Tag Archives: Circumcision

The Skeptic – Does science support infant circumcision?

We often criticize Brian Morris’ methods and advocacy of circumcision, particularly his underestimating of risks and complications, his denial of the harm, his overestimation of benefits, and his recurrent self-referencing.

It’s good to read others who share our concern. This is a great article by Brian D. Earp and Robert Darby, published on The Skeptic: http://www.skeptic.org.uk/magazine/onlinearticles/articlelist/711-infant-circumcision

It calls attention to an interesting contradiction. Morris argues for circumcision to avoid having to treat urinary tract infections with paracetamol (pain medication) in light of new studies that associate early exposure to paracetamol with an increase in the risk of autism… yet fails to correlate the fact that paracetamol is used after newborn circumcisions.

Anyway, great read. It’s sad that people are still being fooled by Brian Morris’ air of respectability and the scientific community continues playing his game and not exposing his pseudoscientific arguments. Really sad.

NEW CIRCUMCISION “STUDY”: Complication Risks May Increase With Age – Does Medical Necessity?

“Circumcision fails to meet the commonly
accepted criteria for the justification of preventive
medical procedures in children. The cardinal
question should be not whether circumcision can
prevent disease, but how can disease best be
prevented.”
Frisch et al, Cultural Bias in the AAP’s 2012
Technical Report and Policy Statement on
Male Circumcision

Another day, another article. This time, it’s about a study by Charbel El Bcheraoui  published in JAMA Pediatrics, funded by the US Centers for Disease Control and Prevention (CDC). The study claims that “Male circumcision had a low incidence of AEs (adverse events – a euphemism for complications) overall, especially if the procedure was performed during the first year of life, but rose 10-fold to 20-fold when performed after infancy.

The question that El Bcheraoui circumvents is, however, are those circumcisions necessary? Without medical or clinical necessity, are those circumcisions ethical?

Without those considerations, this is nothing more than a sales pitch. “Circumcision! Buy now, or tomorrow it will be 20 times riskier,” El Bcheraoui seems to urge.

But, what are the chances a child will need to be circumcised later on in his lifetime?

What are the reasons a man would have to be circumcised at a later age? Do they increase with time? (Answer: No, they don’t. The majority of men who are left intact, stay that way.)

El Bcheraoui concludes that “Given the current debate about whether MC should be delayed from infancy to adulthood for autonomy reasons, our results are timely and can help physicians counsel parents about circumcising their sons” but this is nothing more than self-interested hogwash. The argument of bodily autonomy is mentioned but not expanded on. In effect, what the author is saying, without daring to say it, is that bodily autonomy can be violated in order to decrease the risk of complications; a risk the author already considers to be low.

If we were to extrapolate the reasoning behind this conclusion, it would be possible to argue that removing the breast buds from baby girls is easier, less traumatic and has less complications than waiting for breast cancer to develop and then perform mastectomies, where breast cancer is the second leading cause of cancer death in women.

The authors did not declare any conflict of interest. But of course it is not surprising that El Bcheroui is affiliated with the Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention. Let’s just quickly remember that in 2009 the CDC was considering promoting universal circumcision to prevent the spread of HIV in the United States, despite pre-existing evidence (from the CDC nonetheless) that the high rates of circumcision in the United States had no effect over transmission of HIV.

It seems nowadays no circumcision article or “study” is complete without the obligatory “benefits outweigh the risks” soundbite from the 2012 AAP policy statement on circumcision. Of course, what is never mentioned is that this is only part of the statement, which is rarely ever quoted in its entirety:

“The American Academy of Pediatrics found the health benefits of newborn male circumcision outweigh the risks, but the benefits are not great enough to recommend universal newborn circumcision” - http://www.aap.org/en-us/about-the-aap/aap-press-room/pages/Newborn-Male-Circumcision.aspx

Circumcision advocates love to quote the AAP, but they could not recommend circumcision in their last statement because, in their own words “the benefits were not great enough.” How is it lay parents are expected to analyze the same “benefits” which couldn’t convince an entire body of medical professionals, and somehow come to a more reasonable conclusion? Why are doctors expected to act on it, and why is the public purse expected to pay?

The AAP said in their last statement that “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 (ie, early or late)” and catastrophic injuries were excluded from the report because they were reported only as case reports, not as statistics. The statement also indicates that “Financial costs of care, emotional tolls, or the need for future corrective surgery (with the attendant anesthetic risks, family stress, and expense) are unknown.”

In the opening statements of this study, El Bcheraoui estimates that 1.4 million circumcisions are performed in medical settings annually in the United States. This appears to contradict a previous statement by none other than El Bcheraoui himself, claiming a rate of 32.5% in 2009. Perhaps he expects the 2012 AAP Policy Statement to result in the resurgence of circumcision rates.

