Monthly Archives: January 2016

When it comes to intactivism, Andrea Peyser gets it wrong

peyserOn January 25, Andrea Peyser published in New York Post an article about intactivism, called “Circumcision ‘intactivists’ don’t want you (or your kids) to get snipped“.

The article started wrong from the headline. Intactivists recognize the right of adult men to decide whether they want to get circumcised or not. Intactivists are concerned with protecting the genital integrity of minors, but recognize the autonomy of adults to provide consent and make decisions over their own bodies.

Peyser writes that “Intactivists claim that uncut penises deliver enhanced sexual pleasure“. It would be better to say that circumcised penises deliver decreased sexual pleasure, as a result of the loss of mechanic and sensorial tissue.

Then she adds that intactivists “liken male circumcision to female genital mutilation“. This common claim is usually simplified to make intactivists look as extremists. One cannot deny that both cultural practices are usually performed on minors without regard for their future preference. In the places where these practices take place, it is assumed that the individual has no say on whether they will be subjected to it or not, and shall simply accept the genital alteration and live with it. In that sense, both practices are culturally and ethically similar, even if their physical effects are different. The AAP recognized that “Some forms of FGC are less extensive than the newborn male circumcision commonly performed in the West” (in their 2010 Policy Statement on “Ritual Genital Cutting of Female Minors”).

Circumcision promoters usually get away with claiming that circumcision has benefits while FGM doesn’t. But, as mentioned by a group of 38 European and Canadian Physicians, only one of those benefits has any relevance to children, which is the dubious claim that it reduces the risk of urinary tract infections during the first year of life, infections that are usually easy to treat and of little relevance. All other ‘benefits’ apply to adult life – and an adult would be able to make a decision based on his own review of evidence. When considered the number to treat (100 to 1000 circumcisions to prevent one incident) and the incidence of complications (1 in 500 being an optimistic rate), and the massive loss of normal genital tissue, it simply is not proportional.

Furthermore, societies that perform FGM claim that it has social, moral and medical benefits. Our society denies this. Similarly, other societies may deny the benefits that our society claims, and medical claims often change or stay on the edge, which is why the AAP, CDC and CPS statements simply cannot recommend circumcision – leaving the decision to the parents. Quite an anomaly for a surgery, that it is performed based on a non-medical decision.

Peyser questioned intactivist Anthony Losquadro whether the obsession with foreskin is healthy. From outside, it is quite clear that the American society is obsessed with foreskin – with removing it! Similarly, when some Jewish people claim that circumcision is vital to Jewish identity, they are also being obsessed with foreskin – with removing it. Societies where circumcision is not prevalent are not obsessed with foreskin; they simply have no reason to remove random normal and healthy parts of the bodies of children, foreskin included. This is relevant because Andrea is both American and Jewish. Her non-American parents met while serving in the Israeli army.

Following Losquadro’s response, Peyser seemed surprised that “some men harbor deep-seated issues regarding their members“. But, is there any person in the world who lives unconcerned about their own body, including their own genitalia?

Following a discussion of the rates of circumcision, Peyser wrote that “mohels and doctors recently told The Post that an increasing number of grown men in America are now making the cut for religious, medical or aesthetic reasons” – which falls outside the scope of interest of intactivists. Adult males deciding to get circumcised have every single right to do so and can do it after evaluating the evidence, evaluating their own values, and are capable of  providing informed consent. Babies can’t do that.

Peyser then presents that Losquadro drives a 30-foot “van” and hands out literature aimed at persuading parents to retain boy’s “genital integrity”. Peyser wrote “genital integrity” inside quotes, apparently indicating that she does not share this concept.

As the note closes, Peyser offers the typical list of benefits – benefits that, again, are questionable and apply mostly to adults – without comparing them to the typical list of complications and harms.

For some reason, Peyser felt that it was proper to finish her article by making reference to one episode of “Sex and the City” where circumcision was discussed, and where a perfectly normal intact male was body-shamed. Peyser claims to agree with the characters that enthused that “shafts devoid of hoods were more pleasant to gaze upon and touch than intact ones“.

But this sentence is quite revealing. Imagine dear reader if it was a male claiming that “vulvas devoid of hoods and folds are more pleasant…”, as a rationale to justify the surgical alteration of baby girls. This shows one of the real arguments behind American circumcision, and it is not a medical one. It’s simply abuse of children to appeal a social fetish. Whatever kind of penis Peyser enjoys gazing upon and touching should not have any relevance to what surgeries her children or any children are subjected to.

She closes the article by hoping that “guys who spend their lives feeling wounded by circumcision, and the women who enable them, find new hobbies“. We counter that we hope that men and women who make their livelihood by cutting normal healthy genital tissue from non-consenting minors are the ones who should find another career, especially including those mohels in Peyser’s natal Queens who feel that their religion entitles them to suck blood with their mouths out of infant penises they just cut.

So what happens when a baby dies after circumcision?

