Are YOU Paying for Infant Circumcision?

By Danelle Frisbie © 2010

According to the American Academy of Pediatrics, routine infant circumcision (RIC) surgery alone costs taxpayers close to $70 million annually. Costs are much greater when payments for post-op complications and extended hospital stays are included in the circumcision surgery figures. (1)

The Centers for Medicare and Medicaid Services (federal program) has defined elective circumcision (ICD-9-CM V50.2) as medically unnecessary - the amputation of the prepuce organ is therefore a cosmetic, irreversible, surgical body modification. And it is one that is being done to infant boys with your tax dollars in 33 U.S. states and among TRICARE covered military families.

A study (2009) published in the American Journal of Public Health demonstrates that infant circumcision declines in those areas where Medicaid no longer covers the surgery (graph below). (2) As a result, many human rights activists believe that the key to granting all boys and men their right to bodily integrity lies in a nation wide end to Medicaid funding of RIC.

Members of GI: Genital Integrity for Military Families Abroad are equally concerned with ending TRICARE's coverage of RIC for babies born to military personnel both in the States and abroad. In the Netherlands, where several GI volunteers work, the national medical society, KNMG, takes a firm stance against infant circumcision:
The official viewpoint of KNMG and other related medical/scientific organisations is that non-therapeutic circumcision of male minors is a violation of children’s rights to autonomy and physical integrity. Contrary to popular belief, circumcision can cause complicationsbleeding, infection, urethral stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications.
The International Coalition for Genital Integrity and Colorado's National Organization of Circumcision Information Resource Centers offer the following reasons to stop Medicaid funding of RIC:

* Infant circumcision is not recommended by the American Academy of Pediatrics (3) or any national medical organization in the world.
* Circumcision is considered medically unnecessary by all major medical organizations.
* Circumcision does not contribute to health, and deters from health.
* Nearly 70% of American parents do not want their boys (or their girls) circumcised.
* Routine circumcision of newborns has been abandoned in all English-speaking countries. (It has never been customary in most of the world.)
* According to comprehensive analysis, infant circumcision is not cost-effective. (4)
* Those choosing circumcision for themselves may pay privately if they desire as consenting adults.
* Medicaid savings will average $1 million annually for each State.
* Medically necessary programs need this money.

Currently, Medicaid does not cover infant circumcision in the following 17 states. Each state is listed according to the year in which tax payer funding of RIC ended in the state.

California - 1982

North Dakota - 1986

Oregon - 1994

Mississippi - 1998

Nevada - 1998

Washington - 1998

Missouri - 2002

Arizona - 2002

North Carolina - 2002

Montana - 2003

Utah - 2003

Florida - 2003

Maine - 2004

Louisiana - 2005

Idaho - 2005

Minnesota - 2005

South Carolina - 2011

Colorado - 2011

For further information and to become involved see:

Medicaid and Circumcision File (pdf)

Circumstitions: There's Money in Circumcision

ICGI: Medicaid Project

End Medicaid Funding of Infant Circumcision Facebook Page

End Taxpayer Funding of Routine Infant Circumcision Facebook Group

Find Your State's Medicaid Funding RIC Facebook page here 

Medicaid Sample Letters to send (from

(TRICARE) GI: Genital Integrity for Military Families Abroad


1. Mansfield CJ, Hueston WJ, Rudy M. Neonatal circumcision: associated factors and length of hospital stay. Journal of Family Practice, 1995;41(4):370-376.

2. Arleen A. Leibowitz, Katherine Desmond, Thomas Belin Determinants and Policy Implications of Male Circumcision in the United States. American Journal of Public Health, 2009;99(1):1–7.

3. American Academy of Pediatrics Task Force on Circumcision. Circumcision policy statement. Pediatrics. 1999;102(3):686-693.

4. Van Howe RS. A cost-utility analysis of neonatal circumcision. Medical Decision Making. 2004;24:584- 601.


Drop-Side Cribs Outlawed: MGM Continues

After 32 infants and toddlers have died over the past 10 years from being left alone in drop-side cribs, without an adult caregiver nearby keeping watch, the cribs will now be outlawed by the U.S. government. The banning comes after a unanimous vote by the Consumer Product Safety Commission. Images of how the cribs have played a roll in these deaths are ubiquitous in the news this month (above, below). Yet somehow, in the midst of all the hoopla over yet another baby-item banned, we continue to overlook the 117-229 baby boys (numbers which are likely on the low end of actual statistics) who die each and every year in the United States from circumcision surgery complications. (1, 2)

In 2010, more infant boys died as a result of unnecessary circumcision surgery in the U.S. than from choking, from auto accidents, from suffocation, from SIDS, from (the recently recalled) sleep positioners, and from drop-side cribs.

The question begs to be answered: Where is this recall?

The Associated Press reports from Washington:
It's the end of the traditional crib that has cradled millions of babies for generations.

The government outlawed drop-side cribs on Wednesday after the deaths of more than 30 infants and toddlers in the past decade and millions of recalls.

It was a unanimous vote by the Consumer Product Safety Commission to ban the manufacture, sale and resale of the cribs, which have a side rail that moves up and down, allowing parents to more easily lift their child from the crib.

The new standard requiring cribs to have fixed sides would take effect in June. The move by CPSC would also prohibit hotels and childcare centers from using drop-sides, though those facilities would have a year to purchase new cribs.

CPSC Chairman Inez Tenenbaum hailed the new standard for cribs as one of the strongest in the world. "I believe these new standards will markedly reduce crib-related hazards and help to ensure that young children sleep more safely in their cribs," Tenenbaum said after the vote.

Around for decades, drop-side cribs have come under scrutiny in recent years because of malfunctioning hardware, sometimes cheaper plastics, or assembly problems that can lead to the drop-side rail partially detaching from the crib. When that happens, it can create a dangerous "V"-like gap between the mattress and side rail where a baby can get caught and suffocate or strangle.
 "These products are deadly"
In all, drop-side cribs have been blamed in the deaths of at least 32 infants and toddlers since 2000 and are suspected in another 14 infant fatalities. In the past five years, more than 9 million drop-side cribs have been recalled, including cribs from big-name companies such as Evenflo, Delta Enterprise Corp., and Pottery Barn Kids.

Michele Witte of Merrick, N.Y., lost her 10-month-old son, Tyler, in 1997 when the drop-side rail on his crib came loose, partially detached and then trapped his neck between the rail and the headboard. "It's been a long 13 years," said Witte. "I feel like it's a celebratory time because things are finally being done about the issue."

Witte appeared at a news conference on Capitol Hill with Democratic Sen. Kirsten Gillibrand of New York, Rep. Jan Schakowsky, D-Ill., and Rep. Joe Crowley, D-N.Y., all of whom have pushed for stronger crib safety rules.

The new standard mandates tougher safety testing for cribs, tests that more closely mimic a child in a crib. As children get older, they can apply more force to the crib — shaking on it, running around in it, jumping up and down. The new tests aim to make sure the cribs can take that kind of pressure.

Better labeling on crib pieces will also be required — a measure that aims to cut down on the misassembly problems that some parents have encountered, problems that can lead to the death of a child.

Parents who lost their children in drop-side cribs say Wednesday's ban couldn't come soon enough. Chad Johns, whose 9-month-old son, Liam, died in a drop-side crib in 2005, said he was a little relieved. "Yes, it's a long time coming," said Johns from Roseville, Calif. "But the fact that it is happening — that's what is important."

Crib makers were already phasing out drop-side cribs over the last couple years, amid increasing problems with them. And last year, the organization that sets voluntary industry standards — ASTM International — approved a drop-side ban.

Many parents, however, still have drop-sides in their homes. They can also be found at secondhand stores. Parents who are using drop-side cribs are advised to check the hardware on the cribs to be certain it's working properly and to make sure their crib has not been recalled. The Juvenile Products Manufacturers Association, which represents over 90 percent of the crib industry, says properly assembled drop-sides that haven't been recalled can be safely used.


(1) Baker RL. Newborn male circumcision: needless and dangerous. Sexual Medicine Today. 1979;3(11):35-36.

(2) Bollinger, Dan. Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths. Thymos: Journal of Boyhood Studies. 2010;4(1):78-90.

See also:

Death From Circumcision

Intact vs. Cut Outcome Statistics

Another Baby Dies After Circumcision Surgery

Better baby sleep options:

Healthy Infant Sleep: A Review of Research

Turn your crib into a co-sleeper

Time to Abolish Cribs?

