Tag Archives: Culture

Subtle language to perpetuate the fraud – by Touro Infirmary

I believe we all, regardless of whether we oppose circumcision of children, or promote it, can agree that circumcision is not a necessary procedure.

In fact, the third paragraph of the American Academy of Pediatrics’ 2012 Policy Statement on Circumcision starts: “Although health benefits are not great enough to recommend routine circumcision for all male newborns“. Then it goes on to boast the “benefits” and endorse insurance coverage of the procedure.

Nevertheless, the important point is, the procedure is considered elective. Intactivists and the medical community disagree over who has the right to “elect” the procedure, but there is no medical view that considers the procedure necessary.

Which is why it is important to see how subtle language is used to convince parents otherwise.

Touro Infirmary

Touro Infirmary, Louisiana

We were alerted to Touro Infirmary’s verbiage and had  the chance to verify it on their website. Touro, founded in 1852, claims to be New Orleans’ only community based, not-for-profit, faith-based hospital, and their “about us” page claims they have always  taken a progressive path.

But are they progressive when it comes to male newborns’ genitalia?

The “before delivery” page reads:

You may have already signed the “Consent for Circumcision” for your male child when you signed your other consents at 36 weeks. If not, this consent will also need to be signed shortly before the circumcision procedure is done.”

Notice the language: this consent will need to be signed before the procedure is done. There is no question of whether you are the parents have decided. The language presents circumcision of the male child as something inevitable, and the consent form as something that just needs to be signed so we can move forward and be done with this.

The “after delivery” page then starts with this question and answer:

“I have heard that after the birth of my baby, the baby will remain in my room, with me, rather than go to the nursery. Is this true?”
“Touro offers “rooming-in/mother-baby care” before and during the newborn’s initial bath and examination by the nurse and pediatrician. Of course, circumcisions and other necessary procedures are done in the nursery, not in the mother’s room.”

Notice the wording: “circumcision and other necessary procedures” which seems to imply  that circumcision is one of those necessary procedures. In fact, it seems it is so important that it is the first one mentioned!

The only place where they hint that circumcision is not necessary or otherwise mandatory is on their example of a birth plan, which includes this line:

“If your baby is a boy, do you want to have him circumcised?”

The website makes no attempt to educate parents on why they would want or not, to have their male child circumcised. But by using careful language,  they present circumcision as a necessity, as something that is simply done. And by doing this, they attempt to ensure the perpetuation of male infant circumcision in the United States.

Touro, shame on you.

 

Is it or is it not, Joe DiMaggio?

In an interesting twist of events, the Joe DiMaggio Children’s Hospital tried to deny that the child at the center of the Nebus vs Hironimus dispute, “is or has been” a patient. Shortly afterwards, a copy of a pre-surgical assessment printed on Joe DiMaggio Children’s Hospital at Memorial letterhead, was posted.

Joe DiMaggio Children's Hospital denies that Chase is or has been a patient

Joe DiMaggio Children’s Hospital denies that Chase is or has been a patient

See the screenshot of the pre-surgical assessment, dated 6/4/2015 (first visit) at the bottom of this post.

On it, we can see the typical excuses for circumcision: “father reports frequent urine trapping and ballooning of foreskin. Also has noted mild erythema of distil[sic] foreskin

Ballooning is normal at that age, it’s one of the ways nature has to stretch the balanopreputial lamina to desquamate it. There can be several causes to redness (erythema), from too much soap or improper rinsing, to a mild irritation, to rubbing, to balanitis; all of those causes are usually easily treatable and don’t require circumcision.

The review mentions:

  • “penile pain” – do you cut parts of your body when you have pain, or do you find the cause of the pain?
  • “ballooning of foreskin” – again, not a cause for concern at this age, and
  • “foreskin not retractable”. Per Oster, less than 30% of boys can retract the foreskin at Chase’s age, so again, it’s not a cause for concern.

Down the paper, it reiterates:

  • “Foreskin reduces approximately 30 percent” – foreskin shouldn’t be retractable yet and nobody should be retracting it – indication that doctor was fondling his penis to see whether it would retract or not.
  • “Mild foreskin inflammation” – this is, again, the redness mentioned above; so, if you had inflammation in one ear, would you cut your ear? or treat it? how is this medicine?
  • “Urine noted under foreskin” – the foreskin traps moisture, it’s normal and more in children, every male in the world who has a foreskin maintains a certain moisture between the foreskin and the glans, it’s how mucosas work; to try to make this into a pathological situation is like saying that moisture inside the mouth is indication of improper hygiene, it simply makes no sense!