The study reviewed the medical history of approximately 1.4 million males circumcised between 2001 and 2010, and found that approximately 4,000 infants had suffered complications, leading them to calculate a rate of complications (adverse events) of less than 0.5%

This would mean, using the data they present, that every year, between 5,600 (0.4%) to 7,000 (0.5%) infant males will suffer complications from circumcision; circumcisions that will in all likelihood be medically unnecessary.

This would not include those complications that can be minor or undetected by the parents (skin tags, skin bridges, uneven scarring) or those that will not be detected until much later (pain caused by tight erections, lack of sensitivity).

The researchers note that some complications might not have been picked up because they were reviewing claims data on problems that typically occurred within the first month following the circumcisions.

This would likely exclude meatal stenosis. High prevalence of meatal stenosis has been found in circumcised males (see here and here), possibly as consequence of ischemia (poor blood supply) to the meatus or permanent irritation of the meatus caused by friction with the diaper and resulting in scarring.

A recent ecological analysis by Ann Z. Bauer and David Kriebel found a correlation (but not causation – further studies are needed) between early exposure to paracetamol and other analgesics, and autism spectrum disorders (ASD). This took into consideration that most newborn circumcisions before 1995 used no pain relief at all, but with growing awareness of the pain of circumcision and increasing use of paracetamol, a sudden rise on the rates of male ASD occurred.  According to this analysis a change of 10% in the population circumcision rate was associated with an increase in autism/ASD prevalence of 2.01/1000 persons (95% CI: 1.68 to 2.34) ”

These findings of course would not have been included in El Bcheraoui’s paper, as this would be out of existing billing codes and administrative claims within the first month from the procedure.

So, let’s just think for a moment, if these circumcisions are not necessary, if these circumcisions are “elective,” then what is the tolerance for errors and complications? El Bcheraoui claims that a 0.5% complication rate is low. But how low is it when it means 5,600 to 7,000 babies who will suffer complications annually? And what kind of complications are we talking about?

These low rates fail to explain the increasing rates of circumcision revisions as well.

How many cases like the one of David Reimer can we afford to have before it is ethically wrong, morally wrong? How many more like Jacob Sweet?

How many MRSA infections?

How many partial or full ablations of childrens’ penises, like that baby in Memphis and that other baby in Pittsburgh last year?

How many infections with Herpes?

How many deaths?

Catastrophic complications, rare or not, mean destroyed lives. Not numbers. And to destroy lives of innocent babies in the name of “religious, ethical and cultural beliefs” is simply not right. Because there is no medical indication for surgery in healthy, non-consenting minors, any complications above zero is ethically unconscionable.

On The Stream: To Cut or Not To Cut – Brian Morris, Richard Wamai on circumcision

Spotting contradictions between circumcision promoters on Al Jazeera’s “On The Stream: To Cut or Not To Cut”

If you are outside the U.S., you can watch the video here: https://www.youtube.com/watch?v=GitOnW-nzck&sns=fb

If you are in the U.S., this link may work: http://bc19.ajnm.me/864352181001/201404/3132/864352181001_3492775214001_FULL-to-BC-AJE-0421.mp4

Richard Wamai

Richard Wamai

At 8:25 Richard Wamai denies risk compensation

Richard Wamai: There is no evidence out of Sub Saharan Africa where male circumcision is being promoted to prevent millions of men from getting infected with HIV that somehow there is disinformation and that men get circumcised and reduce using condoms or change behavior, we don’t have that evidence, it simply does not exist.

At 20:21, after a YouTube blogger argues that we don’t need to amputate every tissue that becomes infected, and calls for “our bodies, our choice”,  Richard Wamai responds:

Richard Wamai: I totally disagree with that. First off all, if we talk about human rights, adult men can determine whether they want to keep their foreskin or not. If I know the benefits of circumcision, then I have the right to make the decision. For somebody to say that it is amputation, that is not quite accurate at all.

[Richard Wamai is co-author of "A snip in time: what is the best age to circumcise?" where he, along with Brian Morris and other circumcision advocates, argues that infancy presents a "window of opportunity" for circumcision. Infants cannot provide informed consent.]

Richard Wamai

Richard Wamai

At 22:25 approximately:

Moderator: I don’t understand if you are circumcised as a man, you are still putting a condom on. Why don’t you put a condom on in the first place?

Richard Wamai: Well, why, you don’t, because, you know what the rate of condom use is in South Saharan Africa?

