President’s Endless Plan for Avoiding Rights

PEPFAR held an event today, described as:

Join global health experts in PEPFAR’s sixth VMMC Webinar to consider the pros and cons of offering early infant male circumcision (EIMC) as part of routine Maternal, Newborn and Child Health (MNCH) care.

The title of the event was, “Scaling Up Routine Early Infant Male Circumcision within Maternal, Newborn and Child Health”. I wonder what the outcome of considering the pros and cons will be.

It’s also worth noting how circumcising infants has been separated as EIMC from “voluntary” male “medical” circumcision (VMMC). Is it progress if they’ve stopped pretending that infant circumcision is voluntary? Not really, I think, since no one involved cared anyway and dropping it means they’re comfortable with making it clear they don’t care.

Flawed Circumcision Defense: Karin Klein

Encouraging half-baked opinions, like this one by Los Angeles Times reporter Karin Klein, is the inevitable result of the CDC’s proposed recommendation. The opinion piece is titled, “It’s time to end inaccurate criticisms of male circumcision”, which suggests its author should not offer an incomplete analysis in defense of male circumcision. That is what Ms. Klein offers.

The recent report by the U.S. Centers for Disease Control and Prevention should quell the unfounded arguments that male circumcision is no better than or different from female circumcision, also known as female genital mutilation. According to the draft guidelines released by the CDC, the benefits of male circumcision clearly outweigh the risks, in the form of reduced risks of urinary tract infection as infants and penile cancer later in life, and lower risk of contracting HIV and other sexually transmitted diseases.

The short version of her essay is “Shut up.” It’s her introduction and conclusion. Alas¹, no.

“According to the draft guidelines released by the CDC” involves undue weight for the recommendation. The CDC’s conclusion is subjective. The equation is not merely benefits versus risks. There is a direct cost (i.e. harm) in the loss of the foreskin. That matters, yet it isn’t factored into the CDC’s analysis (or the AAP’s before it or Ms. Klein’s here). And the CDC ignores the individual foreskin owner’s preferences. Someone might value his foreskin more than reduced risks of future maladies. As I do. It isn’t defensible to declare that the potential benefits “clearly” outweigh the risks, for everyone, or that this demonstrates anything conclusive.

The comparison of male circumcision to female genital mutilation rests on the principle involved, not indifference to the disparity in recognized potential benefits. Non-therapeutic genital cutting on a non-consenting individual is unethical. Minimal or maximal cutting is relevant for punishment, but not for whether the individual’s human rights are violated. A female owns her body from birth, including her genitals. A male owns his body from birth, including his genitals.

It’s understandable that circumcision has become controversial. It’s a permanent change made to the body, usually in infancy. (It should be noted that parents make all kinds of decisions that affect their children’s lives permanently; circumcision happens to be a particularly visible one.) …

It’s a permanent change made to the healthy body. Defending this removes any limitation on what parents may do. It isn’t that it’s a particularly visible effect. It’s that circumcision alters the child’s body without need. Proxy consent requires the patient’s need, not the proxy’s preference. Non-therapeutic circumcision is still cosmetic surgery, contra the silliness Ms. Klein will shortly suggest.

Nor is non-therapeutic circumcision acceptable because parents make all kinds of decisions. This common argument rests on the flawed premise that a) Parents make decisions for their children, b) Non-therapeutic genital cutting is a decision, therefore c) Parents may cut the healthy genitals of their children sons. It’s ridiculous. Treating all decisions equally to defend an extreme, gendered decision makes no sense. It imagines a strange scope of parenting we don’t accept, as evidenced by the required strikethrough in c) to narrow the conclusion to what parents may legally decide on non-therapeutic genital cutting. It’s about parental rights only to the convenient extent that it maps to what we want to do. It’s arbitrary.

The CDC report won’t end the debate, nor should it necessarily do so. Perhaps its most important short-term good will be to increase the likelihood that the procedure will be covered by health insurance, because circumcision could not be viewed as solely a cosmetic procedure, but rather one that carried health benefits backed by the most current scientific research. That gives parents the option — either way.