The paper does not mention the tendency to form hypertrophic scars, which has been noted on a previous surgery, and which could have negative results in a circumcision.

Then, the Assessment and plan continues:

Discussed pros and cons, RCA in detail with father and aunt as relatives to elective circumcision. They have asked that we proceed.

Here we can see that the doctor refers to the circumcision as “elective”. He is not recommending it, he is “discussing pros and cons”. In other words, the procedure is not medically necessary. The child has no condition requiring the procedure. Dr. Birken is clearly washing his hands over the procedure: he didn’t recommend it, the father elected it.

It’s clear from the form that the circumcision is not necessary, and the doctor wants it to be evident so he can dodge any blame later. That’s why he is calling it elective and reiterating that the father gave the go ahead.

The problem is also, if the father elected it (because it is not medically necessary), then Medicaid should not cover the procedure at all. But of course we know that this is where medical fraud is committed daily in this country. Should Medicaid cover this procedure, do not doubt there will be clear investigations.

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The court of public opinion speaks against the circumcision of 4 and 1/2 year old in Florida

Hironimus2
While the Joe DiMaggio Children’s Hospital keeps tight silence over the reported scheduled circumcision, activists and public from all over the world rush to the facebook page of the hospital to express their distaste for what a German commenter called a “middle-age procedure”.

Posts to the hospital, reviews, comments on the reviews, comments on the posts of the facebook page of the hospital. Allegedly the hospital started deleting comments yesterday (Tuesday) but gave up given the high numbers.

New Times Broward-Palm Beach, Palm Beach Post and ABC 25 WPBF were among the first news outlets to pick up the information, along with several bloggers and discussion forums.

What can you do? (1) Post on the hospital’s Facebook page, demanding that they refuse to circumcise a healthy child whose mother is vehemently opposed to the surgery, and telling them that if they do, there will be both public relations and legal consequences; (2) call the hospital 954-265-5933, and (similarly) tell the risk-management department that there will be both legal and reputational consequences if they circumcise the Hironimus (Nebus) boy; (3) call the physician’s office (954) 265-0072 and warn him that the mother of the child is vehemently opposed to the circumcision, and that to conduct medically unnecessary surgery under these circumstances is both unethical and legally risky. SPREAD THE WORD, PLEASE!!

The hospital wrote one post trying to “appease” the commenters. It had been shared 236 times and had over 1800 comments:

joed
While posts to the page can be easily deleted, that didn’t stop people from posting to the page anyway.

joed2

Thousands of reviews clearly indicated the rejection:
joed4

joed3

New Times Broward-Palm Beach: In Hironimus Case, Circumcision Scheduled for 4-Year-old; Protest Planned at Hospital,

Palm Beach Post: Protests planned at hospital where Boynton boy may be circumcised

ABC 25 WPBF: Circumcision scheduled for 4-year-old boy

Anonymous information about Nebus vs Hironimus, Joe DiMaggio Children’s Hospital, Dr. Gary A. Birken MD

The Chase’s Guardians page received this anonymous message:

“To the page administrators,

This is a throwaway account. I cannot give you any further information about me. This is NOT my real name. But I work at JDCH and due to my position and job I have gotten to see a lot of what has been going on surrounding Chase’s situation. I want to share what I know because I am so strongly against anyone so much as touching Chase with a ten foot pole. This is what I know – rumor or otherwise – and whether you share it with your followers or not is up to you.

-Chase’s father has not actually met with Dr Birken. From what I understand from his scheduling nurses, they are being ushered in without needing to establish a new patient relationship. Thursday will be their first meeting.

-Dr Birken will cut Chase no matter what Chase says or does in office. I have worked with Dr Birken in his office before and he is a very no nonsense doctor who will do whatever he has to in order to get done what he feels should be done. He has pressured patients and parents into unnecessary or excessive procedures in the past and I have no doubt he will have Chase forcibly restrained and put under anesthesia without regard to Chase’s medical history. Birken is NOT one of the more well loved doctors in our hospital system and that he has agreed to do this does not surprise me. You WILL NOT stop this by trying to reach out to Birken’s office – but you WILL make a big difference through the hospital itself. If you can convince them that their general image will be tarnished or that they may face lawsuits they may bar Birken from taking Chase as a patient.