A collection of quality, helpful baby sleep books is located here.


Ready to Talk: A Jewish Mother's Change of Heart

By Rebekah Costello
More from Costello at Thoughtful Momma

I’m coming out of the closet! I am strongly anti-circumcision and I’ve given a lot of thought to talking about it now. It’s such an important issue and I truly feel as though I have a responsibility to raise awareness.

Circumcision is one of those issues that has moms flaring at the nostrils and screaming in protest, regardless of how they personally feel about the issue. I remember the first time someone challenged me on the topic and how furious I was when she suggested I was advocating for infant mutilation. I was, to put it blandly, enraged.

I grew up being raised in a blended faith. My family are Messianics: Jews who embrace Jesus as the Messiah promised in the Tenach. I remember my youngest brother’s Bris quite well but because his Bris was a reception only (the actual procedure was done in the hospital), and the only other one I’d attended occurred when I was so young I couldn’t really remember it. I had no idea, really, what circumcision entailed other than my parents' sublime explanation: “It’s when a little flap of skin is cut off as a sign…”

Years later, I married a man who is intact. Not to go into too much private detail, but I will tell you that I thought it was so COOL. I had this idea that it made him unique, almost exotic. I laugh a little at myself now, of course. I have only ever “been with” my husband so it’s not as if I had anything at all to compare it to and now it seems ridiculous to consider something entirely normal as “exotic.”

However, as we talked here and there about our faith, future children, that sort of thing, circumcision came up a lot. At that time in my life, I truly believed that our son(s) needed to be circumcised. That not doing it to him would be a sin. For me. Not for my son, but for me and for my husband.

I am explaining this to demonstrate the backward and completely blinded point of view I had at that time. When I conceived my first child, I still felt that circumcision was just something I had to do. Thankfully, she came out without a penis! I deeply cared about my child and had she been a boy, I would have had her circumcised believing I was doing the very best thing for her physically and spiritually. I wasn’t any less of a loving person then. I haven’t become more intelligent over the last six years, either.

That said, I was definitely thinking backward. See, I would never have dreamed of asking my husband to be circumcised. If asked, I would have explained that it was his body, not mine, and that the decision to cut himself was between him and God alone.

Are you catching the discrepancy here? It wasn’t okay for me to ask a grown man to circumcise himself, but it was entirely okay for me to make that decision for my defenseless baby?!

Then, one day, when my oldest was about a year old, I become involved (to my embarrassment, now) in a flame-war going on in a wonderful little Yahoo-group that revolved around birthing. As I’m sure you can imagine, people can be vicious at times and don’t really pull any punches when they are advocating their choices for their children. This little war was epic... Someone had posted an informative link regarding circumcision awareness and someone else had immediately retorted about being judged and it went off from there. I kept my mouth shut at that point as my personal opinion was that circumcision for any reason other than religious was stupid.

But then, the fateful words hit my inbox: “Mutilating your son in the name of your god is still wrong, regardless of your religion.” Ooh I was hot! So angry. It was like someone punched me in the stomach. How dare this woman comment on something so intimate and personal as another person’s religious beliefs! I’m afraid I wasn’t even really hearing her point. I was just pissed she presumed to know another person’s heart when making decisions like this. Looking back on it, she did not say anything cruel or intentionally insulting - she was just speaking truth. But it was ON in that moment. I wrote a lengthy, heartfelt, passionate response. She returned it with one of her own. She made me look like a complete idiot without even trying because she had all this “information” about what was done and its life-long implications and I realized I had no idea what I was talking about! So I set about researching her claims, intent on digging up the opposite research to shut her up.

Only, that isn't what happened. I had been told growing up that the intactivist movement was “the Enemy’s” attack on God’s people. That it was anti-Semitic, etc. And I was convinced that I could prove her wrong by going to science. After all, wasn’t it true that being circumcised was healthier? I mean, obviously she was just bigoted or misled…right? RIGHT?


In fact, every click I made drew me further and further into an education I didn’t even know I needed.

I learned, for the first time in my life, what a foreskin really was and how it compared to female anatomy. I also learned about other forms of ritual genital mutilation (FGM) that are not socially acceptable, but defended with the exact same arguments that I was using!

I watched circumcision videos (not for the faint of heart, let me tell you! I cried…a lot). I read medical websites devoted both to defending the practice and ousting it as an outdated, unnecessary, and yes, harmful procedure. I learned things I never dreamed could be true, including that just as many baby boys die during the neonatal period of their lives from being circumcised as those who die from SIDS. That interesting fact spurned me to learn even more, and by the end, I was a changed person. I was humbled and I had some serious thinking and soul-searching to do.

I, like so many others, looked for ways around the religious “need” without actually denouncing circumcision. I researched “gentler” ways to remove the foreskin from the son I hoped for, even going so far as to consider doing it myself so that it was done “Biblically” and with the least amount of harm possible!

It was then, when considering doing it myself, that I realized that I had lost my friggin’ mind! I mean, I’m sitting there, considering cutting a piece of my son off myself in order to protect him from harm!? What was wrong with me?

I came to the conclusion that there was something seriously flawed with my thinking. My husband, of course, had been going through his own thoughts and research, and being intact himself, came to the same conclusions. It was a relief, in a way, but posed other issues for us. Concerns about “sin” and about rejection from my family (who still see this as something sacred and necessary). I’ll come back to my thoughts on that at a later time.

I’m happy, and even proud, to say that I now have a 13 month old baby boy who is happily and blissfully ignorant of what he’s been spared. His body was left intact, as it was designed, and functions normally. It may be that someday he’ll grow up and, for his own reasons, decide to get circumcised. I admit that as his mother I hope he doesn’t: I think he’s perfectly created just the way he is and it would be a real shame to mutilate a part of his perfect little body. But it’s his decision ultimately, and that’s what matters. HIS choice. Not mine.

I share all of this because I want people to understand that I get it. I know how complicated and difficult this “choice” feels because I’ve been there. I’ve agonized over it, defended it, and seethed when anyone contradicted my perceptions of reality.

I really want to talk about this more - it’s a subject I’ve come to feel very passionate about. I want to help stop this horrible practice and enable other parents to wake up and see what it is that we are doing! I realize this topic may piss people off at Thoughtful Momma. For a long time I hesitated to write about it because I don’t really like intentionally offending people. Unfortunately, though, the truth is the truth. Sometimes hearing it angers people. That’s okay. If someone hadn’t offended me, my son’s little penis would be mutilated today, and I sincerely hope that I can share that gift of enlightenment with someone else.

Costello is a mother and gentle parenting advocate who has been blessed with three amazing children. She likes to think of herself as an instinctual mother. She's a home-birthing, child-led breastfeeding, cloth-diapering/ECing, baby-wearing mom who also formula fed her youngest son due to life throwing some curve-balls her way. Her greatest passion is empowering and supporting mothers in raising and protecting the precious lives they bring into this world. Read more from Costello at Thoughtful Momma.

Additional resources on Judaism and circumcision here.

Additional resources on Christianity and circumcision here.

Additional research (scholarly books, websites, articles) on the prepuce, intact care, and circumcision: Are You Fully Informed?


Foreskin: It's Not 'Icky'

By Audrey Bryk © 2010

One of the most shocking, upsetting, and frustrating things I deal with as an intactivist on a constant basis is the incredible number of expectant parents I encounter who are determined to have their sons circumcised because they think the foreskin must be "icky."

Now, as frustrating as this is, I must admit that I can empathize with the myth. A few years ago I was there too, and not surprisingly as I was a product of U.S. culture – a cutting society where the foreskin has been vilified in popular television shows, parenting circles, and locker rooms alike. Where intact men have been made, at times, to feel embarrassed about the natural state of their body. Where we consider a normal body part that every single mammal is born with to be some sort of defect.

When my first son was born, I honestly was not fully informed on the issue. And I'm not sure what I was expecting. I had never actually seen an intact penis in my entire life – not on a baby, not on a man. I guess I was expecting it to be gnarly, or to somehow look wrong. I expected there to be an obvious part of the penis that looked as if it did not belong - one which begged to be cut off.

