Inquisitir.com: Intactivists Respond To The 2012 AAP Circumcision Policy Statement [Op Ed]

http://www.inquisitr.com/316529/intactivists-respond-to-the-2012-aap-circumcision-policy-statement-op-ed/

On Monday, the American Academy of Pediatrics (AAP) published its updated policy statement on circumcision in the most recent edition of the journal Pediatrics. In a move that shocked and angered intactivits — activists who oppose infant circumcision and support genital integrity for both males and females — throughout the country and around the world, the AAP made the claim that the benefits of circumcision outweigh the risks.
Read more at http://www.inquisitr.com/316529/intactivists-respond-to-the-2012-aap-circumcision-policy-statement-op-ed/#LcHjITBOvqj10QLL.99

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Last year when the AAP issued a call to allow physicians to offer a ‘ritual nick’ on the genitals of girls,[58] the immediate and intense public response led to a prompt retraction. The WHOLE Network calls upon the AAP to act quickly to retract the 2012 circumcision statement, and instead put the rights and well-being of the patient before all other interests by condemning routine infant circumcision.

Dennis Gouws (ERIC): Cutting off a child’s foreskin is a morally reprehensible act. A boy has a right to all of his healthy body, and how he experiences it should be his choice — not the choice of a parent, a religious leader, a government, a philanthropist, or a doctor.

Kim Davis (ERIC): I am deeply saddened by the new statement; however, there are contradictions within the policy. I believe they are grasping at straws to try to and bring up the circumcision rates. People have access to information now more than ever and it shows with the decline in cut rates. Doctors are about business and an elective surgery than takes them 15 minutes from start to finish is quite a profit in their pocket plus any revenue they earn from the sale of the foreskin. I honestly believe that doctors know that most men if left intact will never have a problem nor elect this surgery so they take advantage of parents lack of knowledge and cut before the boy has a choice which ensures they get paid. What really burns me about the new policy is the amount of press. Most people have no idea what the AAP said about RIC before this release (and if they did they did not listen to them then) and now the ONLY thing they will see is the headlines — “THE BENEFITS OUTWEIGH THE RISK” — which will validate their choice for cutting their son without ever considering the risk or the ethical implications.

The researchers say if the trend continues to where only 10 percent of US males are circumcised — rates similar to Europe — the country could face about $4.4 billion in health care costs, an added $407 per man. So, if each circumcision costs about $400, how is the cost any more or less? And what about those that never “have” to have a circ and never get UTIs, STDs, etc.? And what about the European countries: What exactly is their rate of UTIs and STDs?

Micheal (ERIC): This is a basic human rights issue, and no one has the right to take away a piece of a person’s functioning body. It is his body, his choice. There is nothing wrong with foreskin; it is not a birth defect. The foreskin serves a very unique purpose and removing it alters the way the male anatomy functions. This is not only morally and ethically wrong, it is illegal according to the 14th Amendment. It was a pleasure to work with Lauren Jenks and The WHOLE Network in this campaign and I hope that the video goes viral. The AAP should never had renewed its stance on circumcision, stating it is still up to the parents. This is not about a parent’s choice. when does the child get to choose his own fate, we are talking about the very core of a man’s identity here.

Speaking more about the “Wash Your Hands Clean of the AAP” event, Stacey M. Butler, LPN, CBE, Doula, of ERIC explains more about the campaign.

“As the countdown began, The WHOLE Network and Lauren Jenks came up with an idea to launch the “Wash Your Hands Clean of the AAP.” The Idea was to have as many intactivists that were upset with the upcoming new release of the circumcision policy release date (08/27/2012); all the intactivists were to write on their hands “AAP” on one hand and on the other “NO Ethics.” Well, the response was overwhelming; over 540 pics were submitted and it became an overnight sensation to the YouTube world!”

Read more at http://www.inquisitr.com/316529/intactivists-respond-to-the-2012-aap-circumcision-policy-statement-op-ed/#LcHjITBOvqj10QLL.99

Phimosis: Childhood normal phimosis or normal tight foreskin

Found this link quite by accident, talks about normal and abnormal (physiologic and pathologic phimosis,) non-retractible foreskins in male children.

http://www.cfp.ca/content/53/3/445.full

Excerpt: click link for full page

Pathologic and physiologic phimosis
Approach to the phimotic foreskin
Thomas B. McGregor, MD
Resident in the Department of Urology at Queen’s University in Kingston, Ont
John G. Pike, MD FRCSC
Pediatric urologist
Michael P. Leonard, MD FRCSC FAAP
+ Author Affiliations

Chief in the Division of Pediatric Urology at the Children’s Hospital of Eastern Ontario at the University of Ottawa
Correspondence to: Dr Michael P. Leonard, Division of Pediatric Urology, Children’s Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON K1H 8L1; telephone 613 737-7600, extension 1353; fax 613 738-4271; e-mail mleonard@cheo.on.ca

Next Section
Abstract
OBJECTIVE To review the differences between physiologic and pathologic phimosis, review proper foreskin care, and discuss when it is appropriate to seek consultation regarding a phimotic foreskin.

SOURCES OF INFORMATION This paper is based on selected findings from a MEDLINE search for literature on phimosis and circumcision referrals and on our experience at the Children’s Hospital of Eastern Ontario Urology Clinic. MeSH headings used in our MEDLINE search included “phimosis,” “referral and consultation,” and “circumcision.” Most of the available articles about phimosis and foreskin referrals were retrospective reviews and cohort studies (levels II and III evidence).

MAIN MESSAGE Phimosis is defined as the inability to retract the foreskin. Differentiating between physiologic and pathologic phimosis is important, as the former is managed conservatively and the latter requires surgical intervention. Great anxiety exists among patients and parentsregarding non-retractile foreskins. Most phimosis referrals seen in pediatric urology clinics are normal physiologically phimotic foreskins. Referrals of patients with physiologic phimosis to urology clinics can create anxiety about the need for surgery among patients and parents, while unnecessarily expanding the waiting list for specialty assessment. Uncircumcised penises require no special care. With normal washing, using soap and water, and gentle retraction during urination and bathing, most foreskins will become retractile over time.

CONCLUSION Physiologic phimosis is often seen by family physicians. These patients and their parents require reassurance of normalcy and reinforcement of proper preputial hygiene. Consultation should be sought when evidence of pathologic phimosis is present, as this requires surgical management.

Family physicians represent the front line in health care, and, hence, are most likely to make the initial discovery of a phimotic foreskin. Being able to distinguish between pathologic and physiologic phimosis would greatly reduce unnecessary, costly referrals. It would also help primary care physicians recognize and treat these cases more appropriately and help reassure patients and their families.

