Tuesday, September 11, 2012

My Intactivist Journey

The first time I became aware of circumcision was when I was seven and I saw my Mom changing my newborn cousin's diaper. I asked her why his penis was so red. Although I don't remember her answer, it must not have satisfied my curiosity because I remember asking again. I remember that her second response contained a hint of annoyance. Maybe questioning this societal norm caused the slightest bit of doubt in my Mom's mind.

In fifth grade after "family life" (a fancy name for sex ed), on the bus ride home, I asked my best friend a question out of curiosity (although I could only get up enough nerve to spell the word): "Are you C-I-R-C..." Before I finished what was a painfully awkward question, he answered "no." I sat in stunned silence. I didn't know what to make of it. I thought to myself, "well, why not?" Like many kids this age, I wanted my best friend to be just like me. I couldn't help but think that there was more to it than the "hygenic reasons" rhetoric used to justify circumcision back then.

In high school, one of the things I feared was being made fun of in the showers for having only one testicle. The doctors went in to bring down an apparent undescended testicle only to find it dead and undeveloped (possible in-utero torsion or other birth defect) necessitating its removal. I was never made fun of for this and no-one ever mentioned it to me.

For as fervent an effort as boys make not to look at each other in the shower, I couldn't help but notice that one boy in my high school PE class was intact. I felt envious even though I didn't know at that time that the foreskin had any significant function. Even though I didn't have any real reason to doubt the pro-circumcision rhetoric, I was not entirely comfortable with it.

As I got older, I began listening to talk radio. In college, I started listening to Dr. Dean Edell's radio show. He talked about circumcision on a regular basis. This is when I started thinking seriously about it. Although I had never been comfortable with circumcision, it wasn't until Dr. Dean Edell's rants that I had evidence and support to justify my discomfort. Dr. Edell mentioned two websites: National Organization of Circumcision Information Resource Centers and Foreskin.

At the childbirth education class preparing for our first son's birth, the instructor mentioned that the circumcision segment of the class would be next. I was anxious about this whole segment and my emotions were running high. The instructor started the circumcision segment of the class by asking if there were any reasons not to circumcise. I spoke up physically shaking with nervousness, and through quavering voice, entered into rant against circumcision covering the issues from ethical to harm to sexual function to the fact that I hate what was taken from me. I was completely surprised, thankful, and comforted by the instructor's complete agreement with what I had said. When she passed around the various mutilation devices used for the procedure, I passed them by without even looking at them. The instructor argued against it circumcision and backed up the statements I made as well as providing additional information. She recited a story about how she went along with circumcision for her first son when the nurses asked her while she was still delirious from pain medicine. Later, she thought about the issue and left her other sons intact. She now speaks out against circumcision at all the childbirth education classes she teaches. Although she is a nurse, she refuses to participate in the procedure at the hospital. After that class, a woman sitting next to my wife and I thanked me for my bravery at speaking out and indicated that if she and her husband were having a boy instead of a girl that they would leave him intact.

Earlier this year, I started taking an active role in the community on Twitter which has proven to be a tremendous opportunity and a source of frustration. The Twitter community serves as both a support group and a means to get the message out; I suspect it's more successful in the former capacity. It is extremely difficult to change an entire society's view on an issue that has been part of culture for many years: culture is one of the hardest things to change.

Although I believe I may have influenced relatives to keep their boy intact, it is an uneasy outcome as their boy recently had a UTI and the husband is urging to have him cut. My influence is limited.

I have a great number of regrets due to my failure to properly influence friends, family members, and co-workers to follow the right side of this issue. In some cases, my emotions got in the way and my message was not delivered effectively. In other cases, the audience was just plain not receptive and no amount of convincing would have worked. Still other cases are the result of me not speaking up when I should have. I know the outcomes of some cases and not others. Unless the outcome is to leave the child intact, I'd rather not know.

I strive to find my place both in the I2 community and to find the most effective ways to influence friends, family, and co-workers.

Monday, September 10, 2012

The AAP-Circumfetishist Connection

There is at least one connection between circumfetishist groups and the American Academy of Pediatrics. One connection is Edgar Schoen, who was once head of the AAP's "Task Force on Circumcision". Another connection is more recent: there is some evidence that AAP's recently-updated policy statement on circumcision was sent to Brian Morris, in advance of its release to the public, for review and comment.

My view of this connection seems to differ from others in the I2 community. Many view this connection as further evidence of a virtually impregnable coalition of pro-circumcision advocates. It is true that an alliance of pro-circumcision groups, each with their own motives, makes the struggle for I2 more difficult. The alliance is also a weakness.

Associating with depraved and downright evil individuals is a liability for the AAP. The connection between the AAP and circumfetishists—especially Vernon Quaintance—may cause people to rethink what the true motives behind circumcision advocates might be. If circumcision is really about "medical benefits" as the AAP claims, why is it interested in feedback from Brian Morris, a biologist, who is not a medical doctor?

If I were a member doctor of the AAP, I would be appalled to learn that the AAP fraternized with circumfetishists. Publicly revealing the AAP's associations could cause an outcry resulting in embarrassment; a strong enough public outcry might even pressure them into changing their view on circumcision.

Saturday, September 1, 2012

A Look at Circumcision Death Rates

It is quite frustrating for me that finding indisputable, universally accepted circumcision death rate statistics seems to be impossible. Older sources put the number at 1:500,000 (Circumcision: Position Paper on Neonatal Circumcision). A newer study places the number at 9.01 in 100,000 or approximately 117 per year in the United States (Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths).

The study, authored by Dan Bollinger has received both criticism and support in least one forum. Still more criticism can be largely discredited due to straw man analysis and authorship by a circumfetishist. Bollinger's analysis provides the most accurate and up-to-date numbers regarding circumcision death rates the medical community has seen so far.

A number of articles cover this research comparing the death rate from circumcision to that from SIDS. The death rate is greater than that from suffocation and automobile accidents.

Drop-side cribs were banned after more than 30 reported deaths (After dozens of deaths, drop-side cribs outlawed). An entire class of products was banned due to approximately 30 deaths. But we don't ban cosmetic surgery that kills more than one hundred babies a year?

Unfortunately, neither the Bollinger research nor the associated news stories is good enough for Wikipedia:

Neither new source meet WP:MEDRS; Thymos does not appear to be MEDLINE indexed, or even have any information which would help establish its reliability such as discussing its editorial board or policies. There is no indication this meets WP:RS, much less WP:MEDRS. In any event, this would be a primary study anyways, and would not qualify for MEDRS.

Recent deaths due to metzitzah b’peh in New York (Baby’s Death Renews Debate Over a Circumcision Ritual, How 11 New York City Babies Contracted Herpes Through Circumcision) are often dismissed by pro-circumcision advocates as isolated cases not relevant to the discussion. It is disturbing that genital mutilation followed by felatio is legal. It is indisputable that these deaths are associated with and caused by a circumcision ritual and are quite valid as part of the larger discussion.

The corruption and malaise within the medical community is a frustrating reality for intactivists. Whereas science as a whole advances consensus through properly-vetted research, "medical science" is fractured and moves to serve medical device manufacturers, health care providers, and pharmaceutical companies. Good research, such as Bollinger's, is marginalized due to arbitrary constraints (e.g. Wikipedia:MEDRS). Meanwhile, improperly-conducted, unethical research (such as the Africa HIV circumcision studies) published in journals such as Cochrane "pass the test" and are touted as indisputable fact. Cochrane is seen as a reliable source by many despite its tremendous incompetence at properly vetting articles.

Regardless of number, are any deaths from circumcision acceptable? How many children die from being intact?