The reality was that my baby was perfect just the way he was. Nothing looked out of place and I wasn’t grossed out. It was kind of shocking, actually. I hadn’t been educated on the foreskin and I didn’t realize that it would be tightly fused to the head of the penis in infancy. I was fortunate to learn from our foreskin-friendly pediatrician that I should just leave it alone and never try to retract it. This was a relief! When we said “NO” to the circumcision question I thought I might have a long road ahead of me having to retract and inspect and be some sort of detective to seek out any dreaded smegma. Instead, I learned I would never have to do any of that – just leave it alone you say? Wipe like a finger? AND I don’t have to deal with caring for a festering surgical wound on the most sensitive part of my baby’s body? WIN!

For those who've never seen the difference between a perfectly intact baby boy vs. a circumcised newborn, here is one example:


Later on, in my first son’s toddlerhood we moved to Europe, where I learned that routine infant circumcision is not performed outside the USA. I began talking to European mothers about the issue and found out they were literally shocked that Americans would do such a thing to their babies – just as shocked as we are that knives are needlessly taken to girls’ genitals in other countries. But what was more surprising than this was when the discussion would turn to the subject of circumcision status on adult males. Their eyes would get big and wide and they would say things like, “I have never even seen a circumcised penis! What does it look like? Is there a scar? What does it feel like?”

This got me thinking about how the appeal of such things really just comes down to one very simple factor: what we are accustomed to. Everything about the discussions are exactly the same no matter which side of the pond you’re on – the only difference being which state of the penis is being talked about.

A comparison that comes to mind is that we are accustomed to all other mammals remaining intact. Consider how people giggle or get silly when they see a dog's "red rocket" for example (an internal organ typically hidden by the foreskin)... Wouldn’t it be strange if it was always just hanging out there? Scarred and callused for the world to see? This is how I’ve come to think of the human body. It is so utterly strange to see tiny penis heads just hanging out there…exposed. Wounded.

At the time, with nothing to compare it to, I couldn’t really enlighten my European friends. But I looked into the subject a bit further and discovered that a study in New Zealand found that 9 out of 10 women who had experience with both intact and circumcised male partners prefer sex with an intact man. Reading this absolutely stunned me. Wasn’t it just a "useless flap of skin?" Apparently not. I learned that it provides a gliding motion and a rippling effect. It keeps things soft and supple. The head of the penis is meant to be internal – not exposed to the elements, not rubbing against fabric all day, every day for years as it calluses over (the circumcised penis builds up layer upon layer of skin thickness due to callusing in an effort to protect itself). The glans (head) becomes dry and the skin becomes thick, and it loses sensitivity and natural reflex. The result is that the circumcised man needs to work harder to feel something good, and has less control over how things happen. This is a simplified version of the mechanics of natural sex. For more information, please see Marilyn Milos’ video, Penis 101, here.

As I read about this, and began to talk to women who have had intact partners, my ideas about foreskin began to change. Foreskin wasn’t so icky anymore. It was becoming…alluring. There also grew a bad nagging feeling in the pit of my stomach. What are we doing to our boys? To our girls? I have heard the line so many times in online debates: “His wife will thank me someday.” I wouldn’t be so sure. I’m not thanking my mother-in-law! And I’ve begun to understand the sense of loss that the thousands of men who have gone through foreskin restoration must feel. There are millions of us who will never know what sex is supposed to feel like - the way it was designed perfectly to be.

If there is anything I would like today’s parents to know it is that the U.S. circumcision rate has dropped so low in recent years (32.5% in 2009) that by the time today's babies are sexually active, this will all be common knowledge. The functions of the foreskin are already making their way into American consciousness. By the time they are adults, boys who were circumcised at birth today will understand what they are missing. And so will their partners.

Read more from Bryk:

Why All the Circumcision Posts?


For additional resources on the prepuce (foreskin), circumcision, and intact care see: Are You Fully Informed?


A Public Apology to My Circumcised Son

By Mandi Woolery
Read more from Woolery at: Peachy Keen Birth Services

 My little man. How I wish I could go back in time.

My Little Buster,

I’m so sorry. How else do I begin this?

I was teaching today and lecturing my students about the importance of doing independent research when preparing to make decisions for their labor, birth, and the care of their newborn. My final point was to implore them to research every decision. To never proceed with something because some hospital class says 'everyone is doing it,' but rather to research the hell out of it until they are confident that they have all of the information.

And so I come back to this… I’m so sorry.

As a parent, there will be a million things you will look back on and think, “Gee, I wish I would have done that differently…”

Usually it’s something minor. Like becoming upset over something that was totally age-appropriate behavior. Or when you accidentally learned a 'colorful' word while Mommy was driving.

But how do I apologize for having part of your genitals amputated for NO MEDICAL REASON? When you were less than 24 hours old, no less!

Please let me at least explain why - where I was coming from - that I thought I was doing what I was supposed to do.

As I will explain someday, I wasn’t exactly tech-savvy when I was preparing for my first birth. I just literally didn’t even know anything existed beyond the hospital class and What to Expect.

That hospital class taught us that 95% of boys were circumcised, and that it was more hygienic. I didn’t know this was a lie. And I wasn’t in contact with anyone who could tell me that this was a lie. Looking back, that is not an excuse. The mama bear in me begs my pregnant self to questions it, verify it, somehow just double check this number. But I swear to you that my brain was just not wired this way back then. It had never occurred to my naive little mind that a hospital might “misrepresent” facts back then.

As it turns out, in that year, it was actually about 50% of boys who were not being circumcised. Not the mere 5% they suggested (and now it’s about 68% who are remaining intact!). And it is not more hygienic to be circumcised… no more so than it is to circumcise a baby girl rather than teach her to properly clean her labia. But apparently it was still a-okay with this hospital to hack off the genitals of baby boys. Hell, the hospital openly encouraged it!

I wish I had known even ONE person at that time who had chosen NOT to circumcise. I didn’t have a religious reason to circumcise, so that might just have been enough to nudge me into researching just a little more.

But all I had was that stupid hospital class, so I consented to have you circumcised. And there I go downplaying it. Sending blame away from myself. The truth now… not only did I consent, I think I actually asked the doc when you would be circumcised. If only ONCE someone had mentioned that it wasn’t medically necessary... I know I would have questioned it. But no one did, so I willingly handed you over.

I remember briefly feeling sad that something about your perfect little self would be changed… and then feeling selfish because, “after all, this was a medically necessary procedure, done for your own good.”

I vaguely remember asking if they use anesthetic and something was said about sugar water. Good frigging God, I was so stupid. As far as I can tell, you had part of your genitals forcibly ripped off at less than 24 hours old with absolutely no anesthesia.

I’m sobbing now, writing this. I just want to go back in time and kick my own ass. What the hell was wrong with me?

But the way my brain worked back then, it never occurred to me that something so horrific - the outright torture of a newborn - would be even remotely legal. I thought it was really medically necessary like that hospital class had taught us, and I thought you hadn’t felt it.

And when you were a couple of months old, right as I was learning that your cesarean birth could have been avoided, I also learned the truth about circumcision. That there is no medical reason for it. And that the majority of boys are remaining intact these days.

I sobbed. I’m so sorry.

And then I became pregnant with your little brother. You two are only 19 months apart. It took some convincing of your daddy, but he eventually consented that the evidence showed there was not a medical reason to circumcise. So then it was just a matter of having him admit that you and your soon-to-be brother having matching penises was not a valid reason to amputate anyone’s genitals. And your sweet daddy very quickly came around.

You are five, and little bro is three. So far, there have been no questions as to why your penises look different. How will I answer that when it does come up? When you are still little I think I will keep it generic, so as to not freak you out. “Mommy made one decision for you, and another for your little brother.” So far each of you thinks that your penis is the most awesome thing since… well, since anything, so I don’t think it will be an issue.

But when you are older... a man… I would like to explain things more truthfully… and apologize.

I can only pray to God that you will be able to understand why I made such a poor decision, and that you will forgive me.

Of all of the parenting moments I look back upon, those I wish I could re-do, having you circumcised is the only one I have utter remorse for. I’m so sorry.

With much, much love,

Your Mommy


Mandi Woolery is a mommy to three kiddos, wife to a super-supportive man, and owner of Peachy Keen Birth Services, located in Upland, CA. After having an all-around horrible birth experience the first time around, Mandi's passion for gentle birth began. She now teaches natural childbirth classes, and is constantly rewarded as she witnesses her students making informed decisions. In addition to preparing expectant couples through her Natural Childbirth classes, Mandi also has the great honor of attending births as a doula, and is in the process of obtaining her birth doula certification through DONA International.

