Category Archives: Promoters

Edgar Schoen, MD passed away

Edgar Schoen, M.D., (August 10, 1925 – August 23, 2016) passed away peacefully in his sleep on August 23, at his home and surrounded by family.

Edgar Schoen was an American Jewish Physician and worked as a Clinical Professor in Pediatrics at the University of California, San Francisco. In 1987, Schoen was appointed head of the Task Force on Circumcision by the American Association of Pediatrics, where he pushed for routine infant circumcision, but the neonatologists on Schoen’s committee wouldn’t go for it. Under his supervision, the AAP released the Policy Statement on circumcision of 1989, which was greatly reverted by a new statement in 1999. Schoen angrily criticized the overriding statement of 1999 in a letter titled “It’s Wise to Circumcise: Time to Change Policy

As an enthusiastic circumcision promoter, Schoen shamelessly mixed medical, religious and cultural arguments. His bias was clearly obvious in some of his latest articles, such as “Circumcision is not only Jewish, it’s good for you” (JWeekly, 2013) or his 2009 book “Circumcision, Sex, God, and Science: Modern Health Benefits of an Ancient Ritual“.

We share a recently released video interview conducted by James Loewen in 2009, where Dr. Schoen expresses his views rather freely.

Dr. Anthony Chin is severely biased on circumcision

Anthony Chin, MD

Anthony Chin, MD

U.S. News Healthcare published an article (“Circumcision: Why it May Be as Important as Vaccines to Your Child’s Health“) by one Anthony Chin, MD, pediatric surgeon and director of surgical critical care at Children’s Hospital of Chicago. This article is so biased and willfully blind to facts that it is not even worth the cost of the pixels used to display it on your screen.

The author claims that science is clear, that circumcision is a matter of good medicine and smart prevention. I don’t know of any other kinds of “prevention” that remove normal parts of the body without taking into consideration the wishes of the patient, particularly when there is no reason to expect any major pathology of said part (i.e. genetic reasons, preexisting symptoms, etc).

The doctor claims that as physicians “we must respect [the family's] choice“. But, why? What other reductive surgeries are performed for “family’s choice” and -again- without consideration to the wishes of the actual real patient?

He then says “we have a professional obligation to educate parents and help them make as informed and as safe as call as possible“. Well, if one is to educate a parent on the removal of the foreskin, one should be willing and able to discuss what the foreskin is and what it does. And this doctor fails at that, as we will see.

Just to compare, a recent policy for labiaplasties on teenagers, by the American College of Physicians and Pediatricians, recommends appropriate counseling, screening for body dysmorphic disorder, and recommends that the obstetrician-gynecologist be ready to discuss normal sexual development, wide variability in appearance of genitalia, nonsurgical treatment options and autonomous decision making. None of this basic elements is discussed when it comes to circumcising male children.

Then, to support the “science behind an ancient ritual“, he tells us that studies indicate that circumcised males have fewer urinary tract infections. Of course he omits that this UTIs are rare, that the “protective” effect applies only to the first year of life -while circumcision is for life-, that UTIs are generally easy to treat, that with the exception of the first year of life females have more UTIs than males and we don’t perform surgery on them, and that over 100 circumcisions have to be performed to prevent a single UTI -which again, would be easy to treat. So it is hardly proportional to what it is supposed to prevent.

He then says that circumcised males have a lower risk for sexually acquiring and transmitting certain infections. While some studies show a reduced incidence of some STDs on circumcised males, there are far more factors than the presence or absence of foreskin, such as appropriate sexual education, safe sex practices, and the specific risk groups and behaviors the individual moves in, which is why anyone promoting circumcision for STD prevention without educating on safe sex is actually endangering people. Anyone, circumcised or not, can contract an STD. Many STDs are transmitted in the semen, so circumcised or not, an infected male will transmit the STD unless a proper barrier is used.

The next predictable claim is the infamous 60% risk reduction of contracting HIV. As always, he misses the fact that this applies only to female to male transmission through unprotected penetration, that this does not apply to males who have sex with males, to unprotected oral or anal sex, or to any non-sexual form of HIV transmission. Besides, there are numerous questions about the methodology used in the African trials and about their significance in non sub-Saharan environments.

He then tells us that “the biological mechanism behind the protective effect is not entirely clear“. Well, after about 150 years of “medical” circumcision in the United States, something as simple as this is still not clear? He goes on to repeat a biological feasibility that has not been demonstrated, meaning that it is nothing but speculation.

The one good point is the acknowlegding that circumcision is no “silver bullet“, no “replacement  for practicing safe sex” etc.

Then he goes on to try to dispell some “myths” about circumcision.

The first “myth” of course is that circumcision interferes with penile sensitivity. He calls it pernicious and persistence, and says research has found that it doesn’t. I wish that was the case. For one, the 2007 study by Sorrells showed that the foreskin is the most sensitive part of the penis to soft touch. A 2016 study and thesis by Jennifer Bossio that tried to contradict Sorrells actually corroborated it – even if the author then failed to recognize it. She did write that the foreskin was significantly more sensitive to touch stimulus.

Besides, it’s simply logic. If the foreskin is alive, if it is any sensitive, removing it by definition removes any amount of sensitivity provided by the foreskin. Thus, there is a loss in sensitivity no matter what.

His second myth is that only newborns can get circumcised. He claims that the optimal time is before 3 months of age (when the individual is not competent yet so cannot refuse – ethical issue), but that children and even adults can be circumcised safely. Then he says some families “choose to defer circumcision until a child is older and can decide for himself” but he cautions these families that “circumcision later in life tends to be more emotionally scarring“. Interesting that he cautions families AGAINST respecting the individual’s  bodily autonomy. Did he even consider what he was writing?

