The AAP 2012 Circumcision Policy Statement and What I Have Learned from a Decade of Intactivism

By Karen Glennon
Further reading on the 2012 AAP Policy Statement



I have long said that the medical community will not stop soliciting circumcision voluntarily. I have long said that the most effective way to significantly reduce circumcision in America is by educating the individual of child bearing age (or younger) because circumcision happens one parental consent, and one baby at a time.

Each parent that says no to circumcision will raise a child to whom the whole body is normal. I am on the 40 year plan with my intact education and advocacy. If I reach a young adult in their teen years now and they go on to have a whole child in a few years - then that child grows up with a normal whole body. In 20 years, that (1st generation) whole child will be an adult who may have a (2nd generation) whole child of their own. In 20 years that 2nd generation whole child may have one of their own and we’ve arrived at the 40 year mark with 2 generations of acceptance and appreciation and normalization of the natural male body.

How do we get young people to leave their future children whole? We educate them about the anatomy and function of the foreskin. In all my years of face to face demonstration/education on this issue, I have never failed to get a young person to listen to me talk to them about normal sexual development and function of the sexual organs. Young people do not get this information from their parents, from school, from text books, from porn, from their peers or from pop culture. I cannot tell you how many people (of all ages) have said to me “No one has ever told me this.” (I get this same response from older adults too!)

If you do not know what something is made of and how it works, it doesn’t have value to you. You never go to a yard sale, an antique shop, an auction and pick up an item you do not recognize, you know nothing about and say “Wow, this is so neat, I just have to buy it!” You cannot find value in something if you do not know what it is and what it does. The same is true for the foreskin. This is exactly why the prevailing myths in America of “oh, it’s gross” and “it’s dirty” and “it’s a useless flap of skin” thrive – people know nothing of its structure and function.

They do not know:
  • that the foreskin contains far more fine touch nerve receptors than the exterior parts of the female clitoris (over 20,000 verses about 8,000).
  • that the foreskin is a double layered skin system and is approximately 12-15 square inches in an adult. 
  • that the end of the penis is supposed to be mucosal tissue like the inside of the cheek or the inside of the eyelid.
  • that the foreskin slides and has a gliding action during intercourse, all the while providing exquisite sensations for the man that shape his orgasmic response.
  • that this gliding action maintains a woman’s vaginal lubrication and does not dry her vagina out, making for a more comfortable experience for both partners and eliminating the need for artificial lubricants. 
  • that having the foreskin increases the girth of the penis and that it allows a man to have enough skin to accommodate his whole penis – intact men are larger. 
  • that intact men often use shorter, gentler strokes, thus maintaining more contact between his pubic bone and hers, and her clitoris. 
  • that intact men do not need to pound and thrust like many circumcised men do to achieve orgasm.
When they learn this – suddenly the foreskin has value! Once a person sees it has function for the man and for his partner, it is much easier for them to allow into their minds the idea that a man shouldn’t be robbed of this function and value. All of a sudden his bodily integrity seems important. His right to choose seems important.

The fact that the medical community is performing amputative surgery on a baby with no deformity or disease seems important (and wrong). The fact that the American government enacted federal legislation to protect girls from genital cutting but doesn’t protect boys seems important (and wrong).

It’s easy to counter the myths when you believe the foreskin has some importance. All of a sudden hygiene is easy to explain with a shower and “retract, rinse, replace” is easily understood.

All of a sudden infection is easily explained by the fact that girls get genital infections and we medicate them, we do not amputate their genitals. We can do the same for men. (Also, if penile infections were really such an issue, we’d have a section in the drug store for penile infection creams. We certainly have a female genital infection medication section – full of creams and products to “freshen” our nether regions. Ever wondered why we don’t have these products for men? Perhaps these infected penises are truly a myth!)

All of a sudden it’s not just a little snip. It’s the elimination of what will ultimately become 50% or more of the penile skin. It is the destruction of an exquisite system designed to protect the glans in babyhood from the diaper environment, and from abrasion with clothing for the rest of life.

None of these facts sway people until they first establish a value for the foreskin. Until they understand and believe a value in it, circumcision will always be a valid 'parental choice' to protect a baby from disease and to conform to society (in America).

The medical community will not stop soliciting circumcision until the liability of risk outweighs the profits to be gained. This will only happen when lawsuits for damage are greater than profits. While there have been many gross injuries and even deaths, they don’t get the attention they deserve because we don’t value the foreskin more than the risks of cutting babies. The uneducated public is willing to ignore the few horrible mishaps for the greater myth of a cleaner, prettier penis because they don’t know the value of the foreskin.

The general public will say NO to circumcision when the medical community solicits it - IF they know the value of the foreskin, the truth of the procedure and what their son loses forever. It is my commitment that they be informed and that they know the value and that they make the right decision for their son and the man he will become.

I know that so many of us are disheartened by the AAP’s new policy statement, but we have to realize that the AAP is a professional trade organization and it exists for the promotion of its members – pediatric doctors. It is not, and never will be, a patient advocacy group. They have a profit line to maintain and a drop in circumcision rates is not beneficial to them.

They will not stop soliciting circumcision until one of two things happens (or both):
1) The financial risk of performing this unethical surgery outweigh the profit to be made: lawsuits for botched circumcisions or bodily integrity violations cost too much.  
2) The majority of parents staunchly refuse, forcing them to do an internal evaluation of the procedure. I suspect it would take 75% or so refusing before this happens.
Don’t lose faith. The truth has its own longevity. The human body is genetically programmed to form a foreskin. It will always do this. All we need to do is understand its function to give it value. That which we value, we care for. It’s all about education.







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AAP Circumcision Policy Statement: A Critique

On Monday, August 27, 2012, at 12:01am ET the AAP is scheduled to release their newest policy statement on circumcision. While the rest of the world moves in a direction far away from the forced genital cutting of healthy babies and minor children, with many nations implementing bans on the practice, this new AAP statement takes an awkward, pro-cutting slant, and one that it not grounded in sound medical evidence. What follows is the critique of one scholar, Petrina Fadel, who serves as the Director of Catholics Against Circumcision.


PART ONE

Dear AAP Board Members:

I am writing to you to request that you withdraw or rescind the newest 2012 AAP Circumcision Policy Statement. Below I have critiqued for you some of the serious problems with this new statement.