-Hospital administration is threatening staff that chooses to participate in any sort of walk out, protest, or refusal to come in/work with the patient. Nobody in Birken’s office is allowed to call off sick on Thursday. They have said that they will place anyone who participates in any acknowledgement of Chase’s procedure on leave or will outright fire them for insubordination and violation of HIPPA (because by refusing to come in, protesting, or refusing to work with Birken or Chase they are acknowledging that he is a patient who will be in that day – it is a VERY fine line but the hospital believes they are within their rights).

-There is talk of secretly rescheduling the procedure to TOMORROW (Wednesday, June 10) or even to Friday. It’s said that one of the administrators is even considering having Birken be called to “emergency surgery” later today so that Chase can be circumcised, but I do not think this will happen.

-Regardless of when the procedure occurs the hospital will likely hire additional security detail and may also ask the police to be present all day on Thursday. This may mean additional risk for protesters, so those who do choose to protest should bring cameras and be prepared to be as open and obvious about being peaceful as possible.

-Currently the hospital is directing all questions about the case to the director of corporate communications, Kerting Baldwin – and that’s only because if it’s going to one person then all phone calls and emails can be systematically ignored if they are not “important”. I have been told that comments on the Facebook page will likely start being deleted soon (within 24 hours) and that they may shut down commenting entirely.

-Despite discussing taking precautions, hospital administration does NOT think that there will be much to worry about on Thursday. They are PREPARING for the worst but I have personally heard one of the upper level admins say that they would be shocked if there were “more than one or two of those crazy, smelly hippie moms with misspelled signs whose kids are homeschooled and unvaccinated”. That comment will probably stick with me forever. It was wrong on so many levels.”

Nebus vs Hironimus – circumcision scheduled

According to Intact America and intactivist Brother K, there is a report “that Dr. Gary A. Birken, MD, 1150 N 35th Ave, Hollywood, FL phone: (954) 265-0072, has diagnosed Chase with a foreskin problem and that the circumcision is scheduled for June 11 at a Florida hospital.”

Dr. Gary Birken also writes fiction, with his name, and as Mason Lucas MD. As Mason Lucas MD he published “Error in Diagnosis”. Using his name he published “Error in Judgement”

Dr. Gary Birken will commit a terrible error in judgment if he proceeds to circumcise Chase based on a fraudulent diagnosis.

Physicians examining C.R.N.H. or performing surgery on him should be warned that they are being observed by thousands of activists, several intactivist organizations, the national and international media and the international community, and any fraudulent referral or procedure over “phimosis” will no doubt lead to reports of misconduct and ethics complaints.

gary_birken

Tyranny and patriarchy in America – let’s break those mothers who wish to protect their children from unnecessary genital surgery!

You may have heard that thing of home of the free, land of the brave?

I don’t know what country they were talking about. Certainly not the United States of America.

Let’s follow the recent developments in the Heather Hironimus / Dennis Nebus case:

After lawyer Thomas Hunker filed to dismiss the federal case last Wednesday (the child’s last legal possibility to preserve his genital integrity), a date for Heather to appear before the judge was set, for today, May 22th of 2015 at 10:30 AM.

Heather had been in jail one week and one day without seeing a judge.

Judge Jeffrey Dana Guillen has played doctor through the legal proceedings, touting the benefits of the procedure, dismissing the risks, dismissing Heather's fears and Chase's wishes, and ignoring the expert testimony that the circumcision is not medically necessary and the doctor himself wouldn't circumcise a son at that age.

Judge Jeffrey Dana Gillen.

Heather was transferred from the Paul Rein detention facility in Ft. Lauderdale, to a Palm Beach jail around midnight. One has to ask, why around midnight, especially when she was to appear in court in the morning? Sleep deprivation? Psychological torture?

Judge Jeffrey Dana Gillen told Heather that she would be held indefinitively unless she signed the consent form for circumcision – “the clearest instruction in the world“.

Heather initially declined and lawyers left. But then she changed her mind, and crying and hadcuffed signed the consent form.