Moderator: But you have to use it to have protection

Richard Wamai: You know what it is? Very few people ever use a condom consistently so we need to do something, that’s why we are doing studies, that’s why we are doing studies  to test whether there could be a microbicide, a vaginal stuff, gel that women can use…

Moderator: Because men don’t like to wear condoms?

Richard Wamai: Well, that too, but I mean, we know that condom use is very low…

At 23:22 Brian Morris tries to interrupt, I have not been able to figure out what he says. The show goes to a commercial break. Upon return, John Geisheker from Doctors Opposing Circumcision presents his critique of the African circumcision trials.

Brian Morris and John Geisheker

Brian Morris and John Geisheker

John Geisheker: (…)For one thing, the figure of 60% does not rise to the level of immunization, which must, by standard of bioethics, be in the high nineties. A 60% protection of anything is merely a roll of the dice. All that a person is doing who is circumcised and then not bothering to use the usual protection of ABC [abstinence, be faithful, condoms] is playing bio-roulette, Russian roulette. (Continues explaining the real meaning of the 60% figure)

Brian Morris: John is a lawyer, he is not a scientist, he is not a doctor [never mind that Brian Morris is not a medical doctor either], trials are not about following people for ever and ever, trials follow people until they find a statistical difference and in this case the statistical difference happened so soon that the monitoring body stepped in and stopped the trials because it would be unethical to continue them since the evidence showed such a strong protective effect

Moderator interrupts for a back story. Then Brian Morris continues

Brian Morris: I also completely dispute John’s misunderstanding of immunology and vaccines. Vaccines some are quite effective, but look at one of the more common vaccines, the flu vax, the effectiveness of that in the population is about 80%, which is also about the effectiveness of condoms, and with the long, long term follow up of HIV trials and roll out, the protective effect of circumcision has risen over the years, so it’s now approaching that 80% mark, and in public health we advocate [I keep missing this word, sorry] interventions, not just condoms, not just circumcision, but also a behavioral practice, anything else that we can show does work. We don’t say oh let’s just go this way because we like it. We use all of the effective methods and circumcision is one of THE MOST effective [vocal emphasis], and as Richard pointed out condoms cannot be used but once a man is circumcised he is circumcised for life and that is significant. Condoms have to be put on the penis before any sexual contact…

…..

So, let’s point some issues here. In Richard Wamai’s view, condom use rate cannot be increased significantly, so it seems better to go on a crusade to circumcise millions of men, even though men are not running to take the offer. And while Wamai denies risk compensation, he also denies that condom use rate can be increased (which is a risk compensation behavior on its own). And yet he seems to put hopes on hypothetical future gels for women to use, when men cannot (in his mind) be expected to use condoms.

Brian Morris on his end appears to be doing what he usually does: inflating the benefits and overlooking the risks. In his mind the protective effect has been increasing and is close to the 80% mark.

About this increasing protective effect, I’m reminded of this text by Des Spence (BMJ 2010;341:c6368) (we highlighted some keywords):

Study design—Study populations are biased by design. Only high risk, unrepresentative populations are studied because they are the most likely to show an effect. These data are then extrapolated to low risk populations of people who never benefit—statins are studied in Scotland and prescribed in Surbiton. The inverse care effect also means that people at low risk are more likely to seek treatment and comply with it.

The same article indicates:

Statistical trickery—There is systematic and cynical use of statistics to manipulate results [see following paragraph]. This dishonesty—the dark magic of surrogate and composite end points, “validated” questionnaires, the premature ending of studies, the reporting only of relative risks , and the lack of long term follow-up—is just cheating.

The famous 60% figure is a relative risk, a comparison between two very small percentages, as John explained in the debate until Brian Morris interrupted.

One fact often overlooked about the African trials is that the number of individuals lost to follow up was 3 times more than the total number of sero-converted individuals. This alone casts serious doubts over the “statistical significance” of the results.

Trying to listen to Brian Morris and Richard Wamai, we are reminded of the technique known as Gish Gallop: “The Gish Gallop is the debating technique of drowning the opponent in such a torrent of small arguments that their opponent cannot possibly answer or address each one in real time. More often than not, these myriad arguments are full of half-truthslies, and straw-man arguments - the only condition is that there be many of them, not that they be particularly compelling on their own. They may be escape hatches or “gotcha” arguments that are specifically designed to be brief, but take a long time to unravel.

Another important detail, Richard Wamai argued that to call circumcision amputation is wrong because every adult man has the right to decide over his body. John Geishener made clear that he and his organization (Doctors Opposing Circumcision) agree that every adult man has the right to do anything to his own body, and that their opposition is to forceful circumcision of infants and children, and to using the African trials as rationale to push for infant circumcision in the United States (extrapolation).  Brian Morris and Richard Wamai are, however, coauthors of a paper called “A snip in time: what is the best age to circumcise?” where they argue that infancy presents a “window of opportunity” for circumcision. So how would Richard Wamai defend his argument that circumcision is not amputation, after arguing in writing for circumcision during infancy?