For additional letters and testimonies from mothers and fathers who regret not keeping their son(s) intact, or to meet those raising both circumcised and intact boys, see: I Circumcised My Son: Healing From Regret.

For additional information on the prepuce organ (foreskin/clitoral hood), intact care, and circumcision see resources, books, websites, and articles linked from this page.

For excellent pregnancy and birth resources (alternatives to the ubiquitously horrible, What to Expect series that Woolery mentioned), see books listed in this collection.


Circumcision: The Most Twisted Logic in the World

By Clara Franco
This article was translated by the author and editors for and It is available in Spanish here

Let’s imagine for a moment the following series of situations at the doctor’s office.

Scenario 1:

-You: Doctor, now that my baby is crawling, his fingernails get SO filthy - full of dirt! Besides, it’s hard to cut them; it is so much trouble and takes so much time. Because of the dirt and bacteria getting under his nails, and then into his nose and mouth, he’s sick all the time and getting infections. What can I do?

-Doctor: Ma’am, the best solution would be to immediately schedule an appointment to cut your baby’s fingertips off. A solution to last a lifetime!

-You: What?! How can you even think I would cut off my son’s fingertips?

-Doctor: But this is very normal. Lots of moms do it now. It’s harmless, really! We only cut a little piece at the tip of the finger, a very small bit. Only the part where the nail begins to grow. His hands really work exactly the same; but you’ll spare yourself of the trouble of cleaning his nails and trimming them - forever! You won’t even need to teach him how to wash his nails when he grows up.

-You: But doesn’t that hurt?

-Doctor: Absolutely not. Babies this age cannot yet feel pain, and even if they did, they won’t remember it.

Scenario 2:

-Doctor: It’s a girl! Mrs. X, I must remind you that your health care plan will cover the expenses in case you want to perform a radical mastectomy on your baby. The sooner, the better.

-You: A what?

-Doctor: You know, to completely remove her mammary glands. Breast cancer is now the second cause of death in Mexico for women over 25, and it’s more common every day! If we do the procedure on your daughter, you’ll forever forget about that risk. You could save her life! It’s better now that she’s a baby and she won’t remember. No cancer for her - ever! It’s becoming routine to do it when they’re this young. Remember, if you choose not to get the surgery, there’s still a 1 in 10 chance that she will have cancer and need the procedure anyway. Her mammary glands really do nothing but put her at deadly risk.

Scenario 3:

-Doctor: It’s a boy! So ma’am, we’re going for the appendectomy, right?

-You: Well, do you recommend it, doctor?

-Doctor: Absolutely. Look, more or less, four in every fifty children will have appendicitis at some point in their lives. And then it is a problem because if they don’t have the surgery immediately, they may die from peritonitis or septic shock. Now many parents choose to have the surgery done right after birth, and do away with the problem forever! We’ll remove it now, and spare ourselves from a scare when he’s older.

-You: But you’ll use anesthesia, right?

-Doctor: Oh no, that’s dangerous in newborns! We don’t apply anesthesia because then it would be a high-risk intervention. Besides, what’s the point? He’s so small and he can’t feel pain yet. He won’t even remember when he grows up.

Scenario 4:

-Doctor: Mrs. X, this is the third time in two years that your girl has had a urinary tract infection due to bad hygiene. Seriously, she needs to have surgery. These infections are much more common in girls than boys. You’ll see how quickly it is done - just a little cut to the labia, where the smegma accumulates, and that’s it. All better.

Scenario 5:

-You: Doctor, what can I do to keep my son from fracturing his foot for the third time?

-Doctor: Well, clearly, to amputate his feet would be the most effective solution!

Scenario 6:

-Doctor: Well, because we are already performing surgery on your son due to his accident, how would you like us to complete an aesthetic rhinoplasty? With an nice aesthetic nose he will be so much luckier with the ladies later on!...

If any of the situations above, as absurd and ridiculous as sound, seem impossible to us, we are being completely hypocritical. Because - surprise! - this is the very same twisted and ill-conceived logic that we’ve been applying to a single body part, of a single sex: the male genitalia.

It’s a completely altered, ashtray logic that we only apply to a male infant, when we decide we have the freedom to amputate a part of his penis… in a “preventive” manner.

Sure enough, there are societies where, in more egalitarian fashion, the same logic is applied to both sexes. There are societies that practice both female genital mutilation and male genital mutilation. For example, some sections of Indonesia, Malaysia, Somalia, Mali, Egypt, Kenya, etc.

There are also societies where, of course, neither FGM or MGM is practiced at all. But what’s despicable is the medical double standard, in societies where every individual’s body is highly respected, and amputation is a last, extreme resort - reserved solely for truly severe cases. Somehow, male genital mutilation has slipped in as a common, acceptable amputation surgery that a baby boy’s parents “have the right to choose.”

Let’s stop deceiving ourselves: every circumcision is an amputation, because it irreversibly removes an organ that has a name, specific functions, and the purpose of creating a normal sexual response. It is an organ that is healthy and that will no longer exist on the individual’s body after the surgery. Words such as “removal” or “extirpation” mean the exact same: am-pu-ta-tion. We cannot disguise it. Male circumcision is an amputation. And one that should only be decided upon by the owner of the body and no one else.

Rarely does a healthy human being need an amputation of anything. And, in the rest of the medical universe, amputations are rarely practiced. The need might arise because of severe, dated infections; extended, severe and uncared-for wounds; or because of gangrene (which is often the consequence of extended, severe and uncared-for wounds). Diabetes, for example, causes circulatory failures and a certain type of gangrene in the limbs, which sometimes makes an amputation necessary. But, again, those are cases of disease - uncared-for disease that has lasted a long time.

When is an amputation necessary?

• Malignant tumors
• Gangrene
• Severe frostbite (which is somewhat similar to gangrene: the organ or limb dies because the tissue is destroyed)
• Severe damage or trauma. For example, if one nearly loses an arm in an accident. If the arm remains only linked to the body by a very small part, and there is no way to recover it, amputation may be wise if the arm will only remain there as an infected limb.

No one in the medical establishment ever uses amputation as:

• A method of prevention
• Prophylaxis (as supposed “hygiene”)
• A first solution for treating infections
• A first solution for treating tight skin
• A first solution for treating anything

…Unless we are talking about the male prepuce. It is the only body part that we have not conceded the same respect to. Why are we getting carried away by such fallacy, such twisted logic? Why do we respect female genitalia, which by the way is more prone to infection and harder to clean than male genitalia, and yet we never, ever, cut away parts of it? In fact, in some nations (like the U.S.) there are federal laws in place to protect the female genitalia of minors from unnecessary cutting!

Something very similar has happened to our country’s medical establishment. We’ve ended up seeing this amputation (only this one, and exclusively this one), as something normal, desirable, "decidable by parents," aesthetic, hygienic, healthy. This is the only little loophole where no one seems to remember the Hippocratic Oath, or the need to use amputation only as a very last resort in rare and severe cases. We have conceded this amputation a sort of respect that it does not deserve. We have placed it into its own category within medical practice. (Look in many Healthcare Insurance Plans pamphlets: male circumcision really does have its own chapter).

The case becomes shamelessly lunatic when we realize that, today, many studies have been conducted concerning HIV and other sexually transmitted diseases which seek to legitimize the practice of male genital amputation on healthy individuals. These studies hold amputation as a starting point, and not the illness itself. How did we ever let this happen? What other medical study has ever started from the premise of amputation, and then tried to prove its use for something? To first push for genital mutilation, and then attempt to prove it to be good disease prevention.

Let’s imagine that an orthopedic surgeon performs a similar study:

“Medical research conducted by Doctor A. Smith, using experimental samples of individuals from Tanzania, has concluded that foot amputation definitely bears a positive effect in the prevention of various diseases and conditions; such as foot fractures, athlete’s foot and other kinds of fungi, ingrown toenails, and foot wound infections. When performed on newborns, amputation can also completely prevent accidents concerning “hair tourniquets,” a dangerous condition that happens when a hair or fine thread gets wrapped strongly around a toe, cutting blood supply. Out of 1,000 analyzed individuals, those who had feet amputations performed had a 95% lower chance of presenting ANY of these conditions, diseases and accidents!”

Doctor A. Smith is not lying. Amputating body parts does keep us from potentially having any trouble with those parts later. Because if we amputate, these organs or limbs no longer exist. Just as killing my neighbors would help me avoid any trouble with them in the future...

