Genital integrity

The genital integrity movement regards genital cutting of children as a human rights issue [2]. It asserts the principle that every human has a right to a whole and intact body and that, where minors are concerned, "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." It asserts that such interventions are violations of individual bodily rights and "a breach of fundamental medical ethics principles". [3]. Proponents oppose genital modification and mutilation of children, including routine infant circumcision and female genital cutting. Several anti-circumcision organizations also oppose the sexual-reassignment surgery of infants with ambiguous genitalia [4][5] [6] [7]. Some use the more general term bodily integrity [8] [9] [10]. Those promoting this cause are sometimes known as Intactivists (intact activists) [11].

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Overview

This viewpoint contrasts with circumcision advocates, including Muslim, Jewish and tribal practitioners, and the advocates of sex reassignment for children with ambiguous genitals.

Some Genital Integrity advocates oppose these procedures as unnecessary, harmful and unethical [12]; others want the procedures prohibited [13]. Current laws in many countries, and laws in several U.S. states, prohibit the genital modification and mutilation of female minors, with some exceptions based on medical need. Those advocating Genital Integrity assert that laws against genital modification and mutilation of minors should apply equally to males, females, and also to involuntary sex reassignment. Genital Integrity does not imply bias against persons having any particular genital status, and those who agree with Genital Integrity accept the right of individuals to make informed choices about their bodies.

The Genital Integrity Ribbon [14] was created by the "National Organization to Halt the Abuse and Routine Mutilation of Males" (NOHARMM). The pink ribbon symbolizes girls and blue symbolizes boys. The ribbon as a whole can symbolize intersexed people.

Background information

Main article: History of male circumcision

From the late 19th century to World War II, male circumcision caught on in several English-speaking countries [15], though not without considerable debate in the medical community [16]. In a debate in the British Medical Journal in 1935, doctors opposed to circumcision deplored haemorrhage, "the most dreaded sequel of all". Ulceration and sepsis were also mentioned, as well as deaths from shock. Some also voiced concern about psychological consequences of circumcision. [17]Douglas Gairdner's paper "The Fate of the Foreskin" in the British Medical Journal on December 24, 1949 criticized circumcision on the grounds of mortality from the operation, haemorrhage, anaemia from the blood loss and meatal ulcer. His paper influenced the decline in the popularity of circumcision in the United Kingdom [18] and, according to Robert Darby, also in Australia ^[1] and New Zealand ^[1].

John M. Foley, a West Virginia physician, published an article in 1966 that attacked circumcision, claiming it was a mutilation and a fraud. In Australia, IOW Leitch published a study of circumcision in 1970 which found a total complication rate of 15.5%. In 1971, the Australian Pædiatric Association passed a resolution [19] that newborn male infants should not be routinely circumcised. In America, E. Noel Preston published a review of male neonatal circumcision. Also in 1971, the American Academy of Pediatrics (AAP) reported that neonatal circumcision has no valid medical indication.

In 1975, the Canadian Paediatric Society (CPS) issued a statement that said, "there is no medical indication for circumcision during the neonatal period." In the same year, the ad hoc committee of the American Academy of Pediatrics (AAP) published a statement affirming that, "there are no valid indications for circumcision in the newborn period."

In 1989, a committee of the AAP, chaired by Edgar Schoen, updated its 1975 statement [20]. Citing "new research on circumcision status and urinary tract infection (UTI) and sexually transmitted disease (STD)/acquired immunodeficiency syndrome", the AAP stated that male circumcision of newborns "has potential health benefits and advantages as well as disadvantages and risks." In its 1999 statement, the AAP stated that parents should make an informed decision about circumcision.[21]

The Canadian Paediatric Society, the Australasian Association of Paediatric Surgeons, and the Australian College of Paediatrics issued new statements in early 1996. The British Medical Association also issued a statement, which recognised conscientious objector status, regarding the ethics and lawfulness of the circumcision of male children in 1996. These statements are sometimes interpreted as not supporting the practice of circumcision, and as supportive of Genital Integrity. A Canadian statement followed. Fewer newborn boys are circumcised in Canada since the publication of the CPS statement.[22]

The development of the Internet helped the Genital Integrity movement to spread its message. Those opposed to circumcision began creating websites in the mid-1990s, and this process has continued. This period also saw the formation of Genital Integrity organizations in Australia, Canada, the United Kingdom and South Africa. One prominent U.S. organization is NOCIRC, founded by Marilyn Milos, R.N., in 1986. The organization's stated objective is to secure the birthright of male, female, and intersex children and babies to keep their sex organs intact. Protest rallies have been held in the USA and other areas. Eight international symposia on Genital Integrity have been held around the world. The 8th was held in Padua, Italy, in September, 2004.

Although no membership figures are available, Genital Integrity organizations entered the 21st century reporting a continued growth in strength. The worldwide impact of the movement is unknown. In the United Kingdom, Canada and New Zealand, the number of children who have been circumcised has decreased, while in Australia the proportion of children being circumcised decreased and then slowly increased. In the United States, according to figures from the National Center for Health Statistics, overall figures for neonatal hospital circumcisions have fluctuated between 1979 and 1999. A sharp decrease in circumcisions in the West was counterbalanced by a moderate increase in the Midwest and South of the country.[23] When broken down by race, circumcision rates among Whites remained the same while circumcision rates among Blacks increased between 1979 and 1999.[24] No reliable data is available to indicate any global trends.

