EP067: Circumcision – Necessity, Choice, or Neglect?

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Transcript

Sarah Austin: Welcome to SarahTalk. I’m Sarah Austin, Becca and M.K. in the house. Hey let’s talk about penises!

MK: Yeah!

Sarah Austin: Michael calm down. Calm down.

MK: Alright, alright.

Sarah Austin: This is a topic that I’ve been wanting to tackle for a long time now, and I’ve said this on the show before, one of the major regrets that I have in my life is having my son circumcised and I’ve developed some pretty strong opinions on this… and I know that there are a lot of people on the other side with strong opinions, too. So, being a show that tries to look at the facts and do the research and present the evidence, I wanted to do that and see what the medical community really has to say about it. Today we are joined by Georganne Chapin, the Executive Director of Intact America. Georganne, welcome to SarahTalk.

Georganne Chapin: Thank you so much.

Sarah Austin: Our pleasure. So first, why don’t you just tell us a little bit about yourself and your own background.

Georganne Chapin: Sure, I’ll start with my demographic information. I’m a 65 year old woman. I’m a mother of one grown son. He is 36 and he has an intact man which means that for many many decades I’ve been opposed to cutting off body parts from people who cannot consent to it. So that’s been really my belief for as long as I can remember. I don’t really know exactly why I came to that given that so many other people accept that circumcision is normal. And then over the years I just became more interested in why we do this to boys when we are so appalled at having it done to girls. And then I also became much more aware of the long term damage and the long term effects of being deprived of this body part when you’re a baby. And the long term benefits of keeping the body that you want that you’re entitled to, right? People should be able to make their own decisions. So when I was… and I’m a lawyer although I never practiced law I was a health care executive for many years. I actually still am, run a small nonprofit health care company and everything I’ve done and believed in my life has just continued to reinforce my feeling that this is a terrible Human Rights violation and something we have no right to do to somebody else. So that’s really where I come from that’s where intact America comes from. Intact America which is on the web and on Facebook.

Sarah Austin: Yeah, now when we had our son seven years ago we hadn’t really discussed circumcision in a lot of like great detail ahead of time. And then a nurse shows up and says “Are you going to do this?” and you’re just kind of left on your own to decide. I would have loved to have someone in the medical background and no religious bias there to talk through this whole thing with us. I mean, they provide very detailed breastfeeding support now – I feel like we can just do a better job about educating parents about circumcision which is kind of the point of this episode. So I want to get to the damage that happens to kids during circumcision in just a moment. But first let’s walk through a couple of the common arguments, particularly the myths that are offered up in support of circumcision if you don’t mind.

Georganne Chapin: No not at all.

Sarah Austin: The first one – we shared, one of the memes that you sent over, we shared on our Instagram and one of our followers commented “It helps reduce the risk of certain STI’s, helps prevent penile cancer, and also prevents the incredibly painful swelling of the foreskin.” And I was aware of the prominent idea that uncut penises are harder to keep clean and then would cause more infections, like, that I’ve heard of before but the cancer and swelling thing was new for me. So I’ll kind of let you get all of that.

Georganne Chapin: What was the first thought? Oh STI. Yeah no evidence actually. Absolutely no evidence that for a foreskin is associated in any way positively or negatively with the acquisition of sexually transmitted infections. That’s simply unproven. There are studies that show some advantage to having foreskin and some studies that show no advantage to having foreskin. But there’s absolutely no convincing epidemiological evidence associating the presence of a foreskin with increased STI’s. Penile cancer is one that’s been trotted out for decades. And penile cancer is one the rarest cancers among human beings, occurs almost exclusively in very old men. It can occur whether you have foreskin or not, it occurs in another part of the penis. And the American Cancer Society very explicitly says that circumcision should not be practiced as a way of preventing penile cancer. Penile cancer is a fraction less… I mean way way way way less common, for example, than breast cancer and we don’t go cutting off women’s breasts routinely to prevent breast cancer.

Sarah Austin: Right.

Georganne Chapin: The swelling of the foreskin’s funny, you know, that’s kind of funny if it wasn’t so ridiculous to think that people would follow that advice. Any body parts that you have can get infected or damaged and can be incredibly painful, right? I mean ingrown toenail is incredibly pain- incredibly painful. Like horrible, right?

Sarah Austin: Yeah.