But that is such twisted logic that no one in their right mind would use. The body deserves respect. The body deserves treatment options. And it deserves integrity. It deserves our realization that every one of its amazing parts bears an important function - each and every one present to do something vital for normal health and funcitoning.

Would we support similar HIV studies if they were seeking to conclude that FGM is good disease prevention? No, we would probably dismiss such "research" as being unethical, and possibly a bit insane. As western women, we have been whole and healthy for centuries, knowing how to prevent and treat disease without resorting to amputation. By the way, these studies on women do exist. And yes, the results were that circumcised women had a lower chance of getting infected with HIV. Now who said there was no equality among the sexes...?

Unfortunately, too many of us allow ourselves to be sold nonsense justifications for amputation, for the most hollow and false reasons. Those of us sold on the surgery have an easier time if we also buy into the lies - "babies feel no pain" and "it won't hurt." If circumcision actually were helpful in reducing HIV, or sexually transmitted infections, or the latest "disease of the decade" then all our clinical trials would work the other way around. We would analyze the illness, and then conclude that it is solely and exclusively caused by this one body organ, and that amputation is truly the only way. But because this has never been, and likely never will be the case, we continue on in our desperate attempts to keep up with the myths and reinvent the latest "need" for prepuce amputation.

Clara Franco is the director of the National Organization of Circumcision Information Resource Centers Mexico chapter. Read more from Franco (in Spanish) at Mexico Intacto, follow at Mexico Intacto on Facebook, or find Franco's work in English also at:

Is the Pain of Circumcision Truly "Brief"?

Intactivists: Those Uncommon Activists

Related items: 

Routine Toe Removal Has Health Benefits

For further resources on the prepuce, circumcision, and intact care, see: Are You Fully Informed?


Forced Retraction: Don't Let it Happen to Your Son

By Peggy Fenton
Read more from Fenton at Intactivist Examiner

Jenny's pediatrician told her to start retracting her baby's foreskin for cleaning at his 12-month well baby visit. Jenny didn't do it, because she read that it's not good to retract on the internet.

At her son's 15 month well-baby visit, Jenny's pediatrician retracted the boy's foreskin herself, scolding Jenny as she did so, for neglecting her son's genital hygiene. The pediatrician told Jenny to retract her son's foreskin every day for cleaning. This time Jenny listened.

From that point on, she and her husband dutifully retracted their son's foreskin for cleaning, almost every day. This continued until the boy was 18 months old.

Then one day, Jenny noticed her son had not wet his diaper all afternoon. He cried at bath time as he dribbled a little urine. Soon the baby was screaming each time he tried to urinate.

Jenny's son's foreskin was infected, as a result of being retracted long before it was meant to be. By retracting the foreskin, Jenny's pediatrician had severed the fragile connective tissue between the foreskin and glans, and prematurely stretched the sphincter opening. The internal environment was no longer sterile and the natural protective flora had been disrupted.

Instead of cleaning and caring for her son's penis, by repeatedly retracting him as her doctor insisted, Jenny had been setting him up for infection.

After several trips to the emergency room for emergency catheterization to release urine, and a painful distressing week for Jenny and her son, he finally began to mend. Jenny realized her doctor had given her bad advice.

Jenny went online where she quickly connected with other mothers of intact boys, eager to share the intact care information so commonly lacking among American doctors.

What did Jenny find out?

* Only clean what is seen, and never retract. The foreskin is there for a reason - to protect the still developing glans, and to keep it clean and healthy. It is supposed to be attached to the glans during infancy and childhood.

* Forced premature retraction is epidemic among American healthcare workers, including pediatricians, and nurses, even doctors and nurses in the maternity ward. It is also epidemic among day care workers, babysitters, and well-meaning but misinformed aunties and grannies.

* Parents of intact boys must remain vigilant during the diaper years to prevent another person from prematurely retracting their son's foreskin. Parents must proactively warn doctors and nurses at every well baby visit that their son's foreskin is not to be retracted. It can happen in an instant, and then the damage is done. Parents should be direct and firm. If necessary, they may even threaten legal action if their wishes are not respected.

* If a doctor or health care worker prematurely retracts your child, consider reporting them to your state medical society, supplying all the details.

Additional Information


Forced Retraction: Now What?

Only Clean What is Seen: Reversing the Epidemic of Forced Retraction

Medical Testing: Do Not Retract

Forced Retraction: Ask the Experts

Doctors Opposing Circumcision - Warning to Parents: Foreskin Retraction of Intact Boys - an epidemic

Doctors Opposing Circumcision - Development of Retractile Foreskin

Only Clean What is Seen (pdf)


The Functions of the Foreskin: Purposes of the Prepuce

The Phony Phimosis Diagnosis

Protect Your Intact Son

National Organization of Circumcision Information Resource Centers Publication on care of the intact penis (pdf).

Raising Intact Sons

Basic Care of the Intact Child

Painful Urination During Prepuce Separation

Questions Regarding Normal Separation of the Prepuce

How the Foreskin Protects Against UTI

Circumcision Information Resource Page (CIRP) libray - Penile hygiene for intact males

*Note: You may wish to maintain a Diaper-On policy at check-ups to prevent this from happening. Unless there is a suspected problem, there is no reason your physician or nurse needs to remove your son's diaper. Simply state that you will be keeping it on - he can be weighed and checked with a clean diaper on, without removing it. If you'd like to learn more on how to examine your baby yourself, see the excellent book, Take Charge of Your Child's Health.


Genital Autonomy Pumpkins!

By Danelle Frisbie © 2010

Whether or not my son will grow up to be a baby-saver is yet to be seen. But he did a great job selecting the perfect pumpkin for our genital autonomy carving. You can download the pumpkin carving pattern that I sketched by hand (and had help cleaning up for a final version) here.

a little help from Dad

These tall pumpkins were heavier than first meets the eye...

Helping to clean out the 'good stuff' inside (for pumpkin seed baking!) and the carving begins...

I enjoy keeping the cut out pumpkin parts intact, to replace them for a silhouette style look in the dark. It is something I have fond memories of my dad doing with his funny pumpkin ears, eyes and noses when we were little.

We had a good (not so creepy) time doing a little in-the-dark photo shoot:

Above: with the GA person in place for the lighted silhouette effect

Below: with the GA person removed for the natural fully 'carved' effect

After we finished carving our GA pumpkin here on the homefront, we found that another friend did just the same. Guggie Daly writes at The Daily Guggie Daly and showcased some pumpkins here. Her creation reads, "Circumcision: The more you know...the SPOOKIER it gets!"

Mom to a brand new little boy, born unassisted in water at home under the harvest moon, Daly recently noted that, "I did not 'choose' to keep my son intact any more than parents 'choose' to let their newborns keep their legs, arms, nose, etc. It's a non-decision." Isn't that the truth!

A wise, yet commonsense thought for the season:

"Remember: Carve pumpkins, not babies!"
~ Chris McCaw

For additional resources on intact information:

In spirit of the season Christina from Intact Iowa shares this photo of her son


Genital Autonomy Pumpkin Carving Contest!! 

1st, 2nd, and 3rd place winners (as voted on by the Saving Our Sons and peaceful parenting communities) will receive a whole stash of genital integrity items ($20 value) to share in your area and save more babies from this spooky horror.

Request a set of Halloween Info Cards to share here

UPDATE: These sketches and pumpkins were carved in 2009. At the time there was no other existing symbol to represent our core beliefs of genital autonomy and advocacy in this area. Pumpkins were carved for fun, as a family, and shared with the community. As of 2013, the NOCIRC Child Symbol is a trademarked symbol. Per their request, please refrain from using the symbol in the future, for any reason, including family pumpkin carving at home, as it is reserved for their exclusive use. 

copyright free symbol, created by Megan Oregon in 2011, and signed into the public domain for use by any and all advocates of genital autonomy is available to use for future pumpkin carving family fun. 

Genital Autonomy Pumpkin Carving Pattern

To learn more about the genital autonomy symbol, please visit:

To read of how the genital autonomy pumpkin carving pattern came to be and see some photos of pumpkins peaceful parenting readers have sent in, see Genital Autonomy Pumpkin Carving.

You may need to click to open our image in a new window, save, and print as large as you need for your individual pumpkin size.

UPDATE: These sketches and pumpkins were carved in 2009. At the time there was no other existing symbol to represent our core beliefs of genital autonomy and advocacy in this area. Pumpkins were carved for fun, as a family, and shared with the community. As of 2013, the NOCIRC Child Symbol is a trademarked symbol. Per their request, please refrain from using the symbol in the future, for any reason, including family pumpkin carving at home, as it is reserved for their exclusive use. 