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Quotes on common sense and ignorance

I feel I should clarify just because in some Instances someone chooses ignorance over understanding or not thinking over common sense doesn’t mean they do everything without thought and in ignorance.
Or
Just because someone chooses understanding and knowledge over ignorance or uses common sense in certain instances doesn’t mean they always do so……

So we must be careful that when we judge someone’s actions we don’t judge them as a whole. Just because they have done something we may or may not agree with does not define them as a person.

Ok now onto quotes…..
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“In this life you’ve got to hope for the best, prepare for the worst and take whatever God sends.”
― L.M. Montgomery
tags: common-sense 51 people liked it like

“intuition is always right in at least two important ways;
It is always in response to something.
it always has your best interest at heart”
― Gavin de Becker, The Gift of Fear: Survival Signals That Protect Us from Violence

“Common sense is seeing things as they are; and doing things as they ought to be.”
― Harriet Beecher Stowe
tags: common-sense, senisibility 33 people liked it like

“A long habit of not thinking a thing wrong, gives it a superficial appearance of being right, and raises at first a formidable outcry in defense of custom. But the tumult soon subsides. Time makes more converts than reason.”
― Thomas Paine, Common Sense

“It is the obvious which is so difficult to see most of the time. People say ‘It’s as plain as the nose on your face.’ But how much of the nose on your face can you see, unless someone holds a mirror up to you?”
― Isaac Asimov, I, Robot

“Many who are self-taught far excel the doctors, masters, and bachelors of the most renowned universities.”
― Ludwig von Mises

“Maybe the problem was that we never struggled. We just coasted along. The thing about coasting is that it usually means you’re going downhill.”
― Molly Harper, And One Last Thing …

more at : http://www.goodreads.com/quotes/tag/common-sense

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It is a common sentence that Knowledge is power; but who hath duly considered or set forth the power of Ignorance? Knowledge slowly builds up what Ignorance in an hour pulls down. Knowledge, through patient and frugal centuries, enlarges discovery and makes record of it; Ignorance, wanting its day’s dinner, lights a fire with the record, and gives a flavour to its one roast with the burnt souls of many generations.

GEORGE ELIOT, Daniel Deronda

It is as useless to fight against the interpretations of ignorance as to whip the fog.

GEORGE ELIOT, Middlemarch

There is little hope for us until we become toughminded enough to break loose from the shackles of prejudice, half-truths, and downright ignorance. The shape of the world today does not permit us the luxury of softmindedness. A nation or a civilization that continues to produce softminded men purchases its own spiritual death on an installment plan.

MARTIN LUTHER KING JR., A Testament of Hope

The insolence of the vulgar is in proportion to their ignorance. They treat everything with contempt which they do not understand.

WILLIAM HAZLITT, Characteristics

http://www.notable-quotes.com/i/ignorance_quotes.html

Copy: Non-therapeutic circumcision of male minors (2010)

http://knmg.artsennet.nl/Publicaties/KNMGpublicatie/Nontherapeutic-circumcision-of-male-minors-2010.htm

The official viewpoint of KNMG and other related medical/scientific organisations is that non-therapeutic circumcision of male minors is a violation of children’s rights to autonomy and physical integrity. Contrary to popular belief, circumcision can cause complications – bleeding, infection, urethral stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications.

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Click the link above, then click the link presented on that page to get the full file.

Non-therapeutic circumcision of male minors
introduction
Circumcision of male minors is a centuries-old practice. It is part of many different cultures and is carried out for many different reasons. An estimated 13 million boys are circumcised every year worldwide, and in the Netherlands, the annual figure is estimated at ten to fifteen thousand.
Until a few years ago, the attitude towards circumcision was fairly permissive, and circumcision was legitimised by appealing to freedom of religion and supposed medical benefits. In recent years, the attitude towards circumcision appears to have been changing. This is probably partly the result of the debate about female genital mutilation (FGM). With the global condemnation of this practice, including in its non-mutilating, symbolic form, the question regularly arises why circumcision should be judged differently than FGM. These days, more critical articles are being published about circumcision.1 These articles point to the rights of children, the absence of medi- cal benefits and the fact that this is a mutilating intervention that regularly leads to complications and can cause medical and psychological problems, both at a young and a later age.

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below is a link to pictures of a circumcision…. Look at it and realize this torture is happening to a child
http://assets4.pinimg.com/upload/295971006731352403_q5BmioSt.jpg

Copy: Children’s Health & Human Rights Partnership condemns new AAP policy statement

Children’s Health & Human Rights Partnership condemns new AAP policy statement

Correspondence
← Intact America Condemns Anticipated Circumcision Statement from American Academy of Pediatrics
Children’s Health & Human Rights Partnership condemns new AAP policy statement
Posted on August 27, 2012 by admin
27 August 2012 – For immediate release
Contact: Christopher Guest, M.D.
info@chhrp.org

AAP CIRCUMCISION POLICY ‘SERIOUSLY FLAWED’, CONDEMNED BY CANADIAN CHILDREN’S RIGHTS GROUP

CHHRP co-founder Christopher Guest, M.D. said the new policy makes claims that international paediatric associations reject and he encouraged the Canadian Paediatric Society (CPS) to maintain its policy of deterrence with regard to circumcising otherwise normal, healthy boys.

Citing a continued failure of the AAP to recognize the unique sensory functions of the male foreskin, Guest asserted that “A growing number of medical associations now recognize that an intact penis with a foreskin enhances sexual pleasure for the male and his partner.” According to Guest, in 2010 the Royal Dutch Medical Association concluded “the foreskin is a complex erotogenic structure that plays an important role in the mechanical function of the penis during sexual acts.”

“Circumcision alters the structure of the penis, which inevitably alters function. Long term harm to men from infant circumcision has never been studied” Guest said. He referred to a growing body of anecdotal evidence collected by the Canadian-based Global Survey of Circumcision Harm. Guest said that in the past 12 months over 900 men have answered the online survey to document their harm.

Guest also faults the AAP for relying on methodologically weak African trials claiming HIV is lower in circumcised men. He says the studies also contradict global HIV trends, citing the United States, with a high circumcision rate, yet a significantly higher rate of HIV infection than Sweden and Japan where circumcision is rare. “Even if the African trials are scientifically valid, they cannot be used to justify infant circumcision in North America where the incidence of heterosexual HIV transmission is low.”

Guest cautioned that infant circumcision could never be justified based on the ethical principle of proportionality, because there are more effective and less destructive methods to improve hygiene and prevent or treat disease that don’t involve removing healthy genital tissue. “Soap and water and safer sex practices, including condoms, can prevent disease. New vaccines against penile and cervical cancer can prevent human papillomavirus (HPV) infection.”