Georganne Chapin: Well we don’t go cutting off people’s big toes to prevent the incredibly painful swelling and infection of their big toes. Appendicitis is incredibly painful and dangerous but we don’t routinely remove people’s appendixes. So that’s kind of funny because it really falls into the whole paradigm of: this is a bad body part and we really ought to get rid of it sooner rather than later. And of course there’s no such thing as bad body part. The body has evolved over millions of years. All mammals have foreskins, male and female mammals have foreskins. In people the female foreskin is generally called the clitoral hood and it’s there for a reason. And in boys the foreskin is – boys and men the foreskin serves in early life a very strong protective function keeping pathogens from getting into the urinary tract and in adults it serves an incredibly important procreative function in that it enhances pleasure for both partners.

Sarah Austin: Which is generally the reason why religion wants to get rid of things is to control your sexual… yeah.

Georganne Chapin: That is definitely a very big part of the history of male circumcision and female genital cutting in America. We have a very obscure and hidden history of female genital mutilation in this country. Kind of went by the wayside in the 1970s and 80s but it was not unheard of for doctors to remove American girls’ clitorises usually as a result of their parents complaining about them masturbating.

Sarah Austin: Wow.

Georganne Chapin: Yeah. So we just don’t… We’ve completely obliterated that part of our medical history. I wanted to, if it’s OK Sarah at all, I just wanted to address directly your introduction which is to get medical information and talk to the medical experts. Circumcision is not a medical procedure. We should just dispense with that. The fact that a doctor does something does not make it a clinically valid medical procedure, right?

Sarah Austin: That is a fantastic point. Yes.

Georganne Chapin: Yeah, don’t forget that circumcision is carried out among religions all over the world by ritual practitioners. Actually in the U.S. also you don’t have to be a licensed health professional to do a circumcision. The line is actually quite blurry because you can bring some dude into your house who has a religious background to cut off your son’s foreskin can but you can’t cut your son’s foreskin off yourself.

Sarah Austin: Right.

Georganne Chapin: Right? You’re not allowed to do that, and in fact people have been arrested for trying that, usually when it’s botched, of course. But it’s not a valid medical procedure. It’s simply something that crept into fee-for-service medicine – any more than ear piercing is, right? When I had my ears pierced at the age of.. I don’t know, I was a teenager. My parents were very concerned about infection and getting it done right, and I remember going to the doctor and having him kinda with this… this… I don’t want to say despairing look, but this sort of “what the heck am I doing this for? Right, This is not what I was trained to do – pierce this kid’s ears.” There was no discussion about whether I was of an age to do it or whatever. But, just the fact that a doctor does something doesn’t mean it’s medical. And then what happens is, once something has become the purview of the medical profession, like it did in the U.S., then it becomes up to the medical profession to continue to justify it because after all they’re doing it, they’re charging for it, right? And they got to justify it somehow. But it’s not a valid medical procedure. It is the removal of a totally normal, totally healthy body part from somebody who is completely vulnerable because of his size and, an inability to resist other than by screaming… That doesn’t make medicine.

Sarah Austin: We’ve talked on the show before, too, about… and particularly in New York there is a problem that’s becoming rampant more and more with the Orthodox rabbis who are passing on – If you’re worried about STI’s, you need to worry about these Orthodox rabbis who are passing on infections to these young boys because in this Orthodox tradition, once the foreskin is cut then they put it in their mouth…

Georganne Chapin: They suck the penis to stop the blood flow, right.

Sarah Austin: And if anybody else did that we would lock them up. By the way.

Georganne Chapin: Yeah. That is true. So yes, and actually it’s interesting because 100 years ago there was, in New York also, which is where the ultra Orthodox population that does this is mostly located… 100 years ago it was syphilis that, before we had a cure for syphilis, and there was actually quite a lot of syphilis in the adult population. And the rabbis, the mohels were passing on syphilis this way to babies by the mouth to penis contact. These days it’s herpes, syphilis is very low incidence. So it’s herpes, and herpes can be fatal. A herpes infection that is annoying and an inconvenience in an adult can be fatal or cause blindness in infants. So yeah, you’re right there’s that.

Sarah Austin: Then there are some arguments that don’t even try to be medically based like, some fathers that say things like “It’ll be weird if it doesn’t look like mine, or that he won’t look like his friends, or he’ll be teased.”

Georganne Chapin: Right. I always say to that, “Well, you have brown eyes and your son has green eyes. You gonna give him back? Who you gonna give him…” Yeah, our kids don’t look like us especially… I couldn’t tell you what my mother’s genitals look like and whether I look like her. And it’s just, that’s absurd also. Let me just go back to the hygiene thing ’cause you did mention that.

Sarah Austin: Sure!

Georganne Chapin: That’s also, of course a total myth that..

Sarah Austin: It’s hard to keep it clean.