The Abstract states on page 585 that “health benefits are not great enough to recommend routine circumcision for all male newborns,” but this is not repeated even once in the long text on pages 758-785. Other long columns favoring circumcision are repeated over and over again, on pages 761-762, 770, 775-776, and 778. The 1999 AAP Statement was 8 pages long (pages 686-693), but this diatribe against living with a foreskin goes on for 28 pages. There is almost the feeling that AAP physicians hope that if they repeat something over and over again, eventually it might become the truth.

The AAP concludes on page 778 that “the health benefits of newborn male circumcision outweigh the risks”, and yet on page 772 the AAP admits that “the true incidence of complications after newborn circumcision is unknown”. If one doesn’t know how often complications occur, then one can’t make the judgment that the benefits outweigh the risks! The AAP lacks the evidence it needs to make such a claim.

The 1999 Statement studied 40 years’ worth of research, and the 2012 studied only selective research since 1999. Only 1031 of 1388 studies were accepted to look at. Balance might have been found in the 357 studies that were omitted, but the AAP was not seeking balance. The AAP statement goes on ad nauseum about alleged “benefits”, to the point of fear-mongering that something will go wrong if an infant isn’t circumcised. It’s a high pressure sales pitch to try to get the American public to buy the circumcisions that AAP and ACOG doctors are selling. This is in direct contrast to Europe, where circumcision is uncommon and the health of European children equals or surpasses that of American children.

No studies on ethics were included in this statement, and it is clear that the rights of the child and how a grown man might feel about HIS foreskin being stripped from him were never given any consideration at all by the AAP. These are major issues, and even more important than many of the other minor issues the AAP discusses. Material was provided to the AAP to study this aspect of circumcision, but it was ignored. With one bioethicist on the panel, you would have thought that the AAP might at least have given the ethics of circumcision a cursory examination, considering that they were provided with many sources showing the emotional distress many men feel. Ethics and mental health, however, nowhere enter the picture for the AAP. Respect for the bodily integrity of another person were not included, and medical ethics were thrown out the window as infants were thrown under the bus.

Financing studies weren’t included in the studies, but the AAP did its best to push financing repeatedly for third-party reimbursement of non-therapeutic circumcision, at the expense of taxpayers during a time of budget crises. Those with private insurance would see premiums and medical costs rise. The cost for circumcision on page 777 ranges from $216 to $601 per circumcision in the U.S. In 2010, the in-hospital U.S. circumcision rate was 54.7%. Thus, 45.3% of newborn males left the hospital genitally intact. If the AAP were to convince parents of these 45.3% to circumcise (as they are attempting to do in this 2012 statement), then there would be 45.3% of roughly 2.1 million baby boys that could be an additional income source for physicians. (Remember, don’t consider the ethics!) This would be an additional 951,300 male infants to profit from. At prices the AAP quotes, this could mean an additional $205,480,800 to $571,731,300 for doctors who circumcise. This is no small sum, and as Thomas Wiswell, M.D. stated on June 22, 1987 in the Boston Globe, “I have some good friends who are obstetricians outside the military, and they look at a foreskin and almost see a $125 price tag on it. Each one is that much money. Heck, if you do 10 a week, that's over $1,000 a week, and they don't take that much time. “(Lehman 1987) Money like that would certainly help doctors make their mortgage payments and their car payments, pay for vacations, etc. - a “benefit” that the AAP failed to mention. Under Literature Search Overview, it is understandable why AAP physicians might consider it important to investigate “What are the trends in financing and payment for elective circumcision?”

No studies on the anatomy and functions of the foreskin were included. This is surprising, since it would seem like common sense to consider what the functions of any healthy body part are before amputating it. Probably since the male AAP Task Force members are all circumcised, this idea was difficult for them to grasp. Only one study on the sexual impact of circumcision was included, and this from Africa. Other studies were ignored or discounted. “The effect of male circumcision on the sexual enjoyment of the female partner”, which appeared in BJU INTERNATIONAL, Volume 83, Supplement 1, Pages 79-84, January 1, 1999, is not mentioned. Nor is the newest Danish study that was publicized on November 14, 2011 – “Male circumcision leads to a bad sex life” - "Circumcised men have more difficulties reaching orgasm, and their female partners experience more vaginal pains and an inferior sex life, a new study shows." See: http://sciencenordic.com/male-circumcision-leads-bad-sex-life The AAP had time to include this study, but it was ignored. Others sent material to the AAP about CIRCUMserum, Senslip, foreskin restoration that men are undergoing to undo some of the damages of circumcision and how this improves the sexual experience for both men and women. It didn’t fit the AAP’s pro-circumcision agenda, so it was ignored. The Policy Statement is totally lacking in ethics, anatomy, and foreskin functions. Instead, the Task Force is more concerned with how to train more doctors to circumcise, and how to do so with different devices and various forms of anesthesia.

The physical and sexual harms from circumcision are minimized or dismissed outright. Deaths from circumcision and botched circumcisions are considered “case studies”, and the children horribly damaged from circumcision don’t merit the AAP’s consideration, even though the AAP’s alleged mission is that it is “Dedicated to the Health of All Children”. When cribs are faulty or car seats aren’t safe, the AAP becomes concerned and warns the public. When physicians botch circumcisions and are at fault, children don’t matter. After one botched circumcision lawsuit and a large settlement, the company that manufactured the Mogen clamp went out of business. The AAP report should have advised physicians to NOT use the Mogen clamp because of the botched circumcisions that have resulted with this device. If still in use, no doubt there will be future tragedies with the Mogen clamp, but parents will only be able to sue the doctor and hospital and not the manufacturer.

There was so much reliance on studies from Africa in this statement , that it seemed like the AAP should change its name to the African Academy of Pediatrics. In contrast to the AAP, the American Association of Family Physicians (AAFP) has stated: "...the association between having a sexually transmitted disease (STD) - excluding human immunodeficiency virus (HIV) and being circumcised are inconclusive... most of the studies [of the effect of circumcision on HIV] ...have been conducted in developing countries, particularly those in Africa. Because of the challenges with maintaining good hygiene and access to condoms, these results are probably not generalizable to the U.S. population". But generalize the AAP did! In addition, the AAP listed page after page of STDs that allegedly circumcision would prevent, and wrote conflicting statements about syphilis. A recent study in Puerto Rico found that circumcised men have HIGHER rates of STDs and HIV. The 60% reduced risk of HIV following circumcision is the relative risk reduction, not the absolute risk reduction. There’s a huge difference. Across all three female-to-male trials, of the 5,411 men subjected to male circumcision, 64 (1.18%) became HIV-positive. Among the 5,497 controls, 137 (2.49%) became HIV-positive”, so the absolute decrease in HIV infection was only 1.31%, which is not statistically significant.” (Boyle GJ, Hill G. Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns. J Law Med 2011; 19:316-34.)