But please dear readers, don’t take our word; watch the video, do your best research, evaluate the evidence, evaluate the advocates one way or another, and formulate your own conclusions.

Related News:

ZIMBABWE: Men are not buying circumcision…

ZIMBABWE: …so they’re doing it to babies

UGANDA: Myths about circumcision help spread HIV

ZIMBABWE: Circumcised men abandoning condoms

Evidence that “simply does not exist” – according to Wamai:

Botswana – There is an upsurge of cases of people who got infected with HIV following circumcision.

Zimbabwe – Circumcised men indulge in risky sexual behaviour

Nyanza – Push for male circumcision in Nyanza fails to reduce infections

Did a Mayo clinic study confirm health benefits on circumcision? Or Brian Morris, and how to manipulate public opinion on circumcision using clever headlines

Recently, circumcision has resurfaced as a hot topic in the media. All last week, numerous articles with misleading titles were published by big name media outlets,  promoting the latest “study,” which supposedly “confirms” the so-called “benefits” of circumcision.

Here are some of the titles:

Infant circumcision is the healthiest choice, new study claims
Researcher says circumcision should be offered like childhood shots
Circumcision should be offered ‘like vaccines’ to parents of boys
Study determines circumcision comparable to vaccination” (Israel and Stuff)
Call for circumcision gets a boost from experts
Circumcision rates declining in US infants, raising health risks later in life
Circumcision should be seen ‘in same light as childhood vaccination’: study
Circumcision benefits far outweigh the risks, finds study IN MAYO CLINIC PROCEEDINGS (elsevier connect)
MAYO ON MILAH – Mayo clinic study confirms health benefits on circumcision” (The Jewish Press)
New Journal argues circumcision should be mandatory
The benefits of circumcision outweigh the risks 100 to 1
To snip or not to snip – academic claims circumcision should be treated like vaccination

But, is it true? Did the Mayo Clinic perform a new study on circumcision? And, was the study published legitimate?

To the casual observer, these headlines appear to say all they need to know. When they approach a conversation about circumcision, they will remember one of these headlines and quote it or paraphrase it without any real knowledge of what it means or what really happened. And this is exactly what some sectors want.

Now, let’s go step by step:

First off, the Mayo Clinic did not perform a study on circumcision.

The study being discussed is not new, original research, but a literature review of select articles.

The article was not written by unbiased researchers. The three authors have been known to promote circumcision for many years.

To call this article a “Mayo Clinic study” is misleading and manipulative. Independent authors submitted the article to the journal of Mayo Clinic, Mayo Clinic Proceedings. The Editorial Board procured peer reviewers, who then approved the article for publication. This is very different from having actual staff researchers or commissioned experts performing a study at the Clinic’s request. The article was not written at Mayo Clinic’s request or by Mayo Clinic personnel.

Related: Problems with Peer Review

Related: Is peer review broken?

This article (or literature review) was written by Australian retired professor and molecular biologist Brian Morris, and co-authored by Dr. Thomas Wiswell  and psychologist Stefan A. Bailis, both of whom had already co-written other publications promoting infant circumcision with Brian Morris.

Some articles referred to Brian Morris as Dr. Morris. While the fact that Brian Morris has a PhD makes this reference technically correct, it is misleading because it makes it sound like he is a qualified medical physician, when he does not hold a medical degree of any kind. Brian Morris is not a physician or a medical doctor in any way, and the public should know that. He is a professor of molecular science, and does not hold a degree in urology, surgery, pediatrics or epidemiology.

In their last Policy Statement on circumcision (2012), the American Academy of Pediatrics tries desperately to push the soundbite that “The benefits of circumcision outweigh the risks.” Be that as it may, the AAP stops short of the recommendation that circumcision advocates like Brian Morris were hoping for.  In this new review, Brian Morris takes a position far more extrem, going as far as comparing circumcision with vaccines; yet, the implied goal of both papers is to get Medicaid and insurance companies to re-establish coverage for neonatal circumcisions in those U.S. states where they no longer cover it.

This review makes claims that are manipulative and hard to prove, for example that the  “benefits exceed risks by at least 100 to 1” and that “over their lifetime, half of uncircumcised males will require treatment for a medical condition associated with retention of the foreskin”.

