American Anthropological Association
 An Imposed Body Modification

ABSTRACT
1. HISTORY
2. LEGISLATIVE ACTION AND CONSTITUTIONAL CHALLENGES
3. FUTURE ACTIONS

Recent Activism in North Dakota as Part of a Presentation at the

The human body, the first cosmological metaphor, was modified cosmetically to reflect our perception of the cosmos. Cosmetic bloodletting of male genitals (not designed after the divine bleeding and birth-giving archetype), allowed men to participate in sacred blood rites. As hierarchically ordered societies flourished, female genitals also required ritualized altering to fit their roll in the new male-centered cosmogonies.

Ritual cutting of genitals is perpetrated as a sign of imitation or subordination, often disguised in complex rationalizations. When genital mutilations become sanctified customs and rites, those who question their appropriateness are dismissed as outsiders having no right to question them.

Recent challenges will be covered, including the conflict between adults’ prerogatives and children’s rights, the growing awareness of nonconsensual circumcision as sexual abuse, the economic pressures to continue, the development of kinder rituals and information on the function of the prepuce.

The history of the first successful law passed in 1995 to specifically protect the genitals of children will be outlined, including legislative resistance to prohibit our culture’s genital mutilations (routine male circumcision, premature foreskin retraction, routine episiotomy) while criminalizing female genital mutilations as practiced in other cultures, even though very similar arguments are used to justify male and female genital mutilations.

Quotations from government, legal and medical officials even when they know such rituals are medically unnecessary and harmful, illustrate the difficulty educated people have in addressing our psycho-sexual rituals to affirm equal protection for the genital integrity of all minors.

_________________________________________

This paper will:

(1) give a brief history of why North Americans  started routinely circumcising infant males in the late 19^th Century,

(2) discuss the current civil rights movement to protect male and female children’s genital integrity,

(3) provide an overview of legal actions taken to compensate for the harm and to prevent further harm, and

(4) outline future legal remedies.

This paper does not evaluate the arguments for and against the American ritual of “routine infant circumcision.” The moral and legal justifications for stopping this practice are sufficiently presented elsewhere (see Recourses).

       1. HISTORY

A most remarkable aspect about the introduction of secular circumcision over the last hundred years, as a practice outside its use within some religious groups, is the lack of legal maneuvers to institute or prohibit it. One of the reasons for this likely lies in the mid-Nineteenth Century's sexism  and fear of sexuality. These attitudes were also endemic within the medical profession. Physicians began to convince women that birthing was a dangerous medical procedure and to convince men (who were already anxious about their sexuality) that “all women hovered on the verge of hysteria, insanity, and crime.”[1] Women who refused to be controlled were declared hysterical and often institutionalized. Since it was a woman’s sexual physiology that predisposed her to the purported diseases brought on by hysteria, excision of her sexual organs, which could include the clitoris, labia and/or ovaries, was often touted as a cure. Another so-called “cure,” as the medical term reveals, was hyster[ia]ectomy, a procedure still far more prevalent yet today than medical necessity would indicate.[2]

As midwives were eliminated and babies extracted in medical settings and lined up in corporate nurseries, physicians could easily modify the male infant to conform to cultural social myths and inaccurate physiology. The emissions of ejaculation were thought to diminish one’s life force and energy. The guilt of enjoying masturbation’s pleasure (compounded, perhaps, by the feeling of guilt for enjoying “unworthy” women), and the fear of the endless list of purported diseases that masturbation would cause, spawned many methods (from cauterization to bondage) to discourage the sin of self-pleasuring. Everyone knew manipulating the foreskin was pleasurable, so one “remedy,” actually less gruesome than some, was to cut it off.

Anxiety over sexual pleasure has a long history: Recent translations of newly discovered Dead Sea Scroll fragments from the First Century refer to a man who “enjoyed his bodily emissions” and was censured. [3] Rabbi Moses Maimonides, a philosopher of the 12th Century CE, believed Jews circumcised their sons to” bring about a decrease in sexual intercourse and a weakening of the organ,” making them less interested in sex and more interested in God.[4] This very rationale was once given by a physician practicing in North Dakota.

The practice of amputating parts of male and female genitals began without consultation with the patient or his or her permission. After all, insane people can’t give permission, nor can babies. Physicians were convinced circumcision was for the patient’s spiritual welfare even if the medical reasons were not always obvious, so acquiring permission wasn’t an important issue. They were determined to force this “benefit” on their patients.

Those using circumcision for ritual religious purposes had never felt a need to provide medical justifications. Not until the 1970’s, long after it became obvious that circumcision wasn’t useful for health reasons, and after people began to openly reclaim their right to enjoy sexuality, did it become common for physicians to obtain parental permission before amputating. Many often still confusedly think they have obtained the “patient’s” consent when they have the parent or parents' permission, but parental consent is only valid for a procedure that alter a child's bodily integrity if it is immediately necessary for the child’s health [20].