The third “myth” is that circumcision can damage the penis. His first sentence is that “circumcisions can go bad, but they very rarely do“. But since they do, then myth has not been dispelled. How many lives does your child has? How many penises can he afford to lose? There are frequent case reports of partial and total amputations. Unsightly scarring, skin bridges, loss of too much tissue, re-circumcisions, all these happen and frequently. Dr. Chin then provides us with an optimistic rate of complications of “fewer than half percent of newborn circumcisions” developing complications. Well, 0.5% applied to 1.2 million newborn circumcisions in the United States every year amounts to 6,000 babies experiencing complications from a surgery that they didn’t need. I wouldn’t qualify that number as small. At least 2 or 3 die each year, per official estimates – some estimate a lot more. Imagine a room large enough to host 6,000 babies with complications from their circumcision.

One of the most common complications is meatal stenosis, and this is not even factored into that “half percent“.

He says that circumcision is “safe, inexpensive and relatively simple” and that it can “protect individual health, alleviate collective suffering and curb health care costs reducing the number of preventable infections“. What about the preventable complications? The preventable deaths? What is the cost of 1.2 million circumcisions? What is the cost of providing proper sexual education? What is the cost of treating 6,000 baby boys with complications, some requiring transfussions, some requiring additional surgeries…

What about the cost of violating the bodily autonomy and genital integrity of 1.2 million baby boys every year?

Jennifer Bossio confirmed: foreskin most sensitive part of penis

Yet she was too biased to admit it!

Bossio, Jennifer, “EXAMINING SEXUAL CORRELATES OF NEONATAL CIRCUMCISION IN ADULT MEN” is a PhD thesis which attempts to “provide a multidimensional perspective of the sexual correlates of circumcision with implications for public policy and individual stakeholders (e.g., medical professionals, parents, men).”

Jennifer Bossio validated Sorrells study and didn't recognize it

Jennifer Bossio validated Sorrells study and didn’t recognize it.

Chapter 3 is dedicated to study penile sensitivity in men who were circumcised as babies, vs. men who were not circumcised (intact). This is evidently a response to the 2007 study “Fine-touch pressure thresholds in the adult penis” by Sorrells et al.

Bossio writes (pg. 69): “we did not obtain sufficient evidence to support the notion that the foreskin of adult intact men is the most sensitive region of the penis to all forms of stimuli; however, the foreskin was significantly more sensitive to touch as compared to all the other genital sites tested, and it was significantly more sensitive to warmth than the glans penis.” She also writes: “our results—and those of Payne et al. (2007)—differ from those of Sorrells and colleagues (2007) who found that the glans penis in circumcised men was less sensitive to touch than in intact men.”

In her conclusions, Bossio writes that “we directly assessed the assumption that circumcision leads to a reduction in penile sensitivity by testing tactile detection, thermal sensation, and pain thresholds at multiple sites on the penis” and offers one conclusion that “this study provides no evidence that neonatal circumcision decreases penile sensitivity, no evidence that the exposed glans penis in circumcised men becomes less sensitive over time, and insufficient evidence to suggest that the foreskin is the most sensitive part of the penis.” and then suggests that “if differences in sexual functioning or sexual dysfunction are related to circumcision status, these differences are not likely the result of changes in penile sensitivity resulting from neonatal circumcision

Finally, she concludes that “findings from this study can be used to inform individual stakeholders, public policy makers, medical health care professionals, and parents regarding the minimal long-term implications of neonatal circumcision on penile sensitivity.”

We have issues with the inclusion and exclusion criteria. Excluding participants over 40 years of age creates a bias. Many individuals restoring their foreskins typically started after their 40s. They also excluded individuals with history of sexual dysfunction.

Reading her paper we found contradictions to her assertions that “this study provides no evidence that neonatal circumcision decreases penile sensitivity [...] and insufficient evidence to suggest that the foreskin is the most sensitive part of the penis“.

We also suggest that Bossio missed a vital point by neglecting to study men who have undergone non-surgical foreskin restoration.

First, the assertion that the foreskin is the most sensitive part of the penis comes directly from the Sorrells study, and it is one assertion that is often misunderstood. Sorrells simply evaluated “fine-touch pressure thresholds” – nothing more, nothing less. So when Sorrells concluded that “circumcision ablates the most sensitive parts of the penis” it should be read that “circumcision ablates the most sensitive parts of the penis [to fine-touch]“. Sorrells did not make any attempt to measure pleasure or satisfaction. Only fine touch, and his findings are consistent with those of Bossio as she said it herself, that “the foreskin was significantly more sensitive to touch as compared to all the other genital sites tested“.

So, if the foreskin is significantly more sensitive to touch, it follows that the circumcised penis, in which the foreskin has been removed, is less sensitive to touch – particularly to fine touch. Which again, contradicts her conclusion that her study “provides no evidence that neonatal circumcision decreases penile sensitivity“.

Now, we partially agree with her assertion that “if differences in sexual functioning or sexual dysfunction are related to circumcision status, these differences are not likely the result of changes in penile sensitivity resulting from neonatal circumcision“, basically because the studies are missing one important point. Static stimulation is not the main method of stimulation during sexual activity. People don’t just lie down being stimulated by touch, warmth, pain, etc. Individuals move during sex. Stimulation is dynamic.

A visual comparison between a typical intact man masturbating, and a circumcised man masturbating, yields important differences – and  this has even been observed by circumcision promoters such as Guy Cox – in a paper published with the pen name of James Badger. While Badger describes it as a difference in preference, the reality is that it is a difference in what is possible to do with the available tissue.

Most intact men masturbate by grasping the mobile penile skin and sliding it up and down the shaft. In most cases this results in the glans being repeatedly covered and uncovered, with the rim of the foreskin stimulating the glans; typically the hand does not touch the glans. In the case of males with particularly long foreskins, the glans may never be uncovered at all, and the hand stimulates the glans only indirectly, through the foreskin.

In circumcised males, the typical technique consists in moving the penile skin what little length it can be moved during erection, or when no mobile skin is available at all, the hand rubs the penile skin, in which case external lubrication (hand lotion or adult lubricant) is needed to avoid chaffing the skin. In many cases direct contact with the glans is avoided unless using lubricant.

What this indicates is that there is a mechanic component of stimulation by using the foreskin as an agent, a mobile part, which interacts with the glans. Obviously, removing the foreskin makes this action impossible, thus altering the mechanism of stimulation for the circumcised male.

