Recent Confession by the AAP, is it a turning Point?

[RighteousMartyr]

Many intactivists seem to feel that with the AAP's recent back pedaling on their 2011 claim that "Benefits out wieigh the risks" that we've essentially won the war, and I've been all missionary on this issue, I'll confess.

Have we won the war, or just a single, possibly only so remarkable battle.

[TheRifleman]

I don't believe that we have come anywhere near having won the war.

And, I firmly believe that the AAP will continue to do everything it can to promote Male Foreskin Amputation, for many years to come.

And, I do not see that happening in my own lifetime.

[admin]

The AAP is really not our opponent. They took themselves out of the battle when they published that bullshit 2011 policy. It was denounced by leaders of medical associations from around the globe. http://intaction.org/circumcision-policy-denounced/

[TheRifleman]

Thanks for the post, Ron.

[TheRifleman]

Didn't the both the AAP and the CDC both recently work together on a statemetn urging doctors who catch young guys who escaped RIC, to explain to them how the benefits of foreskin amputation oughtweigh the risks?

And, some Intactivists think the AAP is retreating?

Sorry to say it, but I am afraid there are quite a few gullible young guys out there who would fall for that sales pitch, and have themselves cut.

Does anyone know the current state of that effort by the AAP and CDC?

Or, is someone going to tell me that they retreated on that campaign?

I still say as far as I am concerned, the AAP Has not retreated, and will not retreat.

[javeflake]

I think a lor of doctors spread bs that profits them, even if it is not the best thing for the patients. Why are so many "optional" procedures done to single didgit year old children?

At least now there is access to both sides of the arguement online and popular culture is starting to discus it. The problem is that half of the internet is biased towards RIC, and that half looks very reputable with hospital and doctor's websites.
I remember an aunt was talking about my uncle's mother after she went somewhat senile. She said "you know I had joe circumcised for you", "no no, it is really importaint for sex".

So it may not always be just the conservative anti-masturbation crowd that promotes RIC. Some people just believe that the foreskin is a useless flap of skin that serves no more function than the earlobe and gets in the way of sex.

This is where we need scientific facts to educate.
Instead of meantioning sexual biomechanics and sexual pleasure, point out the variety of specialized structures in the foreskin and how it protects the glans from drying out (the conservative folks tend to cringe at any meantion of sex.)

There are times to shock and times to gently suggest a better way.

[Guest]

I will point out the same REAL issues that Distalero used to point out. I belong to the same arena that he belonged to, so we both have the same inside view of the issues:

1. The CDC and AAP are policy statement makers, and as such, are removed from the day-to-day practice of medicine. What they suggest, and why they suggest it, are only suggestions, NOT actual practice. So they are figureheads, NOT the practitioners. Therefore........our fight has nothing to do with them. Anyone who thinks the fight does include the figureheads simply does NOT understand the issue of circumcision in the real world. Unfortunately, that seems to be many would-be intactivists, and most of the forum warriors ;

2. RIC is the battleground; it is where this thing can begin to turn. Everything else is a fait acompli. Adults are free to do what they want, ie elect to be circumcised or not. Clinical indication, for adults, means their situation meets a set of clinical guidelines. If circumcision is just something they desire, then it will be called elective, in which case the PATIENTS pay for it out of pocket. So, it is RIC that is important to us and the future. If a person doesn't understand this, then they may be angry, and they may posture here on the internet, or out there on the streets, but they will also be fundamentally powerless. Why?........

3. The fight has to be with the actual practitioners, and the payers of those practitioners. Nobody here, or anywhere in intactivism, will ever affect a small group of, or all of, the practitioners directly. The practitioners are removed from lay influence for several reasons, so they simply don't listen to laymen, nor should they. They will listen to ongoing research, slowly, which is just as slowly reflected in the guidelines as they are updated. But here's the real area of change: as long as RIC can be hidden within the bundle of the birthing fees, without being monitored, but paid for nonetheless, then RIC will go on, guidelines or not. Who is the only influence on this situation? The only influence on the bundling is........

4. The payers, ie the insurance carriers. THEY have the power, because THEY have the vested interest in monitoring and reducing the cost of clinical practice, which includes RIC. So......

5. The bundle; that's where this will all directly begin to change the terrible status quo from the inside. The fight will ONLY begin to change in favor of eradicating non therapeutic circumcision when the un-monitored (but blindly paid-for) practice is torn out of the bundle, and specifically addressed on a case-by-case basis, as defined by specific sets of clinical guidelines for this point in a newborn's life. It is "generally" assumed that, when this is done, the changed guidelines will recognize that non therapeutic neonatal circumcision is NOT immediately indicated, EVER, and that there needs to be clearer guideline on what is, and isn't, allowed as a procedure per se. This includes a review of devices and their typical outcome, and a review of the procedures used. In the rare event that neonate circumcision IS indicated, then the concept of 'tissue sparring' is the paramount place to begin. Some parts of the guidelines for clinical indication are already in place for children and adults. For this group the provider's request for payment has to align with those guidelines. So......neonates and infants need to be added as the next step. 'Hidden' procedures would be stopped, as would hand-shake deals between practitioners and IP groups or carrier medical directors; circumcision would be out in the light because it is monitored. So not having a clinical indication for circumcision, and not having authorization to perform it, would mean the carrier would decline the request for payment, and for unauthorized procedures the risk of malpractice would be heightened for renegade practitioners.

When the above happens, THEN THE POLICY MAKERS WOULD SUGGEST THESE CHANGES, NOT THE OTHER WAY AROUND, like so many think. It will happen this way because the changed policy will already be in place in a guideline-enforced PRACTICE. That's the real way it all works. The CDC and the AAP don't do RI circumcisions under their banners. Individual OBs (et al) do them, and they WON'T do them if the procedure isn't paid for by a carrier, and they won't do them if there is a guideline that says they CAN'T do them if it's non therapeutic. And hopefully, also because those new guidelines specify that it can't be done because it's otherwise too F'ing early to do anything to an as-yet, still maturing organ.

ICD-10 codes and Milliman talk, sirs, and misdirected attention and vague posturing walk.

I remember that Distalero got a bunch of flack from the warriors on the old forum for saying all of this. So I will encourage you to do the same thing he suggested, and that is: take this post (this amended post, please ) to ANY provider who seems sympathetic to the cause, and see what he or she says about it. If you think I'm wrong here, then you might be surprised by what he or she does say.

What I say here stands on it's own two legs, firmly as an overview. It is admittedly a simplification but still an overview of what is reality. It's an informed assessment that I give to the Intactivist movement (free of a consultancy fee ).

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