The reason consent has been sought since the ‘70s is not because more physicians suddenly became less imperious, but because they were forced to get permission after a series of successful lawsuits. Infant circumcision has always been done without the patient’s permission, and even today it is often done without even the patient’s parents’ permission. However, to do so today exposes circumcisers to very costly lawsuits.[7] Even so, parental consent is seldom “informed,” since few physicians know what risks and losses are involved in this medically contraindicated operation, so parents are left uninformed unless they do their own research.[8]

Clitoridectomy and infibulation, two publicized forms of FGM (female genital mutilation) never did become as common as male circumcision, although some BlueCross insurance companies paid for clitoridectomies until the ‘70’s.[5] But physicians still mutilate female genitals through the overuse of episiotomies, hysterectomies and some unpublicized and malicious genital mutilating procedures that happen far more often than the public is aware, according William Masters of Masters and Johnson.[6]

Most lawsuits, until recently, have been tort actions focusing on recovering damages, either for cutting a child without permission, or because the circumcision was a “botched job” that resulted in infection, loss of the penis, the need for additional surgery, death, and so on.[9] One in 500 circumcisions, according the American Academy of Pediatrics, has such a serious outcome, and others estimate that one in two circumcisions have some problems,[10] problems in addition to the complications inherent in a so-called “successful” amputation, namely, pain, desensitization, lack of normal function during intercourse, feelings of vulnerability, diminished bonding with mother and difficulty in breastfeeding.

One California lawsuit in 1987 did try to establish that a mother’s consent was not legally “informed consent.” She had signed a consent form just before delivery which she claimed not to remember signing. The case was dismissed on appeal without comment, and money for proceeding to the United States Supreme Court was not available.[11]

2. LEGISLATIVE ACTION AND CONSTITUTIONAL CHALLENGES

That male circumcision might be sexual child abuse did not occur to me until 1992 when I first learned about clitoridectomy and infibulation of females in African cultures.[12] I reasoned that we may be just as blind to the abuse of male circumcision as those who culturally cut females.[13] I began a systematic letter writing campaign asking anyone who had something to do with circumcision whether they thought it was justified and why. Queries were made to numerous physicians including my colleagues at the University of North Dakota School of Medicine’s departments of pediatrics, obstetrics and gynecology as well as the Law School. I began researching the origins of the practice and raised the issue in my college ethics.[14]

The state health officer, the head of child protective services, insurance companies, chairs of hospital departments and nursing schools, religious leaders, and so forth, were, surprisingly, nearly unanimous in their statements that the operation was not done for medical reasons, and many said it would be good if the practice stopped. No one was willing, however, to do anything to stop it

The North Dakota Board of Medical Examiners is required by law to protect the public from fraud, unnecessary surgery and any “pattern of inappropriate care.” My first request in 1992 that they declare infant male circumcision a practice that has no medical justification was answered by the president-elect of the Board saying: “It is not the purview of the Board to decide what is necessary and unnecessary surgery.” This flatly contradicted the law.[15] My second request for the Board to censure routine circumcisers in 1995 was on the grounds that circumcision is quack medicine and fraudulent since it exhibits the four criteria defining “quackery” and “fraud” issued by the U.S. government's committee on aging.[16] This request went unanswered, except for a buck-passing paragraph six months later in their in-house newsletter that said circumcision is an emotional cultural issue that should be handled by the state legislature.

In 1994, Jody McLaughlin, publisher of the Compleat Mother  Magazine, and I lobbied the North Dakota legislature to pass a law which would prohibit the amputation or tearing of normal, healthy genital tissue of any minor or nonconsenting person. We had a sponsor for the gender-neutral bill, but he would not introduce the bill without a full slate of co-sponsors from both parties and both houses. This didn’t happen, in part because a female legislator took the bill, added the word “female” in four places and introduced it as a law to protect the genital integrity of female minors only. As such, the bill did have broad appeal.[17] I warned some of the legislators that her gender-biased bill would likely be unconstitutional since it violated the equal protection provisions of the federal and state constitutions.