We can also consider that during heterosexual penetration, the glans touches the opening of the vagina and goes through its vestibule, but once inside it is not in contact with anything else. The vagina instead is grasping the penile skin, and facilitating its gliding motion during the repeated penetrative motion. For the circumcised male, the vagina simply rubs directly against the penile skin – because there is no movement of the skin, which tends to dry the lubrication of the vagina.

So there is a change that goes deeper than simple passive sensitivity. Circumcision alters the mechanics of the penis and causes stimulation to be different, both for the male and the female.

Bossio’s paper simply moves between two contradictory positions: 1) that the foreskin is more sensitive to touch, and 2) that the circumcised penis is as sensitive as the intact penis – which is simply not possible if a) the foreskin is more sensitive to touch and b) has been removed by circumcision.

It seems to me that given the importance of Sorrells’ study as a starting point to Bossio, she missed the mark. Neither Bossio nor her reviewers understood the meaning of “sensitivity” as used by Sorrells.

Perhaps the real importance of Bossio’s paper was to superficially contradict Sorrells, as an attempt to undermine a common argument used by promoters of genital integrity, and by calling the long-term implications of neonatal circumcision on penile sensitivity “minimal” she gained enough approval from a culturally biased academic community to obtain her PhD.

Misuse of Bossio’s paper:

Annette Fenner published in Nature Reviews Urology a highlight of Bossio’s published study (on The Journal of Urology), which is related to her thesis, with the superficial headline “Circumcision does not affect sensitivity“, and the first sentence, predictably enough, reads “Neonatal circumcision has minimal effects on penile sensitivity“. Fenner misrepresents Bossio’s paper by indicating that “No differences in tactile or pain thresholds, or sensitivity to warmth and heat pain, were observed between circumcised and intact men“. This clearly contradicts Bossio’s assertion that “the foreskin was significantly more sensitive to touch as compared to all the other genital sites tested“.

She then offers an allegedly quoted conclusion that Bossio’s data “do not support the idea that foreskin removal is detrimental to penile sensitivity.” – a quote that is really an inaccurate paraphrase, and we repeat, is deeply flawed based on the non-existent definition of sensitivity.

Fenner then offers her own conclusion, the one that everybody was hoping for, the direct contradiction to Sorrells: “removing the foreskin does not, in fact, remove the most sensitive part of the penis.”

We have already shown above how deeply flawed is this, given that the same assertion is contradicted by Bossio herself.

But that’s what Bossio’s thesis was written for: to allow culturally biased academics to contradict Sorrells’ study by quoting a paper that didn’t understand what Sorrells was writing about, and which is so poor that it contradicts itself without raising the eyebrows of any mindless reviewer.

Misleading headlines

We wrote this review back in January, but we didn’t publish it, silently waiting. Last week, however, the media picked up Jennifer Bossio’s paper, and predictably, as we have often indicated, used misleading headlines to make this look as far more conclusive than it really is. Many of the articles we reviewed, clumsily include Bossio’s contradiction without pointing it out.

Some examples of these disappointing articles:

Science Daily: Neonatal circumcision does not reduce penile sensitivity in men, study finds (New research challenges widely accepted beliefs)

UPI: Study: Circumcision does not reduce penis sensitivity. This article even says “In men with foreskin, it was more sensitive to tactile stimulation than other parts of their penises, however when foreskin sensitivity was compared to other sites intact men had no greater sensitivity than the circumcised men” – the first part obviously contradicts the premise of the headline: if the foreskin is more sensitive to tactile stimulation, removing it has to reduce the penile sensitivity (to tactile stimulation). The second part of the statement simply makes no sense and seems to be a derailing tool.

Tech Times: Getting circumcised does not shrink male organ sensitivity.

Medical Express: Circumcision does not reduce penile sensitivity, research finds.  In this article, Bossio is quoted saying “We found that while the foreskin was more sensitive to fine touch, it was not more sensitive to the other stimuli we used, and those stimuli are likely more important in sexual pleasure“. However, that sentence alone already contradicts the headline – and the whole premise of Bossio’s publication. In fact, the underlined sentence alone shows that Bossio validated Sorrells’ study, the very study that she appears to be trying to contradict.

Queens University: NEWS RELEASE – New research finds circumcision does not reduce penile sensitivity. This must be the originating point of all these press releases, as Bossio’s study was the core of her PhD thesis at Queens University. This article, just like the one from Medical Express, quotes Bossio saying “We found that while the foreskin was more sensitive to fine touch, it was not more sensitive to the other stimuli we used, and those stimuli are likely more important in sexual pleasure” – which we are getting tired of repeating, contradicts the headline and the very premise of her study.

Daily Mail: Circumcision does NOT reduce sensitivity of the penis, experts say.  Unfortunately Bossio’s sad excuse of a study made its waves all the way to England. This article is preceded by 3 bullet points, one of which states: “Findings also suggest the foreskin is not the most sensitive part of the penis“. In this article, Bossio herself is quoted saying that her study “provides preliminary evidence to suggest that the foreskin is not the most sensitive part of the penis“. This version of the article avoids saying that “the foreskin was more sensitive to fine touch“, as the Queens University press release and the article on Medical Express did. Perhaps the contradiction would have been too obvious.

Healio, Medical Daily, True Viral News, Australian Networks, The Independent, I Fucking Love Science, GCO News, Renal and Urology News, Today’s Parent and many others also mindlessly reported on this absurd study.

So congratulations Jennifer Bossio. Your nonsense fooled a lot of people. Who knows how many men will be harmed because of your sad thesis.