Because awareness that circumcision of minors violates human rights has been moving from the “anti-circumcision lobby groups” (as Brian Morris refers to pro-genital integrity organizations on his website) to mainstream organizations such as the Royal Dutch Medical Association, the Parliamentary Assembly of Council of Europe, the International NGO Council on Violence against Children and many others, professor Morris now is trying to manipulate the language to suggest that  “not circumcising a baby boy may be unethical because it diminishes his right to good health“, again a claim hard to substantiate.

Morris’ desired conclusion is that “as with vaccination, circumcision of newborn boys should be part of public health policies” particularly on “population subgroups with lower circumcision prevalence“.

Unsurprisingly,  the same authors, in cahoots with some of the promoters of circumcision in Africa, presented a paper called “a snip in time” two years ago, arguing that infancy is the best time to circumcise and that “by making MC (male circumcision) normative in a community, [...] the prospect of [psychological problems] would be largely eliminated“.

As usual, in this new article Morris references his own previous publications numerous times. Out of 80 references, he is author or co-author of at least 12 of them. On the contrary, the American Academy of Pediatrics in their 2012 Policy Statement did not quote a single publication by Brian Morris.

So this is the problem:

In the eyes of the casual observer (and reporter), the fact that this article is being published by Mayo Clinic Proceedings (a publication of the Mayo Clinic) is almost equivalent to saying that the Mayo Clinic performed an original study and/or agrees with it. While this is certainly not true, it is an easy assumption for people to make or believe.

Media headlines are used to manipulate the general opinion by using the more dramatic claims from the abstract to embed them in the collective consciousness. Most people will not read past the headlines, and will reach their conclusions based on this limited information.

Few reporters and authors dare to criticize peer reviewed publications. In this case, one notable exception is Wellington Professor, Dr. Kevin Pringle, who perfectly summarized: “Vaccination is a low-risk intervention to prevent a problem with significant adverse outcomes. Circumcision is an intervention with significant risks (ignored or minimised by the authors of this paper) to prevent problems that will not develop in the vast majority of males; most of which can be simply addressed if and when the need arises.

For those wishing to seriously challenge Brian Morris’ new article, the following is a response from the Editor-in chief of the Mayo Clinic Proceedings journal:

April 4, 2014 at 2:46 am

The article, “Circumcision Rates in the United States: Rising or Falling? What Effect Might the New Affirmative Pediatric Policy Statement Have?” was authored by 3 experts in the subject matter. All 3 have previously authored numerous scientific articles on this topic, and their combined credentials are far more than adequate to allow them to authoritatively address the topic.

Once submitted to Mayo Clinic Proceedings, the aforementioned manuscript was rigorously peer reviewed by other experts in the field, revised, and later accepted for publication. The Journal’s Editorial Board oversaw this process. All of these are typical processes for the review and acceptance of a manuscript. As a result of these processes, the approved manuscript was deemed to provide solid scientific information and appropriate speculative synthesis on the subject matter.

Formal comments regarding this article and other materials published in Mayo Clinic Proceedings should be directed to the journal, in the form of a Letter to the Editor. That communication should be submitted through the journal’s manuscript management portal, http://mc.manuscriptcentral.com/mayoclinproc . There, those wishing to comment will find instructions on the allowable content and other guidelines for formulating a Letter to the Editor. The comments within the Letters must be restricted to the scientific matter under investigation, and will be evaluated by a peer-review process to determine their educational and clinical value to the general/internal medicine readership of the Proceedings. In general, only 15% to 20% of all submissions to the journal are eventually accepted for publication. Ad hominem attacks on the authors, the Journal, or its sponsoring institution, Mayo Clinic, will not be permitted in any published Letters. Further, any letters eventually accepted for publication will be accompanied by a published response from the authors.

William L. Lanier, MD
Editor-in-Chief
Mayo Clinic Proceedings

Why does Brian Morris link his site to a circumfetish page?

The casual observer landing on Brian Morris‘ website (circinfo.net) may believe that it is in fact “an evidence-baised appraisal”. However, as one advances through it, one can’t stop but wonder why Brian Morris includes links on his website to a circumfetish page.

A circum… what?

Yes, a circumfetish website. A page to share circumcision-themed erotica, often involving forced circumcisions, sexual acts during circumcisions, often involving minors, and other similar smut.

Could it be an oversight? A site that changed after Professor Morris initially linked to it?

No. In fact the link has existed for years on Morris’ website, and the page itself has existed for years as it is, known by many who are aware of Morris’ darker links.

The page says it was created for the “benefit of the circlist members” and “not aimed at the general public”. One would wonder why.

We will not reveal the “secret password”, but let’s take a look at this dark side.