Even so, there was some legislative committee discussion that such a bill was not necessary since the genitals of female minors were thought to be safe in North Dakota. I pointed out that we were open to immigration from the Middle East and Africa, and then presented a case of a three-year-old child of Scandinavian decent raised in South Dakota who had her clitoris excised (to stop her from masturbating) as she watched in pain and disbelief in a North Dakota clinic while her mother stood by.[18] The bill then passed both houses unanimously. A year later Pat Schoeder’s federal bill, H. R. 3247, intended from the outset to protect only females, finally passed. A half dozen states have since passed FGM legislation similar to the Federal Law.[19]

The civil rights struggle for genital integrity for both genders was then fully engaged. Finding an attorney to press the unconstitutionality issue was difficult. Most would not touch the case since they worried it would make them look like “kooks” and ruin their careers. Others considered it, but wanted more money than could be raised. Eventually a small-town lawyer, Zenas Baer, was found because McLaughlin knew his wife. She persuaded her husband to look into the issue (their children are intact). He did and was convinced many legal issues were involved. He was also, it turned out, a member of the Minnesota Board of Medical Practice, from whose members he could get no satisfactory answers as to why they do not censure the practice of circumcision, after he pointed out to them how infant circumcision violates the physician’s oath to First Do No Harm. (His expected reappointment was not forthcoming after raising the genital integrity issue at the and was not able to get any satisfaction from the members as to why circumcisions on normal children don't violate the physicians' oath to First Do No Harm.)

Circumcision also violates the American Academy of Pediatrics’ bioethics committee’s guidelines to seek fully informed consent on any invasive medical procedure and only allow proxy consent when there is an immediate urgency for the procedure and the patient cannot give consent.[20] Since infant circumcision removes normal, healthy tissue, and since the newborn cannot give consent (though he always protests to the best of his ability), it meets none of the guidelines for consent. Circumcision is not a trivial (de minimis) procedure, such as, some would say the practice of ear-piercing is, so our legal system must be concerned.

We filed a complaint in U.S. District Court, May 1996. The co-plaintiffs were an infant circumcised after the North Dakota FGM law went into effect on August 1, 1995 and his mother who didn’t want her son cut and didn’t sign a consent form, but whose father did, and to whom she deferred in order to keep peace in the family. We joined the co-plaintiffs and claimed (1) the child would not have been mutilated for non-medical reasons had the law been gender-neutral, and (2) the law as it stands is unconstitutional, violating equal protection provisions of the 14th Amendment of the U.S. Constitution. The judge noted the excellent arguments in the briefs and the noble motivation of the plaintiffs, but said he would not hear the case, saying we lacked standing since the child was already cut and a favorable ruling by the court could not change that and give him relief.

The U.S. Eighth Circuit Court of Appeals agreed, in a ruling handed down in the spring of 1997, that standing was not sufficient, so as of now the facts of the case have yet to be heard. Sufficient grounds likely existed to hear the case, but given its controversial nature, the Judges decided to avoid a hearing by citing the technical ground of standing.

3. FUTURE ACTIONS

Legal actions in the future will likely take two courses:
     (1) Attempts to change laws to explicitly prohibit
          (a) the nonconsensual amputation of healthy genital tissue of males as well as females, and
          (b) the painful premature retraction of the immature prepuce that causes scaring and infections and gives many physicians an excuse to frighten parents into having their child circumcised (premature retraction continues even though all medical authorities recommend leaving the intact prepuce alone), and
     (2) Attempts to get enforcement of the laws prohibiting child abuse already on the books.

                                        Attempts to Change the Law

A new lawsuit will be filed challenging the North Dakota genital integrity law that protects only females. This suit will be a class action and should be much harder than the first suit to dismiss on grounds of inadequate standing. The court will be asked to intervene to protect a newborn from being circumcised by extending the FGM law to cover males, or to strike the law down. Even if the court cannot act fast enough to protect the individual in question, new members of the class will be born each day preventing the case from being dismissed on grounds of mootness. Likely, a similar suit will challenge the federal FGM law.

Legislation will be introduced to amend the present North Dakota FGM bill by striking the word “female” to again make it gender-neutral.

Legislation will also be introduced to prohibit health insurance companies from reimbursing any form of medically unnecessary alteration of male and female genitals,[21] including Medicaid payments for circumcision of normal, healthy, genital tissue fraudulently upcoded as “phimosis” or “balanitis”[22]  to avoid the Medicaid prohibition on paying for routine infant circumcision. (This “upcoding” is done either by physicians or the medical facilities for which they work. Some consent forms for neonatal circumcision have a space to check the reason for the circumcision. Phimosis or balanitis are listed while not providing a space to check that the circumcision is "routine."

Hopefully, a writ of mandamus can be served on the North Dakota Board of Medical Examiners to force them to carry out their legal responsibility to the people of the state, namely, to protect the citizens from “a pattern of unnecessary surgery” and fraudulent misinformation by circumcisers. The Board also has responsibility to see that medicine is not practiced without a license; yet, apparently, no one needs a license to perform the dangerous amputation of a healthy prepuce. It is also unclear at what point, if any, a circumciser, or a parent of the one to be circumcised, can force the operation on a child. At what age would the circumcising parent or the parent’s proxy be prosecuted for child abuse? A recent case in Sweden said the father of a teenage boy was not guilty of child abuse for circumcising his son at puberty as is the Moslem custom.