Guest harshly criticized the AAP’s failure to note the conflict between contemporary medical ethics and infant circumcision, which he says violates the fundamental ethical principles of autonomy, beneficence and primum non nocere (First, Do No Harm). According to Guest “Medical associations in the Netherlands, Finland, Sweden, Norway, Denmark, Germany and other countries confirm there’s no justification for circumcising infants in the absence of medical urgency. Those medical associations are urging an end to the practice due to ethical and human rights concerns.”

He notes that the College of Physicians and Surgeons of British Columbia stated in 2009 that “…routine removal of normal tissue in a healthy infant, is not recommended…[P]roxy consent by parents is now being questioned. …Under the Canadian Charter of Rights and Freedoms and the United Nations Universal Declaration of Human Rights, an infant has rights that include security of person, life, freedom and bodily integrity. Routine male circumcision is an unnecessary and irreversible procedure. Therefore many consider it to be ‘unwarranted mutilating surgery’.”

According to Guest, the AAP has exercised poor judgment in the past. In 1989, the AAP Task Force on Circumcision declared circumcision was “necessary”, but in 1999 reversed its position to declare “There is no valid medical indication for circumcision.” In 2010, the AAP released a statement defending female genital nicking for cultural reasons, only to retract it under pressure from children’s rights groups opposed to circumcision of girls and boys.

“Preservation of bodily integrity is a basic and universal human right that the AAP doesn’t seem to value when it comes to male children” he said. “In spite of the new U.S. policy, we Canadians, as well as our institutions and government, have an obligation to preserve that right for all of our citizens, regardless of gender or age.”

The Children’s Health & Human Rights Partnership was established in 2012 as a partnership of professionals in the fields of medicine, ethics and law, and concerned citizens, to further public education and social advocacy to end non-therapeutic genital surgery on Canadian children.

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Copy: Commentary on American Academy of Pediatrics 2012 Circumcision Policy Statement. By the staff of Doctors Opposing Circumcision

Commentary on American Academy of Pediatrics 2012 Circumcision Policy Statement.
By the staff of
Doctors Opposing Circumcision

http://www.doctorsopposingcircumcision.org/pdf/2012-08-26A_Commentary.pdf

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Commentary on American Academy of Pediatrics 2012 Circumcision Policy Statement.
By the staff of
Doctors Opposing Circumcision
Doctors Opposing Circumcision has been provided with an advance copy of the two-page American Academy of Pediatrics (AAP) 2012 Circumcision Policy Statement1 and the accompanying thirty-page electronically-published “technical report” entitled Male Circumcision.2
The Circumcision Policy Statement was created by an unelected “Task Force on Circumcision”, which was self-appointed in 2007. No non-MD parents of children voted for the AAP or its ‘task force.’ The task force included the following members:
· Susan Blank, MD, MPD, an infectious disease specialist with no expertise in pediatrics and a well-documented religio-cultural bias in favor of male circumcision.
· Andrew Freeman, MD, a pediatric urologist, who is reported to have circumcised his own son for religio-cultural reasons;
· Douglas Diekema MD, who TWICE –both in 1996 and again in 2010,* — on behalf of the AAP, proposed a lucrative “ritual nick” to the genitals of female children, despite the existence of a U.S. federal law forbidding this practice; 3 and,
· Steven Wegner, MD, JD, a doctor-lawyer, who serves on the AAP Committee on Health Care Financing, (whose sole focus is the income flow, over $1.25 billion, annually, —$2.25 billion or more if circumcision could be made mandatory).
The task force was augmented by representatives from the American College of Obstetricians and Gynecologists, and the American Academy of Family Physicians, representing the two trade associations, other than the AAP, which profit most from performing medically unnecessary non-therapeutic circumcisions on children.
It is clear that the members of the task force were chosen with a view to obtaining an outcome favorable for the continued practice of circumcision of male children and to provide for third-party payment to doctors.”
The task force was augmented by representatives from the American College of Obstetricians and Gynecologists, and one the American Academy of Family Physicians,
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representing the two trade associations, other than the AAP, which profit most from performing medically unnecessary non-therapeutic circumcisions on children. Those trade associations are called “stakeholders”(p. 585 and p. e756). Stakeholders are people with a financial interest in an enterprise. When all charges are considered, medically unnecessary non-therapeutic circumcision produces more than $1.25 billion in income annually for the stakeholders.4
The task force asserts that current evidence that the health benefits of male circumcision outweigh the risks, but has failed to produce any sort of analysis to support that conclusion. Previously available cost-benefit studies do not support that conclusion.5 6 7 8
No information on nature and function of the foreskin
Male circumcision is a radical operation that irreversibly excises and amputates a healthy functional body part. The part removed is the foreskin or prepuce of the penis, which constitutes more than fifty percent of the skin and mucosa of the penis.9 The foreskin, which is a complex structure containing, smooth muscle, large vascular structures, and is highly innervated, has numerous protective, immunological, mechanical, sensory, and sexual physiological functions.10 11 The task force on circumcision, however, makes absolutely no mention of the nature or function of the foreskin, although this information is of great relevance to making a decision regarding circumcision.
Rights of the child
It is well established in both domestic law and international human rights law that a child is a person with rights of his own from the moment of birth. The task force on circumcision, however, treats the child-patient as a non-person with no legal rights of his own. There is no mention of the child’s right to bodily integrity12 or the child’s right to security of his person and special protection during childhood,13 which are violated by male circumcision. The child is seen as a chattel possession of the parents, with which they can do whatever they please. The AAP has failed to understand that domestic and international laws for the protection of individuals are written for the protection of the best interests of those individuals and that the violation of those laws cannot be in the best interests of those individuals.
Medical Ethics
Although the section on medical ethics is much expanded from the previous statement of 1999,14 it still suffers the same faults. Infants and children may not consent, so surrogate consent must be granted by parent or guardians, if child circumcision is to be performed. Although the statement quotes from the statement on consent, it omits the section that limit the power of the surrogate to consent:
Only patients who have appropriate decisional capacity and legal empowerment can give their informed consent to medical care. In all other situations, parents or