UPDATE: Additional problems with Bossio’s paper

  • Some readers pointed out that Jennifer Bossio’s measuring point was the outside of the foreskin (see diagram). The foreskin is not a single structure. It has an outer layer of regular penile skin, and an inner layer of mucosa. There is also a transitional area which was pointed by Sorrells as the single most sensitive area to soft touch, and there is the frenulum, joining the ridged band and the inner foreskin to the glans and the meatus. Sorrells measured sensitivity at 8 different points of the foreskin. Bossio did not take measurements on the points indicated by Sorrells as the most sensitive ones to fine-touch sensation, which are the ridged band and the frenulum. Nevertheless, she found that the outer foreskin was significantly more sensitive to touch than the rest of the penis, which is consistent with Sorrells, even if her conclusions fail to indicate that.
    This was the site used by Bossio:
    bossio1
    These are the testing sites used by Sorrellssorrells_sites
  • According to the Queens University press release, Bossio “extended the research methods in her study to include warmth detection and heat pain because these stimuli are more likely to activate the nerve fibres associated with sexual pleasure“.For one, Sorrells did not make any claims regarding fine-touch sensitivity and pleasure.Second, “extending” the method makes the results difficult to compare. For example, Bossio writes “with respect to warmth detection, the foreskin was more sensitive than the glans penis, but not the midline shaft or an area proximal to the midline shaft. Using a different stimulus modality (warmth sensation, as opposed to fine-touch punctate pressure), we partially replicated the findings reported by Sorrells et al. (2007), in that the foreskin was more sensitive than the glans penis, but—unlike Sorrells—not two sites located on the penile shaft.” This makes no sense, because since Sorrells did not take measures of warmth sensitivity, there is no way to compare the data collected to Bossio in this aspect to anything in Sorrells study. It is not correct to say that this data “partially replicates” Sorrells given that they are referring to different types of stimulus.

    Sorrells declared that the foreskin was the most sensitive part (to soft-touch and to soft-touch only). Different parts of the body specialize in different kinds of sensitivity, according to our body’s needs. For example, our eyes are probably the most sensitive part to light. Our ears are probably the most sensitive part to sound. We wouldn’t try to assess sensitivity to sound in our eyes, or sensitivity to light in our ears. If the foreskin is sensitive to soft-touch, it is likely because we need that area to be sensitive to soft-touch, and removing it is going to affect the reasons why we need that sensitivity.

    Think about it this way. Removing one person’s eyes does not make the person deaf. But that is not a reason to justify removing the person’s eyes without necessity, particularly if we don’t know if the person needs to be sensitive to light.

  • Regardless of whether the foreskin is the most sensitive part, or just as sensitive as the rest of the penile skin, or if it was not sensitive at all, removing it would still violate the bodily autonomy and genital integrity of the person. Bossio writes on BJU that her “results are relevant to policy makers, parents of male children and the general public.” This statement misses the point that the most important stakeholder is the person holding the foreskin: the male child, the future male adult, and that no matter to what extent sensitivity is affected, removing the foreskin of the child deprives the child from the freedom to choose and the right to provide informed consent – thus violating his bodily autonomy and genital integrity.

    To be fair, on her thesis, Bossio writes that “Individual stakeholders are also expected to benefit from this research program, such as medical professionals, parents of male infants, and men themselves.” For some reason, “men themselves” were omitted from the conclusion in BJU.

  • Hugh Young pointed out that the graphics on Bossio’s thesis (i.e. figure 3.2) are collapsed across circumcision status. This conceals any existing difference between circumcised and uncircumcised.Figure 3.2 basically shows that the foreskin is more sensitive than the other testing points for tactile, warmth and heat pain (this last one only by a small difference), and that the glans is more sensitive to pain. The collapsed bars fail to show any difference. Young explains: “This makes the inclusion of the bar for the foreskin absurdly different from the others, because the foreskins of the cut men are non-existent. If their measurements were shown, their bars would be infinitely tall, indicating that no amount of pressure, heat etc, would evoke a response.” Sorrells study includes figures that are not collapsed by circumcision status. Two adjacent bars show the results for circumcised and uncircumcised. In the case of the circumcised males, the bar for non-existent measuring sites is simply omitted. If Jennifer Bossio wanted her study to be comparable to Sorrells, she should have considered presenting graphics that were comparable to those by Sorrells.Bossio’s figure 3.2
    bossio_fig

    Sorrells’ figure 3

    sorrells-fig

Bibliography

Bossio, J.A.EXAMINING SEXUAL CORRELATES OF NEONATAL CIRCUMCISION IN ADULT MEN. Thesis (Ph.D, Psychology) — Queen’s University, 2015-09-18 00:15:45.183

http://qspace.library.queensu.ca/handle/1974/13627

 

Bossio, J.A. et al. Examining penile sensitivity in neonatally circumcised and intact men using quantitative sensory testing. J. Urol. http://dx.doi.org/10.1016/j.juro.2015.12.080 (2015)

 

Sorrells ML, Snyder JL, Reiss MD, et al. Fine-touch pressure thresholds in the adult penis. BJU Int 2007;99:864-9.

http://www.cirp.org/library/anatomy/sorrells_2007/

Badger J. A Survey about Masturbation and Circumcision. 2000

http://www.circlist.com/surveys/badger-06.html

 

Fenner, Annette  - Male circumcision: Circumcision does not affect sensitivity – Nat Rev Urol

PY  - 2016/01/20/online

VL  - advance online publication

http://www.nature.com/nrurol/journal/vaop/ncurrent/full/nrurol.2016.3.html

A South African baby loses part of his penis during circumcision – but what went wrong?

As reported by Sunday Times News (South Africa) on November 29th, a Jewish religious court decided that a Johannesburg mohel will not be allowed to perform circumcision again, as a consequence of a botched circumcision performed last year. During that circumcision, the penis of the baby was partially amputated.

The article states that “[n]o details were revealed of why this circumcision went wrong. The Sunday Times was unable to establish how the baby is doing now and whether there have been surgical attempts to rectify the partial amputation of his penis.”

The article then quotes one Rabbi Warren Goldstein saying that circumcision “has a longer track record of proven safety than any other surgical procedure” and that “Jewish circumcisions have been done in South Africa for more than 175 years and this case is the first time that an injury of this severity has been reported“.

The name of the (ex)mohel was not disclosed. Which is not a surprise, considering that even cases where babies die after a circumcision are usually kept secret, as we found happened in Canada recently.