A restraining order should be sought in conjunction with the mandamus to stop the circumcision of nonconsenting individuals done without any clear surgical need. The court order could ask that all third party circumcisers, that is, anyone who is asked to do the circumcision except the child’s parents, be considered abusers (as they would if any other healthy body part were forcibly amputated) unless an immediate medical justification is proven

Finally, there will be suits filed against physicians (by men who were circumcised as minors after they reach the age of majority) for violating their bodily integrity. The suits will allege that parental consent or demand for circumcision is illegal since the consent was not an informed consent, and even if the parents were fully informed of the risks of circumcision, the circumciser has no legal authority to carry out the request, since it is not treatment for a medical condition. A parent is not the patient, and the physician’s first responsibility is to his or her patient.

Attempts to Get Enforcement of the Law

Just as female genital mutilation was unlawful before the FGM bills were passed, so too is the unnecessary amputation of parts of nonconsenting males’ genitals. This is already forbidden by child abuse statues. However, our encultration has desensitized us to the harm and civil rights violations inherent in infant male circumcision. As one of my students naively said, “It has been going on for a long time, and if it were harmful, doctors wouldn’t do it.” Another pre-nursing student, after watching the suffering endured by three circumcised infants at a hospital exclaimed, “There must be an awfully important reason for doing this;” she assumed there was and was horrified to learn there wasn’t.

Reasons for this unnecessary body modification of nonconsenting individuals are numerous, but the "reasons" are not medical and not adequate to override the values of freedom and self-determination our culture claims to prize so highly. The FGM laws do not recognize a long tradition of genital mutilation as sufficient reason to allow it to continue.[23] From the UN Convention on the Rights of the Child[24] to the local statues on assault and battery, the act of unnecessarily cutting, tearing or amputating a healthy body part is considered immoral and illegal.

So, future actions will also focus on sensitizing our law enforcement agencies to the harm and illegality of such acts so they will prosecute the perpetrators. Premature prepuce retraction, non-medically indicated circumcision and episiotomies[25] of minors and nonconsenting individuals are all forms of battery that could and should be prosecuted or lobbied against by our law enforcement agencies, such as, (1) child protection agencies of Human Service Departments, (2) watchdog Boards of Medical Practice, or State Health Offices, and (3) local law enforcement agencies.

A complaint to a law enforcement agency that an individual has mutilated a nonconsenting minor’s genitals cannot be meet with, “We won’t arrest a circumciser,” because federal law and several states’ FGM laws now emphasize the illegality of circumcision (of females). Law enforcement officials now must at least ask whether the cutter is operating on a male or female

The next step is for them to ask whether the cutting was necessary, and if not, they must eventually see (perhaps by the force of lawsuits) that parents, or those they hired, cannot modify the child’s body in this manner any more than they can tattoo, cut off fingers or remove testicles, as was once done to the castrati (young, castrated boys) to keep their soprano voices for church choirs (another profession females were considered unworthy to pursue).

Parental prerogatives and one’s right to continue traditional practices are only legal when they do not diminish the same prerogatives for others and do not violate others’ human and constitutional rights. Just as women were emancipated from being men’s property, so too must we stop thinking of children as property. Parents do not have a right to do with them anything they please. Laws, from car-seat requirements to sexual abuse statutes, intervene to set limits to parental prerogatives.

 Finally, the practice of hospitals selling foreskins for cosmetic testing and other research, without the donor (not even the parents of the donor) having a say in this transaction, amounts to forced organ donation, another aspect of this contra-indicated genital cutting that is already illegal, yet not being prosecuted.

When it comes to circumcision, one must agree with Ashley Montagu, PhD, the well-known anthropologist, who has written extensively on child care customs including genital mutilation: “Thus far the power of precedent and social custom has resisted the force of knowledge, reason, and logic.”[26]

 NOTES

[1] G. J. Barker-Benfield, The Horrors of the Half-Known Life: Male Attitudes toward Women and Sexuality in Nineteenth-Century America, Harper & Row, 1976, p, 83. Return

[2] Some estimate that as many as 90% are unnecessary. Check with HERS, Hysterectomy Education and Resource Service, 422 Bryn Mawr Avenue, Bala Cynwyd, PA 19004 phone: 601/667-7757, http://www.dca.net/~hers/ or e-mail: HERSFdn@aol.com Fax: 601/667-8096  Return

[3] See, The Dead Sea Scrolls Uncovered, Eisenman and Wise, “He loved His Bodily Emissions” (A Record of Sectarian Discipline---4Q477), pp. 258/9. Return

