend to present as beneficial to the children themselves despite evidently negative life-long consequences in many cases: female genital mutilation, the circumcision of young boys for religious reasons, medical interventions during the early childhood of intersex children …


Where this resolution reads “religious reasons” we need to read “non-therapeutic reasons”, in other words, not with the intent of treating a condition or disease. A social or religious surgery.

A few days later, October 10th, the Nordic Association for Clinical Sexology expressed its support to the Council of Europe, and declared that:


The penile foreskin is a natural and integral part of the normal male genitalia. The foreskin has a number of important protective and sexual functions. It protects the penile glans against trauma and contributes to the natural functioning of the penis during sexual activity. Ancient historic accounts and recent scientific evidence leave little doubt that during sexual activity the foreskin is a functional and highly sensitive, erogenous structure, capable of providing pleasure to its owner and his potential partners.

As clinical sexologists, we are concerned about the human rights aspects associated with the practice of non-therapeutic circumcision of young boys. To cut off the penile foreskin in a boy with normal, healthy genitalia deprives him of his right to grow up and make his own informed decision.

Unless there are compelling medical reasons to operate before a boy reaches an age and a level of maturity at which he is capable of providing informed consent, the decision to alter the appearance, sensitivity and functionality of the penis should be left to its owner, thus upholding his fundamental rights to protection and bodily integrity.

Every person’s right to bodily integrity goes hand in hand with his or her sexual autonomy.

This statement involves two aspects: human rights, and bodily integrity. It doesn’t matter if a doctor, a researcher, or even a parent, is convinced that a part of the body of a child, a) has no function, and b) is of no value to the child. While that part is healthy and does not represent an immediate threat to the life or health of the child, it’s the child’s right to discover, explore such part, and make a determination when his mental maturity allows for it.

Overriding this right to bodily integrity and self-ownership, is very problematic. That is why circumcision promoters try to blur this line and dismiss it with statistics of potential benefits.


We mentioned back in August that Morris must have been feeling desperate with the 2011 publication of Frisch’s “Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark” in 2011 and Bronselaer’s “Male circumcision decreases penile sensitivity as measured in a large cohort” early in 2013, so maybe he decided to play professor (maybe he had not retired yet at the time) and “grade” those previously published studies. Given that his coauthor, Krieger, is the author of one of such studies, it’s not surprise that Krieger’s study was the second highest graded study. We could suspect some bias.

But of course, given the recent developments in Europe, Morris and Krieger’s meta-analysis pretty much lost its momentum, so perhaps Morris found a new reporter, strategically located in Europe, with the hopes of bringing attention back to his paper and try to counter the effect of these European changes.

According to Anna Hodgekiss, the “lead author of the study, Professor Brian Morris of the University of Sydney, told MailOnline: ‘This is a ground-breaking article’“. Of course Morris would say that, given that he wrote it. One thing we know is that Morris loves to toot his own horn.

Hodgekiss writes:

The professors found that the very high quality studies reported circumcision ‘had no overall adverse effect on penile sensitivity, sexual arousal, sexual sensation, erectile function, premature ejaculation, duration of intercourse, orgasm difficulties, sexual satisfaction, pleasure, or pain during penetration.’

In contrast, the studies which find negative effects were poor quality, Dr Morris said.

This begs the question of if the high quality studies did in fact report one way, and poor quality ones reported in a different way, or if the quality was assigned by the professors depending on what the studies reported. Furthermore, the title of “Dr” is not the appropriate one for a molecular biologist.

She continues: “He added: ‘The methodology was impeccable’” (he would say that, of course, the advantages of ranking one’s own work)

Hodgekiss provides as example the discussion of “One high-quality trial of nearly 3,000 sexually experienced men in Kenya” (surprise surprise, Krieger’s study!).

One quick observation of Krieger’s study shows three suspicious elements: 

  • The age range of the participants was 18 to 24 years. At this age, males are very sexually active, and even those circumcised in early infancy have not suffered the long term desensitization. Not only that, but all the participants already wanted to become circumcised, which would be a prejudice factor. This is selection bias
  • The length of the study is of only 24 months. The gradual desensitization of the glans takes much longer, which makes long term follow up almost impossible.
  • One of the most surprising elements is that “For the circumcision and control groups, respectively, rates of any reported sexual dysfunction decreased from 23.6% and 25.9% at baseline to 6.2% and 5.8% at month 24“. In other words, by participating in the study, even if assigned to the control group (no treatment), the final result was a decrease of dysfunction. Exactly how is this possible?
In his study Morris spends considerable space trying to debunk those “poor quality” studies. We might go over them later. Morris also promises to review histological information in a future article, a hint at an upcoming attempt to discredit Taylor’s “The prepuce: specialized mucosa of the penis and its loss to circumcision“. 

As usual, it is amusing to check his references and see Morris’ last name repeated several times. He often refers to his own studies in third person. For example he writes: “In the Danish study that found more frequent orgasm difficulties in circumcised men, a number of flaws have been identified [58]“, and subsequent evaluation of reference 58 reveals Morris BJ,Waskett JH, Gray RH as the authors.

In the end, the authors report no conflicts of interest. Considering that Morris is author of a book called “In favour of circumcision” and a website called “circinfo”, and co-founder of the “Circumcision Foundation Australia” -an entity created to present a Policy Statement when the RACP disowned him, and that Krieger is the author of one of the highest quality studies referred, as ranked by Morris and Krieger, this lack of conflicts does not appear sincere.

Oh Morris, it’s official. You should retire from this debate too. You are getting too repetitive.


Your tax dollars, hard at work – circumcising African males

So while the U.S. struggles with its own health system, taxpayers continue funding African circumcisions.

According to an article in the Huffington Post, “New Achievements on AIDS Show Targets Matter — So Let’s Set New Ones “, “By the end of this year, PEPFAR reports that it will have supported 4.7 million voluntary medical male circumcisions (VMMC), meeting a goal the President announced in 2011. Nearly all of these procedures, almost four million, were performed in just the past two years.

Also “The ultimate goal of global VMMC efforts is for 80 percent of men to be circumcised in 14 priority African countries. That requires some 20 million circumcisions, meaning that we’re just a quarter of our way to the goal.

This article was authored by Mitchell Warren, Executive Director of AVAC (AIDS Vaccine Advocacy Coalition).

So now you know where your tax dollars are going.