It is still cosmetic surgery, even with potential health benefits backed by the most current scientific research. It is backed by an incomplete analysis of all factors involved. Arguing only from potential benefits and risks without factoring in the costs (i.e. harms), as well as preferences for how an individual weighs those three aspects for himself, is biased, inaccurate nonsense. The CDC shouldn’t peddle it. Ms. Klein shouldn’t defend it.

But it should end the scurrilous argument that male circumcision, with its very low complication rate, is mutilation on par with female circumcision. There are no known health benefits to female genital circumcision and a long list of not-uncommon consequences, including fistulas, abscesses and childbirth complications.

If Ms. Klein is going to use a word like scurrilous to criticize critics, she should first understand mutilation. Should we assume that a case of non-therapeutic female genital cutting without the girl’s consent that doesn’t result in a complication, or at least only a “very low complication rate”, isn’t actually mutilation? I assume Ms. Klein’s answer is the correct answer, which is “obviously not”. We can also search for the unifying principle that shows how weird it is to argue that parents should have the choice to surgically alter the bodies of their children, except this choice is for sons only because we’ve researched that. For example, in the WHO factsheet on Female Genital Mutilation, this:

Female genital mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons.

Partial removal or other injury to the genital organs for non-medical reasons? As long as you don’t foolishly suggest “reduced risk of X” is somehow a medical reason² for non-therapeutic circumcision, removing the foreskin is clearly such an injury.

And:

FGM has no health benefits, and it harms girls and women in many ways. It involves removing and damaging healthy and normal female genital tissue, and interferes with the natural functions of girls’ and women’s bodies.

Removing and damaging healthy and normal genital tissue, and interferes with the natural function of bodies? Male circumcision fits that, too. Without need or consent, male circumcision is indefensible genital mutilation. Awareness of potential benefits does not change the equation. It is mere question-begging.

Of course, even religious traditions shouldn’t outweigh health concerns. Just as female genital mutilation is outlawed in this country no matter what the religious beliefs of the parents, if the CDC report had found similar complications with male circumcision, then there should be serious conversations about whether the procedure should be allowed. But that’s not what the science shows; until there is solid evidence to contradict the CDC report, conversations about restricting parents’ ability to make this decision for their sons should end.

It makes sense to ask if the boys who suffer the complications, including the most serious outcomes, could be considered mutilated, or is it merely based on the intent we assume for the parents? (The simplistic, “Male genital cutting is well-intentioned. Female genital cutting is ill-intentioned.”) But complications and consequences are unique. Consequences includes the costs (e.g. loss of the foreskin). That ignored aspect is what makes non-therapeutic male circumcision an unacceptable parental choice. Again, using the subjective conclusion that the benefits outweigh the risks while excluding the factual harms and the child’s preference is an incomplete analysis. Demanding, as Ms. Klein does, that we guide policy on this subjective opinion is ludicrous.

The CDC’s recommendation and Ms. Klein’s demand aren’t made better by using SCIENCE! as an incantation. Å normal, healthy foreskin is science. The numerous methods short of circumcision to prevent and/or treat maladies are science. A condom is no less SCIENCE! than circumcision. Antibiotics are no less SCIENCE! than circumcision. Soap and water are no less SCIENCE! than circumcision. It might be interesting that parents prefer SCIENCE! to SCIENCE!, but the issue involves ethics. The ethics are the same, whether it’s daughters or sons. Non-therapeutic genital cutting on a non-consenting individual is unethical. We all have the same basic rights. Non-therapeutic genital cutting without the individual’s consent violates her – or his – basic human rights.

¹ The piece includes a “Shareline” suggestion to tweet out a link to it with propaganda, “There are reasonable debates about male circumcision — but not about its benefits vs. risks”. That’s also nothing more than “Shut up”. It poisons the conversation by setting boundaries on what’s “reasonable” to debate. It’s also incorrect.

² The factsheet makes it clear that this would not be accepted for any non-therapeutic female genital cutting, as the law against FGM in the United States also makes clear. There is a principle, and it doesn’t negate the principle of equal rights simply because we’ve agreed to study the possible benefits of cosmetic surgery.

Start a pilot project on the ethics of consent

It’s banging a well-beaten drum, but as always, when public health officials discuss voluntary adult male circumcision, they never mean voluntary or adult. Again:

Kenya could expand circumcision of newborn babies if a pilot project in Nyanza is successful.