[4] Moses Maimonides, Guide for the Perplexed, Part III. “With regard to circumcision, one of the reasons for it is, in my opinion, the wish to bring about a decrease in sexual intercourse and a weakening of the organ in question, so that this activity be diminished and the organ be in as quiet a state as possible, and thus cause man to be [sexually] moderate...for there is no doubt that circumcision weakens the power of sexual excitement, and sometimes lessens the natural enjoyment; the organ necessarily becomes weak when... deprived of its covering from the beginning.” Return

     “It has been thought that circumcision perfects what is defective congenitally. This gave the possibility to everyone to raise an objection and to say: How can natural things be defective so that they need to be perfected from outside, all the more because we know how useful the foreskin is for that member? In fact this commandment has not been prescribed with a view to perfecting what is defective congenitally, but to perfecting what is defective morally.

     “The bodily pain caused to that member is the real purpose of circumcision. None of the activities necessary for the preservation of the individual is harmed thereby, nor is procreation rendered impossible, but violent concupiscence and lust that goes beyond what is needed are diminished. The fact that circumcision weakens the faculty of sexual excitement and sometimes perhaps diminishes the pleasure is indubitable. For if at birth this member has been made to bleed and has had its covering taken away from it, it must indubitably be weakened.       

     “The Sages, may their memory be blessed, have explicitly stated: It is hard for a woman with whom an uncircumcised man has had sexual intercourse to separate from him. In my opinion this is the strongest of the reasons for circumcision.

     “The parents of a child that is just born take lightly matters concerning it, for up to that time the imaginative form that compels the parents to love it is not yet consolidated....For the love of the father and of the mother for the child when it has just been born is not like their love for it when it is one year old, and their love for it when it is one year old is not like their love when it is six years old. Consequently if it were left uncircumcised for two or three years, this would necessitate the abandonment of circumcision because of the father’s love and affection for it. At the time of its birth, on the other hand, this imaginative form is very weak, especially as far as concerns the father upon whom this commandment is imposed.”

[5] According to Constance A. Bean, coordinator of health education at MIT and author of Methods of Childbirth (p. 227), some BlueCross plans covered clitoridectomies as late as 1977. Return

[6] Carla Miller, founder of >Patients In Arms (636-274-ARMS; or patientsinarms@aol.com) who had the nerves of her vulva cut and her vagina sewn shut during an operation supposedly to repair a minor rectocele, speaks out in agony for many women: “The complications of women’s physical and sexual disabilities and emotional devastation, compliments of US physicians, have yet to be examined, learned, and dealt with in any way by the U.S. medical, legal, and justice systems.

     “Even the woman who knew her sexual abilities well, will find herself looking into a doctor’s eyes, and hear him say, ‘You’re anatomically normal, if you think not, it’s in your head­––seek psycho-sexual counseling––live with it.’ Both the woman and the doctor know he’s lying, that he is refusing to become involved because he sees obvious and severe malpractice [Carla now in 2001 says it is not just malpractice, but "evil"), but of course he chooses to cover up for his friends, even when he knows that to do so is to let her die. The resulting anger and rage for the sexually mature woman who had it all––and then lost it in her sexual prime without ever being told why––is unbearable. A hell that I could never have even imagined. It is, all of it, pure torture.

     “I have a mailing list of more than 40 American women who thought the very same thing. They say they’ve been ‘raped with knives and then raped again by the legal system.’ Unfortunately, the women are beaten down by the demeaning and dehumanizing treatment they receive afterward. They read embarrassing lies designed to shame them in their medical records, and they become so angry that they even attack the written page because the perpetrator isn’t there to lash out at, and then the woman is labeled also as a psyche case because she ‘defaced’ such important legal medical documents. (If only they knew all the horrible ways we desire to ‘deface’ them.)

     “Most give up, become recluses, and do not get involved because they simply can’t take any more embarrassment and humiliation than they’ve already endured, and also because the physical pain is excruciating, and they have great difficulty just surviving each day and sleepless night. There are many others whose names and addresses I don’t have. James Burt in Ohio mutilated 4,000 women. And that says nothing about all those mutilated, ‘repaired,’ by the famous William H. Masters, who, throughout his career, took calls from all across the country from doctors describing mutilated women, with Masters then instructing, over the phone, how to ‘repair’ excisions and infibulations. Masters coined a term for excision and infibulation. He trivializes the completely closed vagina, calling it a ‘Dashboard Perineum.’” Return

[7] A case in Minnesota is now in arbitration. The infant was taken in for abdominal surgery. The parents were horrified to learn the physician had taken it upon himself to circumcise their son. Return

