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2015-01-09 Official User Forum statement on the CDC's 2014 proposed guidance on circumcision

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  • 2015-01-09 Official User Forum statement on the CDC's 2014 proposed guidance on circumcision
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    WE the 5000+ active members of condemn the CDCs proposed guidance on circumcision.

    It fails to properly distinguish between reasons an adult might choose circumcision for himself, and reasons a family might consider forcing circumcision on a defenseless child.

    It fails to advocate for a thorough doctor/patient discussion of the exquisite functions of the normal slack skin tube.

    It fails to properly and thoroughly address the ethics of forcing an amputation of a healthy normal body part from a person too young to give rational informed consent.

    It fails to acknowledge that most of the world is intact, and that nearly all places where circumcision is rare have generally better health outcomes than the US has.

    It fails to recognize that the real costs and harms of circumcision are still unknown, as stated in the AAP's circumcision policy.

    It fails to call for monitoring of circumcision outcomes. If patients are to be subjected to forced circumcision as children then they have a right to full disclosure upon their 18th birthdays of what was the diagnosis that warranted cutting, what was tried first, who cut, who paid, who hosted, who witnessed/helped in the assault, and what monies if any changed hands for the processing/exploiting of their stolen body part. Until there is accountability and long-term tracking of circumcision outcomes forced non-therapeutic genital cutting of children simply must not be allowed.

    The policy fails to acknowledge that many men are so bothered by the imposed loss of their foreskin that they endure a tedious process of non-surgical foreskin to undo some of the sexual damage. In fact in light of a recent proposed defunding of circumcision in New Hampshire it was revealed that for every hundred New Hampshire babies circumcised last year, two New Hampshire men began the painful journey toward non-surgical foreskin restoration.
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    Feel free to affirm your agreement in a reply in this thread.
    -Ron Low
    847 414-1692 Chicago

  • #2
    My personal statement to the CDC (commenting is now closed):
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    The CDC should withdraw its recent guidance on circumcision. The evidence cited might - if true - affect a man's decision about whether be circumcised. It has no bearing on a family's decision whether to force circumcision on a child too young to offer rational informed consent for the amputation of a healthy normal valuable body part.

    The aspects of the CDC's case which might seem to support rushing to cut in infancy are specious:

    A) Early cutting supposedly affords some protection from UTI in early infancy.

    - This effect is small and has NEVER been observed in a population where the caregivers knew NOT to fiddle with the infant foreskin or forcibly retract.

    - UTI are treated with antibiotics in girls, who get far more of them. Why is a different radically invasive solution discussed for boys?

    B) Cutting a child later is supposedly more risky.

    - The odds of actually needing a circumcision later are vanishingly small.

    - That extra risk is due to general anesthesia - which is required if the kid is old enough to kick and scream - but, wait LONG enough and the patient attains a maturity where he could be cut with a local anesthetic.

    - The infant is often spared the risks of anesthesia at the cost of literally ENDURING TORTURE WITHOUT ANESTHESIA. Such early childhood trauma has been shown to correlate with negative effects on the psyche and interfere with breastfeeding and bonding.

    C) Cutting later is supposedly more complicated and expensive.

    - This is extremely offensive. It's more expensive only because nothing could be cheaper than the violent simplistic haphazard methods tolerated for infants. The foreskin is brutally torn from the glans before cutting can commence, and sutures are rarely used to ensure a predictable result. If cutters took care to do the job right (impossible because the foreskin is fused to the glans at birth) it could cost just as much or more to cut a baby as it does to cut an adult. Of course doing the job "right" would also include finding out how much healthy normal slack skin the patient would like to keep.

    - In fact the adult method of circumcision by PrepEx is FAR CHEAPER AND EASIER than infant circumcision, in part because the adult foreskin does not need to be violently torn from the glans. The adult can care for himself during recovery (as opposed to recuperating with an open wound in a fouled diaper) and he can verbally report anything that doesn't "feel" just right while healing.

    D) The CDC reports that in 2010 no circumcision-related deaths were found.

    - A casual scan of news headlines proves this false. For example baby Joshua Haskins died of blood loss within hours of his non-therapeutic hospital circumcision. Another baby died from circumcision-related infection that year (*. (Five seconds of Googling is all it takes to catch the CDC's lie? Why lie?) In Brazil, where careful records are kept, they report about 1 death per 7500 circumcisions. If the US kept careful records instead of blaming circumcision deaths on other factors the rate would be about 1 death per 10,000 procedures**. Tell families that.