Infants are not at risk of STDs or HIV through sexual contact, so this speculation about their future risk is foolhardy. Infants can also be at risk for many other diseases, but surgical amputation of healthy body parts is a foolhardy approach for prevention and treatment of disease. If an infant is at risk of an STD, then it is probably safe to say that an adult is perpetrating a crime against the child and needs to be arrested and charged.

Judaism and Islam are mentioned as religions that practice religious circumcisions. Once again, the statement ignores Christianity, which teaches that circumcision is unnecessary. Christianity is the largest religion in the U.S., but its teachings don’t even get a mention by the AAP, which is rather insulting! With an over-representation of members on the Task Force who have a religious bias favoring circumcision, this is not surprising.

The AAP promotes parents choosing medically unnecessary circumcision for their male children, completely contradicting what it said in PEDIATRICS, Volume 95 Number 2, Pages 314-317, February 1995. It said then, “Thus "proxy consent" poses serious problems for pediatric health care providers. Such providers have legal and ethical duties to their child patients to render competent medical care based on what the patient needs, not what someone else expresses. . . the pediatrician's responsibilities to his or her patient exist independent of parental desires or proxy consent.”

Parents deserve factual information about circumcision, but they won’t find it in the new AAP Statement. In fact, the AAP wrongly advises parents of intact baby boys to retract the foreskin and wash it with soap and water. (page 763) Soap can alter the good bacteria under the foreskin, potentially causing infections that should then be treated with liquid acidophilus to restore the good bacteria. Water is sufficient for cleansing. Circumcised doctors with circumcised sons probably don’t know this.

On page 764, the AAP speculates that the foreskin contains a high density of Langerhans cells, “which facilitates HIV infection of host cells." Actually, the exact opposite is true. "Langerin is a natural barrier to HIV-1 transmission by Langerhans cells" (Nature Medicine- 4 March 2007). This study states, "Langerhans cells (LCs) specifically express Langerin . . . LCs reside in the epidermis of the skin and in most mucosal epithelia, such as the ectocervix, vagina and foreskin.”

UTIs can be prevented through breastfeeding, which the AAP allegedly supports. This is nowhere mentioned under “Male Circumcision and UTIs” on page 767. HPV can be prevented with a vaccine for both boys and girls, but it is not mentioned on that same page. A recent study reporting on the large number of re-circumcisions done following infant circumcisions is also not even mentioned. On page 770, EMLA is mentioned as a possible anesthetic, but EMLA is not supposed to be used on infants. The fact remains that unnecessary surgery performed with anesthesia is still unnecessary surgery.

There is so much wrong with this new statement that it should immediately be withdrawn before it is presented on Monday. The AAP should either start all over again (with new, unbiased Task Force members), or renew its 1999 statement which attempted to at least give a more balanced view of circumcision. The 1999 circumcision statement certainly had its flaws by ignoring ethics and the anatomy and functions of the foreskin, but it wasn’t as atrocious as this new statement is.

If the AAP wants to be regarded as a credible organization, it will look to the judgment of other foreign medical associations who recognize that circumcision is medically unnecessary and has serious ethical problems underlying its practice. American parents should look to these foreign medical associations for good advice, since the AAP is not providing it in its new statement.


To the AAP Board of Directors and the AAP Task Force Members:

After rereading the AAP's new Circumcision Statement, several more problems have emerged with this statement. This statement needs to be rescinded and withdrawn immediately! Others are becoming aware of this matter as well.

Under "Ethical Issues" (pages 758-759), two of the references for this opinion come from Dr. Douglas Diekema (AAP's bioethicist), who signed his name to this statement. The rights of the child are totally ignored in this section, from an organization that claims to be concerned with the welfare of children but in this case isn't. This is Diekema's own personal opinion that the Task Force has bought into, based on what he wrote before. References are also taken from M. Benatar and D. Benatar (both Jewish circumcision supporters), as well as from AR Fleishman (whom I suspect has a religious bias favoring circumcision). Under "Ethical Issues" (page 759), there's an interesting choice of words by the AAP. "In cases, such as the decision to perform a circumcision in the newborn period, ... and where the procedure is not essential to the child's immediate well-being ..." , the AAP admits here that circumcision "is not essential". It even calls circumcision "elective" in several other places, but it then proceeds to do a massive sales pitch for this unnecessary surgery.

Under Ethics, Reference #14 comes from the British Medical Association- "The law and ethics of male circumcision: guidance for doctors: J. Med Ethics 2004. The BMA did not print a favorable piece on circumcision, but the AAP cherry-picked something from it on page 760. Medical associations in other countries, like the British Medical Association, do not promote circumcision as the AAP has so foolishly chosen to do.

On page 760, the AAP states, "The Task Force's evidence review was supplemented by an independent, AAP-contracted physician and doctoral-level epidemiologist who was also part of the entire evidence review process." Who was this? The AAP should reveal the name of this physician.

Several times in the report, the AAP states (page 762), "For parents to receive nonbiased information about male circumcision in time to inform their decisions...clinicians need to provide this information at least before conception, and/or early in the pregnancy, probably as a curriculum item in childbirth classes." There is absolutely no way doctors can do this before conception, and "Inform their decisions" is code for brainwashing parents as early as possible. This is mind control at its worst, supported by the AAP!

The AAP on page 763 uses the term "Uncircumcised" under "Care of the Circumcised Versus Uncircumcised Penis", and later the term "non-circumcised" when saying, "The non-circumcised penis should be washed with soap and water." The correct terminology is intact penis, or normal or natural penis. We don't say "uncircumcised" female or "non-circumcised" female.