Georganne Chapin: For one thing in an infant it’s much harder to clean a newly circumcised penis because you have a wound. So, in addition to all the other things you have to do with a newborn and you know this, you have a son who’s what, eight you say?

Sarah Austin: He’s seven now, yeah.

Georganne Chapin: Seven, right. So, you know having a baby is lots of work, it’s a lot of stuff to do, and to have to do wound care for a newborn is insane, right? So that hygiene argument is another kind of reflex rhetorical point that people make, because nobody’s going to answer you back, “Well, I don’t care if my kids dirty.” Instead they’re going to say, “Oh yeah, you know, easier to keep clean.” It’s easier to keep an intact penis clean in a baby and I always say, if you can teach your kid to clean his ears, brush his teeth, blow his nose.

Sarah Austin: Wipe his butt.

Georganne Chapin: … become a scien… wipe his butt, become a scientist, become an airplane pilot… You can teach him to wash his penis especially since having a foreskin and pulling it back to, to do whatever, feels really good. So most boys really don’t have any trouble figuring out how to rinse off their penis in the shower. Once that foreskin becomes retractable and up until that time, that is the self-pleasuring that males routinely engage in, and so, it really isn’t- again that’s the myth is that it’s somehow cleaner. Of course, if we talk about anybody’s genitals, women’s genitals have lots of folds.

Sarah Austin: We have an infant daughter too, yeah, we’ve got both sides of that.

Georganne Chapin: And that argument, by the way, is one of the arguments that’s used in the parts of the world where female genital mutilation is = practiced, that it’s cleaner. And the word for cutting girls’ genitals is, or for the ceremony and for the processes is the Arab word for purity. So it’s a purification ritual and that’s essentially how we treat circumcision in the U.S. We just don’t use that word, we use hygiene, which is somehow a more scientific sounding word than purification but it’s exactly the same principle.

Sarah Austin: Now my own thoughts have evolved over the past seven years. And again, this is something that you talk about in some of the informational research on your website, intactamerica.org. And that’s this: I realize it’s a dangerous and painful procedure. I realize we’ve only been doing it for so long because, God. I realize it wrongly gets portrayed as normal, especially in America. But the one thing I think that really changed me on this, and we touched on this earlier, but my son was unable to give consent to a major elective surgery, basically. It wasn’t like he needed a hole in his heart repaired. This was absolutely an elective thing and he had no choice in the matter and that’s probably where most of my guilt comes from I think.

Georganne Chapin: Right, yeah. And then he has to live with the consequences forever.

Sarah Austin: Yeah.

Georganne Chapin: Yeah, that’s exactly right. And I have, as I said, I always thought of this as an issue and I talked to a lot of people over my lifetime, but since I started Intact America, by the way together with a group of other people who have been working on this issue, I didn’t do this single-handedly at all. We have a huge movement right now. But since I started Intact America, I’ve probably spoken to thousands of people about the effects of circumcision. I was going to say men but I’ve also talked to their partners, and to their children, and to their parents about the terrible regret and trauma that this causes to families, and to couples, and to parents and children. And it’s so sad because it’s so unnecessary. Right now, there’s a couple from Florida who I’m in contact with a lot and they have started to speak out. They have an 18 month old son and the father thought he should be circumcised. And the mother didn’t want that to happen and a doctor chipped in with his opinion that, wouldn’t hurt a bit and it would be better. So they went ahead with it and it caused a tremendous breakdown in their marriage and they’re struggling to keep their marriage together. And then of course, the really terrible thing is, well one of the terrible things is, they’re worried about their son, they’re worried about explaining to him because if you don’t know anything then you’re probably not worried about explaining it but once you’ve become aware then this is something you need to deal with. But then the father is also dealing with his own guilt about his son, he’s dealing with having betrayed his wife by not listening to her. He’s dealing with his own circumcision grief. And meanwhile, his wife who should- is sympathetic to him, is also furious at him and really doesn’t have any room for dealing with his grief. And then her associated grief at realizing that he’s not complete. So it’s just this cascading series of realizations. And this is all, Sarah, this is all apart from the physical, right?

Sarah Austin: Yeah.