[8] See J. R. Taylor et al., “The Prepuce: Specialized Mucosa of the Penis and Its Loss to Circumcision,” British Journal of Urology 77 (1996): 291-295. Return

[9]--Notice in the Anchorage Daily News, August 6, 1995--

$10,000 REWARD
FOR INFORMATION LEADING TO THE RECOVERY OF THE PROVIDENCE HOSPITAL MEDICAL RECORDS OF JACOB SWEET OR INFORMATION LEADING TO THE DISCOVERY OF THE PERSON OR PERSONS RESPONSIBLE FOR THE LOSS OR DESTRUCTION OF JACOB’S RECORDS

Jacob Sweet was born at PROVIDENCE HOSPITAL in Anchorage on January 16, 1986. He was a healthy and normal baby boy. On January 17, 1986, Jacob was circumcised by JAMES NESBITT, M.D. of THE CHILDREN’S CLINIC. On Saturday, January 25, Jacob’s parents, Gary and Beverly Sweet, brought Jacob back to the emergency room at PROVIDENCE because he was vomiting and was fussy and the circumcision site was red and swollen. They were met by DANIEL TULIP, M.D., also of THE CHILDREN’S CLINIC. DR. TULIP admitted Jacob to the hospital. Late in the evening of January 26, Jacob suffered a prolonged seizure or “crash” and was transferred to the hospital’s neonatal intensive care unit at 2:15 a.m. on Monday, January 27.

Today, Jacob is nine years old and is severely brain damaged. He cannot walk, talk or care for himself in any respect.

SIGNIFICANT AND IMPORTANT PORTIONS OF JACOB’S PROVIDENCE HOSPITAL MEDICAL RECORDS FOR THE 26-HOUR PERIOD FROM THE TIME HE WAS ADMITTED UNTIL THE “CRASH” ARE MISSING.

The attorneys for the Sweets, listed below, believe that there are persons with knowledge of how records may have become “lost” and would like to speak to anyone with any knowledge regarding Jacob or his “lost” records...

We understand that you may feel pressured not to come forward. All we ask is your complete honesty and your assistance in a matter of extreme importance, not only for Jacob and his family, but also for the medical care of future patients... Payment of all or a portion of the reward is in the good faith discretion of Jacob’s attorneys who assure you that you will be treated fairly.

Richard H. Friedman                                     
Friedman, Robin & White                        
1227 West Ninth Ave./Suite 201             
Seattle, WA 98104                                      

907-258-0704
Mark Alan Johnson
Law Office of Mark Alan Johnson
701 Fifth Avenue, Suite 6850
Anchorage, AK 99501
1-800-247-2157                                       .

[10] William E. Bridgman, PhD, in The Journal of Family Law , Vol. 23, No. 3, 1985, said: “Not only is routine [circumcision] surgery unwarranted, but an article published in 1966 in The Canadian Medical Association Journal [‘The Problem of Routine Circumcision’] reported a complication rate running as high as 55% for hospital-performed routine neonatal circumcision. Other studies showed that approximately 10% of all circumcisions were repeated [Id.]. While most of the surgical complications were minor, Dr. Robert L. Baker, writing in a 1979 issue of Sexual Medicine Today calculated that 229 infants died in the United States per year as a result of circumcision [Baker, ‘Newborn Male Circumcision: Needless and Dangerous,’ Sexual Med. Today, Nov. 1979].” Return

[11] The Appellant argued “that to grant a parent the legal power to consent to a surgical procedure which has no medial purpose is to grant a parent an unlimited license to abuse their children....All courts have held that the surgical removal of any normal, healthy, non-diseased, uninjured part of the body is not treatment.” This case is written up in The Truth Seeker, July/August 1989, pp. 47-50. Return

[12] Making this connection is hard for many people. While presenting this information at the American Anthropological Association’s annual convention, I asked a member of the New York-based organization, Human Rights Watch (HRW, headed by Linda Shipley, Director, and located found online at <http://www.hrw.org/hrw/campaigns/crp/crp-cmp1.htm>) that oversees the worldwide progress made to stop FGM), whether she had ever been in a discussion there regarding the possible negative effects of male circumcision, she said my presentation was the first she had heard of the issue, and as far as she knew the subject had never come up at HRW. HRW oversees the worldwide effort to end FGM. Return

[13] I later found others who expressed the same sentiment from a different cultural background: Dr. Nahid Toubia, respected campaigner against female genital cutting, states in gender-neutral terms: “The unnecessary removal of a functioning body organ in the name of tradition, custom or any other non-disease related cause should never be acceptable to the health profession. All childhood circumcisions are violations of human rights and a breach of the fundamental code of medical ethics. It is the moral duty of educated professionals to protect the health and rights of those with little or no social power to protect themselves.” Toubia, N., “FGM and Responsibility of Reproductive Health Professionals,” International Journal of Gynecology & Obstetrics, 46 (1994) pp. 127-135. Return