The APP on page 764 states, "Mathematical modeling by the CDC shows that, taking an average efficacy of 60% from the African trials, [Note: This is the relative risk, not absolute risk, which is 1.31%.) and assuming that protective effect of circumcision applies only to heterosexually acquired HIV" ..." The AAP states here that they are assuming, which means to "suppose to be the case, without proof." There's a saying that if you "assume" anything, it makes an ass out of u and me. Assumptions are not evidence, and since when should the AAP be relying upon or making assumptions? "Sexual Satisfaction and Sensitivity" (page 769) never once mentions or considers how circumcision impacts the sexual experience for females. The AAP gets it totally wrong about males, while then totally ignoring females! A Danish study by Morten Frisch (whom the AAP uses as a reference in #118) revealed late last year that circumcised men have more difficulties reaching orgasm, and their female partners experience more vaginal pains and an inferior sex life.

"Analgesia and Anesthesia for a Circumcision After the Newborn Period" (page 771) states, "Additional concerns associated with surgical circumcision in older infants include time lost by parents and patients from work and/or school." The AAP is promoting newborn circumcision so parents don't have to miss work? Parents miss work all the time when their kids get sick as toddlers or later on as young children. Now, all of a sudden, the AAP is concerned about parents missing work, but not concerned about the rights of the child.

Under "Complications and Adverse Events" (page 772), the AAP twice mentions how circumcision risks are lower in hospitals with trained personnel than those performed by untrained practitioners in developing countries. U.S. parents don't live in a developing country, and this doesn't even belong in an AAP statement!

"The true incidence of complications after newborn circumcision is unknown ..." (page 772) "Two large US hospital-based studies with good evidence estimate the risk of significant acute circumcision complications ... " "(T)here are no adequate studies of late complications in boys undergoing circumcision in the post-newborn period; this area requires more study." (page 773) "There are not adequate analytic studies of late complications in boys undergoing circumcision in the post-newborn period." (page 774) Under "Stratification of Risks" the AAP says, "Based on the data reviewed, it is difficult, if not impossible, to adequately assess the total impact of complications, because the data are scant and inconsistent regarding the severity of complications." After admitting that the true incidence of complications is unknown (i.e. the risks), the AAP then has the audacity to state that "the health benefits of newborn male circumcision outweigh the risks". (page 756). Under "Task Force Recommendations" (page 775), the AAP says, "Physicians counseling families about elective male circumcision should assist parents by explaining, in a nonbiased manner, the potential benefits and risks ..." The AAP doesn't know the incidence of risks, so how do they expect physicians to know that?

The AAP sings its own praises under "Medical Versus Traditional Providers". "Physicians in a hospital setting generally have fewer complications than traditional providers in the community setting." Was this the AAP saying that doctors are safer than mohels? I don't think they'll like that!

In 2009, ten years after the AAP did not recommend circumcision (and still doesn't apparently, doesn't on its words on page 585, but which one would never know after wading through this rubbish), their own survey of AAP members found that "18% responded recommending to all or most of their patients' parents that circumcision be performed." (page 776) I don't find that surprising that AAP doctors would recommend a surgery that means more money for them. On pages 777-778 the AAP wants to know about the effectiveness of their new 2012 statement to mislead parents. "The Task Force recommends additional studies to better understand ... The impact of the AAP Male Circumcision policy on newborn male circumcision practices in the United States and elsewhere." In other words, how effective are we in deceiving American parents and people in other countries?

The AAP wants to work with the ACOG, AAFP, American Society of Anesthesiologists, and American College of Nurse Midwives to develop a plan about which groups are best suited to perform newborn male circumcisions. (page 777) In other words, how is the AAP going to divvy up the money it so eagerly wants?

The AAP targets blacks and Hispanics in the U.S. for unnecessary circumcisions. "African-American and Hispanic males in the United States are disproportionately affected by HIV and other STIs, and thus would derive the greatest benefit from circumcision." (page 777) But then, under Areas for Future Research, the AAP says, "The Task Force recommends additional studies to better understand ... The impact of male circumcision on transmission of HIV and other STDS in the United States because key studies to date have been performed in African populations with HIV burdens that are epidemiologically different from HIV in the United States." The AAP just spent several pages before this promoting newborn circumcision to allegedly prevent STDs and HIV based on African studies, but now it's admitting that more studies are needed because the results could be different in the U.S. Was this put in to help with the solicitation for more funding for pro-circumcision researchers at Johns Hopkins and elsewhere, to keep them going? Maybe these researchers are tired of Africa and want to come home?

The AAP did actually say ONE good thing, but only ONE good thing in this whole statement. On page 760 the AAP says, "The Task Force advises against the practice of mouth-to-penis contact during circumcision, which is part of some religious practices, because it poses serious infectious risk to the child." If I were to guess, I'd say that perhaps Dr. Susan Blank put that in. While working for the New York City Health Department, Dr. Blank has done nothing to ban metzitah b'peh, so as not to offend the Orthodox Jews who practice it. Babies have died of herpes from metzitzah b'peh under her watch.

This atrocious AAP Statement needs to be rescinded immediately. I suggest that the AAP use good judgment and do precisely that.


Sincerely,
Petrina Fadel,
Director Catholics Against Circumcision


Please write to the people below, and call the AAP and ACOG headquarters to ask them to rescind their new male circumcision statement. Remind them that their support of male genital cutting is no more acceptable than their 2012 statement in favor of female genital cutting, which they were forced to rescind.

National Headquarters:

The American Academy of Pediatrics
141 Northwest Point Boulevard
Elk Grove Village, IL 60007-1098

USA 847/434-4000
(tel) 800/433-9016
(toll-free tel) 847/434-8000 (fax)

Washington, DC Office:

The American Academy of Pediatrics
Department of Federal Affairs
601 13th Street, NW Suite 400 North
Washington, DC 20005 USA

202/347-8600 (tel)
202/393-6137 (fax)

Upon request, this is an easy copy/paste of the 2012 AAP Task Force on Circumcision and AAP Board of Directors' email addresses:

sblank@health.nyc.gov, michael.brady@nationwidechildrens.org, ebuerk@aap.org, wcarlo@peds.uab.edu, diek@u.washington.edu, andrew.freedman@cshs.org, maxwell@email.chop.edu, swegner@ncaccesscare.org, clebaron@cdc.gov, lesley.atwood@allina.com, scraigo@tuftsmedicalcenter.org, Susan@susanflinn.com, esther_janowsky@unc.edu, ezimmerman@aap.org, robert-block@ouhsc.edu, Thomas_McInerny@urmc.rochester.edu, marion.burton@uscmed.sc.edu, CAllen@aap.org, dlaraque@maimonidesmed.org, shassink@aap.net, ferushton@embarqmail.com, mbull@iupui.edu, mseverson@aap.org, KMatthews@aap.org, kyasuda@uw.edu, mabbottmd@aol.com, sgoza@aap.net