Links and resources page, on Brian Morris’ website.

morris1

Notice link #16.

morris2

When we click on link #16, a new tab opens:

morris3

We clicked on the last link (images) and entered the password. (We will not reveal the password at this time)

morris4

We clicked on one of the “stories”. Notice this one is about a 15 year old whose dad “needs” to have him circumcised and then goes on to tell the story of dad’s own forced circumcision during adolescence. We don’t need to see it all. We already feel dirty reading this garbage.

morris5

Now, given how meticulous Brian Morris is with his references, can anyone think that it is an accident that his website has included a link to a password protected circumcision fetish website describing forced circumcisions, sexual acts during circumcisions involving minors and similar trash,  for years?

Rabbi Avrohom Cohn proudly breaks the law during ritual circumcisions

w-metzitzahbpeh-032614.jpg

There are so many things wrong with this, I can only refer you to the article on Forward, about how this New York City mohel (and chairman of the American Board of Ritual Circumcision) proudly breaks the law requiring him to obtain signed parental consent from parents before performing the ritual of metzitzah b’Peh (oral suction) after circumcision, even when parents have instructed him not to do it.

Where do we draw the line between child endangerment and religious freedom?

Please read: http://forward.com/articles/195306/rabbi-performs-controversial-metzitzah-bpeh-circum/?p=all#ixzz2xBoOTYwT

700x450-crop-90-images_djmediatools_a.jpg.2

Circumcision Goes Wrong: 1-yr-Old Loses Manhood to Cutting

Posted: http://frontpageafricaonline.com/index.php/news/963-circumcision-goes-wrong-1-yr-old-loses-manhood-to-cutting

1 year old boy loses his penis in a circumcision performed on January 5th by a doctor in Liberia. Phillip Zinnah, Sr. 25, father of the boy explained that he took his son to the TB Annex to one Dr. Nimley for circumcision, but it all went wrong when the doctor completely cut off the boy’s penis, leaving him in severe pain. The doctor is not responding for the damages, and the institution, TB Annex, says they don’t perform circumcisions and this would have been done in secret by the doctor.

Meanwhile, a child’s life has been irreversibly damaged in a way to seems to echo the baby hurt by a rabbi from Pittsburgh and a Memphis baby hurt at Christ Community Health Centers last year. A Saudi baby also had his penis partially cut off last November.

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What Brian Morris, in conjunction with Richard Wamai (research on HIV), Aaron Tobian (Johns Hopkins University), Ronald Gray (Johns Hopkins University and director of one of the 3 African trials on HIV and circumcision), Robert Bailey (responsible for another one of the 3 African trials), Daniel Halperin (author of several papers on HIV and circumcision),  Thomas Wiswell (author of the often cited study on circumcision and UTIs) and others, wrote on their propaganda paper from 2012, “A ‘snip’ in time“:

Infant circumcision is safe, simple, convenient and cost-effective. The available evidence strongly supports infancy as the optimal time for circumcision.“ 

Of course, for those illustrious individuals, this child’s horrible experience is simply an “adverse event“. According to a 2012 paper by Robert Bailey cited by the World Health Organization:

“In developed countries, adverse events following neonatal circumcision are well documented and their incidence is very low, from 0.2 to 0.6%.5 Before the RCTs, outcomes in Africa for male circumcision among adults were poorly documented. In a review,6 adverse event rates following African male circumcisions ranged from 0 to 24%. The RCTs, which provided services in a clinical trial setting, reported the following adverse event rates: 3.8% in Orange Farm, South Africa; 1.5% in Kisumu, Kenya; and 3.6% in Rakai, Uganda.1,7,8 Most recently, at the former Orange Farm RCT site, 1.8% of medical male circumcisions offered in one high-volume facility resulted in an adverse event”

Let’s stop treating children as statistics. Let’s respect children. Children of all genders deserve to grow with intact genitals.

2014 – New case of neonatal herpes following circumcision and oral suction – metzitzah b’peh

https://a816-health29ssl.nyc.gov/sites/NYCHAN/Lists/AlertUpdateAdvisoryDocuments/2014%20-%20NeonatalHSV.pdf

 Direct orogenital suction during ritual Jewish circumcision (also known as metzitzah b’peh) has been documented to transmit herpes simplex virus (HSV) type 1 to newborn males (1-4). In January 2014, the New York City (NYC) Department of Health and Mental Hygiene received a report of a new case of HSV-1 infection in a newborn male infant following direct orogenital suction. To date, a total of 14 laboratory-confirmed cases of HSV-infection attributable to direct orogenital suction have been reported to the Health Department since 2000. Two of these infants died, and at least two others suffered brain damage (4).