Georganne Chapin: Because this child is 18 months old and a happy baby. One can hope that he will grow up to be a happy, functional – in every way – boy and man. So, I mean, he did not lose more than his foreskin in the surgery, right? It’s sort of an ordinary circumcision. He’s not botched. So when they went to consider legal action against the physician for having really misled them, right? The lawyers wouldn’t even consider it because the child was not botched… except that he is because he’s missing his foreskin, right? So all of this is just preliminary. And so unnecessary, right? If we just left our babies with their healthy normal bodies instead of being compelled to chop off some part of it we wouldn’t have to worry about any of this, you know? Then there’d just be fighting about what everybody else fights about whether it’s money, or religion, or whether to move or remodel, or something. But instead there’s this horrible thing that happened and both parents, you know, immense grief and fear for the future of their child. And then this man’s dealing with his own feelings of betrayal, and his own injury, and his own worry about his own sexual function what it means for him over time.

Sarah Austin: Now we may need a content warning on this next bit. But I think it’s important for people to know what kind of harm there actually is in these routine circumcisions and before we get into this, your group was kind enough to send over some photos to me of babies strapped into this circumstraint.

Becca: Oh God.

Sarah Austin: I’m not going to show you all of them, guys. But it’s, they’re basically a step-by-step of the procedure, right? So I picked out some of the lesser ones for you to… Right, so you’ve got the baby strapped in here to the- strapped down to this board so they can’t move their hands and legs.

Georganne Chapin: As the circumstraint company advertises “A four-point restraint with gentle velcro straps”, four-point restraint of course what we brag about using on prisoners, right? So yeah. And let me just mention to you Sarah that there are lots and lots and lots of videos online of circumcisions. And I, who after decades of thinking about this, I cannot watch them. I just finally came to terms with the fact that I will never watch a circumcision video ever again.

Sarah Austin: Yeah I don’t think I could. Nope. I’m glad you didn’t take me back.

Becca: Right?

Georganne Chapin: But parents who are going to circumcise their sons, who made the decision to circum- should be asked to watch a video before they…

Sarah Austin: That’s a great idea.

Becca: Absolutely. Yeah.

Georganne Chapin: And of course then if they refuse to do that, that should tell them something. If you can’t watch the video… and then somebody said well “You wouldn’t watch a video of open-heart surgery if you’re going to have open-heart surgery.” Well, one thing is, maybe you would but you presumably need open-heart surgery right? So, watch the video or don’t watch the video, but this is a medical procedure. Again circumcision is not a medical procedure, it’s just torture.

Sarah Austin: What are some of the things that can happen, I think I read a story on the web site about a baby who screamed so hard he had a hernia. What other kinds of things are common?

Georganne Chapin: If it’s OK with you, I will describe what happens in a circumcision…

Sarah Austin: Certainly.

Georganne Chapin: All right. So, again, as I mentioned earlier, or I think I mentioned earlier… the force forsaken is attached to the head of the penis in an infant. With the same kind of tissue that our nails, our fingernails and toenails are attached to the nail bed. It’s called the [inaudible] tissue (frenulum). And in order to be able to circumcise a baby, to cut off his foreskin, the first thing that you need to do is detach that foreskin from the head of the penis. And that is done with a metal probe that’s inserted – exactly as though you were detaching a fingernail from the nail bed. Exactly.

Sarah Austin: Becca’s headphones are off already.

Georganne Chapin: OK, so a metal probe is inserted and rammed under the foreskin and then basically sawed around the entire circumference of the penis between the foreskin and the glans, the glans is the kind of acorn-looking head of the penis, of the denuded penis, right? And that causes as much pain as it would if somebody was detaching your fingernail from the nail bed. In a newborn, in somebody who’s been only on this earth for a few days, maybe in some cases even only a few hours. And there is no anesthetic that can safely be given to a baby that will block all the pain. And in fact, for many decades circumcision was carried out with absolutely no anesthetic. Now a lot of doctors and hospitals are using sugar. A glucose pacifier, which imagine going to the podiatrist for an ingrown toenail, again, and having them give you a Tootsie Roll Pop for pain? Or Emla creme, which is a topical which does not block all the nerve sensation. It takes a long time to take effect, and a lot of hospitals don’t use it because it takes too long. Or an injection into the base of the penis – three injections, actually, which is a block, a penile block, also not 100% effective, although probably the most effective. But again, involving three unanesthetized injections into the base of the penis and all, of course, totally unnecessary. So the first step of the procedure is to detach the foreskin from the glans and then usually a clamp is put onto the foreskin to keep it from bleeding. And then some other kind of severing clamp is used. There are several of them. One is called a Gomco clamp, there’s another one called the Mogen clamp which has been implicated in many, many circumcision injuries. And then there’s something called a Plastibell which can be put on your son’s penis and he’s sent home with it and it falls off in a week or two. Now can you, this is just what this newborn baby needs, right? And they basically all result in the severing of the foreskin. So, what can go wrong? You’re operating on a very tiny body part and just as no two adult penises are the same no two baby penises are the same. And most of the who do circumcisions are not trained penis specialists, they’re often OBGYN’s and they… there’s a medical school joke which is “Watch one, do one, teach one.