The organisation carrying out the pilot exercise reports that more parents are warming up to the idea of their babies being cut a few days after birth. The exercise follows earlier studies that proved circumcision of infants would be safe and acceptable.

Nyanza Reproductive Health Society says they have cut 600 male infants since January in the pilot programme.

If the 18-month project is successful, infant circumcisions will be rolled out countrywide. “The circumcision of an infant is safer, less technically challenging, faster, easier to care for postoperatively,” says Marisa Young, the PhD student at University of Illinois who is heading the project.

Was it acceptable to the 600 males circumcised in this program since January? Science without ethics is disgusting.

In 2012, Marisa published a study in the journal Pediatrics [ed. note: link], which revealed a high acceptance of circumcision for infants in Nyanza where circumcision is not a rite of passage.

“As adult MC becomes more prevalent, demand for Infant Male Circumcision (IMC) is likely to increase,” Marisa says in the study, which found mothers more willing to have their babies circumcised, compared to men.

From the beginning, WHO/UN/UNAIDS aimed for social acceptance, which would lead to high acceptance of circumcision for infants. We don’t want to admit we’ve made a mistake or been harmed in any way. To admit this, we must admit the obvious flaw in believing that “high acceptance of circumcision for infants” matters. The issue is always whether there would be high acceptance of circumcision by these infants. We do not know. Post hoc defenses are interesting, at best. They are irrelevant. But as we see again here in Ms. Young’s unethical study and program, the key is always to circumcise males before they can choose not to volunteer. It would be too obvious a violation to force circumcision on non-consenting adults, so children become the target.

Cutting matters more than the “why”

Mona Eltahawy writes in The New York Times:

I am a 47-year-old Egyptian woman. And I am among the fortunate few of my countrywomen whose genitals have not been cut in the name of “purity” and the control of our sexuality.

This is an important topic. She explains it well as it pertains to Egypt. But this paragraph bothers me:

The practice is sometimes erroneously referred to as circumcision. According to the World Health Organization, it “comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for nonmedical reasons.” The procedure has no health benefits. We hack away at perfectly healthy parts of our girls’ genitals because we’re obsessed with female virginity and because women’s sexuality is a taboo. This cutting is believed to reduce a girl’s sex drive. And families believe their daughters are unmarriageable unless they are cut.

“Sometimes erroneously referred to as circumcision” is meant to distinguish FGM from male genital cutting. “No health benefits” demonstrates this point for the few readers who didn’t catch the “male circumcision is okay” implication¹. That’s nonsense. It’s reasonable to state that the two inflict different degrees of harm in common practice, and that difference can be significant. It is not reasonable to distinguish the two as “acceptable” and “unacceptable”. The World Health Organization quote she used describes male genital cutting, too.

The end of the paragraph demonstrates this point. Were I to write the second half of that paragraph, I’d write it from this perspective:

We hack away at perfectly healthy parts of our girls’ genitals.

That sentence doesn’t need the because. She was correct to include it. It’s relevant for explanation. But the sentence as I wrote it does not need a “because”. It doesn’t matter why we do it, hacking away at a child’s perfectly healthy genitals is always wrong. Get the principle right and the comparison takes care of itself.

For example, does anyone believe Ms. Eltahawy would change her mind if someone discovers health benefits for any form of FGC? Would she be okay with research studies to determine if there are benefits? I wouldn’t. I don’t believe she would. What about cases where her “because” is wrong and parents are honest-but-mistaken in their intent? Nothing changes. The truth that we shouldn’t hack away at a girl’s healthy genitals is clear. There is no excuse for making or endorsing an implication that hacking away at a boy’s healthy genitals is somehow acceptable. People who make the argument Ms. Eltahawy makes in that paragraph advocate for special rights, not human rights.

¹ See also.

Science is more than intervention

This thread fascinates me. I read as much as I could stand and was repeatedly amazed at the logic and tactics, especially those from self-professed “skeptics”. It’s also a useful insight into why I don’t use Facebook for activism. (To those who agree with me that non-therapeutic child circumcision is unethical, please don’t engage in the vitriol and name-calling in this thread. It’s wrong and hurts our efforts.)