Well, let me tell you what Goldstein won’t tell and the reporter won’t research. Jewish circumcisions typically use a Jewish shield (barzel) or a Mogen clamp. Neither of those two devices protects the penis. The devices are supposed to clamp on the foreskin leaving the glans on one side, but improper installation, device malfunction or anatomical variation can cause part or all the glans to be trapped by the device, allowing the scalpel to cut through it without the operator even realizing it. The mogen clamp has an increased risk of injury or amputation of the glans, even with experienced physicians.

I have no way of verifying that no cases have been reported in South Africa, but I can quickly reference one in Pittsburgh, where Rabbi Mordechai Rosemberg amputated the penis of a baby in 2013. The penis was re-implanted using microsurgery and… leeches, but there is no way to know yet if the baby will even have normal sexual function.

In 2004, another Rabbi, Daniel J. Krimsky, also amputated part of the penis of a baby during a bris in Florida. The resulting lawsuit ordered Mogen instruments to pay a settlement of 10.8 million dollars, but the company was already in default after another millionaire lawsuit, over similar injuries occurred in 2007.

In 2004, Dr. Haiba Sonyika amputated most of the glans of a baby circumcised with the Mogen clamp (in a Medical environment). Reattachment was not fully successful.

All these cases could have been prevented, since in 2000, the FDA warned about the potential for injury from Mogen and Gomco clamps – but no changes were made to the devices and the warning was later archived. Ten years later Mogen Instruments would be out of business due to the lawsuits mentioned above.

Another Floridian mohel posted a blog in 2010 warning others not to use the Mogen clamp.

In spite of all this, researcher Rebeca Plank conducted a trial of Plastibell vs. Mogen clamp in Botswana in 2010, concluding that the Mogen clamp could be safer in regions where immediate emergent medical attention is not available. We wonder what she would recommend in cases of penile amputation, without immediate emergent medical attention. BTW, when stating the safety of circumcision in Botswana, Plank neglected to mention that one “participant” baby died within 24 hours of being circumcised. No autopsy was performed and the death was simply not mentioned at all in the final report. Good to know that Dr. Plank holds her research to such high standards.

The Good Samaritan Hospital in Cincinnati also performed a trial, this one of Mogen vs Gomco clamp, between 2012 and 2014. When intactivists protested, a spokesperson for the hospital released a statement calling the clamps “two medically accepted circumcision processes” – neglecting to mention the FDA warning and incidents related to the Mogen clamp.

The Good Samaritan researchers concluded that “Mogen clamp is associated with less neonatal pain physiologically by significantly lower percentage change in salivary cortisol, lower heart rate, and mean arterial blood pressure. There was no difference in CRIES scores. Mogen clamp circumcision duration is significantly shorter than Gomco clamp. Both methods demonstrate satisfactory maternal and pediatrician short-term follow-up.” I’ll let the readers find for themselves what the metrics are in the CRIES pain score, so that you know what the babies were consciously subjected to by the researchers.

Other clinical trials took place in 1999 (USA) and 2013 (Zambia) favoring the Mogen clamp.

Additionally, the Mogen clamp is the favored device of Dr. Neil Pollock in Canada, and the many disciples he enlists. Pollock also exported it to Haiti and is currently looking for the support of Charlize Theron and Sean Penn to provide similar training in South Africa.

And with this we have gone full circle, starting with a Jewish botched circumcision in Johannesburg, South Africa, and finishing with a Canadian doctor who wants to export to South Africa the very same technique that caused said botched circumcision.

While the Mogen clamp appears to cause less pain through a faster procedure, the risk of glans or penis amputation may not be realized in 100 or 200 procedures, but will eventually occur. As it happened to this baby, in Johannesburg, in 2013. Even when performed by experienced doctors or mohelin.

Sean Penn, Charlize Theron, save your money. There are better ways to actually help people.

 

 

More forced circumcisions – paid by American tax dollars

What is up with forced medical circumcisions in Africa, performed by NGOs on the bodies of minors?

Today we have this report from Noordgesig Primary School in Johannesburg, South Africa.  A few weeks ago, blogger Joseph4GI mentioned a case in Uganda. In the same article, he mentions previous cases in Kenya and Zimbabwe.

In this particular case in South Africa, we recognize that the NGO Right to Care became aware of the wrong doing of a provider, terminated its contract with the circumcision clinic and provided a public statement.

On their statement, Right to Care indicate: “Right to Care has supported the Department of Health (DoH) in this initiative over the past four years and has completed over 500,000 MMCs (circumcisions), through this partnership.

The Right to Care was founded by USAID (United States Agency for International Development) and the Global Fund to Fight AIDS, Tuberculosis and Malaria, so, again, this is a case of African circumcisions being paid for with American tax dollars.

Little sproutings and circumcision – more of the same

Jeni Taylor, MPH MSN RN is a nurse, public health advocate and new mom from Northern Virginia, who blogs on her website, Little Sproutings, to share her experiences as a mother and discuss relevant baby-health topics to help parents.

On July 25th, 2015, Jeni published an article called “The circumcision decision“. On this article she intended to “research what the current evidence says about whether or not it’s indicated to circumcise in the developed world“. Her article obviously caused some backslash among the intactivist community.

Jennifer Marali Taylor, MPH MSN RN - we cropped the image to respect the privacy of her baby.

Jennifer Marali Taylor, MPH MSN RN – we cropped the image to respect the privacy of her baby.

In response, Jeni added a disclaimer: “I want to clarify that I am not an expert on the subject of circumcision, and this post is not intended to cover every aspect of such a complex issue. This post is focused strictly on the medical perspective.” Also, responding to a commenter who indicated that Jeni “never once bothered to mention the structure and function of the foreskin“, she responded that she “didn’t discuss the function of the foreskin. That wasn’t what this article was about and that wasn’t what I was set out to do when I wrote this article.”

At the end of the article, Jeni claims that “with regards to expert opinion, the research all points to maintaining this evidence-based practice“. Jeni, however, only reviewed U.S. sources. European medical associations for example hold different points of view in spite of having access to the same evidence.