Sarah Austin: Woah.

Georganne Chapin: Right. So, you should know ,the parents who are thinking about doing this, should know that there are very few… probably… we talked earlier, probably a mohel, a trained mohel, Jewish circumciser has actually more training in circumcision than a doctor does. So, too much tissue can be taken off. Too much foreskin, which results in very, very tight erections. Sometimes so much foreskin is removed… because the foreskin’s just part of the penis. It’s not this separate thing that has a little red dotted line that says “trim here”. So if you pull down too much foreskin into the clamp, then the boy, when he starts to get sexually mature, could have… you’ve actually pulled down scrotal tissue, and you would know that in a newborn. But then, the person will have hair on the shaft of his penis which is very painful during intercourse for both partners. You could have, the man could have very tight painful erections, a bent penis. The most common circumcision complication that’s extraordinarily rare in an intact male is meatal stenosis, which is the blood flow to the tip of the penis is interrupted. So, it becomes stenosed, it becomes narrow, and it can result in inability to urinate or boys or men who urinate in a split stream and don’t know why? That’s always meatal stenosis which has caused their urinary opening to close up in part. Then of course, all of these are all in the realm of “normal” circumcision complications. Then there are, not infrequent terrible bleeding. Again, you’re operating on a newborn. There could be a bleeding disorder because nobody knows what the blood supply to any individual baby’s penis is like. You can hit a major vessel instead of a minor vessel and the mother takes baby home and the diaper is completely full of blood and just a couple of teaspoons of blood loss and an infant can cause shock and death. That’s the biggest cause of circumcision-related deaths would be bleeding. And people are extremely unaware of that. And often, these cases, the parents will have contacted the doctor or the hospital and then told not to worry, that a little bleeding is normal but a little bleeding in adults not the same as a little bleeding in a baby. Then you can have severing the glans of the penis, all or part of it. Or more of the penis and this is something that is more common when a Mogen a clamp is used. And Mogens, actually one of the manufacturers of the Mogen clamp went out of business because of lawsuits. Yet they continue to make them, different manufacturers, and continue to use them despite the fact that there have been so many reported injuries. So those are just some of the things that can immediately go wrong. And then of course there are long term complications, actually I did mention some of the long term complications like hair on the shaft of the penis and painful bent erections, chafing… and then the consequence of a “normal” circumcised penis and a “normal”, perfectly executed circumcision always results in a scar and always results in the eventual keratinization of the head of the penis because the foreskin keeps the head of the penis soft, and moist, and pliable, that’s what it’s supposed to be. And so if you remove that, the constant abrasion on the clothing of a boy and then a man results in desensitization, basically callousing, right, on the head of the penis. So there’s very little research, but I think there will be more in the future that is, to me, doubtless one of the causes of sexual dysfunction among adults and increasing complaints of dryness and performance issues in older couples. The man often is blamed for, you know, banging and excessive kind of activity in order to have an orgasm. And we just don’t hear that among partners of intact men. There are other reasons for it, I’m sure, personal and psychological but very compelling evidence that it’s because sensitivity is- normal sensitivity is not there and so men have to work much, much harder just to feel something and reach an orgasm. And we haven’t done cross-cultural studies, and as you certainly know, sex research is very complex and very subjective but the use of artificial lubricants in sex is off the charts in the U.S. compared to Europe where men are not circumcised. And again, we don’t know exactly why but it’s generally… I would be very surprised if the main reason for this is not related to the fact that most American adult men are circumcised and most of European adult men are not. So you don’t need… most American men, it’s my understanding… I shouldn’t say that… That the use of lubricant is very common for masturbation in this country and I’ve heard from European colleagues who work on this issue, who are aware of this issue, that that is not true in Europe. And the use of lubricant for sex is also much more frequent and more common in the U.S. than in countries where men are not circumcised. Again, we don’t have objective data on why this is but I think it’s not a far stretch to say that removing the body part that protects the penis and keeps it moist and soft must have some consequence.

Sarah Austin: Sure. And knowing how the foreskin moves during the actual action of intercourse… we don’t have the studies but it sounds like common sense to me.