In response to a picture (used without permission) of a man holding a sign¹ explaining his opposition to circumcision, the moderator for a group called “I fucking love vaccines” posted this:

Those evil “doctors”!!111! Performing minor operations on infants in sanitary conditions with proper pain relief, giving the lifelong benefits of prevention of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV. A procedure that would be significantly more complex and painful for an adult male.

If that’s a skeptic’s analysis, skepticism means nothing. Discussion of non-therapeutic child circumcision needs a thorough cost-benefit analysis because that is appropriate for proxy consent and demonstrates the ethical failing, not just the question begging of the benefit recitation provided above.

In response, a pediatrician² responded with a deeper analysis:

So I have to disagree with the sentiment here. I am a Board-Certified Pediatrician. When we look at the benefits of a procedure, we need to consider the Number Needed to Treat (NNT). In other words, how many boys do we need to circumcise to prevent one case of…something?

For HIV in the highest-prevalence regions of Africa, the answer is 72. 72 circumcisions must be done to prevent one case of HIV. That number hasn’t been calculated in the US, but with our much lower HIV prevalence and the fact that HIV in the US is primarily transmitted by anal intercourse, the number would be orders of magnitude higher. Even for unprotected anal intercourse, the NNT is over a thousand. For UTI in the United States, the answer is 200-300. For penile cancer the number ranges into the millions.

I can show that routine appendectomy reduces the risk of acute appendicitis by 100% and that routine tonsillectomy reduces the risk of tonsillitis by 100% and yet we don’t routinely perform either. So why are we performing a mutilating procedure on infant boys on a routine basis? It’s the only such elective operation we do. It flies in the face of medical ethics that we perform routine circumcisions on infant boys. And for that reason, I refuse to do them.

And yes, it’s mutilating. That isn’t a judgmental or emotionally-charged term in my usage. Any procedure that changes the appearance of the body is mutilating. That includes a medically necessary appendectomy. Now, I would never argue against a medically necessary appendectomy, but the key words are: “medically necessary.” Circumcision isn’t. And the proof is Europe, Asia, Australia, and New Zealand where these things aren’t done and yet their overall epidemiology for related conditions stay the same.

I do agree, however, that equating circumcision with female “circumcision” or “rape” is insulting to people who have been subjected to these things. I find that absolutely disgusting that any man would equate his circumcision to rape and complete excision of the clitoris.

I disagree that equating male and female genital cutting is insulting. The comparison is more complex than and focused on principle than “removal of the male prepuce is the same as removing the clitoris.” Non-therapeutic genital cutting on a non-consenting individual is unethical. That’s the principle. Everything else in the doctor’s comment is spot-on.

The moderator replied to the last paragraph:

Yeah, that is my issue with this actually and the whole reason I posted it. This does nothing but trivialize male violence against women.

Then why not post about that relevant issue instead of providing the one-sided, non-skeptical benefit recitation? But that isn’t the curious response. This is:

I also remain skeptical of your claims of being a pediatrician when you come into a socially charged thread never having commented on my page before and going against official recommendations in the US, but no biggie.

This is embarrassingly free of skepticism. It’s skepticism as a label rather than a process. I’m supposed to trust someone offering only the benefits of a non-therapeutic surgery on a child when that person can’t be bothered to do even a minimal amount of research to confirm a commenter’s identity? It took me about 60 seconds to find evidence that the Facebook profile matches a real person who is a pediatrician. This does not prove that the Facebook profile isn’t an elaborate scam to post biased, misleading comments on a random Facebook community’s rant. It could be, but that seems to require a few too many (convenient) assumptions.

Anyway, his job title is interesting, but there’s more than just an appeal to authority. Google exists for more than just verifying a random doctor’s identity. Does what he wrote hold up? Number Needed to Treat is a topic anyone can research. Is he explaining it correctly? Are his numbers accurate? What are the implications to the question of non-therapeutic child circumcision? But maybe I’m wrong and a skeptic doesn’t need all the information.

Of course, the moderator seems to value the appeal to authority fallacy. Better still would be to read the AAP’s technical report to see what it omits instead of merely regurgitating the inadequate abstract. I read the technical report. It is lacking.

Also, the “official” recommendation is that parents should decide, not that circumcised males are incorrect if they’re unhappy.