AAP Circumcision Policy Statement Reading and Responses:

AAP 2012 Policy Statement Excerpt: http://www.facebook.com/notes/saving-our-sons/aap-policy-statement-on-infant-circumcision-sept-1-2012/476789462340180

AAP Circumcision Policy Statement: A Critique: http://www.drmomma.org/2012/08/aap-circumcision-policy-statement.html

Children's Health & Human Rights Partnership Condemns New AAP Policy Statement: http://chhrp.org/index.php/news/childrens-health-human-rights-partnership-condemns-new-aap-policy-statement/

Doctors Opposing Circumcision Commentary on AAP Policy Statement: http://www.doctorsopposingcircumcision.org/pdf/2012-08-26A_Commentary.pdf

Circumcision Resource Center Response to AAP Policy Statement:
http://www.circumcision.org/aap.htm

Circumstition's Annotated AAP Policy Statement: http://www.circumstitions.com/Docs/aap-12-anno.pdf

ARC Law Response: http://arclaw.org/resources/press-releases/attorneys-rights-child-condemns-american-academy-pediatrics-hiding-truth-pu

Intact America Response: http://www.intactamerica.org/pr_082212

The Bias of the AAP: http://www.udonet.com/circumcision/vincent/bias_of_the_aap.html

Doctors Opposing Circumcision Response: http://www.doctorsopposingcircumcision.org/pdf/2012-08-22_PublicNotice.pdf

My thoughts on the AAP Circumcision Policy Statement and What I've Learned from a Decade of Intactivism: http://www.drmomma.org/2012/08/the-aap-2012-circumcision-policy.html

Circumcisions R Us: Try Again AAPhttp://pippaabston.wordpress.com/2012/09/01/circumcisions-r-us-try-again-aap/

Money Over Oath: Today We Grieve: http://www.ourmuddyboots.com/?p=5295

Around the Bush and Closer to Nowhere: http://joseph4gi.blogspot.jp/2012/08/aap-around-bush-and-closer-to-nowhere.html

AAP: Breastfeeding Advocates or Pro-Circumcision Profiteers? http://lifesasaladbar.blogspot.com/2012/08/aap-breastfeeding-advocates-or-pro.html

I don't need the AAP to know: http://www.attachedparentsatwork.com/EffYouAAP.html

Where logic and ethics go to die: http://mamaraw.com/2012/08/24/where-logic-ethics-go-to-die/

To the AAP Task Force on Circumcisionhttp://intacthouston.wordpress.com/2012/08/27/to-the-aap-task-force-on-circumcision/

AAP / Circumcision Graphics: http://www.facebook.com/media/set/?set=a.476778032341323.112615.166998263319303&type=1

AAP Protest Planning: http://www.facebook.com/events/339781256109134/permalink/340627516024508/

Join in the conversation: www.Facebook.com/SavingOurSons


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CIRCUMserum: Renewal Ointment for the Circumcised Man

By Danelle Frisbie © 2012


A new topical product is available for circumcised men that proposes it will help you 'feel what you've been missing.' CIRCUMserum is the latest tool being marketed to the large population of American men who had one of the best parts of their penis amputated at birth - the prepuce. Meant to be an internal organ for life, the glans (head) of the penis calluses over the years when it is exposed as an external organ. This dulls sexual sensation, increases rates of erectile dysfunction, impacts orgasm response and alters the manner in which sexual intercourse functions -- something CIRCUMserum makers refer to as Dullness Syndrome, or DS.


CIRCUMserum was created by Dr. James L. Yeager, who has been at the forefront of topical and transdermal pharmaceuticals. Through Yeager's work at the Centric Research Institute, he formulated the first approved topical treatment for Erectile Dysfunction (ED), among other health care products for men. CIRCUMserum boasts Yeager's newest patent-pending formula, CRI-44, and is the product of his many years of research focused on men's sexual health. He states that this formula is the right combination of natural oils that will serve to once again condition the specialized tissues of the penile glans, mimicking what would have been in place had the foreskin been left to do its thing. CRI-44 also provides just the right amount of biofeedback for most men, so they do not become another statistic of those who have lost their 'trigger reflex.'


The sensitivity of the glans of the penis (or clitoris) impacts sexual response - something sexologists and urologists refer to as the 'trigger reflex.' The prepuce typically boasts upwards of 70,000 nerve endings, and provides a protective sheathe over the glans, keeping it subtle, moist, and precisely sensitive (much like the way our eyelids protect our eyeballs) for both men and women. [In men we commonly call the prepuce organ the 'foreskin' while we refer to it as the 'clitoral hood' in women.] The foreskin is the most nerve-dense organ of the male body, and is highly responsible for normal sexual functioning. In American style circumcision, virtually all of these nerves are amputated, and the sensitive glans is no longer protected in order to do its thing when the time comes: that is, regulate sexual response.

Because these nerve endings serve as the gateway to orgasm build up, when they are missing, there can be a whole host of sexual functioning complications that occur, and these issues tend to become more amplified as men age. CIRCUMserum poses the question: "Ever had an erection but not been able to reach orgasm? It happens to a lot more guys, a lot more often than you might think!" The loss of this trigger reflex may be the culprit -- the nerve endings of the foreskin are completely missing, and the nerve endings in the glans are covered over by multiple layers of old, hardened skin as a result of the glans' altered, external state. CIRCUMserum researchers write:
The keratin, or protein, layer of the stratum corneum [outer glans tissue] is much thicker on circumcised men than on intact men. CIRCUMserum is formulated to rehydrate and condition your glans to bring back those searing feelings of ecstasy with your partner. Doctors are learning that circumcision can reduce sensitivity of the glans in adulthood, affecting sexual pleasure and performance. Men who have been circumcised in adulthood report considerable loss of sensitivity and sexual pleasure. Besides the removal of nerve-dense and reflexogenic tissue, callousing on the exposed glans is another factor in sensitivity reduction. The buildup of a keratin layer on the outer surface of the circumcised glans is a documented phenomenon, and reduces sensation of the underlying subcutaneous nerves. The rise in erectile dysfunction in older men may be linked to loss of sensitivity in the exposed glans due to three factors:  
1) removal of nerve-dense reflexogenic foreskin in infancy
2) callousing of the exposed glans due to rubbing on clothing and other materials
3) dryness of the exposed glans resulting from constant exposure to air and evaporation
CIRCUMserum suggests it can help to reduce all three of these ED- and problem-causing factors.