A copyright free symbol, created by Megan Oregon in 2011, and signed into the public domain for use by any and all advocates of genital autonomy is available to use for future pumpkin carving family fun. 

A Letter to My Intact Son: Why I Kept You Whole

By Ashley Goldstein © 2010
Dear Diego,

As you know, you are my first born. You are the child that taught me how to be in tune with natural living. You have erased much of my ignorance and made me grow up before necessary. I owe it to you to give you the best, and try everything I can to keep you innocent and out of harm's way. I love you more than I love living. This is a letter to you, my beautiful boy, explaining why I chose to keep you intact when the rest of the country is cutting.

You will probably be reading this when you are old enough to understand statistics, emotional reasoning, human rights, and what circumcision is (that is, if I taught you correctly). So I will start with the emotional stuff you might have already heard from me while growing up. It's a no brainier that I am of Jewish descendant, brought up in the hands of the Judaic Religion. We attended temple, your eldest uncle and 2nd cousins had a bar/bat mitzvah, and much of your distant family speaks Yiddish and Hebrew. We followed all the holidays and the children were taught the history of our people, but the males of the family were special in the way of becoming Jewish. On the 8th day of life, a newborn male is given a Brit Milah. The Brit Milah is the ceremony to welcome the newborn into Judaism by giving him a Hebrew name and a circumcision. A female newborn is just given the Hebrew name. I never wondered why this was the case, until I learned the little soccer player in my tummy was blessed with an anteater between his legs.

I always wished for a boy as my first born. I was terrified to have a daughter (an irrational fear that I have overcome) and cried tears of joy when I knew I was having a son. Your father couldn't have smiled brighter and your grandmother cried. Why she cried is something I still do not know of at this time. I never asked and just assumed it was because she knew I would go through hell over the circumcision idea (we had discussed circumcision once or twice before finding out your gender and they knew I was basing the decision on your dad, who is intact).

You probably already know what I went through with your grandparents, uncles and great-grandmother over circumcision, and if you don't, I will have no problem discussing this all after you have read this letter. But this letter is not for me to vent - it is for me to express my love for you - all of you.

Because my family went through so much trouble trying to convince me to circumcise you, my brother going so far as to print out pro-circumcision information and place it on my desk with a note, I wanted to know what it was all about. Growing up, I always asked, "Why?" I didn't want to do something if I didn't know why and how it was done. I have always been natural minded, not wanting to litter, waste or live beyond human ability, so to hear that something you are born with is bad made me curious. Why would nature have every single male grow this skin when it's harmful?

So I turned to my computer and your father. Surely since he is intact, others must be too! I thought circumcision was something that happened to every boy and only a few were kept whole. I was 15, and ignorant to everything but the things I was taught growing up. I spent many days using Google. I came to the conclusion that I had been lied to. Circumcision was done to very few and keeping a boy intact was decided for many. Europe considered it a barbaric act and many people equated it to Female Circumcision. There were activists called INTACTivists, solely fighting for the rights to genital integrity. I saw pictures of botched circumcisions, scars and videos of poor babies screaming while the doctor explains to that he is only crying because he is strapped down and not because he is slicing open his penis. I became angered and my motherly instincts kicked in to fight for you, again.

I would have been angered if someone cut me when I was a baby (since female circumcision wasn't illegal until I was 5 years old) so I had to assume you would be angered if someone cut you without your consent. What if you wanted your foreskin? And I had taken it away, for you to never get back? That didn't set right in my mind. Circumcision is permanent. I wouldn't tattoo you without you wanting it. I wouldn't force food down your throat if you pushed away because that's not my choice to make. Your penis wasn't mine. It is not anyone's but yours. You feel the pleasure/pain when it is messed with. You are the one it is attached to, so shouldn't you decide if you want a part of it to stay with you? The answer is simple: yes. I wanted you to tell me if you wanted to keep your foreskin, but you couldn't. Now you can when you are older, and when you know how it feels to have a foreskin, and I feel no guilt. If you don't want your foreskin as you grow, still no guilt because you can remove it on your own terms. But for me to say, "My son, I know you will hate this foreskin as you grow, let me get rid of it now," seemed strange in my mind. How would I know? The case is easy - I didn't know.

I had read that circumcision interferes with breastfeeding and I was so determined to breastfeed you without problems that this hit me the hardest. What if I did decide to cut you, and you didn't latch, and needed a bottle of formula? My ultimate goal/dream was to nurse you. If I was to fail I would take it to heart and never get over it. Little did I know how much I would go through with your short tongue and allergies, so I bet if you had been cut, I would have failed as I predicted. I would have a hurting baby boy, hurting breasts full of milk that I wouldn't be able to get rid of, and a baby trying to get comfort out of something made in a factory/lab. I wanted to be your comfort, for that warmth to be human and not from the stove. I needed you close by me, and selfishly, I needed you to reduce my risk for breast cancer as my mother was a breast cancer survivor. I never wanted to go through what she did. I left you intact, and you nursed whenever you wanted it, not needing the comfort to settle a pain that didn't exist, but none the less wanting it anyway.

I was not afraid of you being made fun of. Children are cruel and will make fun of you for being beautiful, kind and generous. Not much you can't do that children won't make fun of you for, so when I was given that argument, I blew it off. What I was afraid of was infections. I was told over and over again that no matter what, you WILL get an infection and it can only be treated by circumcision. I turned to the internet once again, that it being the only place I could go. I talked to many grown men who have never had an infection, or have only had one and it was treated easily with medicine. Non-painful medicine. I was content with that. That even if you did get an infection, you would just get medicine like you would if you got a sore throat or the flu. No different except in the area that it is in. I have gotten a few UTIs and yeast infections. They aren't a big deal and I knew if you got one, you also would be fine and not die. It would be another experience to learn from about the human body and the world around us.

We live in a house with running water and we always will. Keeping you clean as you grew older and your foreskin became retractable wasn't something I would be worried about. I know you could just rinse it like you do the rest of your body. You may not want to hear this, but I have taken showers with your father, I have seen how easy it is to clean, and that it takes no extra time or effort. I wasn't worried that cleaning your foreskin would be a chore.

Little did I know when I was pregnant with you that the year you would be born the circumcision rate would drop from 50% to 33% in the U.S., and it is predicted to continue dropping. Hopefully that was right, and you are among the majority instead of the minority. We may not even be living in the U.S. by the time you are reading this, therefore you definitely won't be the odd man out! I hope you grew up loving your body for what it is and how it was created. I hope you appreciate the decision I made for you and decide the same for your sons. I love you and am lucky to have such a great son to teach me the facts of life, human anatomy, and the ways of natural, healthy living.

Love unconditionally,
Your mommy!

Goldstein is a teen intactavist, lactavist and cloth diapering mama to Diego. She blogs about her daily struggles with her family, herself and the world around her at Fridge Magnets. A mommy by day and a student by night, she is on her way to change the world one reader at a time.

For additional information on the prepuce organ (foreskin), intact care and circumcision see: Are You Fully Informed?


Who Are You Calling an Intactivist?

An Intactivist Responds to the Death of Baby Joshua Haskins and the Virtual Mudslinging.

By Jennifer Coias © 2010

Intactivists are social reformers and, as such, have a long-standing history of ruffling feathers and challenging the mainstream. While intactivism is not new to criticism and attacks from those with opposing views, I’ve never witnessed something as volatile as the virtual mudslinging that ensued during this past week. Intactivists everywhere have been blamed, attacked and even threatened over what appears to be a complex web of lies and gossip as well as a general misunderstanding of the intactivist position concerning the death of baby Joshua. In order to clear up such a loaded debacle I find it necessary to speak for my community and explain the nature of our interest in the events that lead to Joshua’s death, as well as, to address the backlash concerning our community’s response to the this tragedy.

Before I delve into the details about the community’s true response to Joshua’s passing and the allegations leveled against the intactivist community, I’d like to take a minute to outline who intactivists are and what intactivists do. I firmly believe that much of this misunderstanding stems from the fact that the general public genuinely does not understand the work of intactivism. This ignorance leads to hasty generalizations, unfair accusations, and, ultimately, resentment toward a group of people who have done nothing to warrant such foul treatment.