The problem we have with this kind of article is that many parents will take it as a recommendation, in spite of the disclaimer (“I am not an expert”). And, many people who are not familiar with the topic won’t even ask the question of whether the foreskin has any kind of function or not.

Sure, Jeni said that “wasn’t what this article is about“, but you cannot separate these two elements. When you circumcise a baby, you negate the functions of the foreskin. The baby will never experience those functions. When you do not circumcise the baby, he will grow up to experience those functions. It’s just like the two sides of the coin. You can’t just flip one single side of the coin. Wherever one side goes, the other side follows.

Jeni wrote: “The risks of complications from a circumcision are very low, and most of those that occur are minor“. This statement alone is very incomplete and misleading.

According to the American Academy of Pediatrics, AAP, on their 2012 technical report on circumcision (page 17 of 32): “The true incidence of complications after  newborn  circumcision  is  unknown, in part due to differing definitions of “complication”and differing standards for determining the timing of when a complication has occurred

A few sentences later the same report indicates: “Significant acute  complications are rare, occurring in approximately 1 in 500” – But is this really number really “rare”? Take into consideration approximately 1.2 million circumcisions in the United States every year, and you have 2,400 babies suffering significant acute complications every year, over a surgery that they didn’t need.

The Royal Australasian College of Physicians, on their policy statement from 2009, actually says: “Some of the risks of circumcision are low in frequency but high in impact (death, loss of penis); others are higher in frequency but much lower in impact (infection, which can be treated quickly and effectively, with no lasting ill-effects). Low impact risks, when they are readily correctable, do not carry great ethical significance. Evaluation of the significance of high-impact low-frequency risks is ethically contentious and variable between individuals. Some are more risk averse than others“.

But we are talking about babies. How do we know how risk adverse is a baby? Can parents even know?

We know for sure that babies had died as a result of circumcisions, and others have lost their penises (at least two of them in the U.S. in 2013). Babies have been forced to grow without penis, with the most known case being David Reimer (1965-2004) who was raised as a girl after the destruction of his penis, resumed male identity as a teenager, underwent two phalloplasties, and finally committed suicide in 2004. There were also two cases on the same day in a hospital in Atlanta on Aug.22, 1985. A two year old child suffered the same fate in 1984. Then, we have Mike Moore, who lost his penis during circumcision at age 7, circa 1991. And of course, the two babies from 2013, one in Pittsburgh and one in Memphis.

How many babies and children is it tolerable to force to go through life without their penis? Dear reader, how many of your sons would you consider tolerable to endure this complication?

While the American Academy of Pediatrics touts benefits -without being able to fully recommend circumcision-, the Royal Dutch Medical Association indicated in 2010:

“There is no convincing evidence that circumcision is useful or necessary in terms of prevention or hygiene. Partly in the light of the complications which can arise during or after circumcision, circumcision is not justifiable except on medical/therapeutic grounds. Insofar as there are medical benefits, such as a possibly reduced risk of HIV infection, it is reasonable to put off circumcision until the age at which such a risk is relevant and the boy himself can decide about the intervention, or can opt for any available alternatives.

“Contrary to what is often thought, circumcision entails the risk of medical and psychological complications. The most common complications are bleeding, infections, meatus stenosis (narrowing of the urethra) and panic attacks. Partial or complete penis amputations as a result of complications following circumcisions have also been reported, as have psychological problems as a result of the circumcision.

“Non-therapeutic circumcision of male minors is contrary to the rule that minors may only be exposed to medical treatments if illness or abnormalities are present, or if it can be convincingly demonstrated that the medical intervention is in the interest of the child, as in the case of vaccinations.

“Non-therapeutic circumcision of male minors conflicts with the child’s right to autonomy and physical integrity.”

In 2013 the Nordic Association for Clinical Sexology wrote: “Ancient historic account 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 potential partners

Not discussing the functions of the foreskin, dismissing the sexual role of  the foreskin and minimizing the impact of the risks, are three ways in which the American medical community shows its bias in favor of circumcision.

Jeni claims that “Both the AAP and the medical community recommend male circumcisions, for the health and medical benefits”. The AAP never actually recommends circumcision. They favor it, but they do not recommend it, leaving the decision to the parents (which we disagree with since the parents are not the ones who have to live with the consequences, and as we showed before, these consequences can be catastrophic). It would be difficult to limit what Jeni means with “the medical community”. As we have seen in this article, the global medical community at large finds much less value in circumcision than the American medical community.

The AAP says: “Parents are entitled to factually correct, nonbiased information about circumcision“. Skipping the functions and anatomy of the foreskin is providing incomplete and biased information. The AAP themselves are guilty of this omission, and so is Jeni.

A 2013 letter by 38 European and Canadian Physicians, heads of medical associations, says of the AAP: “while striving for objectivity, the conclusions drawn by the 8 task force members reflect what these individual physicians perceived as trustworthy evidence. Seen from the outside, 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, including Europe, Canada, and Australia.” Furthermore, “To these authors, only 1 of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against urinary tract infections in infant boys, which can easily be treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves.

This conclusion contradicts the conclusion in Jeni’s article that we noted earlier, that “the research all points to maintaining this evidence-based practice“.

We wish that Jeni will understand that circumcision and non-therapeutic genital alterations on children of any gender violate the bodily autonomy and physical integrity of children, violates their human rights, and that she as a nurse, as a mother and as a blogger has a responsibility to protect children from unnecessary and harmful procedures.

If you are neutral in situations of injustice, you have chosen the side of the oppressor. If an elephant has its foot on the tail of a mouse and you say that you are neutral, the mouse will not appreciate your neutrality. Desmond Tutu

If you are neutral in situations of injustice, you have chosen the side of the oppressor. If an elephant has its foot on the tail of a mouse and you say that you are neutral, the mouse will not appreciate your neutrality.
Desmond Tutu

 

A situation of injustice. Which is your side?

A situation of injustice. Which is your side?