A good deal of the CIRCUMserum site reads in similar fashion to Viagra ads that pop up ubiquitously online today. But with this topical product, makers remind us that there are no pills to pop with side effects and the goal is softer, more moist, more sensational sexual functioning, rather than 'bigger, harder, stronger' that rarely solves the problem:
It goes against everything you’ve been told about getting bigger and harder. Bigger and harder are good for your ego. But what about your pleasure? CIRCUMserum gives you feelings like you’ve never felt before... Moisturizing with CIRCUMserum’s dedicated formula will remove layers of old skin, and help you restore your original condition, leading to a more intense experience of sex. CIRCUMserum helps make you softer...for greater performance.
Urologists who have made CIRCUMserum available in their practices for men with dullness ranging from slight to almost complete loss of sensation have found it to be an effective step in moisturizing and de-callussing the glans. It is possible that the ointment would serve especially well for those men who have found restoration options difficult or impossible due to how tightly they were cut as infants. In combination with foreskin restoration, CIRCUMserum may enhance more rapid results as well. It will be interesting to hear back from those men who try the product on their own at home -- one that you can order or obtain a free sample of at the website: CIRCUMserum.com

While the effectiveness of CIRCUMserum may be up for debate in years to come, it is good to see a wider range of options coming on the men's health market that openly recognize the tragic detriment that circumcision is to human sexual health. With a significant amount of research on the subject, and an increasing number of men speaking up each year on the issue, it is one that is bound to be at the forefront of men's products and marketing through this generation of young adults. Here's hoping CIRCUMserum and related items are those very products that empower men today, but are no longer needed in the future when our sons grow up fully intact as their bodies are meant to be. Through recognizing the very real impact circumcision has on adult men, we can take one step further in ensuring this is the last generation of men harmed by such a barbaric practice, and say NO to infant circumcision. Our sons, and the men they will one day become, deserve to enjoy their whole penis, for their whole lives, and so do their partners.


Related Reading:

How Male Circumcision Impacts Your Love Life

Intact or Circumcised: A Significant Difference in the Adult Penis

Identifying Keratinization (NOHARMM)

The Lost List: Identifying what is lost to circumcision

Circumcision to Reduce Men's Sexual Pleasure

The Sexual Effects of Circumcision

Does Circumcision Cause Erectile Dysfunction?

Erectile Dysfunction: Is Circumcision Making You Soft?

Identify Circumcision Damage in the Adult Male (NOHARMM)

"Alexithymia and Circumcision Trauma: A Preliminary Investigation" in International Journal of Men's Health, Vol 10:2, 2011.

"Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark" in International Journal of Epidemiology, May 2011. [Full text pdf]

Erectile Dysfunction: Outcome of men circumcised in Kenya (Bulletin of the World Health Organization)

Erectile Function Evaluation Post Circumcision (China)

Adult Circumcision Outcomes Study (Journal of Urology, 2002) [Full text]

Erectile Function After Anterior Urethroplasty (Journal of Urology)

"Fine Touch Pressure Thresholds in the Adult Penis" (British Journal of Urology International) [Full Text pdf]

Prevalence and Risk Factors for E.D. (PubMed)

Is Circumcision Why We Need Viagra? (Canada Free Press) 

Long-Term Adverse Effects of Circumcision (DOC)

Circumcision Sexual Dysfunction (CIRP)

Functions of the Foreskin: Purposes of the Prepuce

The Prepuce (British Journal of Urology International)

Perineal Nerve Stimulation: Role in penile erection (International Journal of Impotence Research)

Neuroanatomy of the male urethra and perineum (British Journal of Urology International)

Effects of Male Circumcision on Female Arousal

Male Circumcision: A Human Rights Primer

A Change in How Intercourse Works

Improve Marital Sex: Keep the Foreskins

Realization of Circumcision

Removing Pleasure: Male Genital Mutilation

Men Ask: Why Was I Circumcised?

RestoringForeskin.org

NORM.org (National Organization of Restoring Men)

PostSecret: His Foreskin Turned Me On

Male Circumcision and Women's Sexual Health (Resources)

Partners of Restoring Men (Women's Facebook Group): Facebook.com/Groups/Restoring

Join in the SOS conversations: Facebook.com/SavingOurSons

Resources on infant circumcision and intact care: Are You Fully Informed?

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Circumcision: My Story

By Danielle LeRoy © 2012

My two sons walking along the ocean's edge.

I feel like I have to tell my story.

Not because I think I am some super human that needs to be studied. Because I am just like every other mother out there. Nothing makes me special or different. I found out I was pregnant when I was 21 years old. I went to bed at night dreaming about pink dresses and barbie dolls. I had the *perfect* little girl name picked out. I dreamed all about how a little girl would look up to me and I would do all these fun girl things with her. I also dreamed of breastfeeding and baby wearing. I would let her run around naked in the summer sun. I would let her sleep in my bed. She and I would wake up to the warm sun on our faces!

January 2007 I practically danced into my ultrasound. Telling the tech that I JUST KNEW my baby was a little girl! I laid down, she squirted that cold gel onto my belly. The tech wasn't overly nice, I was freshly 22 years old and single. No family, few friends. I was in the ultrasound alone. It didn't bother me but it seemed to bother her.

She smirked and asked me if I had any boy names picked out. "Nope." "Well you are having a boy so you will need to pick a boy name." She said indignantly. I am pretty sure I was in shock. I just kept thinking, what in the heck am I going to do with a little boy? Was she sure? This baby is a *gasp* boy?

I went to work after the ultrasound and told all my co workers that it was a boy. Everyone laughed about me thinking it was a girl. We joked that he might have to wear a dress, or at least some pink! Then someone, and I am not sure who, asked if I would circumcise him. I said, "I don't know. Maybe not. I mean. I don't know." I remember this conversation so clearly. It was over five years ago but it could've been yesterday in my mind. I remember what I was wearing and where in my work place I was standing. I don't remember who asked me, but I remember their words.