Georganne Chapin: Yeah. What are the parts of your body that guarantee perpetuation of the species. Right? Because that’s what it’s all about. It’s your mouth and your genitals. Right? You can live with no arms, and a leg, you can live blind but you have to ingest food and you have to be able to procreate. So, to mess with the genitals is really kind of astonishing to think that somehow they were badly designed so that every baby- so that half of all babies are born needing correction. Now, people do dress up, and as you know do lots of other things with their genitals once they’re of an age to make a decision as to what makes them feel good. Right? What turns them on. That’s fine. But you can’t be doing that to little babies. You have to be aware that you’re changing form and function and what the consequences of that is. And babies cannot make that decision.

Sarah Austin: Absolutely. Now, that was a lot of information and that was a lot of heavy information. So, we’re going to take a quick break. When we come back we’re going to talk a little bit more about the organization Intact America, and what some of those conversations are like with doctors, and maybe we can figure out why circumcision is so prevalent in America yet almost all of Europe has done away with it and look at us like a bunch of fools. More SarahTalk after this.

Sarah Austin: Welcome back to SarahTalk. I’m Sarah Austin. We are speaking today with Georgann Chapin, the Executive Director of Intact America. Now, part of the activism work that you do involves educating medical professionals, and we kind of mentioned this a little earlier, but my experience with the doctors and nurses… in the hospital, and Becca doesn’t really remember a whole lot of this at all.

Becca: I had a C-section.

Sarah Austin: But it was really like the doctor came in and said “This is not a thing that we do here in the hospital, it’s a you go to your doctor thing. Some people do it some people don’t. It’s really, basically your choice and we can’t tell you what to do.” What does… I’m going to guess it’s lacking or completely just not there at all, what does the law look like or hospital policy say about… you mentioned earlier the doctor that recommended, “Yeah you should, it doesn’t hurt. No big deal let’s do it.” What does the law in hospital policy say about that?

Georganne Chapin: You know, it’s really all over the place. But in essence circumcision violates all kinds of bioethical rules and even hospital and medical rules when it comes to consent because Informed Consent is supposed to be… consent is supposed to be from the person who’s going to live with the consequences of whatever the action is, except if the life or health of the child, for example, is at risk or the life or health of somebody who cannot consent is at risk. And then you can have a substitute decision maker. The weird thing about circumcision is that the life and health of the baby is not at stake. This is a purely cosmetic and cultural surgery. But it’s so deeply embedded in American medicine that it’s basically been given a pass over all these decades. I’ve seen hospital consent forms, that for one thing no one reads them. And the solution is not to develop a better consent form because the parents should have no… the job of the parents is to protect their children’s rights. Right? Not just to protect their bodies but to protect their children’s rights, preserve their children’s rights. So no amount of information on a consent form for a medically unnecessary procedure on a child is going to be valid. But I’ve seen consent forms that say, “Condition to be Treated” and then it says “Presence of Foreskin”.

Sarah Austin: Oh my god. What?!

Georganne Chapin: So yes. So again, this is something that you cannot sum up in any few sentences what the rules are in different hospitals, even who does it, what people are told. But the point is nobody should be selling a circumcision. Nobody should be saying, if no one had come up to you and said “Now do you want him circumcised?” That’s solicitation. That’s like you walk into a store and they say, “Would you like to try our lip gloss?” or something. They’re selling! Right? That’s OK in a store you can decide. But they shouldn’t be selling circumcisions and they continue to. The other point is that most medical professionals are not educated about the foreskin. Most male doctors don’t have one. They’ve been- now although this is changing. Because there are more intact younger men but most older male doctors don’t have a foreskin, it was taken away from them when they were babies. And then if doctors have done circumcisions over the years there’s a lot of denial about the damage that it causes. Denial or just repression of awareness. How can you do that to a baby and not hear the screams? In medicine you’re taught to turn off to the patient’s distress in a lot of cases because what you’re doing is necessary for the patient. In this case it’s not necessary.

Sarah Austin: I couldn’t imagine being that doctor and then, like, having to go to sleep that night. I would hear those screams in my nightmares.

Becca: Mm hmm.

Georganne Chapin: Right. One wonders if they do or don’t. I’ve heard doctors and nurses say “oh they sleep through the circumcision”. They used to do open heart surgery on babies with only Curare to paralyze them because they said babies didn’t feel pain. Anyone who says that, any mother or any parent knows babies feel pain. I remember discovering that my son’s onesie, that the zipper was all the way up at the top. And it was, instead of the zipper pull being down it was up and it was poking into his neck and he kept screaming and screaming. I couldn’t figure it out. Finally, I saw it… it was a tiny baby. You gonna tell me, they say “oh it doesn’t cause pain, they just don’t like being strapped down” or people will say babies sleep through it and of course that is always the result of a child going into shock screaming so hard or just going into shock and some kind of dissociative state. Let me just mention, I’m doing a lot of talking.