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other surrogates provide informed permission for diagnosis and treatment of children with the assent of the child whenever appropriate.15
Since the typical infant circumcision is a non-therapeutic surgical operation that is neither diagnosis nor treatment, this section would prohibit parental consent, so the task force ignored it. It appears that no one has the power to consent to non-therapeutic excision of healthy body tissue from a child’s body, which is the conclusion of appellate courts in Canada,16 Australia,17 and Germany.18
This task force relied, as did the previous task force, on a paper by Fleischman et al. (1994) on caring for gravely ill children.19 This paper is totally inappropriate and inapplicable to the care of healthy children who do not need treatment.
The Task Force consistently asserts parental rights while ignoring the rights of the child. It is clear from reading the task force’s distortion of medical ethics, that the protection and preservation of ritual circumcision is a major preoccupation of the AAP.
Use and misuse of medical literature
Due to the emotional issues created by involuntary amputation of part of the male phallus,20 21 the medical literature is “voluminous, argumentative, polemical, confusing, chaotic, and contradictory.”22 For this reason, references can be found to support either side of an argument.
The task force examined medical literature published from 1995 to 2010. By doing this they excluded important articles unfavorable to male circumcision that were published before 1995 or after 2010. The task force then selectively cherry-picked the medical literature to support its predetermined position that male circumcision has health benefits. Much of their medical literature was produced by a team from the pro-circumcision Bloomberg School of Public Health, which is funded by Michael Bloomberg, the well-known billionaire and current mayor of New York City.
Sexually transmitted disease
The task force claims that male circumcision reduces STD infection by forty to sixty percent. The task force frequently uses unreliable studies from Africa that may not be applicable to the United States, of which many were produced by the pro-circumcision Bloomberg group.
American studies that do not confirm the task force hypothesis that the foreskin contributes to STD infection were ignored. Van Howe (1999) said in his systematic review, “In summary, the medical literature does not support the theory that circumcision prevents STDs.” 23
A longitudinal study of a birth cohort in Dunedin, New Zealand found little difference in STDs in circumcised and intact males.24

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Human immunodeficiency virus
The decision to create a new task force was based on the publication in 2005 and 2007 of three randomized clinical trials (RCTs) that were carried out in Africa. The three studies purported to prove that male circumcision provided a 60 percent reduction in female to male heterosexual transmission of HIV.
Since 2007 a substantial number of papers have been published that debunk the claims of the three RCTs.25 26 27 28 29 30 The task force totally ignored these important papers.
Recent evidence shows higher rates of HIV infection among circumcised men as compared to non-circumcised men in numerous population groups, however the task force did not choose to report this information.
The three RCTs, even if they are correct, studied HIV transmission among adults in Africa. They are not applicable to children in North America. Nevertheless, the task force has attempted to use these RCTs to promote the practice of male circumcision in North America.
Urinary tract infection
The 2012 task force, in its zeal to promote male circumcision, has resurrected the UTI myth, which was partially debunked by the 1999 task force.31 Furthermore, Chessare (1992) showed, even if the claims about UTI were correct, that the complications from circumcision exceed the benefits from prevention of UTI.32 (The task force would not have read this significant paper because it was written in 1992.)
The best way to prevent UTI is breastfeeding, which is well known to the AAP,33 but the task force chose not to divulge this information to the public, apparently preferring to promote male circumcision, instead of child health.
Bacterial Vaginosis (BV)
The task force on circumcision proposes that male infants should be circumcised to protect adult women from BV! This is a ludicrous suggestion at best.
The studies that suggest male circumcision prevents BV were carried out in Africa and may not be relevant to North America. One study was authored by known pro-circumcision doctors associated with the Bloomberg School of Public Health,34 so it is likely to suffer from researcher bias. The other study found that black race, cigarette smoking, lack of vaginal H2O2-producing lactobacilli, and anal intercourse before vaginal intercourse were confounding factors.35 The science that supports this claim is extremely dubious at best.
Even if the science was indisputable, it is not clear that amputation of a body part from a child to help an unknown adult non-related party is in the child’s best interest. The task
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force on circumcision has not provided any evidence that a surgical excision operation of a healthy functional body part from a child to help an unknown adult party is in any child’s best interest.
In a few cases, organ removal has been found to be in the best interest of the child, if the organ removal is to help a family member, however that is not the case here. Parents may not grant surrogate consent to surgery unless it is the best interest of the incompetent child-patient.36
Sexual function and sensation.
The task force used dubious studies carried out in Africa by pro-circumcision researchers,37 38 studies that did not study the foreskin,39 40 and an unreliablehttp://www.cirp.org/library/legal/conundrum/ telephone survey from Australia.41
The task force ignored significant findings that did not meet their objective. Solinis and Yiannaki (2007) studied couples and reported:
There was a decrease in couple’s sexual life after circumcision indicating that adult circumcision adversely affects sexual function in many men or/and their partners, possibly because of complications of surgery and loss of nerve endings.42
Frisch et al. (2011) reported:
Circumcision was associated with frequent orgasm difficulties in Danish men and with a range of frequent sexual difficulties in women, notably orgasm difficulties, dyspareunia and a sense of incomplete sexual needs fulfilment. Thorough examination of these matters in areas where male circumcision is more common is warranted.43
Taylor (2007) speculated that the ridged band of the foreskin regulated the bulbo- cavernosus reflex.44 Podnar (2012) found that it is difficult to elict the bulbo-cavernosus reflex (now called the penilo-cavernosus reflex) in circumcised men.45
The task force, inadvertently or intentionally, has withheld significant information on the adverse effect of circumcision on sexual function from the American people.
Lack of knowledge of the foreskin
The task force has displayed an appalling lack of knowledge of the human foreskin. The task force falsely claimed (citing Camille et al. 2002) that “adhesions (actually fusion, not adhesions) present at birth spontaneous dissolve by age 2 to 4 months” (p. e763), however Camille et al. actually said no such thing.46 Øster (1968) proved that the fusions break down slowly over a widely variable period of years and can last to as late as 17 years of age.
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The task force says that penile wetness (subpreputial moisture) is “considered a marker for poor hygiene and is more prevalent in uncircumcised men than in circumcised men.” In actuality, sub-preputial moisture is completely normal in the intact male,47 and contains lyzozyme and other protective substances.
As one trial lawyer exclaimed, “if they are wrong about this, what else are they wrong about!”
It’s all about the money
The AAP has been concerned about state Medicaid agencies stopping payment for unnecessary circumcision because its doctors get less money. The protection of the source of the money is so important to the AAP that a section on financing newborn circumcision by third-party payers has been included in this so-called medical position statement.
A careful reading of this 2012 Circumcision Policy Statement shows that the task force was created five years ago with the clear intention of using fear of HIV infection to make infant circumcision nearly universal in the United States. If this happened, the medical industry’s income from circumcision would increase from about $1.25 billion to about $2.25 billion. The AAP, ACOG, and AAFP apparently saw HIV infection prevention as the way to make this happen. Unfortunately for their scheme, the three African RCTs have been debunked in the five years that have elapsed since the formation of the task force.
One apparent purpose for this statement is to cause taxpayer-funded Medicaid to start paying doctors to perform non-therapeutic, unnecessary circumcisions again.
To increase the income of their members (fellows), these medical associations are willing to put all American boys under the circumcision knife.
Conclusion
The 2012 Circumcision Policy Statement was created by a team put together for the specific purpose of protecting the goose that lays golden eggs for the medical industry. None of the members had any specific expertise in circumcision and know little or nothing about human foreskins. They collected a lot of literature but ignored older but useful studies. The advice given by this Circumcision Policy Statement is designed to support the continuation of an income stream for its stakeholders and also to protect ritual circum- cision by misapplication of ethical and legal rules for therapeutic operations to a non- therapeutic operation.
The American Academy of Pediatrics – and more importantly the vulnerable children they claim to protect – would have been better served had the task force been fully neutral. Rather than choosing individuals with ethnic, religious, financial, professional, and even psychological motives to continue the practice of circumcision, a better choice would have been an unpaid group of volunteers, with no financial or cultural stake in the procedure
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A group composed of Europeans, medically trained and some not, from historically non- circumcising cultures, would have been much more scientifically honest and more credible.
This the AAP failed to do.”
The Canadian Paediatric Society, the British Medical Association, the Royal Dutch Medical Association, and the Royal Australasian College of Physicians have issued statements that stand in opposition to this new position of the AAP.
Parents should be aware that the so-called medical information in the AAP Circumcision Policy Statement is tainted with conflict-of-interest.
Government and insurance company officials should be aware that the claims of this statement are designed to protect third-party payment and should not be considered genuine medical advice.
The American public should have none of this. The public should reject the 2012 AAP Circumcision Policy Statement.
The American Academy of Pediatrics has overplayed its hand and should repudiate this travesty of a medical article immediately, before it loses even more credibility.
References