Next is a string of comments from people who don’t seem to understand that words have meaning and should be applied in a way consistent with their definitions. For example:

Consent is given by the parents. It is not forced when the parents give consent on their son’s behalf.

And:

Because the surgery is for the benefit of the child not to create harm. The use of the term “mutilation” is hyperbole to generate a negative emotional response. This dishonest technique is used by intactivists because the facts do not support their position.

Parents consent. The surgery is forced on children who do not consent. This is not complicated. It’s the essence of proxy consent. The question is whether that consent is valid on this topic. And the surgery is not harmless and cost-free merely because the parents don’t intend to do harm. I agree they don’t intend harm. But harm is inevitable, despite their intentions.

Nor is the use of the term “mutilation” hyperbole. The doctor made the case, but here it is in the context of another post from the moderator:

There were of course the inevitable hysterical people saying circumcision of infant males is equal to FGM, most of which occurs in the developing world in unsanitary conditions, and which offers ZERO health benefit, serious long term health complications and is considered a violation of the human rights of girls and women. There is no comparison between circumcision and FGM.

I am seriously skeptical of the skepticism of a lot of these commenters on what is supposed to be an anti-woo page are caricaturing medical doctors as being “savage” and “barbarians”… this is no better than what people against “Big Pharma” and the “Medical Establishment/”Western” medicine/Allopathy caricaturize doctors as.

I am offended by it and I do not even have any family members in the healthcare professions. Here is a link to some fact these hysterical/testerical dimwits should know about or stop ignoring.

http://www.who.int/mediacentre/factsheets/fs241/en/

*The procedure has no health benefits for girls and women.*
*The procedure has no health benefits for girls and women.*
*The procedure has no health benefits for girls and women.*

Not only do you show your lack of scientific understanding but you also engage in vile misogyny when you compare to FGM, a HUMAN RIGHTS VIOLATION to basically harmless infant circumcision.

That link is full of gender-neutral principles arbitrarily assigned a gendered difference. When the WHO states that “[i]t involves removing and damaging healthy and normal female genital tissue, and interferes with the natural functions of girls’ and women’s bodies”, we can ask ourselves if we’d dismiss that if its preceding sentence stated “FGM has health benefits…” I believe the overwhelming response would be “no”, as it should be. Change the pronouns. The principles remain the same. Genital cutting without need or consent is mutilation.

I also invite anyone to read through my archives to see if I’m a dimwit who doesn’t know about or who ignores the facts about FGM.

More on mutilation:

Except that circumcision is not an act of physical injury that degrades appearance or function, so once again, your own definition does not support calling circumcision mutilation.

Assuming the perfect form comes at birth is rather ridiculous when you consider evolution does not select for perfect. If the foreskin was perfect there would have not been the need to make surgical improvements starting several millennia ago.

“Degrades appearance” is subjective to the individual circumcised. That it degrades function is not up for debate, or at least not that it alters function. If you change the form, you change function.

The evolution bit is mere question begging. There is no “need” to alter healthy genitals. Evolution didn’t screw up. Most males (and females) live normal, healthy lives with their prepuce. And notice how circumcision becomes a “surgical improvement”. It’s always “heads I win, tails you lose” on every subjective question.

Next comes the tired false dilemma fallacy about how only one side loves science:

You would advocate against a procedure with medical benefits? OK. I admire your honesty in admitting that even though it makes you look like a callous jerk.

“Why do you want babies to get UTI-laden HIV Cancer, you monster?” Except, that’s not the only choice or the only (or likely) outcome from leaving a child with all of his (or her) normal, healthy genitals.

Finally:

the big mean doctor touched my wee-wee!

“[T]he big mean doctor touched my wee-wee with a scalpel without medical need” is the scenario. If you must offer unfunny ridicule, at least attempt to ridicule what’s happening. That’s if this community’s form of skepticism involves facts, which I’m unconvinced it does.

¹ I’ve made my opinion clear on the accuracy and value in calling circumcision “rape”. I stand by that here.

² I’m not using names here because they’re irrelevant for my purpose here. Click through the links, if you wish.

Who won here?