In the most recent case, the infant was the term product of a full-term pregnancy and normal vaginal delivery. He had ritual Jewish circumcision including direct orogenital suction on day of life 8. On day of life 13, at a well-child visit, a rash was noted on and around genitals. The baby was treated with topical antibacterial ointment. On day of life 16, the baby returned to his provider for worsening rash, and a topical anti-fungal was added to the regimen. On day of life 18, lesions progressed to include the perineum and the right foot. HSV infection was suspected, and the infant was referred to a pediatric dermatologist. The next day, upon evaluation of the baby, the dermatologist, also suspecting HSV, collected specimens for direct visualization and for viral culture, and the baby was admitted to a hospital for treatment. The location of herpes lesions (on the genitals and on the foot, a dermatomal distribution reflecting involvement of sacral nerves), viral type (HSV type 1, which is commonly found in the mouth of adults), and timing of infection (5 days after circumcision) are consistent with transmission during direct contact between the mouth of the ritual circumciser (mohel) and the newly circumcised infant penis.

The document is co-signed by Susan Blank, one of the members of the AAP Task Force on Circumcision from the infamous policy statement of  2012 – the one that says that “the benefits outweigh the risks” – and the one that does not have the guts to say that “orogenital suction” (baby penis in adult’s mouth) should not be performed. So much for that Dr. Blank.

1476561_10100402081723815_873512049_n

Some Catastrophic Complications of Circumcision Recorded During 2013

This is what the American Academy of Pediatrics (AAP) says about catastrophic complications from circumcision, on the 2012 Policy Statement on Circumcision and 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,
198–206 transmission of herpes
simplex after mouth-to-penis contact
by a mohel (Jewish ritual circumcisers)
after circumcision,207–209 methicillinresistant
Staphylococcus aureus infection,
210 urethral cutaneous fistula,211
glans ischemia,212 and death.213

January 2, 2013. TURKEY: Boy loses penis in circumcision
http://www.hurriyetdailynews.com/Default.aspx?pageID=238&nid=38346&op=sent

February 14, 2013. BELGIUM: Male circumcision tied to less sexual pleasure
http://www.reuters.com/article/2013/02/14/us-health-male-circumcision-idUSBRE91D1CO20130214

February 19, 2013. BRAZIL: Study: mortality of medical circumcision, one death in 7700
http://www.ncbi.nlm.nih.gov/pubmed/23386015

February 21, 2013. JAKARTA: 3 year old Boy with haemophilia bleeds after circumcision
http://www.thejakartapost.com/news/2013/02/21/toddler-with-hemophilia-bleeds-after-circumcision.html

February 28, 2013. JAKARTA: Mother kills 9 year old son after circumcision shrinks penis
http://www.brisbanetimes.com.au/world/indonesian-mum-kills-son-over-penis-size-20130228-2f94r.html#ixzz2MDuQOUQn

March 5, 2013. Queens Infant Disfigured in 2011 Botched Bris, Lawsuit Charges
http://www.dnainfo.com/new-york/20130305/forest-hills/queens-infant-disfigured-botched-bris-lawsuit-charges

March 8, 2013. Baby bleeds after circumcision, suffers seizures and dies two days later. Hospital and family deny that circumcision was the cause.
http://circumstitionsnews.blogspot.com/2013/03/sacramento-another-circumcision-death.html

March 16, 2013. UNITED STATES: More than $80 million paid out for botched circumcisions since 1985
http://www.arclaw.org/resources/settlements

April 6, 2013. NEW YORK. Two Infants Contract Herpes Following Circumcision and Metzitzah b’Peh.
http://www.medicaldaily.com/articles/14560/20130406/circumcision-male-circumcision-jewish-ultra-orthodox-herpes-hiv.htm#445eUUYH8QRI6GtZ.99

May 29, 2013. CHICAGO: $1.3 million for botched circumcision, baby had the tip of the glans amputated during his circumcision in 2007
http://www.suntimes.com/news/metro/20417085-418/jury-awards-13m-for-newborns-botched-circumcision-attorneys.html

May 29, 2013. MOROCCO. A 3 year old child had part of the glans amputated during a hospital circumcision. This was reported online by the family, with a text in Arabic and a horrific youtube video (which was later deleted). The mother commented in our blog to let us know that a Canadian urologist had already seen the child and recommended long term follow up in case there was stenosis later, which may suggest that they were either able to re-attach or otherwise close the wound without further complications.
http://circwatch.org/boy-3-years-old-suffers-partial-amputation-of-the-glans-during-circumcision-in-morocco/