References on on pages 7-9

references on pages 7-9: http://www.doctorsopposingcircumcision.org/pdf/2012-08-26A_Commentary.pdf

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

Please click the link below to read the article in its entirety.
http://www.drmomma.org/2012/08/the-aap-2012-circumcision-policy.html?m=1

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!)

—–

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!)

—–

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.

This is the letter I sent to the AAP reps.

Circumcision for healthy children is not in their best interest. Females are protected from any genital cutting, males need to be as well. It is your job as doctors to protect your patients not actively advocate unnecessary surgery on minors. Proxy consent given by parents is not a valid form of consent for unnecessary, harmful and risky surgery. Death and disfigurement due to medically unnecessary and unjustifiable surgery are not risks to be taken lightly as the AAP seems to be doing. Unless there is a defect that requires surgery to fix, proxy consent should not be considered in cosmetic preference cases like circumcision.

Infants and children do not have sex. UTIs are rare in infants especially makes and just because a boy is intact does not mean he is prone to infection. Circumcised boys get UTIs as well.

The soon to be release to be put out by the AAP on circumcision is unethical and does not put the needs of the child first.

Sincerely,
(name omitted on my blog)

http://www.zimeye.org/wp-content/live_images/2012/01/44-419-1-PB.pdf

Abstract
The World Health Organization and UNAIDS have supported circumcision as a preventive for HIV infections in regions with high rates of heterosexually transmitted HIV; however, the circumcision solution has several fundamental flaws that undermine its potential for success. This article explores, in detail, the data on which this recommendation is based, the diffi- culty in translating results from high risk adults in a research setting to the general pub- lic, the impact of risk compensation, and how circumcision compares to existing alterna- tives. Based on our analysis it is concluded that the circumcision solution is a wasteful distraction that takes resources away from more effective, less expensive, less invasive alternatives. By diverting attention away from more effective interventions, circumcision programs will likely increase the number of HIV infections

Smell the color 9

Wow! I just heard this song and it really struck a note with me…..
a video to the song: http://www.youtube.com/watch?v=Ip2WgqBHYqM&feature=youtube_gdata_player

http://www.lyricsmania.com/smell_the_color_9_lyrics_chris_rice.html

Lyrics to Smell The Color 9 :
I would take ‘no’ for an answer
Just to know I heard You speak
And I’m wonderin’ why I’ve never
Seen the signs they claim they see
Are the special revelations
Meant for everybody but me?
Maybe I don’t truly know You
Or maybe I just simply believe

‘Cause I can sniff, I can see
And I can count up pretty high
But these faculties aren’t getting me
Any closer to the sky
But my heart of faith keeps poundin’
So I know I’m doin’ fine
But sometimes finding You
Is just like trying to
Smell the color nine

Now I’ve never ‘felt the presence’
But I know You’re always near
And I’ve never ‘heard the calling’
But somehow You’ve led me right here
So I’m not looking for burning bushes
Or some divine graffiti to appear
I’m just beggin’ You for some wisdom
And I believe You’re puttin’ some here

‘Cause I can sniff, I can seek,
I can count up pretty high
But these faculties aren’t getting me
Any closer to the sky
But my heart of faith keeps poundin’
So I know I’m doin’ fine
But sometimes finding You
Is just like trying to
Smell the color nine

Smell the color nine?
But nine’s not a color
And even if it were you can’t smell a color
That’s my point exactly…

20120827-144217.jpg

Copy/paste: Gloria Lemay: Pediatric Response by Petrina Fadel

this is a copy/paste. Even though I pasted the entire article please click on the link provided to leave feedback with the original poster. Show support for this well thought out arguement

http://www.glorialemay.com/blog/?p=780

Part 1 : Dear AAP Board Members and AAP Task Force on Circumcision:

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 true.

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.

Sincerely,
Petrina Fadel, Director
Catholics Against Circumcision

Part 2 : Sent to the AAP Board of Directors and the AAP Task Force Members on Aug 24, 2012 :

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

Debunk the African HIV circumcision trials.

http://blog.practicalethics.ox.ac.uk/2012/05/when-bad-science-kills-or-how-to-spread-aids/

A fatal irony: Why the “circumcision solution” to the AIDS epidemic in Africa will increase transmission of HIV

a must must must read. Debunks the African trials

——
http://sync.democraticunderground.com/10021171713

Studies showing “benefits of circumcision” highly flawed

When bad science kills, or how to spread AIDS
Published May 22, 2012 | By Brian D. Earp
——-

http://www.zimeye.org/wp-content/live_images/2012/01/44-419-1-PB.pdf

Abstract
The World Health Organization and UNAIDS have supported circumcision as a preventive for HIV infections in regions with high rates of heterosexually transmitted HIV; however, the circumcision solution has several fundamental flaws that undermine its potential for success. This article explores, in detail, the data on which this recommendation is based, the diffi- culty in translating results from high risk adults in a research setting to the general pub- lic, the impact of risk compensation, and how circumcision compares to existing alterna- tives. Based on our analysis it is concluded that the circumcision solution is a wasteful distraction that takes resources away from more effective, less expensive, less invasive alternatives. By diverting attention away from more effective interventions, circumcision programs will likely increase the number of HIV infections.