Readers need to know, first and foremost, that simply being a person who is against circumcision is not the definition of an intactivist. Simply being a parent who did not circumcise their child(ren) does not make a person an intactivist. A person who was circumcised as a minor (a victim) and is now upset about what happened to them is also not necessarily an intactivist. Finally, it should be known that intactivists are not anti-circumcision. Intactivists are solely concerned with forced circumcision of minors and take no position against the personal choices of consenting adults with regards to their own bodies.

So what is an intactivist and what do they do?

- An intactivist is someone researches heavily to gather scientific evidence for the purpose of educating society and medical professionals as to: the functions of the intact genitalia; the proper care and natural development of the intact genitalia; the true, documented risks and complications of circumcision; and the harms of performing genital reduction surgery on non-consenting minors.

- An intactivist is someone who spends a great deal of time reviewing the following: circumcision statements and the ethical code statements of medical associations from around the world, the history of circumcision, the endless studies conducted for the purpose of either supporting or denouncing circumcision, human rights literature, litigation involving circumcision and any other material that involves circumcision.

- On the internet platform, some intactivists engage in open forum debates for the purpose of using reason, logic and scientific evidence to combat irrational thinking and to debunk common myths about circumcision and intact genitalia, however, other intactivists prefer to seek out parents who are in need of information. Many intactivists provide parents, both on the internet and in person, with information and resources so that they can make an informed decision before subjecting their child to this non-therapeutic surgery.

- At the activist level, intactivists participate in marches and peaceful demonstrations around the globe and push for legislation to regulate routine infant circumcision.

- Intactivists are primarily concerned with promoting bodily integrity - the right to a whole body - as one of the most essential and basic human rights granted to every person regardless of age, gender, race, nationality, religion, class and/or culture (meaning your body belongs to YOU), thereby giving a voice to our most innocent and fragile of citizens: babies and children.

The events leading up to Joshua’s death

Joshua was the newborn son of Jill and Shane Haskins and his short life was plagued with a series of heart complications due to congenital heart defect (CHD) and specifically: hypoplastic left heart syndrome. The events surrounding Joshua’s death were posted publicly by his mother, Jill, via her blog; however, have since been removed. For this reason, I will summarize a few of the events leading to the loss of this loved baby boy, as told by his mother.

The day prior to Joshua’s death, his parents consented to an elective circumcision. The doctor who performed the surgery accidentally severed an artery in the penis which resulted in hemorrhaging. The doctor applied pressure and powders to attempt to stop the bleeding, but even after multiple hours of doing so, was unsuccessful.. Only after 6.5 hours of bleeding did a pediatric surgeon finally come to see Joshua’s wounded penis. At that point the surgeon recognized that an artery had been cut and informed the his parents that he would need a couple stitches to stop the bleeding. That evening Jill recounted the events in a teary, heart wrenching blogpost titled, I Almost Killed My Son. Jill wrote:
Right at this moment, Joshua is now back on 85% oxygen through his nasal cannula, his stats are in the upper 60s, he’s drugged, pale, and his crit levels are 41. They are going to give him until midnight and run his crit levels again. If they have not risen, then he will receive yet another blood transfusion.

I should have known better, I should have said no. I had hoped that he would do well and that it wouldn't be such a big deal. But instead I almost killed my child by consenting....I’m watching him sleep and I’m struggling with extreme guilt over all this. I put him through it, Shane and I chose to have this done to him. It wasn’t necessary. Why did we do that? Why is this so freaking hard?

Early the following morning, Joshua went into cardiac arrest and tragically departed this world. He was seven weeks old. Following his death, Jill’s friend, Carla, reported on the blog that the hospital doctors had, "reassured them over and over that that circumcision had nothing to do with Joshua’s death."

Jill and Carla have both reported that there were several mean, attacking comments left by readers in response to the blogposts about Joshua’s death. From there it was assumed by Jill, blog readers, and even some intactivists that the intactivist community, or at least some members of the community were heartlessly bullying, threatening and blaming this grieving mother and family. There were a few pro-circumcision people who told others that intactivists were "behind it" and telling their readers to bully Joshua's parents. Jill tweeted to the Ellen Degeneres show, “I just lost my 7 wk old son today. died in my arms. the anti circumcision community is bullying. he died of CHD not circ. help.”

Intactivists Respond

Why can’t the real intactivist “just shut the f*** up” (as was requested by this blogger) about the death of this infant boy? Well the answer is rather simple: duty. Duty to Joshua and duty to every other innocent baby boy subjected to genital reduction surgery. As a community that seeks truth and transparency regarding the issue of circumcision, we have an obligation to speak up when what is being reported is inconsistent with the facts, especially when the facts would tend to show that circumcision was the primary culprit in the death of a defenseless child. As tempting as it might be to just bury our heads in the sand and let our knowledge and experience go unused, doing so would be a disservice to our society, to parents, and to the boys who we work so diligently to protect. Our end goal is to protect non-consenting minors from the harms of circumcision and to prevent irresponsible actions and decisions, which result in pain and suffering, from going unpunished and undocumented.

Mistakes are a part of life, but unless we take the time to recognized and learn from those mistakes they will continue to happen again and again, as has been the case for little boys subjected to non-therapeutic circumcision. One could say that without mistakes and taking the time to process and learn from mistakes there can be no true progress. Based upon the events surrounding Joshua’s death, as presented by his mother, there are enough inconsistencies and red flags that make it well-worth the time to investigate his death.

Regardless of how things turned out for Joshua, the hospital doctors made some serious errors in judgment which put Joshua at significantly increased risk, plain and simple. That said, let’s take a minute to examine some of the facts and inconsistencies as well as address some intactivist concerns regarding little Joshua’s death.

When considering the evidence available to us it is virtually impossible for Joshua’s doctors to make the claim that Joshua’s death was entirely unrelated to the complications of his circumcision. This past May, Peaceful Parenting posted an article which synthesized research about the well documented risk of cardiac arrest and hemorrhage resulting from circumcision. These are real risks for a even healthy newborns and the harsh reality is that circumcision surgery is extremely taxing on little hearts. Readers should know that professional medical and health organizations such as the RACP, AAP, CPS and others have even listed circumcision as contraindicated for unstable infants.

The day prior to Joshua’s surgery Jill blogged:
Now that Joshua is is ‘somewhat’ stable condition, the doctor didn’t want to wait any longer to get it done. There is a risk that comes with having Joshua circumcised. Once babies are bigger, they run a higher risk of bleeding too much. The longer we wait, the higher the risk of bleeding. So the doctor ordered for it to be done TODAY.

Following his death Jill’s friend Carla posted the news of his death with the following explanation, “Put simply, he has been working his heart since birth. Every day was a stress on his heart and it was just not able to continue.” So based on his mother’s perception, Joshua was somewhat stable; however, based on the doctor’s testimony that each and every day was a stress on his heart, it is clear that Joshua was in no way stable, and therefore not a candidate for elective surgeries.

Additionally, Joshua hemorrhaged for 6.5 hours before a surgeon came to assess his condition. His mother described how they were applying pressure and a powder to stop the bleeding but nothing worked because, unbeknownst to her, the doctor who performed the surgery had actually severed an artery. This level of hemorrhaging causes the heart to work much harder and beat faster due to a rise in blood pressure. Combine that with the extra work the heart already had to do during the actual operation, and you have one extremely tired little heart. A seven hour workout for an already fragile heart will have lasting effects, even into the following day. The heart is a muscle and just as you can feel soreness or tiredness the next day after a big workout, the heart also gets weak and tired after a big workout. If everyday stress was enough for Joshua’s heart to give out, would it not stand to reason that the 6.5 hours of extra work his heart did the previous day could have been the finger that pulled the trigger of a loaded gun? How can a medical doctor reason that "everyday stress" caused Joshua’s death but not the added exhaustion from hours of hemorrhaging and cortisol spikes (stress hormones that tax the heart muscle) the previous day?

Finally, it is still unclear whether Joshua received a blood transfusion, but if so, this is another factor that could have lead to cardiac arrest. Cardiac arrest is a well documented risk of blood transfusions. It is entirely possible that the blood transfusion, which would have been required as a result of the hemorrhaging, could have caused little Joshua to go into cardiac arrest. In fact, there were a cascade of medical interventions that ensued after the complications of his circumcision. Given this reality, there are simply too many factors surrounding Joshua’s circumcision complications and subsequent medical interventions to rule out circumcision as a cause of death.

It is highly appropriate to point out that the blatant negligence of the hospital, and to question how these actions could have played a role in the loss of an innocent life.