June 7, 2013. TEL AVIV. Baby Dies in Israeli Hospital following Circumcision. Rabbinate denies any connection with the procedure. Baby stopped breathing minutes after the circumcision.
http://www.jewishpress.com/news/breaking-news/baby-dies-in-israeli-hospital-following-circumcision/2013/06/07/

June 10, 2013. EGYPT: Girl dies during circumcision at clinic
http://english.alarabiya.net/en/News/middle-east/2013/06/10/Egyptian-girl-dies-while-being-circumcised.html

June 17, 2013. SAUDI ARABIA: Doctor who botched 7 circumcisions gets 6 months
http://gulfnews.com/news/region/egypt/egyptian-doctor-convicted-of-botched-surgery-1.1198313

June 20, 2013. SOUTH AFRICA: R2.2M for botched medical circumcision of a child in 2009. He suffered severe burning, infections and a loss of his normal penile tissue after the procedure.
http://www.iol.co.za/news/crime-courts/r2-2m-for-boy-s-botched-circumcision-1.1534852

July 7, 2013. CHINA: man loses penis after botched circumcision
http://www.malaysia-chronicle.com/index.php?option=com_k2&view=item&id=125131:ouch-penis-amputated-after-botched-circumcision&Itemid=4#ixzz2YRJLaCh6

July 8, 2013. 20 more die, nearly 300 in hospital in botched circumcisions in Eastern Cape, South Africa
http://www.news.com.au/world-news/circumcision-ritual-kills-30-tribesmen-in-south-africas-eastern-cape/story-fndir2ev-1226675702537

5 men held for about 30 botched circumcision deaths in Eastern Cape, South Africa
http://www.news24.com/SouthAfrica/News/5-held-for-botched-circumcision-deaths-20130708

UGANDA: Man loses penis in circumcision botch – July 2013
http://www.newvision.co.ug/news/645118-man-loses-penis-in-medical-circumcision.html

JULY

Boys forcefully circumcised in South Africa, several botched procedures
http://www.iol.co.za/news/crime-courts/r3m-claim-for-six-botched-circumcisions-1.1594608#.Umt1WlOhs_c

Surgery on intersex children could be unconstitutional – after sex reassignment of an intersex boy in State custody in S.C. (castration and amputation of penis)
http://www.splcenter.org/get-informed/news/federal-court-says-sex-assignment-surgery-on-child-could-violate-us-constitution-r

AUGUST

Two more babies reported to have contracted Herpes after metzitzah b’peh during Jewish circumcision in NYC. August 2013
http://newsok.com/babies-herpes-linked-to-circumcision-practice/article/3875218

More men seeking legal advice after botched infant circumcisions in Australia.
http://www.perthnow.com.au/news/western-australia/botched-circumcisions-on-the-rise/story-fnhocxo3-1226701536216

4 year old boy dies after hospital circumcision in South Africa. August 2013
http://www.iol.co.za/news/south-africa/gauteng/child-dies-after-circumcision-at-hospital-1.1563203#.Ug6TD6z2L2w

Nearly 80 boys and young men die after traditional circumcisions in South Africa. August 2013
http://www.africanspotlight.com/2013/07/20/when-circumcision-can-mean-death-in-south-africa/

NOVEMBER

UAE baby has penis partially cut off during circumcision. November 2013
http://www.emirates247.com/news/18-day-old-baby-s-organ-partially-cut-off-during-circumcision-2013-11-14-1.528015

UK Doctor accused of botching circumcision quits NHS – in order to perform circumcisions independently
http://www.bbc.co.uk/news/health-24961405

Tennessee baby suffers amputation. August 2013. Reported November of 2013
http://www.myfoxmemphis.com/story/23912521/mother-upset-over-botched-circumcision#axzz2p4dLMw5W

November 28, 2013. A baby died during a medical circumcision in Afghanistan. The parents wanted to avoid the pain of a later circumcision without anesthesia. The anesthesia was improperly applied and the baby died as a consequence. This was only reported on a facebook post which was later deleted by the family.

DECEMBER

Brooklyn Rabbi botched circumcision of baby with hypospadias. December 2009, reported December 2013.
http://www.courthousenews.com/2013/12/05/63485.htm

Canadian Doctor barred from performing circumcisions after more than 80 botched procedures. Botched procedures recorded since 2010. News reported December 2013
http://www.montrealgazette.com/health/Doctor+barred+from+performing+circumcisions+after+dozens+botched+procedures/9323461/story.html

Jewish baby in Pittsburgh has penis cut off during Jewish circumcision. April 2013. Reported December 2013
http://www.dailymail.co.uk/news/article-2530755/Jewish-Rabbi-sued-accidentally-SEVERING-newborn-baby-boys-penis-Bris-Ceremony.html#ixzz2otJjZ9Ht