[14] The results of this research, was delivered first as a speech at the Third International Symposium on Circumcision and now are published in expanded form online in Circumcision, a Virtual Journal, “From Genetic Cosmology to Genital Cosmetics: Origin Theories of the Righting Rites of Male Circumcision” located online at: http://weber.u.washington.edu/~gcd/CIRCUMCISION/v2n1.html      Return

[15] The NDBME’s position was: “It is not the purview of the Board to decide what is necessary and unnecessary surgery. That is a function of peer review that takes place at the local hospital level and is accomplished through surgical case review committees. If a physician is found to have [a] pattern of recurrent in­appropriate and un­necessary surgical procedures, then action is taken at either the local level or through the Commission on Medical Competency” (Letter from Rhonda Ketterling M.D. representing the NDBME, Aug. 4, 1992). This is double talk. The Commission is the Board’s investigative arm.

     The North Dakota Century Code (North Dakota’s body of laws) 43-17.1-07 (Sec. 4) and 43-17-31 (Sec. 6 and 7) says in part: “The board of medical examiners may revoke or suspend a physician’s license to practice medicine in this state or may attach conditions or restrictions thereto on any one or more of the following grounds:... 4. A continued pattern of inappropriate care, including UNNECESSARY SURGERY, in the performance of his duties as a physician. “The board may refuse to grant a license to practice medicine in this state or may suspend or revoke such license...upon any of the following grounds:... 6. The performance of any dishonorable, unethical, or unprofessional conduct likely to deceive, defraud, or harm the public. 7. The use of any false or fraudulent statement in any document connected with the practice of medicine.” (emphasis added)     Return

[16] U.S. Congress Select Committee on Aging’s 1984 report on quackery defines a quack as “anyone who promotes medical schemes or remedies known to be false, or which are unproven, for profit.” Michael Booth, MD, a North Dakota physician who was a member of ND Medical Association’s Commission on Legislative Affairs and President of the ND Chapter of the American College of Surgeons testified to a legislative committee in 1995 that “These practitioners of quack medicine [have] always been difficult to deal with.” They are successful because of their ability to (a) “take a bit of scientific fact and then extrapolate [it] to incredible proportions to justify the use of their therapy, oftentimes ignoring the very real toxic potential that their treatments involve...” and (b) because “too often, the victims of these practitioners fail to take action, out of embarrassment....” Circumcision is also a fraudulent practice because it is (c) a billion dollar a year business, and (d) done without the circumciser providing full information to the victim.  Return

[17] The  North Dakota Female Genital Integrity law.  Return

[18] Renee Bergstrom, psychologist and health educator now living in Minnesota speaking out publicly for the first time, and videotaped, at the Third International Symposium on Circumcision, University of Maryland, Washington DC, May 1994: “I was born and raised on a farm in South Dakota (to very loving parents), and when I was three years old, my mother who was concerned about the fact that I was masturbating (she had read some place that it was the ultimate sin), took me to a doctor in a clinic in [Wahpeton] North Dakota, who took me to a hospital in [Breckenridge] Minnesota and removed my clitoris. My mother was at the end of the table. I remember the pain, and I also remember knowing that I couldn’t trust her any more....” She went on to explain how the clitoridectomy has ruined much of her life, and how clergy, counselors and physicians have been no comfort. Please do not call her for an interview without first contacting Duane Voskuil.    Return

[19] As of November 1997, ND, CA, DE, MN, RI, TN, WI, have passed FGM legislation in addition to the and the federal FGM statute.  Return

[20] The article “Informed Consent, Parental Permission, and Assent in Pediatric Practice; “ Pediatrics, Vol. 95 No. 2, February, 1995, provides the opinion of the American Academy of Pediatrics’ bioethics committee: “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.” This is also the opinion of Dr. Margaret A. Somerville, Founding Director of The McGill Centre for Medicine, Ethics and Law, and Gale Professor of Law at McGill University, Montreal in a paper presented at The Third Annual Conference of The Canadian Institute of Law and Medicine, “Consent to Health-Care.”   First Return  Second Return

[21] Wording for the bill is: “No health insurance policy, health service contract, or evidence of coverage may be issued, delivered, executed, or renewed unless the policy, contract, or evidence of coverage restricts coverage for infant circumcision to cases in which the patient has a life-threatening or health-threatening condition require immediate care.” Return

[22] BlueCrossBlueShield, which administers both Medicaid and the state employees’ health insurance plans in North Dakota, neither of which will pay for routine infant circumcision, seems to be paying for circumcisions or normal, healthy foreskins if the physician or the administration of the clinic or hospital where the circumcision takes place “upcodes” the routine circumcision to phimosis (which is impossible to diagnose in a newborn), or to balanitis (which if it occurs in an infant is nearly always the result of someone forcing the prepuce back leaving open wounds to become inflamed where the tissues of the glans and prepuce are torn apart).  Return

[23] Dr. Nahid Toubia points out, anger filling her voice, that in Africa, “Some men say it’s [FGM] a good thing. They say American women jump from man to man because their sexual organs are driving them to have sex.”  