Sarah Austin: No please!

Georganne Chapin: There are lots, there’s lots of evidence now about the long-term negative impacts of circumcision. There’s the physical stuff I talked about the meatel stenosis and the sexual dysfunction, but in the International Journal of Human Rights earlier this year there was an article published by, written by Tim Hammond and Adrienne Carmack (Adrienne is a urologist, a medical doctor, urologist) about long-term adverse outcomes from neonatal circumcision. They did a survey of more than a thousand men and talked to them about their feelings about having been circumcised and both their physical and psychological consequences of having been circumcised. And if you read that, it’s just incredibly compelling evidence that this is not a benign procedure. I mean, even if this were the only thousand men who felt like this the justification for a medically unnecessary surgery just is not there. And of course there are millions of men who are becoming aware of this issue and saying- I’ve had men tell me, “in some ways I wish I had never become aware, I wish I was still blissfully ignorant” but once they know the consequences are really quite devastating. And then men have to work through that. or not. So there is lots of material being published, there’s another book published by a man from New Zealand. It’s called Unspeakable Mutilations. And again it’s 150 pages of anecdotes and this would be a different base of men who are talking about the impact of circumcision on their physical and emotional well-being and their relationships.

Sarah Austin: Just an aside, that’s another one of those things that I think is maybe not uniquely American culturally, but we talk a lot about, you know picture that awkward conversation in the TGIF sitcom where the dad is having this awkward conversation with his son about the birds and the bees and- like we are repressed so much in just talking about our bodies and sexuality. This is just another- maybe a deeper kind of layer to that.

Georganne Chapin: It is because often if that child has been circumcised and then if the parent is really quite ignorant about it, you’ve got a conversation that is just fraught with emotional distress and the ignorance also makes it so hard for people to even explain. And then on top of it- I know there are a lot of men who I’ve talked to who said “when I first heard about circumcision, my thought was ‘I am so glad my parents would never do that to me.'” And then the immediate realization “Oh my god they did. They did that to me. How did that happen?” So yeah, just as doctors are in denial about what they’re doing to babies, parents understandably go into denial about the decision they made. Sarah, could we take just a second because you kind of alluded to it and I kind of said “yeah yeah”. But what the history of medical circumcision is in America cause I think it’s helpful for people to understand.

Sarah Austin: Yeah absolutely.

Georganne Chapin: I’ll try to be really brief about it. But our founding fathers of America were all intact and they seemed just fine. So we can safely assume that George Washington and Thomas Jefferson and the Native Americans and pretty much people all over the world, but certainly in American history men were intact. In the mid 1800’s, in the Victorian era where lots of things happened, this was pre-Freud and people started to be very concerned about sex and not just morality but it was believed that masturbation, excessive sexual activity caused the human body to dissipate in its energies. So if anyone saw the movie “The Road to Wellville” that was about Kellog, the cereal guy, and his spa I believe in Michigan where people were encouraged to eat vegetarian and not masturbate, basically, and not have sex. So it was recognized that boys did a lot of masturbation and girls, too. And it was thought that that was very unhealthy and that the solution for that was to remove the source of pleasure and removing the foreskin would cause boys not to touch themselves anymore, not to masturbate, which of course doesn’t work. Everybody pretty much masturbates, but foreskin removal in adolescence was promoted as- and that was kind of the original- that became like the moral hygiene argument, that it was kind of immoral to masturbate and that was for adolescent boys and girls. And then over the next few years they kind of started doing circumcisions earlier and earlier and when obstetrics became a specialty and childbirth moved into the hospital, one of the things that doctors started to do as part of the tricks of their trade was to circumcise infants because if it’s good to remove the foreskin from teenagers it’s even better to remove it early when they can’t run away from you, right? You can strap ’em down.

Sarah Austin: And they get the business.

Georganne Chapin: And they get the business and it made its way into fee-for-service medicine. This was not the case, Britain of course was a country with Victorian tradition, that’s really where it came from with Queen Victoria, also was circumcising much as America was, but then by the Second World War when it was really ramping up in the U.S., Britain adopted a national health service and made decisions not to cover medically unnecessary procedures and there were a couple of very influential British physicians and a very famous midwife named Penelope Leach who had recognized at that point that circumcision was not medically necessary and that the foreskin had a function – a positive function and a role. So Britain just gave up on it and the U.S. just kept going with it. Other English-speaking countries followed the route of Britain. Australia a little less, there’s still some circumcision in Australia but New Zealand gave it up. You know, all the commonwealth countries. Canada is a little mixed. It kind of follows American geography, but it basically went by the wayside in these other countries and persisted as a part of fee-for-service medicine in the US. And then we taught the South Koreans and the Filipinos to do it too as part of our military occupation of those countries. So those countries and the U.S. are really the only countries where circumcisions is part of the childbirth routine.