—–

http://blog.practicalethics.ox.ac.uk/2011/08/circumcision-is-immoral-should-be-banned/

My argument against circumcision of children and infants is no more and no less than that it’s a human rights issue. All people, male as well as female, are entitled to bodily integrity, and nobody — for any reason — has the right to cut off part of another person’s body when that person is too young to understand and to consent.

Under bioethical principles, parental consent for medical treatment is permitted only if the treatment being considered will save the life or health of the child. Circumcision is not medically necessary, and so it violates those principles, as well as that child’s entitlement to a complete body, his own personal freedom and autonomy.

… Circumcision is a so-called cure that’s in search of a disease. The vast majority of men in the world are intact, and they are not suffering from illness or infection. There is no justification for cutting off a body part for a hypothetical future disease, especially ones like STDs that can be prevented in ways that don’t involve mutilation. It’s crazy that we don’t think it’s crazy.

………

But let’s set this disturbing episode aside for the moment, and just suppose that circumcision really does cut down on STD receptivity as a general matter of fact. OK then, why not pass this information on to males of our species when they’re actually starting to have sex, and see how many choose, at that time, to sign themselves up for your treatment? Show them your studies. Lay the evidence before them. Cajole, coax, convince—just don’t coerce. Let them decide about their own bodies when they have the mental capacity to process what you’re selling. Little babies simply aren’t the at-risk population when it comes to sex-related diseases.

——-

Keurig noisy…

Sooo my keurig started making a lot of racket again. I really should switch to distiller water Instead of tap water…..
I put diluted vinegar through my machine twice before I finally poured in almost straight up vinegar and finally my machine is running smoothly again.
Good thing I have a back up coffee pot!!!
Oh and make sure you flush out your machine well! Vinegar and coffee don’t mix well!

Copy: Circumcision: Human Rights Make No Anatomical Distinctions – By Maria Bangs

Click link to read entire article. Very informative.

http://martinspribble.com/archives/2962

I invite you to read this post with an open mind, to discard your latent xenophobia & Islamaphobia at the top of this screen, and enter this article with the understanding that child genital cutting isn’t about penises or vulvas or potential yet unknown health benefits. It is about gender, sex, power, control, and children. Mostly it’s about children.

Copy/paste: circumcision and common sense

http://www.letsnotcut.ms11.net/index.html

And yet, despite all this point-counterpoint in the learned journals, there are some aspects of circumcision that desperately need the light of plain common sense shined upon them. Advocate and foe alike overlook some issues that are matters of common sense, and debate others without making some commonsense observations that would provide clear guidance. This article discusses four such aspects: circumcision’s effect on the experience of sex, the question of whether there is a right to circumcise, keeping clean, and circumcision’s potential effect on the parent-child relationship.

——-

Circumcision is, in fact, nothing less than the amputation of a major component of the penis. This touches upon an important point: contrary to what many people assume, the foreskin is more than just a “flap of skin.” It is (as many articles explain in more detail) a major functional part of the penis, replete with sexually sensitive nerve endings. A circumcised penis, therefore, is not a normal penis. It is a penis from which a major part is missing. It is an incomplete penis. If you remove a boy’s foreskin, we must assume that he will never experience sex as nature intended, which is his birthright.

——

A right to circumcise? Since when has it been acceptable to amputate healthy, well-formed parts of a baby? Many people have trouble with ingrown toenails; should we prophylactically rip out all of a baby’s toenails to prevent this potential problem? If not, why not? Because nobody has a right to remove normal, healthy parts of a baby. This seems self-evident and unarguable, yet most Americans have a blind spot when it comes to circumcision.

A thought experiment may help clarify this concept. Imagine that an uncircumcised man in his forties has minor genital surgery. When he awakens, he discovers that in addition to the expected surgery, he has been circumcised. When he asks the surgeon for an explanation, the reply is, “I figured that as long as I was operating in that area, I’d go ahead and do a circumcision. It’s best for you. Don’t worry; it’s on the house.”

Would this be grounds for a lawsuit? You bet! And most people would be shocked at the surgeon’s gall. Yet I too am a man in his forties, and like the imaginary man, I was circumcised without being consulted. The only difference is that in my case it was done over forty years ago. But the result today is the same: a man in his forties, missing an important piece of his sex organ as a result of actions taken without his permission. The imaginary man at least had a complete penis for over forty years; I had one for no more than a few days.

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We in America have to ask ourselves why, if circumcision is such a good thing, the rest of the world doesn’t follow our example. Other than in countries where most of the population practices circumcision for religious purposes, neonatal circumcision has never been widely practiced in the population as a whole outside of the predominantly Anglo countries, and all of those countries except the United States have to a large degree dropped it. Why?

Joseph4gi on the to-be-released soon aap statement summary on circumcision

Below is only a small portion of joseph4gi’s criticism. Click the link to read the entire article.
http://joseph4gi.blogspot.com/2012/08/aap-around-bush-and-closer-to-nowhere.html?m=1

What data was used to come to this conclusion? Were other methods of prevention considered? And, again, why have other medical organizations in the world come to this conclusion?

I have read the entire thing, and I can already tell readers, it focuses myopically on how to necessitate circumcision. Not a word on alternatives. Worse than that, it fearmongers by insisting over and over again that parents should be encouraged to circumcise in infancy “because it is when they can benefit more from it.” (Nevermind countries that do well without it.) They also skim over the fact that older men would be less than likely to buy this crap and refuse to undergo circumcision in adulthood, but instead of respecting older men’s decisions, trampling over their basic human rights to choice over their own bodies seems to be a REASON to recommend circumcision in children, and it is ignored as the very crux of the ethical debate. Basically, a blatant endorsement of abuse, where I define it as taking advantage of those smaller, and weaker and unable to fend for themselves.

another good article from joseph4gi: http://joseph4gi.blogspot.com/2012/06/texas-utmb-debates-pros-cons-and.html?m=1

Circumcision complications

The site below is not an anti-circ site. Circumcision is not a surgery without complications…. Serious complications may be rare but if it is your child suffering it is a decision you can never take back.
Infants do not need circumcision! In almost all cases there is no medical need. In the case of medical need, doctors usually wait until the baby/child is older so that the “work area” is bigger and more developed.
Circumcision complications can kill or cause life long pain and problems.