This video is interesting to me:

The doctor’s evidence-free accusation at the end, “anti-Semitic like you”, is both disgusting and interesting. I side with Brother K’s response and outrage on that charge. The problem is that no one in that video was talking to anyone else. Everyone was talking at each other. I assume all four people walked away thinking they won the interaction. Instead, I want the video where the doctor’s question gets a response rather than an information dump. Show him how his question – and by extension, his view of circumcision – is broken.

His question is excellent: “If there was a vaccine for HIV that reduced the rate by 50%, would you be okay or would you be protesting?” It provides insight into what concerns the doctor professionally. It provides a chance to discuss more about HIV than just this isolated 50% claim. It provides a direct way to distinguish the ethics of vaccination and removing body parts. It provides the doctor an opportunity to experience someone who has thought about this more than just “don’t hurt the babies”.

Non-therapeutic child circumcision is indefensible. The burden of proof should be on those who want to circumcise. They propose intervention. They haven’t proven their case. They can’t prove it because it’s flawed. But society puts the burden of proof on those who challenge tradition, not those who wish to intervene on the healthy body of a non-consenting child. It’s wrong, yes, but we have to work with society tilting at this windmill. Do we want to change society or do we merely want society to know we’re better? My preference is for the former, and especially so when seeing how little the doctor in the video agreed to the latter.

**********

It’s a valid expectation, so my answer to the doctor’s question is this:

Yes, I would be okay with it (qualified by verification of both efficacy and safety of the vaccine within some reasonable bounds). Circumcision isn’t a vaccine. Vaccine’s work with the body’s immune system to trigger a response that then protects the individual from infection. Circumcision removes skin. It operates on the theory of “less skin, fewer entryways”. This is relevant, too, since the mechanism for the claimed risk reduction from circumcision is unclear. Perhaps it’s a confounding factor not yet understood and/or researched? There’s also the scientific fact that condoms work better and do not involve the violation of human rights. And, what about the possibility that removing bits of female genitals could reduce risk? Are we ethically bound to allow that, too, or does it reveal the ethical question we don’t wish to consider? We know it’s unethical to investigate, because the answer doesn’t matter. Our societal fear is convenient, not justified, when it comes to HIV and circumcision.

Circumcision Is

In a comment on a post last month, paper0airplane wrote:

Sorry this comment had a typo, and now apparently my blog is being screen capped and line by line minutia is being debated so I want to make sure there’s no confusion or conspiracy theory because I delete or edit the comment lol.

Act shocked when I note that paper0airplane has used screen caps five times in posts in the last month. Some of that appeared to be in direct response to my criticism of unsupported claims. And I’m not actually criticizing the use of screen caps. I think they can be useful, as some of those links show, even if their point is incorrectly generalized. If it helps make the point, and they’re presented as fairly as possible, why not? For example, they can demonstrate when someone deleted a post, as this screenshot shows that paper0airplane deleted a post without comment.

That’s merely an intro for my “line by line minutia” response to this post.

Medical Circumcision and Brit Milah is not…

Circumcision is not rape

On the obvious intent of that statement, I agree. This has been the biggest frustration for me recently. It’s offensive. It isn’t effective. There’s more nuance involved, which I addressed in Truth and Loaded Words, but that isn’t how “circumcision is rape” is used. So, here, the core point remains. I agree with paper0airplane.

Circumcision is not violence

To the extent that paper0airplane probably means “intent” to injure or harm, sure. But that’s a pedantic way to address it. Circumcision is violence. There is a foreskin. Then there isn’t a foreskin. The foreskin doesn’t just fall off without specific action. That action is violence.

Circumcision is not dangerous

Again, I suspect paper0airplane means “intent”. Again, that’s a pedantic way to address it. Or the claim is that complications are usually minor. Either way, it’s wrong. Circumcision is objectively dangerous. There is always risk involved. How dangerous it is and whether that danger is worth the trade-offs are subjective. The problem here is that in paper0airplane’s view, the subjective preference of a (male only) child’s parents is enough to ignore the objective danger involved without concern for the child’s preference (or – obviously – need, as the circumcision we’re discussing is non-therapeutic). If circumcision weren’t dangerous, the death rate would be zero. The complication rate would be zero. Neither rate is zero. And there is objective harm in every instance. Circumcision is dangerous. When circumcision isn’t therapeutic, proxy consent is unethical.