Sexual Functions of Intact Genitals

Main article: Sexual effects of circumcision

The genital integrity website Circumcision Information and Resource Pages (CIRP) lists twelve functions of the foreskin, such as contacting the G Spot.^[2] C.J. Cold and J.R. Taylor believe that the foreskin facilitates intercourse.^[3] In her book Sex as Nature Intended It, author Kristen O'Hara argues that the foreskin is a natural gliding stimulator of the vaginal walls during intercourse that increases a woman's overall clitoral stimulation, enabling women to reach orgasm more easily, quickly, and often.^[4] Bensley and Boyle argue that without the foreskin and its gliding action it is more difficult for a woman to achieve orgasm during intercourse.^[5] Taylor (2007) argues that the "real importance of the ridged band to sexual intercourse lies in an ability to trigger a reflex contraction of muscles responsible for ejaculation." ^[6]

In April 2007, the British Journal of Urology published a study (Sorrells et al., 2007) that stated it "conclusively shows that circumcised males have a significant penile sensory deficit as compared with non-circumcised intact men." and that "the most sensitive regions in the uncircumcised penis are those removed by circumcision."[25] The study was funded by NOCIRC and Doctors Opposing Circumcision. In June 2007, the BJU published a letter by Waskett and Morris, two pro-circumcision activists. This letter concluded that "despite a poorly-representative sample and a methodology prone to exaggerating the sensitivity of the prepuce, NOCIRC's claims remain unproven. When the authors' data are analysed properly, no significant differences exist. Thus the claim that circumcision adversely affects penile sensitivity is poorly supported, and this study provides no evidence for the belief that circumcision adversely affects sexual pleasure."[26] Hugh Young, a critic of circumcision, responded to this, stating that Waskett and Morris "critique the finding of Sorrells et al. that 'circumcision ablates [removes] the most sensitive part of the penis' by excluding that part from consideration... That the foreskin itself has a sexual function was well-known for centuries before secular circumcision became widespread. What would need to be proved rigorously is that cutting a significant part of the distal penis off does not diminish sexual pleasure." [27]

Legislation

Main article: Circumcision and law

In 1996, the U.S. Congress passed the Female Genital Mutilation Act (18 U.S.C. 116), which prohibited genital modification and mutilation of normally-developed female minors. Similar laws have been passed in the United Kingdom, Australia, and New Zealand. The New Zealand law (Crimes Act 1961 Part 8 Crimes against the person, ss 204A and 204B) makes female genital cutting illegal even when the adult woman gives consent.^[7] In Africa, where female genital cutting is most common, there is a widespread movement to abolish the practice.

Boyle et al. suggest that "As we enter the 21st Century, appropriate legal action must be taken to safeguard the physical genital integrity of male children."[28]

International

The National Organisation of Circumcision Information Resource Centers (NOCIRC) has organised a series of International Symposia in cooperation with local Genital Integrity organisations since 1989. They were

1. 1989 Anaheim, California (on Circumcision)
2. 1991 San Francisco, California (on Circumcision)
3. 1994 Maryland (on Circumcision)
4. 1996 Lausanne, Switzerland (on Sexual Mutilations)
5. 1998 Oxford, England (on Genital Mutilation)
6. 2000 Sydney, Australia (on Genital Integrity)
7. 2002 Washington, DC (on Genital Integrity)
8. 2004 Padova, Italy (on Human Rights and Modern Society: Advancing Human Dignity and the Legal Right to Bodily Integrity in the 21st Century)
9. 2006 Seattle, Washington (on Circumcision, Genital Integrity, and Human Rights)
10. 2008 planned for Keele, UK (on Circumcision, Genital Integrity and Human Rights)

The proceedings of several of these symposia have been published in book form.

United States

Genital Integrity Awareness Week (GIAW) includes an annual demonstration and march in Washington, DC against infant circumcision. The slogans "The Foreskin Is Not A Birth-Defect!", and "You wanna cut off what!" are prominent during some events.^{[citation needed]}

The National Organization of Circumcision Resource Information Centers (NOCIRC), the International Coalition for Genital Integrity, and Stop Infant Circumcision Society launched the First Genital Integrity Awareness Week in Washington, D.C. during the first week of April, Child Abuse Prevention Month. The 12th Annual Demonstration/March Against Infant Circumcision took place during March 29 - April 3, 2005.[[29]]. From 2004 to 2007, the organization MGMbill.org sent a proposed bill to the US Congress and 15 state legislatures to extend the prohibition on genital modification and mutilation of minors to include male and intersex children.[30] The proposed bill has not been endorsed by any member of Congress. [31]

The Bay Area iNtactivists Group (BANG) in the San Francisco region takes part in baby fairs, the Solano Stroll, Gay Pride marches and other events. An interview broadcast on Outlook TV in April 2006 emphasises genital integrity for boy, girl and intersexed babies.

See also

• Bioethics of neonatal circumcision
• Human rights
• Ridged band
• Gliding action
• Circumcision advocacy

References

1. ^ ^{a b} Darby, Robert (2005). A surgical temptation: the demonization of the foreskin and the rise of circumcision in Britain. University of Chicago Press, Chicago.  page 314, 315
2. ^ http://www.cirp.org/pages/anat/
3. ^ http://www.cirp.org/library/anatomy/cold-taylor
4. ^ http://www.sexasnatureintendedit.com
5. ^ http://www.cirp.org/library/sex_function/bensley1
6. ^ http://www.cirp.org/library/sex_function/taylor2007
7. ^ http://www.legislation.govt.nz

Criticism of Genital Integrity / anti-circumcision organisations

• "Debunking the Anti-Circumcision myths"
• "Anti-Circumcision Lobby Groups"
• "Myths, Lies and Half-Truths About Male Circumcision (Part 1)"
• "Myths, Lies and Half-Truths About Male Circumcision (Part 2)"
• "The new enemies of circumcision"