Click the link to see the pictures of the complications.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3253617/

The rate of adverse events varies widely across reports, depending on the definition chosen for a postoperative complication. In a large meta-analysis of prospective and retrospective series, Weiss et al. reported a frequency of adverse events of and for serious adverse events [14]. This can represent a significant cost in terms of utilization resources and healthcare dollars. During a five-year period at the Massachusetts General Hospital, 7.4% of all visits to a pediatric urologist were for circumcision complications. This translated to an average total cost per patient for redo procedures of $1,617 and an estimated annual cost of $137,122 to the institution [15].
For ease of discussion, adverse events following circumcision can be categorized as either early or late complications. Early complications such as: bleeding, pain, inadequate skin removal, and surgical site infection tend to be minor and quite treatable. However, postcircumcision bleeding in patients with coagulation disorders can be significant and sometimes even fatal. Other serious early complications include chordee, iatrogenic hypospadias, glanular necrosis, and glanular amputation. The latter, of course, requires prompt surgical intervention. Late complications include epidermal inclusion cysts, suture sinus tracts, chordee, inadequate skin removal resulting in redundant foreskin, penile adhesions, phimosis, buried penis, urethrocutaneous fistulae, meatitis, and meatal stenosis. These are commonly treated in an outpatient setting. Most of the aforementioned conditions are avoidable giving attention to detail and proper technique. Mayer et al. found that some subtle anatomic variations are significantly associated with late circumcision complications, including penoscrotal webbing, suprapubic fat pads, and prematurity [16].
4.1. Death
Fortunately, death from neonatal circumcision is fortunately an extremely rare occurrence. King reported a period when 500,000 consecutive circumcisions were performed in New York city without a single fatality [17]. However, a case of a misplaced Plastibell ring which caused complete meatal obstruction resulted in acute venous stasis and subsequent death from sepsis reported by the Ontario Pediatric Death Review Committee in 2007. In this situation, prompt recognition of the obstruction is critical and primary management should be immediate removal of the Plastibell ring and catheter placement [18]. There are other reports in the international literature that describe mortalities from tetanus as a result of circumcisions performed under nonsterile conditions. Bennett et al. reported that topical antibiotics could decrease this risk of neonatal tetanus 4-fold [19].
4.2. Bleeding
Bleeding is the most common complication of circumcision, with an incidence of 1% in a large retrospective review [20]. Bleeding may occur along the skin edges between sutures or from a discrete blood vessel, most commonly at the frenulum. Meticulous attention to hemostasis during an open procedure and adequate time for skin edge compression during newborn circumcisions should prevent the majority of cases although dislodging of a clot or cautery eschar can occur. The majority of postcircumcision bleeding can be controlled with application of direct pressure or careful application of silver nitrate. Rarely is wound exploration and suturing necessary. A hematologic workup is warranted only in patients who persistently bleed, or bleed significantly. In a retrospective review of the Mayo Clinic Pediatric Hemophilia database, 48 patients with a range of coagulopathies were circumcised. 21 patients had known coagulation disorders, while the remaining 27 patients were diagnosed after prolonged bleeding from their circumcision. There were 11 bleeding complications, three of which were severe and required transfusion of RBC’s for severe anemia despite preoperative factor replacement [21]. In those patients with hemophilia who must undergo circumcision, preoperative and perioperative factor replacement is a definite requirement. Fibrin glue has also been shown to decrease the amount of recombinant factor replacement needed (and the cost of treatment, as well) without significantly altering bleeding complications [22].
4.3. Infection
Due to the superb dual blood supply of the penis, wound infection occurs infrequently. In a series of 5,521 circumcisions comparing the Plastibell technique to the Gomco clamp, Gee and Ansell reported only 23 (0.4%) infections. Of those, the Plastibell group had significantly more infections, 19 versus four (P <; 0.005) [20]. All responded to a combination of topical treatment and oral antibiotic therapy. Causative organisms are usually skin flora, but due to the uniquely dirty environment of the diaper, colonic flora has also been reported. Most infections can be prevented with proper patient preparation, glove wearing and good local wound care including cleaning the penis, and application of antibiotic ointment with diaper changes [2].
Severe infections following Plastibell circumcision, including necrotizing fasciitis, have been reported as well. Several authors describe presenting signs and symptoms as erythema, induration, pain out of proportion to physical findings, coupled with tachycardia, leucocytosis, or bandemia. As in adults, this is usually a polymicrobial infection. Empiric broad spectrum antibiotics to cover Gram-negative, Gram-positive, and anaerobic organisms are essential. A suggested regimen is an aminoglycoside, nafcillin, or vancomycin and clindamycin. Prompt surgical evaluation and aggressive debridement of necrotic tissue is required [23].
4.4. Loss of Skin/Wound Dehiscence
Wound dehiscence and degloving injuries of the shaft are possible following using any of the techniques described above for neonatal circumcision. De-gloving injuries result from excess skin being drawn up into the clamp and then amputated. While, less likely, improper determination of the amount of skin to remove during free-hand circumcision may occur. Often these injuries are treated with local wound care and allowed to heal by secondary intention. There are reports of autografting the excised skin with good cosmetic result [24].
4.5. Trapped/Concealed Penis
Similarly, a concealed penis can result from overzealous removal of shaft skin coupled with a prominent suprapubic fat pad resulting in healing within the fat pad. Another consequence of this configuration is a secondary phimosis from the progressive closure of the skin over the glans penis. This can be avoided by firmly compressing the fat pad to the abdominal wall to best determine how much skin should be removed [16]. In addition, the suprapubic fat should be compressed regularly after the procedure to allow the penis to be protrude. Corrective surgery may be necessary if there is absence or significant laxity of the penoscrotal angle or penoscrotal webbing that precludes adequate protrusion of the penis.
4.6. Redundant Foreskin/Circumcision Revision (Figure 6)
Inadequate circumcision, or excess foreskin, is a fairly common indication for referral to a pediatric urologist. In a retrospective review of 476 late circumcision complications treated at Massachusetts General Hospital, 40% were for inadequate circumcision and another 5% were for phimosis requiring revision. The criteria for treatment are purely subjective and mainly cosmetic excepting those with phimosis, of course [15]. Repair is scheduled electively under general anesthesia and is best accomplished using the “free-hand” skin sleeve technique removing the redundant skin.

Figure 6

Examples of redundant skin following circumcision (a,b,c).
4.7. Preputial Adhesions/Skin Bridges (Figure 7)
Preputial adhesions often result from either inadequate lysis of natural adhesions prior to circumcision or from distal migration of the skin from a prominent suprapubic fat pad. Williams et al. report that 63% of patients presenting for circumcision revision were found to have prominent suprapubic fat pads [25]. The majority of adhesions should lyse spontaneously as the penis grows, suprapubic fat recedes, and erections become more frequent and firmer. Otherwise, lysis of preputial adhesions can be performed in the office by gently pushing away the adhesions from the glans after administering a topical anesthetic cream such as EMLA. Recurrence of these adhesions can be limited by regular compression of the suprapubic area to make the penis protrude and placement of petroleum jelly or any other such ointment. During healing, the circumferential incision can adhere to the glans and in some cases heal into an epithelialized skin bridge [2]. If thin and transparent, they can be divided in the office. However, extensive adhesions and thick skin bridges require surgical intervention. These can be divided sharply after a period of compression with a hemostat. Skin bridges accounted for nearly 30% of the late complications reported by the Massachusetts General Hospital group [15].