Circumcision does not ruin your sex life

Probably, although I hope we can agree that a boy who loses his penis or his life probably has a ruined sex life. Policy from the margins is usually bad. Ignoring the margins for policy is usually bad. This does the latter, which is unacceptable here because there are individual human rights involved. It’s foolish and cruel to treat individuals as mere statistics within the group. We can’t know which boys will actually have their sex life ruined. We can know that some will. For a non-therapeutic intervention, that is indefensible.

Circumcision does not mean your parents didn’t love you

Circumcision is almost never the reason you’re not enjoying sex

Almost certainly, although the same caveat about the margins applies.

Circumcision does not increase sales of Viagra or increase ED

I wouldn’t make the opposite claim because I can’t prove it. A citation for the negative claim would be appropriate for such a definitive stance.

Circumcision does not make someone a pervert

I read this as “circumcising”, not “being circumcised”. Both are obvious. To the former, support for bodily integrity rights for all people (i.e. opposition to non-therapeutic male child circumcision) does not make someone a pervert, either, despite the ease with which some propagandists casually lob that smear. To the latter, being circumcised does not guarantee a preference for being circumcised, regardless of how many times someone like Brian Morris¹ trots out the irrelevant “regarded by most men and women as being more attractive”.

Circumcision does not make someone a cripple

In the generalized context, this is true. How much can we debate the crippling effect of rare-but-serious complications from (non-therapeutic) circumcision? This is about individual rights, so individual outcomes matter.

Circumcision is not replaceable with a made up ceremony for Jewish boys

It seems like there are Jewish individuals who disagree with that point. Even if that false claim were true, individual rights in a civil society must trump the religious rights of another individual over that person when the rite inflicts objective harm. Circumcision inflicts objective harm, regardless of the obvious-but-irrelevant implication above that parents do not intend harm. Of course they don’t, usually. But circumcision always inflicts harm. So, even if I grant paper0airplane’s point here, it’s irrelevant. Religions must adapt, not human rights.

Circumcision is not to blame for everything wrong in the world

Agreed.

Circumcision is not on the decline

Please provide a citation. Even Brian Morris recognizes that circumcision among newborns has declined. That paper claims an increase to 81%, but I hope we can agree that an increase from 79% to 81% among 14 to 59 year old males is hardly the demographic in this debate. Where those 14 to 18 who don’t consent matter here, the remaining males in that group are irrelevant to this part of the debate. (Note, too, that he states, “Delay puts the child’s health at risk and will usually mean it will never happen.” A delay that means circumcision will usually never happen means that circumcision will never be necessary or needed. That’s damning.)

Circumcision is not used to routinely acquire foreskins for cosmetic or medical uses and never without parent’s informed consent

This asks used and routinely to do too much work, to the point of question begging. Are neonatal foreskins routinely used for cosmetic or medical purposes? No, I don’t think so. Does it happen? Yes. Whatever happens to the foreskin matters, whether it’s used for another purpose or is tossed in an incinerator. It matters because the foreskin belongs/belonged to the individual, not his parents. Their informed (or uninformed, which is also permitted) consent to this non-therapeutic surgery isn’t sufficient to negate his right to self-ownership. A male’s foreskin is part of his self. He owns it.

And until things change with presentation…

Intactivism will not succeed at changing minds.

That’s a weirdly broad statement. But I agree with the implication that making unsupported claims, tossing around hyperbole, and generally being an ass are unhelpful, at best. In the sense that people who nominally share a goal with me believe those are acceptable, there is work to do. And I’ll state it as many times as it takes for the point to be internalized into others’ activism, circumcision is not rape. This claim is offensive and unhelpful.

May I trust that the same expectation to improve one’s activism applies to those who (mistakenly) believe that parents have a right to choose genital cutting (for their sons only – of course, somehow)?

¹ I never provide hyperlinks to Brian Morris’ site. Throw a dart at any paper he’s authored and you’ll probably find this claim. Regardless, the specific quote is from the summary page of his site.