    But infant death is indeed rare and not the reason hundreds of thousands of men who are enduring non-surgical (partial) foreskin restoration object to forced genital cutting. Circumcision alters sex dramatically when done "right," and haphazard unintended effects of US infant circumcisions are common and far under-reported because the population of victims often has no basis for comparison, no idea of how an intact penis normally works. Nobody has a right to meddle with someone else's life irreversibly at birth like that.

    Medical ethics dictates that an intervention may be imposed by force when waiting for the patient's own rational informed consent would lead to net harm and when less-destructive options have been exhausted. Circumcision of healthy children fails this test dramatically. CDC staff should ask themselves why no other allowed procedure violates medical ethics like that.

    If routine circumcision were unheard of and someone proposed it today for the treatment or prevention of anything, that person would rightfully earn the scorn of all. People would say the costs, risks, ethics violations, and known losses are too great and there are other less-invasive ways to attain the same supposed benefits. They would say informed adults can decide for themselves.

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    -Ron Low
    Northbrook, IL

    *From the ABC News article linked (emphasis mine):
    "In 2003 and 2004, three babies, including a set of twins, were infected with Type 1 herpes; the cases were linked to circumcision, and one boy died. Another died in 2010. In the last decade, 11 babies in the city have contracted the virus, and two have had brain damage, according to health officials. All were circumcised by the metzitzah b'peh method."

    ** 1 in 10,000 based on Bollinger et al. A more recent study by Earp places the death rate closer to 1 in 50,000. Any deaths of healthy normal children from a non-therapeutic intervention are too many.
    -Ron Low
    847 414-1692 Chicago


    • #3
      While I empathize, let's get real. Let's keep in mind (as Distalero once said):

      1. The CDC doesn't practice medicine (not directly). The CDC is primarily an organ for forming general policy. Policy is policy; by definition it is not practice.

      2. There are other groups, at other levels, who also focus on policy. This means there can be a political aspect to policy making; governmental policy, and the internal policy found within Medicine. It's this fact which places a few more degrees of grade in the uphill climb. The fact that there are multiple political influences on the CDC explains why the CDC's policy has changed from time to time. The CDC's policy has changed. What does that imply, with reference to figureheads vs the percieved "the enemy"?

      3. The CDC takes it's cue from those groups mentioned, and from ongoing research and practice. In other words, it serves as a general reference for policy, not a director of practice.

      What I'm focusing on is:

      1. The CDC does not hold the scalpel.

      2. The CDC does not even talk about the scalpel. In fact nobody professional does, except as comment. Not a single group has ever (since Kellogg, in the US) discussed circumcision as a procedure, with regard to the standardization of any aspect of the practice. No standardization in a medical procedure is a fundamental mistake, and leads to mistakes in practice.

      3. While the CDC may accept input from the public in the form of comment, it's comment only. In other words, the CDC does not recognize the expertise of the public.

      4. There is a large gap between the hand holding the scalpel, and the CDC. There is an infinite gap between the hand holding the scalpel and the public.

      However, consider this:

      While it would be misleading to think that public input has much effect, it's important for the would-be intactivist to know who is who in this game, and how things work. I have nothing against public comment; after all, it's all the public has in this issue. However:

      Those from the public who are most affected have something important: the consent form, and the direct, face-to-face direction (an order, in other words), which comes from informed parents, to the hand holding the scalpel. For the public which has, from the CDC's perspective, a vested interest in practice and policy, it can't be more direct than that. This would imply that this is a front worth pursuing.

      Now, my policy statement;

      All of the above has worth only if you are an experienced intactivist. Otherwise you won't understand it. The definition of "experienced intactivist" precludes virtually all on this site. "Experienced" means an intactivist who has the basic information needed to go in front of the players in the game, with his professional career in the balance. This starts with knowing who the players are. If you think you're an intactivist then look into it. Doing this will make things clearer, and will make any effort more effective.

      For the rest on this site who claim intactivist credentials, at least get a little more information so you can sound real. Not many who even make this claim, of course, and that's ok. This is the world of the internet. It's small to the point of suffocating, it's uninformed, it's become inbred, and the agendas are removed from even wanting to know. And besides, the restoration message takes precedence, as it should. It's a good message. For the victims.

      Reading this is irritating for the claimants (based on what the response to Distalero's comments were, on the old forum) . But it happens to be fact whether you ignore it or not. I have little respect at this point for those who have zero understanding of the dynamics involved, and I have less than zero respect for those who resist knowing those dynamics. I've read some of you in your replies to Distalero. This type lives in the constrained world of their own emotional self-focus. You are simply staring at the ceiling while you masturbate.

      Get real, get info, accept some measure of reality. And for those fewer still, who work in a professional capacity, you are closest to this. Do something; for the victims-to-be.

      Last edited by Reality; 10-12-2018, 05:28 PM.