 

Intermountain moms, nurse Dani and Doctor R. bring their lies to circumcision

Oh the circumcisers are desperate and they have the lies to prove it. It’s been a while since I last woke up to two terrible YouTube videos full of half truths and obvious lies about circumcision.

So, let’s see. Intermountain Moms’ nurse Dani “tries to” answer this question: “Will a doctor numb a baby boy if he gets circumcised?”

Nurse Dani says “circumcision is usually done before a baby goes home from the hospital or two weeks later“… What about the other possibility, like, not doing it at all? Not mentioned, which reinforces the sense of normality that all boys are circumcised.

And the good thing about doing it when a baby is very very new”, says nurse Dani, “is that they kinda are in a natural sleep state, this is almost a natural anesthetic

Yes folks, that’s what she says. She must have missed that Oxford University study published in April and widely reported in the media, where “researchers at Oxford University have watched infants as young as a day old as their brains process a light prodding of their feet. The results confirm that yes, babies do indeed feel pain, and that they process it similarly to adults.

The Time article reports that: “Until as recently as the 1980s, researchers assumed newborns did not have fully developed pain receptors, and believed that any responses babies had to pokes or pricks were merely muscular reactions.“, but clearly nurse Dani still believes it. In fact, as early as 1997, most of the neonatal circumcisions (some 95% or so) were performed without any anesthestic. The American Academy of Pediatrics on its last policy statement on circumcision states that “adequate analgesia should be provided whenever newborn circumcision is performed“.

Nurse Dani continues: “in addition to that, we give babies a binky that has sugar water on it, and let them suck on it, and that is very soothing to them“. The AAP indicates: “Nonpharmacologic techniques (eg, positioning, sucrose pacifiers) alone are insufficient to prevent procedural and postprocedural pain and are not recommended as the sole method of analgesia. They should be used only as analgesic adjuncts to improve infant comfort during circumcision.”

She then completes her statement: “and yes, they are also numbed

So what was that all about? Why the “natural sleep state”? Why the “soothing binky with sugar water“? To make parents feel better?

Nurse Dani says “if you don’t want to watch, then that’s okay“. What’s that all about? As a parent, if anyone is going to do ANYTHING to my baby, it will be in front of me. And if it’s too horrible for me to watch, it’s probably too horrible for my baby to endure. And if on top of it all, it is unnecessary, then you better believe I’ll keep my baby safe.

No nurse Dani, I won’t recommend you to my friends or family. You are just too willing to hurt babies.

From there we go to Doctor R. who brings Dr. Geoffrey Nuss, an urologist with Urology Associates of Texas and a surgeon specialized in reconstruction of the urinary tract, to speak about circumcision.

Doctor R. spends some time making puns and jokes about circumcision.

Doctor Nuss describes the foreskin saying: “there is a redundant portion of skin that covers the glans“. How was it defined that the foreskin is “redundant“? Who ever made that call?

Asked what functions the foreskin has, doctor Nuss goes on: “mainly protecting the glans from the  outside environment but really we don’t… we don’t have… it doesn’t have a major function today“. You can see him choking on his words.

Perhaps he needs to be reminded that “The amount of tissue loss estimated in the present study is more than most parents envisage from pre-operative counselling. Circumcision also ablates junctional mucosa that appears to be an important component of the overall sensory mechanism of the human penis.” Taylor JR, Lockwood AP, Taylor AJ. The prepuce: specialized mucosa of the penis and its loss to circumcision. Br J Urol 1996;77:291-295.

Why remove it, that’s a good question. Many people will remove it for religious reasons” (except that it’s not the person getting it removed the person who practices the religion, which means it is an intromission on a person’s physical integrity, an assault), he goes on: “health related reasons: the American Academy of Pediatrics recommends circumcision to prevent … ” STOP.

The AAP recommends? Let’s see what the AAP ACTUALLY says: “Although health benefits are not great enough to recommend routine circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns.”

And to prevent AIDS, AIDS, or HIV infection“. Unfortunately referring to the African studies in this non-specific way is irresponsible and does way more harm that good. Need we remind our readers that thousands of circumcised Americans have died of AIDS related complications?

But that’s in very young boys, less than six months. Adult circumcision is much different“.

Here we have that other common myth. It’s easier when they are young. “Buy now and you will get!”. See, if the American medical community wished, they could do away with this myth by certifying for use in the United States the devices that were invented for adult circumcisions in Africa. The PrePex, the Shang Ring, the AccuCirc. With these devices the cost of an adult circumcision can decrease from thousands (due to required location and general anesthesia) to a few hundred, like infant circumcision is now. But of course that’s not a good business for the American medical community, as many adults won’t submit since they would know that their foreskin is pleasurable, and the hospitals would lose their role as suppliers of human tissue to the biomedical industry.

Asked if the foreskin makes a different for sex, dr. Nuss answers “I tell men, what you have is what you should have“. He says “changing your foreskin or altering in any way will not provide any benefit” (so what happened with those health benefits he was touting for young boys?) “ and in fact some men will complain that it’s different and they don’t like it. So I don’t recommend circumcision for enhancing sexual performance or sensation

He says he doesn’t recommend that men get circumcised for aesthetic reasons, and he says that when men go to him for circumcision it is due to phimosis.

He says: “Unless kids are [at least] 6 months they don’t have the sensation developed to have a painful experience.”  We just discussed this point at the beginning of the article. Apparently the medical community was too busy in April to read the news.

Asked what is the current trend, he says:  “to circumcise most men still in America however there are many people who are advocating against it.”

Let’s think about this one point. If he knows that adult men who get circumcised often do not like it afterwards, what makes it okay for parents to decide (or for doctors to coerce parents into “deciding”) to alter a baby into a state which, if he had reach as an adult, he would not have liked it?

Asked about complications he says: “Potential complications would be shortening of the foreskin and just an altered cosmetic appearance as an adult. As a kid, you obviously will not know what the difference was as you grow up with it.

Can we send these guys back to the 19th century, where they truly belong?

 

Morris and Cox playing around again – so who are they again?