Error 404 proves paper0airplane’s “Standards for thee, not for me”

An image for your consideration:

paper0airplane-Error404

That link is http://thecaseagainstintactivism.wordpress.com/2014/08/09/choose-intact/, but that page no longer exists. Remember, that’s the page where paper0airplane wrote in the comments that “the post I’m responding to appears to have been edited somewhat, and included a blurb about someone else in a middle of an article about my posts. Interesting.” The only thing interesting is how that post is now gone (i.e. “edited somewhat”) and paper0airplane will almost certainly continue the smear tactics with zero acknowledgement of how cowardly and dishonest that behavior is. And how ironic, given paper0airplane’s complaints. Again, should that behavior reflect poorly on everyone who shares the mistaken view that parents should be able to choose non-therapeutic genital cutting for their children sons only? Or should it reflect poorly on only paper0airplane (and anyone who explicitly¹ endorses it? I still choose the latter.

I’d like to say that makes me happy. Maybe it should, since it’s an obvious vindication of what I’ve said and a self-inflicted error by paper0airplane. But I bet it’ll be pyrrhic. Why should I doubt that paper0airplane will continue smearing as if all people must own the behavior of a few and will continue imagining this standard applies only to opponents? The evidence I’ve presented suggests I shouldn’t doubt my reservations about paper0airplane.

The details from paper0airplane’s now-deleted post can still be read in my post.

**********

¹ Unlike paper0airplane, I know what the word explicit means. The standard is on the accuser, not the accused. In an acknowledged edit to a post, paper0airplane wrote:

EDITED TO ADD

I suppose it’s obvious that I don’t feel that it’s necessary to post any commentary on this. However, I am shocked that so little response was given to such a heinous thread. Why is this ok, intactivists? Sure, a few prominent intactivists distanced themselves FROM THIS POST. FROM THIS OPINION. But not THIS PERSON. To me, that is an EXPLICIT acceptance of this behavior.

This is not ok.

That is not what explicit means. If someone distanced themselves “from this post”, that’s an explicit rejection of this behavior. Perhaps the rejection needs to be stronger. (e.g. Was my response sufficient?) Yes or no, that is a different argument. But it should be obvious that an explicit rejection is not an explicit acceptance, unless one believes in “Heads I win, Tails you lose”, as paper0airplane’s behavior demonstrates.

Deplorable Behavior in Screenshots

8/12/14 Edit: I’ve edited the links in this post because the html was broken. All content remains unchanged.

Disclaimer: Based on what I documented in my last post, I’m unconvinced this disclaimer will be noted or accurately represented by paper0airplane, but I write it with the common usage of the words: The behavior in the linked screenshots is deplorable. It isn’t something I support.

I asked for evidence to support paper0airplane’s accusation that a “prominent intactivist … has decided to set up a database of circumcised boys.” I said it was deplorable and that “[m]y guess is that it’s true,” while asking for a source. That was a simple demand that brought a ridiculous response (that didn’t source direct criticism with a link to my post). That response, addressed here, included this in a comment:

… It’s not a problem to provide their sources. However, I am pretty sure that even if I were to, that fact wouldn’t make it into the blog post.

In what I presume is a passive-aggressive challenge, paper0airplane posted two screenshots to support part of the original claim. I encourage you to review them. They’re repugnant and deplorable. Learn from them what the behavior of an ass can include.

I, of course, expect it to be completely obvious that my original point stands. It is not appropriate to assign the bad behavior of a person to every person who shares a nominal goal. I expect paper0airplane’s behavior in this series of posts to reflect only on paper0airplane, and not well. But anyone else who also incorrectly believes parental choice is legitimate for non-therapeutic child circumcision is not responsible for paper0airplane. I expect the same basic courtesy, which reflects my belief that people are individuals first.

For the record, I do not know the person mentioned in the screenshots, as I wrote twice, nor am I aware of any alias Facebook accounts she might use. I do not use Facebook for my activism.

As for the database mentioned in the screenshots, I have questions.

  • I’m with paper0airplane’s point from the original post. Why? This database doesn’t achieve anything toward ending the practice of non-therapeutic child circumcision.
  • Where is she getting her data? Medical records are private. HIPAA is supposed to protect this data. Is it collected from what people post publicly on Facebook?
  • Is there evidence that this website exists or is under construction? Is there a URL? Is it “merely” pointless, damaging trolling?

The comments in the screenshots aren’t dated, so I don’t know when they occurred. Also, this doesn’t provide evidence that the person was arrested for harassment.