As soon as I said I might not do it, everyone chimed in. "You have to snip the tip!" "It is cleaner, you don't want them to get an infection." "Foreskin is so gross...who likes turtlenecks?!" None of these really phased me. But then... "You have to have him cut, you don't want him to be the only guy in gym class with a covered wagon." First of all...that is hilarious. Covered wagon? Ha! I busted out laughing! Covered wagon! Then I got to thinking about my own gym classes in high school. Ugh. I was bigger than most girls in every way. Taller, bustier, bigger feet. It was terrible. Going into those locker rooms and slipping into gym clothes as fast as my over-sized body could move. Torture. In fact I stopped going to gym class in the 10th grade and had to take it again my senior year. I didn't know anything about having a son or a penis, but I did know about the horrors of the locker room. No way was my son going to go through that!

A month or so later I moved 1,000 miles away with a friend. Circumcision didn't really come to mind again. One OB visit close to my due date I asked the doctor about his opinion on circumcision. I remember this very clearly also. "Well, it is cleaner. I would have it done if I were you." Something inside of me wilted. I remember thinking, "Well, if he says I should do it then, I have to do it." This was before Facebook -- social networking was limited to Myspace and even that was pretty basic. I only knew how to shop online, I never used the internet to do research. In fact, when I was in high school and college we used real books to do research. I took a "Childbirth Class" and circumcision was never once mentioned. Car seats were. The epidural was. There was one day on breastfeeding. That class was a joke. I was the only one there as a single parent, so no one talked to me. It was so awkward.

June 2007 my beautiful boy was born. 1:39pm. 9lbs 12oz. I turned into a mother in that exact moment. He had to go to the NICU because he had gotten stuck. I tried to get out of the bed to follow him, I hadn't even delivered the placenta yet! I cried and some nurse told me to relax. Please, I hadn't even touched my son yet... I just birthed all alone and I wanted my baby! I was up and walking in 45 minutes. I paced outside that NICU waiting to be let in. I needed my baby in my arms. I needed him to hear my voice and smell me. I knew he needed my milk.

I was finally let in, but I was not allowed to hold him just yet. I couldn't nurse him either. They wanted to bathe him first. I was all alone, I didn't know I could refuse. 4:45pm that night I finally got to hold my baby. I was so scared, I had never held a newborn before. But I knew that he was mine and I was his. I held him for about 30 minutes before they made me leave him in the NICU. I was told to eat and relax, he needed more tests, and NO, he could not breastfeed yet. He was so big they thought he had high blood sugar (he didn't). I was up all night walking back and forth to the nursery, begging for my baby. At 2am the nurse promised me that if I went to sleep until 6am, I could have him in my room for the whole day. But this story isn't about my birth or birth experience so I won't go further into my feelings about the way we were treated while we were there.

At 6am I sat straight out of bed and rang for the nurse. I started crying happy tears, I could finally have my baby all to myself! I had no family and no friends around so no one would bother us - just me and my baby all alone, finally. They brought him into me and I scooped him up and put him inside my hospital gown. He stayed there until 1:30pm. Then they came in to get him to be circumcised. Everything inside of me said no. I started crying. I felt like I had fought so hard to get him here and now they wanted to take him away again. I told the nurse I didn't really want to let him go. She said it is better if it is done now because he won't feel it. She told me that most babies don't even cry. She said she wouldn't give him a pacifier, she would just put some sugar water on her finger tip, and it would be over in just minutes. She calmed me down enough to take him, and I cried when he left the room. I wrote in my journal about how awful this whole thing was, and nothing like I wanted it to be.

The nurse brought my son back to me. He was asleep. She said, "He did great." And added that he never even cried and that it was probably harder on me than it was on him. He slept all day and nursed just one time.

The next day we went home. He slept all day again and nursed only once. But he grew to be a strong boy and turned 5 years old this June.  He was exclusively breastfed until he was 7 months old and weaned at almost 14 months.

Fast forward to 2010. I was pregnant again and having another boy! I was ecstatic! I loved having a son! I loved everything boy and was SO glad that my first born was a boy! There was a lot going on during my second pregnancy. We became homeless when I was 20 weeks pregnant. I was single again. I needed to move back to my home state and figure things out. Get back on my feet. There was A LOT on my mind, and circumcision was never one of those things. I just assumed I would have it done. After all, I didn't want him to look different than his brother. I think I actually said that to someone too.

I did have friends with intact children, and it never bothered me. I never thought twice about it. In fact, no one ever said anything to me about it at all. All penises are different, whatever. No biggie.

My second son was born in June 2010. 4:55pm 8lbs. 11oz! He was beautiful and perfect just like his big brother. We were going through some trying times as a family but I was so glad to have this little boy! I stood up for myself a little more with this birth. I had a c-section (again, this story is not about my birth so I won't complain here) but he never left the OR, and as soon as I was wheeled out of the OR I had them put him skin to skin on my breast. He nursed right away! I tucked him into my hospital gown and thanked God that we were finally together.

I don't remember him being taken to be circumcised, nor do I remember signing any consent form for circumcision. His pediatrician (who was also my pediatrician) came in when he was two days old and while looking him over she said, "Oh, you've had him circumcised." All I could say was, "Yeah."

Five days postpartum I was readmitted to the hospital with necrotizing faciitis. I refused to leave my son and I needed emergency surgery. The nurses told me he could stay, but I had to have a non-patient adult with me at all times. Also, if he was circumcised, he could not be skin on skin with me. I didn't understand what his penis had to do with anything. I wouldn't learn until later this was because we could not have two open surgical wound sites (mine and his) coming into contact with one another.

I was in the hospital for two weeks. That was a lot of time to hang out with my friends who took turns staying in the hospital with us all day and all night. It was also a lot of time I spent on Facebook. I stumbled across a link to Peaceful Parenting on Facebook and then to DrMomma.org. I saw a lot of things on this site that I practiced. Cosleeping, babywearing, extended rear facing, breastfeeding, home and unschooling and... circumcision? Wait, what?!

I spent one full night reading everything on circumcision at DrMomma.org, and then I left this site and went onto other pages. I looked at the American Academy of Pediatrics. The World Health Organization. The CDC. No one recommended routine infant circumcision. I cried and I cried. I laid in the hospital bed and I wept. I kept telling my recently circumcised son how sorry I was.