In my time as an intactivist, I have seen this scenario play out a few times. A parent, relative or friend of a relative posts in facebook asking for prayers for a baby who became severely ill after a circumcision. One of them kept bleeding and had seizures. Another one developed a UTI and a fever after a second procedure to try to fix an already botched circumcision.

Then the baby dies.

The intactivist community at large starts expressing sadness and grief, but they also start sharing the story, hoping that some parents will realize that there is a real danger of death when you send a baby to circumcision.

And then the family comes back… asking for silence. They claim that it was not the circumcision what caused the death. They claim that they are being attacked for their decisions and their beliefs.

What should the community do in those cases?

Accepting that their child died as a consequence of their circumcision means accepting that their child died because of a decision they took. It’s easier to go into denial. In fact, the circumcisers have an interest in keeping the family quiet, so they will likely distort the facts to make it seem as if circumcision was the only chance for the child to survive a pre-existent condition.

In the case of the baby that bled in 2013, the parents later said that bleeding gave them the only chance to fight a bleeding disorder; never mind that their baby didn’t make it.

In fact, in an amazing display of arrogance and irresponsibility, doctor Nisha Jain, M.D., chief of the Clinical Review Branch in FDA’s Office of Blood Research and Review, wrote Patients [of hemophilia] can be diagnosed as infants during circumcision”

In the case of a baby that stopped breathing shortly after a circumcision in Israel in June 2013, the Rabbis claimed a pre-existent condition and said that the circumcision had been performed “flawlessly”.

That same week, a teenage girl died in Egypt after circumcision (FGM) by a medical doctor. A health inspector report said the cause of the death was due to “a sharp drop in blood pressure resulting from shock trauma”. The doctor who performed the female genital mutilation was found guilty, but it is said he is not in jail.

But shock trauma is never considered in the case of baby boys dying after circumcision.

It is likely that hospitals offer some kind of incentive to families of babies dead after circumcisions. Families in turn will keep quiet about what happened. For example, when Jacob Sweet became severely disabled after having an infection and seizures after circumcision, and the hospital “lost” the records, the family offered a reward to anyone coming back with the records. The legal proceedings lasted for years, and the family was finally compensated. The family, that up to that point had even attended genital integrity events, suddenly became silent. When Jacob died, at the age of 26, his circumcision was not even mentioned in the obituary and related news.

But, who benefits from this silence?

The families don’t want to have their story plastered on the news and all over the internet. They want to settle and move on. The doctors don’t want the bad publicity. So, is it a surprise that the AAP didn’t find studies of mortality, only case reports, and thus didn’t provide any numbers on mortality on their policy statement on circumcision of 2012?

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)
- American Academy of Pediatrics
Technical Report on Circumcision 2012

In Canada, a baby, the son of an Iranian couple, died in 2013 after a circumcision that the parents didn’t even want in the first place, but were convinced by a doctor to have it done for medical benefits. The story remained silent for two years, until the family succeeded in seeing the doctors named. So you can see that there is an interest in keeping silence over these cases.

But, who speaks for the child? Who speaks for the one whose voice was never heard?

Genital integrity activists claim that circumcising a minor is a violation of human rights. Many medical communities refuse to accept this and frame circumcision as a parental right. But when a baby dies after his circumcision, can we claim that his rights were violated?

The World Health Organization (WHO) frames female genital mutilation as a violation of human rights, with this paragraph:

FGM is recognized internationally as a violation of the human rights of girls and women. It reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women. It is nearly always carried out on minors and is a violation of the rights of children. The practice also violates a person’s rights to health, security and physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death.

We disagree that it “reflects deep-rooted inequality between the sexes” as those societies that practice FGM also practice traditional forms of male circumcision, often resulting in death and mutilation. However, in this moment, we are more interested in the last part of the paragraph:

The practice also violates a person’s rights to [...] life when the procedure results in death

Circumcision apologists claim that every medical procedure has risks. Genital integrity activists remind them that circumcision is not essential to the well-being of the child, and as such is considered an “elective” procedure – and yet the subject is not given the chance to “elect” (or refuse).

So what happens when circumcision results in death?

Who speaks for the baby whose right to life was violated?

How can we stay silent, and wait in silence for the next victim? What good is that?

Sorry families of those babies who died after circumcision. We grieve with you. We feel your pain. But staying silent is the worst form of disrespect for your lost one, and we will speak, if anything with the hope that one family won’t have to go through what you just went.

A death after circumcision and a revision

A one month old baby from Pennsylvania died yesterday, January 2nd. It’s said he had a botched circumcision and a revision. It was said he had a UTI and was running a fever. And now he is not there anymore, and a family’s dreams are shattered.

Whether the procedures caused his death, or not, I’m sure the death certificate won’t tell. Infection, sepsis, systemic failure, will be the most likely causes mentioned.

It’s not our interest to mention the names, for the family it is time to grieve; but it is also not our interest to let this death be swept under the rug; the medical community needs to be held accountable.

Rest in peace sweet baby.