May Cain, new attorney for Dennis Nebus

May Cain, new attorney for Dennis Nebus

Nebus’ new attorney , May Cain, requested full custody for Nebus, suspension of the parenting agreement rule that each parent notify the other. She wants Nebus to be able to enroll the child in voluntary pre kinder without consulting with Heather and to have him circumcised anywhere in United States without notifying Heather before or after.

Attorney May Cain said extraordinary measures are necessary because “intactivists continue to make death and kidnapping threats on social media”, and the judge agreed.

Judge Gillen chastised Attorney Thomas Hunker for being in touch with “fringe circumcision” groups and extremists – alluding the email Hunker directed to the intactivist community on Monday announcing the dismissal of the federal case. Hunker apologized for being in touch with “those people” and swore that he has had no contact with intactivists since then.

(“Those people”, including the over 11,000 followers of the Chase’s Guardians Facebook page, collected thousands of dollars to pay the bills from Thomas Hunker.)

According to the Sun Sentinel, while the contempt charges have now been dropped, Heather still faces a criminal charge of interferring with custody, from her time keeping the boy from his father in an apparent violation of a custody-sharing agreement. The charge is a third-degree felony punishable by up to five years in state prison for a conviction and will appear before a criminal court judge next Tuesday

sign

From Shyann Malone, anchor/reporter in South Florida

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Marc Freeman, criminal courts reporter for Sun Sentinel

So there you have it, this is what happens when you threaten the patriarchy to try to protect a child’s right to physical integrity in the United States. That infectious cultural disease that is forced genital cutting will attack you with all its might to make an example of you. It will ruin you.

If a foreskin is such a “negligible thing” in this culture, how come there is such a forceful strength used to dispose of it?

It’s ironic that courts in Israel, where over 90% of the boys are circumcised for religious reasons, had the common sense to protect the right of one child to remain intact when the mother did not agree to the circumcision, but in the United States, where circumcision is not even a religious issue, they will destroy you and they will label everyone who helps you as “fringe groups” and “extremists”… until they break you… until you provide…

FORCED CONSENT.

This is not the face of someone about to sign real consent

This is not the face of someone about to sign real consent

This is not how you sign your consent

This is not how you sign your consent

This is not what you do when you really consent

This is not what you do when you really consent

This is not the face of a person who consented

This is not the face of a person who consented

These photos belong to the Sun Sentinel

These photos belong to the Sun Sentinel

 

Forced consent isn't consent. It's rape.
CBS: Circumcision Battle: Heather Hironiums signs consent form

IBT: Florida Circumcision Case Update: Mom Heather Hironimus Signs Consent Form Allowing Son’s Surgery

WPBF 25 News: Mom jailed in son’s circumcision case emotional when she signs consent form

Sun Sentinel: Mom signs consent for son’s circumcision to get out of jail — but now faces new criminal charge

Joseph4GI: And the Florida Circumcision Court Battle Draws to a Close

Katharina von Kellenbach – feminist? religious? pro-circumcision?

 

Katharina von Kellenbach

Katharina von Kellenbach

Katharina von Kellenbach is Professor of Religious Studies at St. Mary’s College of Maryland. A native of West Germany, she studied Evangelical Theology in Berlin and Göttingen (1979-1982) and received her PhD in 1990 at Temple University. She became active in Jewish-Christian dialogue and Holocaust Studies while studying in Philadelphia and completed her dissertation on Anti‑Judaism in Feminist Religious Writings (Scholars Press, 1994). Her areas of expertise include feminist theology and Jewish-Christian relations, the ordination, life and work of the first female Rabbi Regina Jonas of Berlin (1902-1944), who was murdered in Auschwitz, as well as the theological, ethical, personal and political issues raised by the Holocaust.

Article: What’s wrong with the movement for genital autonomy

On July 9th of 2014, Katharina von Kellenbach published an article on Feminist Studies on Religion, titled “What’s wrong with the movement for genital autonomy”. In this article, Katharina attributes the creation of the Genital Autonomy to the Cologne case of 2012 which led to temporary age restriction of circumcision in Germany. In this regard, Katharina is wrong, as the genital autonomy movement can be formally traced at least to 1970 in Florida (Van and Benjamin Lewis), although there are individual books and articles (mostly by physicians but also by humanists) prior to this time, mostly in the countries where secular circumcision had become a custom (United Kingdom – Gairdner, 1949, United States – AP Morgan Vance, 1900, and Joseph Lewis, 1949), some as old as 1894 (Elizabeth Blackwell).