-Should doctors have ever cut into the most sensitive, nerve-laden part of this fragile boy’s body knowing that he had this preexisting condition and that he was not in stable enough condition to manage even the stresses of everyday living? Why didn’t these doctors honor their oath to do no harm and to put the interest of their patient first?

-Should this NICU infant have been left to bleed for almost seven hours without being assessed by a surgeon when it is well known that even an ounce of blood loss is enough to cause hypovolemic shock and 2.3 ounces of blood loss in a healthy newborn results in death by cardiac arrest secondary to exsanguination?

-Should doctors have openly pressured Joshua’s parents to consent to a non-therapeutic surgery, claiming that the older he was, the higher the risk, especially considering that most parents of extremely fragile NICU babies are advised to wait a full year before electing to circumcise, should they choose to do so, at a time when the child is stronger and general anesthesia can be used safely?

These are all very hard but necessary questions that community members, government authorities and intactivists should be asking Joshua’s medical care providers. The doctors were the ones who were ultimately responsible for Joshua’s wellbeing. What is particularly interesting is the way in which the hospital doctors went about reassuring Jill and Shane “over and over” that the circumcision played no role in Joshua’s death. In yet another blogpost following his death, Jill wrote, “The team of neonatologists and cardiologists made it extremely clear that Joshua's cardiac arrest was NOT in any way related to the circumcision. His heart simply could not work any more. He put up a good fight, but he just simply couldn't do it.”

While it is very appealing and comforting to trust that the hospital is telling the absolute truth to these grieving parents, after examining the blatant negligence, it is highly likely that this hospital is just trying to cover up their own fatal errors to avoid a lawsuit, especially in light of the media attention that yet another circumcision lawsuit would arouse (Baby Mario’s lawsuit). In other words, we don’t buy it! Doctors are scrambling to discredit the complications of Joshua’s circumcision as a possible cause of his heart failure, but the evidence says otherwise. Doctors may see it as a win-win situation. They never have to face the repercussions for their errors and Joshua’s parents never have to go to bed wondering whether the circumcision was what pushed their baby boy’s heart over the edge.

While it might be too late for Joshua, we must think about the next boy who will enter that NICU and about all of the other families with sick newborns who are considering circumcising.

It is a fact that almost all infant deaths from routine infant circumcision are due to cardiac arrest and/or hemorrhage resulting from the circumcision. It is also a fact that only a small fraction of actual deaths resulting from these well-documented circumcision complications are formally linked to the actual act of circumcision within the medical record of each victim. This means that while these boys’ records report “blood loss,” “hemorrhaging,” and/or “cardiac arrest,” there is absolutely no mention of the root cause: circumcision surgery. This is a huge problem that should concern all parents.

Based on sketchy reporting by hospitals in the U.S., researchers acknowledge that the current statistical figures for circumcision death rates and complications is far lower than the actual death rates and complication rates. If parents are making decisions about the fate of their son’s life, it only makes sense that they should also have access to accurate statistical information prior to opting for this potentially life-threatening genital reduction surgery. At present, the majority of parents do not have a clear understanding of the true risks of circumcision because the medical community has not been able to provide reliable statistics concerning death and complication rates. Essentially, this means that no parents are able to give true informed consent when they sign off on genital reduction surgery for their son. This is yet another reason we need to ask some hard questions when these tragic situations arise.

Intactivists are working against more than a century’s worth of misconceptions and tradition in North America. If we are ever to free our society from the hold of genital mutilation, or at the very least expose the truth regarding the dangers of circumcision, we must ask the tough questions and challenge a medical community that continues to partake in cosmetic surgery on non-consenting minors.

While educating parents is an important step to progress, the single most effective way to end unnecessary circumcision is to remove this non-therapeutic operation from the hospital menu. We can only do this by holding the medical community accountable for their actions. Gone are the days where people sit back and accept the proclamations of doctors as the gospel truth. Doctors are not gods and they are not perfect. Like anyone else, they have their own agenda and they have their own livelihood to protect. At this point, every medical association in the world agrees that circumcision is non-therapeutic in nature, and that there is not sufficient evidence to support routine infant circumcision. So why, then, are doctors still doing this to healthy babies and, more importantly, why are they doing it to extremely ill babies? I challenge readers to seek the answer.

On the Backlash.

It is evident that an entire community of professional intactivists (who work tirelessly to accomplish the items listed at the beginning of this article) are being blamed for the voices and actions of a handful of people who happen to be against circumcision or possibly even a few trolls (circumcision fetishists in disguise posing as intactivists to cause trouble). There is little doubt that several attacking, mean statements were made to Joshua’s mother; however, readers should be reminded that the internet is a rather a big space, with contributors from all walks of life. When something is posted on the internet there should always be healthy skepticism of the the origin and validity of the statement. Blog comments and tweets are two particularly anonymous means of communication in which it is very difficult to assess the true intentions and origins of what is written. Let it be it known that our community does have a few well-documented enemies who troll around and impersonate intactivists for the sole purpose of making us unpopular, unliked, and creating distrust in our organizations and message. In particular, there is a user by the name of "CircInfo" on Twitter who has created additional fake accounts in order to cause exactly this type of uproar. Sadly, there are individuals, such as this user and others, who use their blog, their Facebook pages, and their Twitter accounts in their obsession to ensure that pro-cutting propaganda is perpetuated, and/or that well informed intactivists are routinely and constantly bashed and made to look like "terrorists."

While I believe it is quite easy to understand why a particular interest group, such as ours, would be in support of protecting children’s bodies, it is beyond rational understanding as to why any person would spend their time and energy striving to ensure that doctors cut as many children as possible by way of spreading myths and out-dated information on the internet, and blocking/banning/deleting the response comments made by intactivists. The intentions of these particular people are sick and can usually be linked back to circumcision fetishist sites and organizations, such as Circlist.

Finally, as mentioned previously, simply stating one is "against circumcision" does not make a person an intactivist. People who are simply against circumcision but do not aspire to the goals listed at the beginning of this article often share their opinions in a haphazard manner and create a lot of confusion as to what really constitutes someone as an intactivist. These pseudo-intactivists simply do not have the expertise or experience with the subject matter to make well-rounded, articulate discourse. Any person who made nasty remarks or attacks against Joshua’s mother is not - I repeat - NOT, a member of the intactivist community. The intactivist community has absolutely zero interest in attacking, threatening and/or making cruel statements, especially towards parents who have lost children because of circumcision. Such behaviors are not only fruitless to our goals, but they are simply not becoming to a group of people who ultimately wish to promote peace and humanity for all.

Among my intactivist colleagues, which are innumerable, I have not encountered a single person who is without deepest sympathy for the this family’s loss. Let it be known that intactivist community has absolutely no interest in blaming Joshua’s death on his parents or in attacking a grieving family. Placing the blame or attacking these loving parents does virtually nothing to further any of the goals or interests of intactivism. I’ll take a moment to speak for my community... If Joshua’s parents are reading this now, I would like to extend our sincerest condolence for your loss. No parent should ever be faced with the agony of burying a child, our hearts go out to you and your entire family.


Information on newborn circumcision-related death in the United States:

Bollinger, Dan. Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths. Thymos: Journal of Boyhood Studies. 2010;4(1):78-90.

Baker RL. Newborn male circumcision: needless and dangerous. Sexual Medicine Today. 1979;3(11):35-36.

Death From Circumcision

Circumcision Information Resource Pages - Death

Doctors Opposing Circumcision - Statement

Circumstitions - Complications

NOHARMM - Complicaitons Incidence

National Organization of Circumcision Information Resource Centers 2010 newsletter

Partial list of those who've died during/post-circumcision

Doctors Re-examine Circumcision

What Your Doctor May Not Tell You About Circumcision

Circumcision: The Hidden Trauma

Chidren's Genitals Under the Knife

Circumcision: The Rest of the Story

Several texts examine past research on this subject here

Today more baby boys die from circumcision surgery each year in the United States than from choking, from auto accidents, from suffocation, from SIDS, from (recalled) sleep positioners and from (the newly banned) drop-side cribs.

Additional Articles by Jennifer Coias:

The Phony Phimosis Diagnosis

Circumcision: Already Illegal?

The Nuts & Bolts of HIV in the USA and why Circumcision Won't Protect Men

Basic Care of an Intact Child

Painful Urination During Prepuce Separation

Turn Your Crib into a Co-Sleeper

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