What had I done? Why had no one told me? How did I not know? Why didn't I find this out sooner? I researched car seats for MONTHS - why did I never look into circumcision? I flashed back to that nurse in 2007 who took my first son to be circumcised. SHE LIED TO ME! That was my first thought. My son did cry! He was hurt! He did not sleep through it - he shut down from the pain and the trauma of being cut. It never should've been done. Then I thought back to the doctor, a man with dark hair and very hairy arms. He wore the ugliest green scrub top. He lied to me! It is NOT cleaner. He should not have recommended it! Then my coworkers who joked about the "big snip." Did they lie to me too? Or were they like me and just didn't know?

Not only was I over coming this massive infection that almost killed me, but now, because my son had an open wound, I could not undress him and slip him into my shirt. I did not get to feel his soft warm body on my breast. I needed that comfort - I needed to feel his little body rise and fall on mine. But he had a wound too. I kept him dressed. I was careful when I changed him. We left the hospital when he was two weeks old, both of us with healing wounds.

A few months after I learned the truth about circumcision, I started asking people about it. A LOT of my friends said things like, "It is a personal choice for parents to make." I didn't agree with that but I didn't know how to tell them this. How do you just tell people that they are wrong? A month or so later I decided that my friends were good people and they just didn't know the truth or facts about circumcision. I mean, I am a great mother... I do my best. I love both of my children with every fiber of my being. I make educated decisions. I never purposefully hurt them. Sure, it was horrible when I found out the truth of what I put my sons through, but I am glad that I know now so that I can make sure that no future sons will go through that. Certainly my friends will want to know the truth too! I made it my job to tell people the truth about circumcision.

Wasn't I surprised when I discovered that a lot of people do not want to know the truth. Babies are dying every week, here in the United States, from circumcision. How could people get angry and defensive about this fact? I lost friends. I was called names. Then one day someone called me a name I had never heard before: Intactivist. It felt so good.

None of my new 'intactivist' friends called me names or made me feel bad about circumcising my boys. In fact, a few of them called me brave for admitting that I was wrong. It took a while, but I do feel brave now. I am not afraid to talk to people about circumcision. I am not afraid to save babies. I post links on my personal Facebook profile and I make them public. I send messages to people I know are expecting. I send intact info packs of materials. I card Target and Walmart. I wear a tshirt that says, "If men were meant to have foreskin, they would be born with it!" I serve as Director of my state's Intact Chapter. I can turn a conversation with a stranger to the subject of circumcision in no time!

One day I will apologize to my boys. My oldest has no foreskin at all and has the brown scar line from his circumcision. When the time comes, if he wants to do so, I will offer to support him in restoration. My youngest does have foreskin left and his glans is covered completely. I am thankful for that, at least he still benefits from having part of his foreskin remaining. I know they will forgive me because they are so kind and compassionate. They will know that I never meant to hurt them. I cried a few times writing these words...my heart is still so heavy. I sometimes look at pictures of the boys when they were first born. Being propped up by a nurse, their wet little bodies and swollen faces... and their intact penises. That is when I am most sorry. That is when I want to turn back the clock and tell myself to go with my gut and that if it feels wrong it IS wrong. I speak out against routine infant circumcision because the pain and remorse I felt when I found out the truth cut me so deeply that I cannot let anyone else feel like like this. Please, research circumcision.

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PostSecret: Foreskin Turned Me On


This postcard was shared at PostSecret yesterday, and this individual may or may not realize that they are far from alone... The organs of the human body have a purpose - each and every one. It is not strange, or shameful, to be turned on by the intact male body, after all, that is precisely as it was meant to be.

This individual's second secret - "I wish my fiancé had one" - is also not uncommon. Just as there is a mourning of loss (and sometimes anger, resentment, remorse) when a man discovers the full truth of all that was taken from him, his partner goes through a similar (yet different) process of dealing with a sex life, and a loved one, who was not allowed to have it all. Love for this man is no less powerful, they are no less 'sexy.' But until we can talk about what is lost to MGM, really wrap our heads around it, and have conversations about how this impacts all parties involved, we're not able to move forward, look at our options (restoration, perhaps?) and ensure we end the cycle of stealing foreskin from future men, and those they come to love...


Related Reading:

Purposes of the Prepuce: http://www.drmomma.org/2009/09/functions-of-foreskin-purposes-of.html

Penis 101: http://www.drmomma.org/2009/10/change-in-how-intercourse-works.html

Intact vs. Circumcised: A Significant Difference: http://www.drmomma.org/2011/08/intact-or-circumcised-significant.html

The Lost List: http://www.norm.org/lost.html

Restoration Resources: http://www.savingsons.org/2009/10/foreskin-restoration.html

Male Circumcision & Women's Sexual Health (resource list): http://www.drmomma.org/2009/07/how-male-circumcision-impacts-women.html

How Circumcision Impacts Your Love Life: http://www.drmomma.org/2009/10/how-male-circumcision-impacts-your-love.html

Women Affected by Circumcision (Facebook Page): http://www.facebook.com/womenarevictimstoo

Partners of Restoring Men (Private Facebook Group; PM Saving Our Sons on Facebook to be added): http://www.facebook.com/groups/Restoring/


Want to help shift the attitude about foreskin in our culture today? These info cards were designed with straight, young women in mind (those who make up the majority of future mothers in our nation). The cards were created upon request from a couple librarians who wanted an intact info card that fit with the romance novel and 'sexy magazine' theme, and for hosts of Passion Parties and Pure Romance gatherings.

We've had an overwhelmingly positive response from those who've included them as an awareness raising, or conversation starting, tool in an already sensually-driven setting. They are easy to slip into copies of 50 Shades of Grey at your local store, into the women's magazines that highlight every imaginable article on sex and the male body, quick to leave in the women's restroom when you're out for a night on the town, or to give to a friend and plant some seeds of insight... Together, we can change the thinking on the normal male body, and in turn, spare a future generation of men from having something so important taken from them.


 Suggested donation for cards (includes shipping costs):
$3 = set of 25
$6 = set of 50 
$10 = set of 100
$20 = set of 200
REQUEST HERE

Cards, Stickers, Stampers and more at Etsy.



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