Hanny Lightfoot-Klein in, Prisoners of Ritual: An Odyssey into Female Genital Circumcision in Africa, has a list of reasons for cutting African girls that is nearly identical to the reasons she found in North America to cut boys: Comparative Quotations on FGM and MGM      Return

[24] Article 24, Paragraph 3 of the United Nations Convention on the Rights of the Child states: “The Convention calls upon States Parties to take all effective and appropriate measures with a view to abolishing traditional practices prejudicial to the health of children.” So far, 187 countries have ratified the Convention making it the most rapidly and widely adopted human rights treaty in history. Unfortunately, the United States stands with the six nations, including Iran, that have not yet ratified. Not only is this an international embarrassment, but it stands as a reflection, hopefully an inaccurate reflection, of our nation’s attitude toward its children. Return

[25] An article in the Journal of Family Practice a couple years ago has statistics that indicate women who have episiotomies are more likely to have their sons cut. Return

[26] From the Introduction to the book, Circumcision: The Hidden Trauma by Ron Goldman, PhD, 1997, Vanguard Publications, Boston. Return

____________________________________

 RECOURCES
See URL Source Page

Some internet sites:
http://www.cirp.org/CIRP  [general site with links to many others] http://faculty.washington.edu/gcd/CIRCUMCISION/v2n1.html#reprint3 [online journal devoted to circumcision] http://www.tde.com/~derrickt/restore.html  [restoration information] http://members.aol.com/MaggiMagoo/fleiss.html  [first best magazine article]

Organizations
Doctors Opposing Circumcision (DOC)
2442 N.W. Market Street, Suite 42
Seattle, WA 98107 206-368-8358
http://weber.u.washington.edu/~gcd/DOC/ 
Attorneys for the Rights of Children 
The National Organization of Circumcision Information Resource Centers (NOCIRC) Box 2512, San Anselmo, CA 94979-2512;  415-488-9883  
http://www.nocirc.org 

The National Organization to Halt the Abuse and Routine Mutilation of Males (NOHARMM) PO Box 460795, San Francisco, CA 94146­0795 415-826-9351 http://www.nohammm.org 

Nurses for the Rights of the Child
369 Montezuma, Suite 354
Santa Fe, NM 87501
505-989-7377
http://www.cirp.org/nrc 

Books
Bigelow, Jim, PhD. The Joy of Uncircumcising! Exploring Circumcision: History, Myths Psychology, Restoration, Sexual Pleasure and Human Rights. 2nd ed. Aptos, CA: Hourglass, 1995.

Denniston, George C., MD, MPH, and Marilyn Fayre Milos, RN, eds. Sexual Mutilations: A Human Tragedy, Proceedings of the Fourth International Symposium on Sexual Mutilations, Lausanne, Switzerland, 1996.) New York: Plenum Press, 1997.

Goldman, Ronald, PhD. Circumcision: The Hidden Trauma: How an American Cultural Practice Affects Infants and Ultimately Us All. Boston: Vanguard Publications, 1997.

Goldman, Ronald, PhD. Questioning Circumcision: A Jewish Perspective. 2nd ed. Boston: Vanguard Publications, 1997.

O’Mara, Peggy, ed.. Circumcision: The Rest of the Story—A Selection of Articles, Letters and Resources 1979-1993. Santa Fe, NM: Mothering, 1993.

Rider, Thomas J., MD, and George C. Denniston, MD. Say No to Circumcisions 40 Compelling Reasons Why You Should Respect His Birthright and Keep Your Son Whole. 2nd ed. Aptos, CA: Hourglass, 1996.

Video
Whose Body, Whose Rights? Examining the Ethics and the Human Rights Issue of Infant Male Circumcision. Award-winning documentary. 56 min. VHS. Personal use: VideoFinders, 1-800-343-4727

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The following article also contains the history of the last 130 years:

BULLETIN OF SCIENCE, TECHNOLOGY & SOCIETY,
 Volume 21, Number 4, Pages 297-311, August 2001.
"Below the Belt: Doctors, Debate, and
the Ongoing American Discussion
of Routine Neonatal Male Circumcision"
>http://www.cirp.org/library/general/dritsasl/

19th & 20th Century   Ancient History