Figure 7

Penile adhesions (a) between the shaft skin and the glans can be manually separated while penile skin bridges (b) cannot be manually separated and need to be excised—skin bridge.
4.8. Meatitis/Meatal Stenosis (Figure 8)
In the absence of the prepuce, the erythema of the meatus commonly occurs after circumcision as a result of irritation. Meatitis is commonly a self-limited problem but can be treated by application of an antibiotic ointment and keeping the area dry. Meatal stenosis has been postulated to be a result of ligation of the frenular artery or from ammoniacal meatitis [2] and account for 26% of the late complications [15]. While the meatus may appear small, it can open adequately during voiding; this explains why most children with meatal stenosis do not present until after toilet training. Surgical treatment is indicated in the presence of symptoms such as deflection of the urine stream, dripping, dysuria, or urgency frequency from inadequate emptying. The treatment is meatotomy or meatoplasty, which can be accomplished under local anesthesia in the office or in the operating room.

Figure 8

Meatal stenosis in a 3 year old circumcised male who presented with a narrow stream.
4.9. Urethrocutaneous Fistula
Urethrocutaneous fistula is a rare complication, but nonetheless has been reported after both Plastibell and Gomco circumcisions [9]. Fistulae may present as an obvious fistulous tract or as a split urine stream. Often this is a result of compression necrosis from a retained Plastibell ring or a direct injury from incorrect placement of the Gomco clamp. Injury to the urethra during any ventral dissection can occur during a “free-hand” circumcision. Delayed flap repair can be done electively after the child's penis has grown enough for good tissue handling.
4.10. Glanular Necrosis/Glanular Amputation
Necrosis of the glans can occur as a result of cautery injury during a Gomco circumcision or from distal migration of an incorrectly sized Plastibell ring [9, 20]. Management of glans necrosis depends on its severity. Mild cases can be managed with local wound care and topical antibiotic ointment and allowing the necrotic skin to slough. Some authors report management of severe cases with suprapubic diversion and delayed urethroplasty [9]. There are rare case reports of complete necrosis of the glans and phallus in which gender reassignment was performed after multiple attempts at staged repair [20]. For this reason, the use of electrocautery is contraindicated in clamp circumcision.
Amputation of the glans occurs extremely rarely, but is a devastating complication of Mogen clamp circumcision. The Mogen clamp or shield seems uniquely susceptible to this particular injury given the surgeon's inability to directly visualize the glans prior to incising the foreskin. Sherman et al. report seven glanular reconstructions after traumatic amputations. The authors reported that minimal debridement and recovery of the amputated tissue were critical to the repair. Simple primary reanastomosis of glanular tissue was possible in 6 of 7 patients, the last patient required urethral reconstruction [26]. The patient's own tissue can remain viable up to 8 hours and used successfully for repair if adequately preserved by wrapping the tissue in moist saline gauze placed in a plastic bag and transported on ice [26].
4.11. Hypospadias
Isolated cases of iatrogenic hypospadias have been reported after the surgeon performed a ventral rather than a dorsal slit prior to initiation of circumcision [27]. It is important that the proper plane be entered for the initial lysis of adhesions so that the meatus is not inadvertently entered and then damaged.
While not technically a complication, failure to recognize a hypospadias prior to circumcision may be problematic if there is insufficient skin for subsequent repair. While most cases of hypospadias are associated with a dorsally hooded prepuce, the megameatus with intact prepuce variant will have a configuration as described in its name. Thorough physical examination is imperative prior to circumcision regardless of the method employed.

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Taken from an online forum…. Cropped to protect speaker and privacy.

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The Journal of Sexual Medicine-on circumcision

http://www.thewholenetwork.org/14/post/2012/08/new-study-circumcision-increases-likelihood-of-sti-hiv-infections.html

“New Study: Circumcision Increases Likelihood of STI & HIV Infections
08/20/20120 Comments

Just published a few days ago in The Journal of Sexual Medicine: “We assessed the association between circumcision status and self-reported history of STI/HIV infection using logistic regressions to explore whether circumcision conferred protective benefit…

Compared with uncircumcised men, circumcised men have accumulated larger numbers of STI in their lifetime, have higher rates of previous diagnosis of warts, and were more likely to have HIV infection. Results indicate that being circumcised predicted the likelihood of HIV infection.”

ABSTRACT

Introduction.  Circumcision among adult men has been widely promoted as a strategy to reduce human immunodeficiency virus (HIV) transmission risk. However, much of the available data derive from studies conducted in Africa, and there is as yet little research in the Caribbean region where sexual transmission is also a primary contributor to rapidly escalating HIV incidence.

Aim.  In an effort to fill the void of data from the Caribbean, the objective of this article is to compare history of sexually transmitted infections (STI) and HIV diagnosis in relation to circumcision status in a clinic-based sample of men in Puerto Rico.

Methods.  Data derive from an ongoing epidemiological study being conducted in a large STI/HIV prevention and treatment center in San Juan in which 660 men were randomly selected from the clinic’s waiting room.

Main Outcome Measures.  We assessed the association between circumcision status and self-reported history of STI/HIV infection using logistic regressions to explore whether circumcision conferred protective benefit.

Results.  Almost a third (32.4%) of the men were circumcised (CM). Compared with uncircumcised (UC) men, CM have accumulated larger numbers of STI in their lifetime (CM = 73.4% vs. UC = 65.7%; P = 0.048), have higher rates of previous diagnosis of warts (CM = 18.8% vs. UC = 12.2%; P = 0.024), and were more likely to have HIV infection (CM = 43.0% vs. UC = 33.9%; P = 0.023). Results indicate that being CM predicted the likelihood of HIV infection (P value = 0.027).

Conclusions.  These analyses represent the first assessment of the association between circumcision and STI/HIV among men in the Caribbean. While preliminary, the data indicate that in and of itself, circumcision did not confer significant protective benefit against STI/HIV infection. Findings suggest the need to apply caution in the use of circumcision as an HIV prevention strategy, particularly in settings where more effective combinations of interventions have yet to be fully implemented.

Rodriguez-Diaz CE, Clatts MC, Jovet-Toledo GG, Vargas-Molina RL, Goldsamt LA, and García H. More than foreskin: Circumcision status, history of HIV/STI, and sexual risk in a clinic-based sample of men in Puerto Rico. J Sex Med”

Direct source for abstract: http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2012.02871.x/abstract

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below is a link to pictures of a circumcision…. Look at it and realize this torture is happening to a child
http://assets4.pinimg.com/upload/295971006731352403_q5BmioSt.jpg