Katharina uses double quotes when the descriptions do not match her ideal view of reality. For example in reference to the Cologne case, she uses double quotes when she writes the words “grievous bodily harm”. These were the words used by the local judge in Cologne to describe the condition of the Muslim child, who had to be put under general anesthesia and operated as a result of the injuries sustained during and as a consequence of his circumcision.

Genital Integrity in Europe

Von Kellenback’s article states that “By December 2012, German lawmakers passed a law defending the right of Jewish and Muslim religious communities to circumcise their sons—though not their daughters.

The law however required a physician or trained practitioner to perform the surgery and limited the maximum age for the surgery (which could be a problem for some Muslim communities). The law allows non-physicians to perform the procedure until the 6th month (something definitively oriented to allow Jewish religious practitioners to perform the procedure). The Bundestag ignored the opinions of the German Academy for Child and Youth Medicine (DAKJ), the umbrella organization of all pediatric associations in Germany (German Society for Child and youth medicine DGKJ, Professional Association of the Child and Youth doctors, German Society for social pediatrics and youth medicine DGSPJ) and relied on the recently released statement of the American Academy of Pediatrics, in spite of the harsh critique by most European medical associations.

Von Kellenback then writes: “This spurred a movement across Europe that demanded the protection of boys’ bodily integrity in the name of gender equality. Their declarations and websites use gender-neutral language and declare “genital autonomy” a “fundamental right of each human being,” which includes “personal control of their own genital and reproductive organs; and protection from medically unnecessary genital modification and other irreversible reproductive interve.

In this paragraph we can see again the use of double quotes around the words “genital autonomy” and “a fundamental right of each human being” which seems to denote her disagreement with those expressions.

Ayan Hirsi Ali

Von Kellenbach extends her critique to “Somali anti-Muslim activist Ayan Hirsi Ali, never known to shy away from controversy“. Apparently the feminist branch of Von Kellenbach does not extend its compassion to women who have been subjected to female genital mutilation and death threats by religious extremists from patriarchal groups, if said women criticize male circumcision. (Shortly after posting the article online, the comments section was closed due to “continued ad hominem attacks” – this didn’t prevent Katharina from employing ad hominem attacks and generalizations throughout her article, most notably this one on Ayan Hirsi Ali).

While von Kellenbach initially quotes many scientific facts from intact positive websites, she then goes on a religious-politic tirade, neglecting to address rationally any of the facts she previously quoted.

Ironies

In ironic terms, Von Kellenbach assumes that the Genital Autonomy movement “aims to outman the political battle against FGM” and seems to mock the movement by saying that “suddenly, men must be rescued from marginalization and traumatization“. In this she ignores that the Genital Autonomy movement aims to protect all children, not adult men (or women for the matter). The Genital Autonomy movement also aims to protect intersex children, often the victims of horrific medical experiments. In fact, in the United States, the Genital Autonomy movement represented in Intact America, was one of the first organizations to oppose the Policy Statement on Ritual Genital Cutting of Female Minors of the American Academy of Pediatrics in 2010, one statement that tried to argue for allowing American pediatricians to perform a ritual nick on the genitals of female minors to appease parents from regions where female genital mutilation is practiced.

Von Kellenbach commits a logical fallacy frequently repeated by critics of the Genital Autonomy movement, in misrepresenting that male circumcision is considered by intactivists to be biologically equivalent to female genital mutilation. The intactivist argument is explained to be on an ethical level: non-medically indicated procedures that remove part of the external genitalia of a minor who has no need for the procedure, did not consent to it and cannot remove himself or herself from the situation, performed mostly to appease the cultural or religious traditions of the parents, in spite of real existent risks and harms.

Feminism?

Von Kellenbach goes on to say that “The gender-neutral code of “genital autonomy” serves to conceal the “seamless garment” of coercive violence that aims to control women’s sexual and reproductive bodies.“. In this she ignores that historically secular circumcision and secular female genital mutilation were implemented in English speaking countries during the 19th century to punish children for touching their genitals (control of their sexual bodies) and that it was known, even to ancient Jewish philosophers and physicians, that circumcision “excised the superfluous pleasure” and “weakened the organ of generation”.