Sexual Medicine is publishing an article by Brian Morris, Guy Cox and John Krieger, titled “Histological Correlates of Penile Sexual Sensation: Does Circumcision Make a Difference?“.  2 years ago Morris and Krieger had published “Does male circumcision affect sexual function, sensitivity or satisfaction”, in which they said they would soon review the histological studies, so this must be their follow up.

(Please note, in this particular post we evaluate the “no conflict of interest” disclosure of the paper – we will soon take the time to actually respond to the paper).

The appearance of Guy Cox as coauthor is most interesting for us, and particularly its timing.  Almost one year ago we posted an expose of Guy Cox, a former coworker of Brian Morris at University of Sydney, and who used the pen-name of James Badger to publish papers about circumcision, to interact in circlist, to write fiction about circumcision, to review his own articles and fiction in a non-credited website, etc.

Guy Cox, University of Sydney honorary associate professor and circumcision advocate

Guy Cox/James Badger

On March 17th of this year, we received a comment on our article from someone identified as James Badger, accusing us of publishing “a lot of hot air”, acknowledging his identity as Guy Cox, and failing to dispute any of the issues we exposed. You can see the comment – and our response- in the expose.

We responded reiterating some of our questions. One important question was about a very peculiar site that promoted a chastity undergarment for teenagers to prevent masturbation -except with parental permission. This site, boyguard.com, had a contact address which matches lemonred, the hosting company (owned by Guy Cox’s son, Cassian). James Badger had presented this website to circlist as something he found out about. The site also promoted high and tight circumcisions as a way of making masturbation more difficult for the teenagers.

We shared the news that James Badger had commented on our post, and waited to see if he would respond. He didn’t.

Well, when we saw this new paper by Morris, and realized that Guy Cox (James Badger) was one of the coauthors, we were certainly intrigued. And just a couple of nights ago as we were talking with friends about this mess, we went to check the boyguard site and found it down!

Of course this deserved attention, so the first thing we did was check ownership of the domain. One year ago, the registrar for boyguard was private, but the DNS records showed that it was hosted by lemonred (Cassian Cox, Guy’s son). Well, today, the registrar is “SYNERGY WHOLESALE PTY LTD” but the DNS records are still managed by lemonred. The DNS records are simply not pointing to an active website right now.

Boyguard domain resell

Boyguard domain resell

So who is Synergy Wholesale? It’s a company who resells domains. In other words, Guy Cox/James Badger is trying to get rid of the boyguard domain. Of course, after ignoring our questions regarding this website.

synergy

So, now, back to this new paper. It says:

Conflict of Interest: The authors report no conflicts of interest.”

Really? No conflict of interest whatsoever?

How about Brian Morris’ book, “In favour of circumcision”?

How about Brian Morris’ website, circinfo.net?

How about the interesting details in Brian Morris’ website, such as his link #16 (to a password protected circumfetish fiction website)? Or his links to fictitious doctors’ websites (James Badger, Pierre Lacock)?

How about “James Badger”‘s website, aboutcirc.info, linked by Brian Morris and credited to a pen-name?

How about “James Badger”‘s constant interaction in circlist?

How about “James Badger”‘s erotic fiction including the topic of circumcision, such as his “Airport Encounter” book?

How about Brian Morris and Guy Cox’s cooperation on text for “The surgical guide to circumcision”? – Especially considering that neither Brian Morris nor Guy Cox are licensed physicians or have ever performed a circumcision?

How about Guy Cox’s article, “De Virginibus Puerisque: The Function of the Human Foreskin Considered from an Evolutionary Perspective” – where he hypothesizes that the function of the human foreskin is to “form an obstacle to early coitus”?

How about the constant promotion of circumcision by the authors?

Are we sure there is no conflict of interest? None whatsoever?

I simply don’t understand how anyone in the medical community can give any credibility to these individuals.

 

Kenya: NGO forcibly circumcising children – our tax dollars in use

Daily Nation Kenya reported anxiety over several cases of children who were forcibly circumcised by a NGO, “Impact Research and Development Organization”. Allegedly a car from this organization lured boys with candy and drove them to a hospital for circumcision, without any information or consent from their parents. Many of these boys were from cultures where circumcision is not accepted or tolerated.

Sila Boit, Uasin Gishu County Executive for Health (right) and Dr Evans Kiprotich, Director of Health Services in the county talks to boys from Kapsoya Estate in Eldoret Town at the Kapsoya Health Centre on April 22, 2015, where they were taken for check-up, after they were allegedly forcefully circumcised by an NGO. PHOTO | JARED NYATAYA | NATION MEDIA GROUP

Sila Boit, Uasin Gishu County Executive for Health (right) and Dr Evans Kiprotich, Director of Health Services in the county talks to boys from Kapsoya Estate in Eldoret Town at the Kapsoya Health Centre on April 22, 2015, where they were taken for check-up, after they were allegedly forcefully circumcised by an NGO. PHOTO | JARED NYATAYA | NATION MEDIA GROUP

Three officers from the NGO were arrested and booked at Kapsoya Police Post.

Let’s remember that the circumcision programs in Africa are supposed to be voluntary (VMMC – Voluntary Medical Male Circumcision).

In November of 2012, the CDC acknowledged this organization, Impact Research and Development Organization, in an article about progress in voluntary medical male circumcision programs in Kenya.

According to a post dated in 2011 on Impact Research and Development Organization’s website, “IRDO’s Voluntary Medical Male Circumcision program is supported by PEPFAR through a cooperative agreement with Center for Disease Control (CDC)” – So there you have it folks, our tax dollars paying for forceful circumcision of children in Kenya.

 

James Badger/ Guy Cox contacted us

10 months ago we posted about Guy Cox/James Badger. We were surprised to find a comment from Mr. Cox himself on the comment queue, waiting for approval. Contrary to what Mr. Cox said, we were happy to hear from him and to approve his comment, and we added a few questions on facts that we still don’t understand completely.

So we invite our readers to read Mr. Cox’s comment, on our May of 2014 post, “Circumcision, Lies and Fetishism at the University of Sydney