Sarah Austin: That is so interesting.

Georganne Chapin: So people tell you that, it’s that doctors do it so it must be necessary. Of course they don’t realize that doctors started doing it as a way to keep boys from masturbating. And then there were all these other justifications that followed. You know, that it prevented hip dysplasia or prevented blindness. Well, people used to think that masturbation caused blindness, right? So, sure circumcision prevented by blindness by preventing masturbation. Things that people would have no trouble identifying as totally ridiculous but they just don’t, they’re just not aware of the history.

Sarah Austin: Sure. Well this is such an important topic, and god if you can’t change the doctors minds at least hopefully parents can get access to better education at a minimum so I’m really thankful-

Georganne Chapin: And that’s what Intact America is aiming for. Not just parents but the public in general because parents listen also, they listen to their own parents, they listen to popular culture. So we are really trying to reach to the mainstream so that we can achieve that tipping point so that it becomes unpopular to circumcise your baby. So that people realize not only is it not necessary, it’s not desirable, it’s not cool. And that is what Intact America- we are trying to change the way America thinks about circumcision and I think we are. I think we’re being very successful, actually. I think we’re going to reach a tipping point and I doubt circumcision will ever be outlawed in this country for various reasons including its religious- but I think that we will reach the point where parents of newborns will say “No, I’m not doing that” and that can’t happen soon enough. We just need to make that happen.

Sarah Austin: Absolutely. And I have long been a proponent of refuting bad science. You know, crystals don’t have healing powers. Vaccines don’t cause autism. And so, this is probably the newest one on my list but I am right there with you and I will gladly claim the label of Intactivist.

Georganne Chapin: That’s wonderful. I so appreciate you doing this show. I think it’s just great. Everybody needs to hear that circumcision affects everybody whether you have a penis of your own or not, whether you’re the parent of a- It affects everybody because it’s such a pervasive practice in our culture. It affects us in terms of what we pay for medical care. It affects us in how we deal with each other, how we deal with our lovers and our friends. So, I really, really applaud you for dealing with this issue on your program. I just want to tell people again, we’re on Facebook as Intact America. There’s a Facebook group called Intact America that’s not us, we’re a Facebook page. And you’ll know the difference we have about 50,000 followers and then there’s our website intactamerica.org. And also your listeners can reach me on my e-mail address or actually comes to me info@intactamerica.org. And we definitely answer people’s personal questions about themselves or about their babies. We try to get them the resources they need if they have questions. One of the biggest questions we get is about forceable forsaken retraction. The doctors told them they have to retract their son’s foreskin- Never. Never never. There’s only one answer to that. No. You do not need to retract your son’s normal foreskin, it’ll retract on its own in time. So, we get a lot of questions about that and people should feel free to contact us about anything they want to know.

Sarah Austin: Excellent and I’ll have that information on the show notes of this episode. Episode 67. Thank you so much for having this conversation with us and helping educate both ourselves and our audience. That was a lot of really great information.

Georganne Chapin: It’s been my pleasure and good luck to all of you and everything that you do. You’re doing great work.

Sarah Austin: Thank you. I appreciate it. Georgann Chapin, Executive Director of Intact America. That was a lot of really great information. And if you’re still here and you hung through the graphic part of that, thanks for sticking around because the history… that was very interesting. But, in light of our own experience, we’re going to have this seemingly difficult, although it shouldn’t be, conversation with our kids at some point when they’re older, of course. But if they choose to have kids I want them armed with information and I want them to make their own choices not just because that’s what we do and because the doctor says it doesn’t hurt. So again, Georgann, thank you so much for coming on the show. I want to give a big special shout out to our patrons. Russell, Andrea, Jeremy, Harry, Heather, and Josie. As always thank you so much for supporting the show and helping us get information out like this to people. It’s very important. So thank you for that. That’s going to do it for this episode and we’ll see you next week. This is SarahTalk.

 

Sarah Austin

Sarah Austin

Sarah is a transgender female (MTF) living in central Florida. She started SarahTalk to create a space to discuss LGBT stories, news, etc.
Sarah Austin

Sarah Austin

Sarah is a transgender female (MTF) living in central Florida.  She started SarahTalk to create a space to discuss LGBT stories, news, etc.

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