She then takes a skewed point of view in writing that “The religious reasons for men’s “mutilation” are fundamentally different from the arguments that drive the wounding of women. Women are cut for aesthetic reasons in order to purify and protect men from promiscuous female sexual pleasure. Women’s pleasure and agency is the target of the knife and it serves no religious signification. Men’s circumcision, on the other hand, does not aim at sensation and potency. On the contrary, men’s virility is enhanced by circumcision and loaded with religious meaning.

First, groups which “circumcise” girls often give a religious meaning to the ritual. It may be the Western position to deny this (perhaps for political correctness), but Muslim women have argued that it is “an honor” and a “purification”, in other words, religious values denied by von Kellenbach.

In arguing that women are cut for aesthetic reasons, Von Kellenbach also ignores the globality of the debate. It is often heard from pro-circumcision women in the United States especially, that circumcised penises look “prettier”, that “uncircumcised” (intact) penises “look weird, gross, ugly, dirty, like an anteater, like an elefant trunk, are smelly”, etc, in other words, aesthetic reasons, and intact males are ostracized in some communities, i.e. considered children in Africa, called “supot” to ridicule them in Philippines, and supposedly made fun of in the locker room in the United States.

Katharina argues that “Men’s circumcision, [...] does not aim at sensation and potency. On the contrary, men’s virility is enhanced by circumcision“. In this she ignores not only the writings of Philo and Maimonides, but also scientific studies by John Taylor, Sorrells, Bronselaer and Frisch.

In stating that “God seals the covenant with Abraham promising him progeny, land, and everlasting life” von Kellenbach seems to ignore that not all the world ascribes to the Judeo Christian tradition and that babies are not aware of these dogmas when they are subjected to such “covenant”.

Von Kellenbach then compares “The sacrifice of (fore)skin” to “the pain and blood of breaking the hymen“, comparison that ignores that women have a right to choose if, when and with whom they will break their hymen, a right to genital autonomy not granted to baby boys who unwillingly undertake their “sacrifice“.

Strange for a feminist, von Kellenbach then writes that “Male circumcision and the penetration of women constitute the basis of the “covenant between me and you, and your offspring after you throughout their generations as an everlasting covenant.”“. In this statement women are sexually objectified and conceptualized as valuable only for their reproductive power.

Uncircumcised men?

In her opinion, “The movement to criminalize ritual circumcision is spearheaded by uncircumcised men who feel morally obliged to protect innocent boys from “ancient stone age rituals”“. This, of course, ignores the testimonials of men of all nationalities who were hurt physically and psychologically by their circumcision or simply oppose the idea of submitting babies to this painful and unnecessary procedure, and continue to push for the age restriction of the procedure, such as Richard Duncker of Men Do Complain (UK), Christian Bahls, president of Association of Children Victims Affected by Violence Against their Physical Integrity (MOGiS eV), Eran Sadeh Israeli founder of “Protect the Child” and many others.

Von Kellenbach goes on to say that “It is Christian men who want to prevent the medically unnecessary suffering of Muslim and Jewish boys” – Again, this is an attempt at creating a division that does not exist. There are Jewish, Muslim, African, Christian, American, Atheists, Pagans and men and women of all races, nationalities and faiths, expressing their opposition to circumcision. The attempt to re-frame and create this division is simply an attempt to frame the opposition to circumcision with anti-Semitism, something far from the truth.

Another common way to derail the discussion, used also by von Kellenbach, is to argue that the arguments against circumcision are simply emotional. This is simply countered by the opposition of medical associations, the existing studies showing the negative effects, not only the sexual effects, but also the traumatic effect of neonatal pain.

Von Kellenbach keeps trying to divide the readers by arguing that “Feminists, who work against sexual violence, such as FGM, are recruited into campaigns to outlaw gender-neutral ritual circumcisions“. In other words, feminists do not join the movement for genital integrity, they are recruited, they are deceived, with the purpose of “criminalizing Muslim and Jewish minorities” (and she still has the nerve to say that the arguments against circumcision are emotional!)

So basically, in von Kellenbach’s view, the genital integrity movement is created by European uncircumcised Christian men who recruit feminist women with the purpose of criminalizing Muslim and Jewish minorities. Perhaps Ms. von Kellenbach should visit the United States and speak with some of the intactivists here before writing about a movement that she evidently didn’t take the time to understand and learn about.

Conclusions

She concludes that “Feminists should insist on the fundamental difference between male and female circumcision and speak out against criminalizing male circumcision in countries where such bans serve to marginalize religious minorities.” So feminists should insist in denying the rights of male baby boys to their physical integrity.

It is sad when one has to argue for the physical integrity of children against political and religious entities and individuals who insist on being dense in ignoring the pain, trauma and vulnerability of babies. Of all babies, regardless of their gender.

CIRCUMCISION, PROSTATE CANCER, and AUTISM: Misleading Headlines and Selective Reporting

A few months ago, in reference to the publication of an article by Brian Morris on Mayo Clinic Proceedings, we argued that:

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.

We recently saw this phenomenon at work again,  regarding a possible link between circumcision and prostate cancer. A combination of fear-mongering and wishful thinking are being used to promote America’s favorite forced genital surgery. We are also listening to the deafening silence regarding a study that correlated the use of paracetamol during routine infant circumcisions with increasing rates of autism, arguably because the media has no interest in reporting negative side effects from circumcision procedures.

Prostate Cancer

Let’s take a look at the headlines:

June 4th, 2014. Fox News: Circumcision Linked to lower risk of prostate cancer 

May 30, 2014. Daily Mail. Circumcision reduces the risk of prostate cancer by up to 60% – but is most effective when done after the age of 35

Apr 7, 2014. Science Daily: Circumcision could prevent prostate cancer

Apr 11, 2014. Men’s Health. Should You Get Circumcised? New research suggests a surprising benefit to getting snipped—but here’s why we’re skeptical

Jun 5, 2014. Jerusalem Post: Study links circumcision, lower rates of prostate cancer

May 29, 2014. Medline Plus: Lower Risk of Prostate Cancer Seen in Circumcised Blacks: Study. But findings still preliminary, need confirmation (linked by National Institutes of Health)

Apr 8th, 2014. Prostate Cancer UK: Not enough evidence to suggest that circumcision could reduce risk of prostate cancer

All of these headlines and more, are in reference to a single paper:

March 24, 2014
BJU. Circumcision and prostate cancer: a population-based case-control study in Montréal, Canada
Spence AR1, Rousseau MC, Karakiewicz PI, Parent ME.

 

Marie-Élise Parent

Marie-Élise Parent

So, you can see, dear readers, the disparity in the headlines. “Could prevent“, “Linked“, “Reduces the risk“, “Links“, “Lower risk is seen“, “Not enough evidence“. Some of the headlines appear to be conclusive (“reduces the risk“, “linked“, “links“), some are conditional (“could prevent“) and a few are skeptical (“not enough evidence“). Depending on which media outlet you read, you may get a different impression just from reading the headline.

So what does the study really say?

The results of the study read: “Circumcised men had a slightly lower risk, albeit not statistically significant, of developing prostate cancer“. Among the conclusions: “Circumcision appeared to be protective only among Black men, a group that has the highest rate of disease.

In Sense About Science, Dr Matthew Hobbs, Deputy Director of Research at Prostate Cancer UK responded to the study saying:

Although this study appears to show that circumcision after the age of 35 could reduce your risk of prostate cancer, the evidence presented is nowhere near strong enough that men should begin to consider circumcision as a way to prevent the disease. While the total sample studied was large, the number of men who had been circumcised after the age of 35 was very small, so this should not be seen as strong evidence of an association. There was no statistically significant association between prostate cancer and circumcision for men circumcised at all other ages. No reason was collected for circumcision, so we can’t say if the association is with circumcision later in life or with whatever causes men to have circumcisions after that age. It is also highly likely that diet, lifestyle, socioeconomic status and healthcare behaviours may have played a role in skewing these results.” – See more at: http://www.senseaboutscience.org/for_the_record.php/148/quotcircumcision-cuts-risk-of-prostate-cancer-by-45quot#sthash.w3uMSk3Y.dpuf

While the main benefit boasted in the study has been for black males circumcised over the age of 35, Fox News cites Dr. Christopher Cooper, a professor and urologist at the University of Iowa, declaring that ”The number of black men studied was too small for any conclusions to be drawn. Only 103 of the participants with prostate cancer were black men, and only 75 of the healthy men in the comparison group were black.“. The Fox News article finishes quoting one of the researchers, Marie-Elise Parent, saying: “We are too early in the game to make it a public recommendation. It could be that in the future it will be confirmed that it’s a good thing and may have an added protection from other diseases“.

Being early, however, didn’t stop the media from planting the idea that circumcision prevents prostate cancer, through the use of misleading and manipulative headlines.

The Daily Mail also cites Dr. Parent saying: “We do not know why a protective effect was observed for men circumcised after the age of 35. These men may have had a pathologic condition of the foreskin that lead to them being circumcised“.

Medline Plus quotes Dr. Parent cautioning that the black men in the study, mainly of French descent, may not reflect black men as a whole. And she said the study included few men who were circumcised at a later age, so that finding is potentially questionable. (Only potentially?)

Some of the articles indicate that the researchers suspect the connection may be a “lower rate among circumcised men of sexually transmitted diseases (STD), which raise prostate cancer risk” but they are not conclusive.

To this, Fox News cites Dr. Christopher Cooper, a professor and urologist at the University of Iowa indicating that the number of black men studied was too small for any conclusions to be drawn, and saying: “The STD mechanism is possible but quite a stretch“. He pointed out that there were factors the researchers could not control in the study, such as how honest participants were about having STDs or, among the men circumcised as adults, the reason for their circumcision.

Medline Plus cites Dr. Stephen Freedland, urologist and associate professor of surgery and pathology at the Duke University School of Medicine in Durham, N.C., pointing out that men circumcised after age 35 are unusual. “They’re usually older guys who are sick and have medical problems,” he said. The study findings as a whole aren’t convincing, Freedland added, especially since it included relatively few black men — just 178 of more than 3,100 participants. “I don’t think we’ll be recommending massive circumcisions to prevent prostate cancer,” he said. “And men shouldn’t go around thinking, ‘I’m circumcised, therefore I’m safe from prostate cancer.‘”

Men’s Health adds a healthy dose of skepticism: “…if this study was done in a healthy population, you might get different results.

What is important to know is that the authors of the study do not explain why there would be such a protective effect, do not claim their results to be statistically significant, and furthermore acknowledge that the sample of black males over 35 was small. So, in other words, this study is very far from being conclusive, or even useful for the general public at all. If anything, this study could motivate further studies, but as for being applicable right now, it is not, and it would be irresponsible to act based on it. The media circus around this overall pointless study is atrociously misleading.

Autism

In the meantime, Environmental Health published a study last year about prenatal and perinatal analgesic exposure and autism. This study found correlations between indicators of prenatal and perinatal paracetamol exposure and autism/ASD. While the available data cannot provide strong evidence of causality, biologic plausibility is provided by a growing body of experimental and clinical evidence linking paracetamol metabolism to pathways shown to be important in autism and related developmental abnormalities.

While the abstract and title themselves do not specify circumcision, there is a detailed analysis of circumcision rates in the full text of the study. As our readers may remember, anesthesia during neonatal circumcisions was not common until a 1997 randomized controlled trial had to be halted due to trauma from pain. Lander et al’s early terminated study suggested that pain control should be administered prior to circumcision and that ring block was the most effective method.

Fast-forward to 2013, Bauer and Kriebel analyzed country-level data for the years 1997-2006, and found a strong correlation (r = 0.98) between circumcision and autism spectrum disorder prevalence rates for boys born after 1995, around the time when circumcision guidelines began recommending analgesia for routine infant circumcision. The slope of this trend for 9 countries with available data indicates that 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).

Again, when evaluating circumcision data for the United States, it is sobering to remember that approximately 1.2 million baby boys are circumcised every year. Could the use of paracetamol be causing autism and autism spectrum disorders in 2,400 baby boys annually?

A comparison of autism rates in boys and girls  found that male to female prevalence ratio increased from 3.9 to 1 prior to 1995, to 5.6 to 1 after 1995. The researchers suggested biological plausibility based on the infant’s lower capacity to metabolize drugs due to the underdevelopment of the glucuronidation pathway and inefficiency and immaturity in renal function.

So, basically we find two positions, one that circumcision without anesthetics is severely traumatic, and another one, that commonly used analgesia can increase rates of autism.

In spite of this strong data, practically no media outlets published any articles about this study and its implications on newborn circumcision.

In Summary

In summary, we have two studies that looked at correlations. One was not statistically significant; the other was. One did not offer a biological plausibility, the other one did.

And yet, which one got extensive media coverage? The one that suggested a benefit from newborn circumcision.