CPT Codes for "Circumcision"

 "Circumcision" made its way into the medical field in the late 1800s when there were beliefs that touching one's genitalia was a source of ailments.  To this day there are claims that you may or may not believe.  Whether you believe the claims or not is not important here.

CPT codes are used in the medical field to handle billing for medical services.  They are maintained by an editorial panel of the American Medical Association:

"Circumcision" continues to be done without a pathology present.  In the USA it is more often done in the medical field as a preventative measure and/or to meet parents' religious and/or cosmetic beliefs.  The challenge with the CPT codes is that there is no differentiation between addressing an existing pathology and when there is not.  This makes it impossible for insurance companies (including Medicaid) to be able to only cover medically needed procedures.  You would think that the insurance companies would apply pressure on the AMA to correct this.

In 2022 there was a lawsuit in Massachusetts to stop Medicaid from paying for the non-therapeutic procedure:

https://www.gofundme.com/f/legal-challenge-to-medicaid-circumcision

Due to the Federal government's protection of Medicaid so that they do not take on any undue administrative burden, it failed and Medicaid in Massachusetts continues to cover the procedure.  If separate CPT codes were used, this administrative burden would not exist.

Here are the codes as they exist:

"Circumcision" is a euphemism that stems from the religious texts that state "circumcise the flesh of the foreskin."  When considering anatomical diagrams, what is removed is part or all of the prepuce.  I request that the CPT Editorial Panel add codes for prepuce amputation.  This would give the insurance companies the ability to continue covering medically necessary procedures (like a prepuce amputation or "posthectomy") and deny those that are not.

I have created the following petition to convince the AMA to do so:

https://chng.it/4zRQPnpYbW

What makes me particularly good at genital autonomy advocacy

There have been several events in my life that have led me to become an avid advocate for genital autonomy.  I feel the need to document these, so here they are:

My prepuce was amputated shortly after birth. (I was "circumcised.")

I was born in a time when there was no public internet and no books existed that discussed what "circumcision" was other than religious texts.  In fact, it wasn't until the following year that the American Academy of Pediatrics made its first statement regarding the fact that there was no medical indication for the procedure.  It's very interesting that there were so many baby boys getting cut during that time when there was no medical indication for the practice.  This shows how it became popular for other reasons including but not limited to the capitalistic healthcare system in the USA and I dare say that there is a connection to the war.

Thus, I have a hard time finding fault with my parents for allowing it to occur.  My own father was cut as an infant as well and clearly never critically analyzed the practice.  I imagine being in the military, where individuals are given very little agency, it probably never even occurred to him that there was any other way.

Nightmares that seem to be connected to the event re-occurred throughout my childhood and young adult life.

I wasn't one to cry or scream as an infant, toddler, or child.  I DO remember having the same nightmare frequently.  There were only two other nightmares that re-occurred during my childhood.  This particular nightmare repeated well into my late 20s.  The nightmare involved me being unable to move and something was approaching me that was going to harm or kill me.  Of course, I would always wake up just before it happened, and I would wake up in a cold sweat.  That something was vague: I never had a clear vision of what it was.  This makes sense considering how limited the vision of a neonate is.

This challenges the idea that humans do not develop memories at such young ages.  I know other men that have reported similar nightmares as well.

Vivid memory of my brother getting the Vaseline treatment.

Certain memories from my early childhood really stuck with me.  My mother putting Vaseline on my brother's penis is one of them.  I guess I always wondered why you would have to do that.  Of course, NOW I understand.

Tight erections

Looking back at my childhood after figuring out how the loss of my prepuce affects the normal operation of a penis, I have come to realize that the physical feelings I experienced during erections (which happen without an attraction, in case you didn't know) were not normal.  Yes, intact males can have tight erections too, but for very different reasons.  These physical feelings drove me to do something about them whereas I believe that something would have been completely different if I was left intact.

I have often been able to step outside of myself and look at my life and choices as though I was looking from someone else's perspective.  One day I woke up thinking about that boy and the tight erections he experienced throughout his youth and I felt very sad for that boy.

I've said this before, but those tight erections have caused physical issues throughout my life.  One was the tightness of my scrotum which drew up my testes so much that one would often get pressed to the point of being very uncomfortable.  Another is that the tightness on the other side would cause a bend, which is not something that an erect penis does very well.

Meatal stenosis

Another clear memory was having urine not spray in a stream but spread in a way that I would sometimes make a mess.  My grandmother wasn't having it and took me to the doctor.  The doctor found that tissue grew across my meatus (where the urine exits the glans).  While I don't remember it being painful, it was another one of those odd things that didn't make sense to me at that time.

Since I have been studying intact and cut penii, I have noticed that intact men do have a larger opening in most cases.  Stenosis just means narrowing.  It seems that many, if not most, males that had their prepuce removed at an early age have a degree of stenosis.  I often wonder whether the sharp feeling I get when I urinate would be that sharp if I was intact.

Christian upbringing

I went to several different churches during my youth.  Sometimes Baptist, sometimes Assembly of God, and sometimes another.  As my current wife (Jennifer) was brought up Lutheran, I have attended some of those.  I have also attended a "Religious Science" church. Jennifer has also attended a Lutheran college.  Jennifer and I have had many conversations about the Judaic family tree (Islam and Christianity as limbs of that tree).

As there are many things about this religion that don't make sense to me, the whole sacrifice idea completely fails for me.  As a parent, I would never want my children to make a sacrifice to me that involved harming themselves.  Today I have come to see religion as a man-made thing that has simply developed over time.

Religions can be abusive in many ways, but there is no abuse worse than making permanent body modifications to a child.  Even if they might not remember the event, they can look at the modification later in life and have extreme emotions about it.

Met a Mohel

I have actually met a couple mohels, but there's one in particular that sticks out in my memory.  Now, before I go any further, I suspect you may be one to think "oh, he's just anti-Semitic."  To me, an anti-Semite is a person that advocates for the oppression of Semites simply because they are Semites, not a person that challenges a religious doctrine.

In case you don't know what a mohel is, it's the individual in the Jewish religion who performs the Brit Milah (the "circumcision").  Ever since they decided that the glans (head of the penis) needs to be laid bare (you can look up "lay bare the glans"), they had to keep a sharp thumbnail in order to break the connection between the glans and the inner part of the prepuce (aka "foreskin").  As a teenager, I noticed a thumbnail that was shaped like the end of an arrow (speaking of archery here).  I never knew why this person kept his thumbnail that way until I learned more about this topic.

Appendicitis/appendectomy

You're probably thinking "what does this have to do with genital autonomy?"  It is often brought up that parents have to make choices for their children, so the claim that the child cannot consent does not apply. But, IT DOES!  "Circumcision" is a ritual, not a medical practice even though they use the term.  A prepuce amputation, posthectomy, or preputioplasty are surgical terms instead of a euphemism for a ritual.  "Circumcision" is not a choice that a parent "has" to make unless they are so religious that they believe that they have to.

Another thing that is brought up is that it's better to do it early so they don't have to deal with the pain of doing it later.  The chances that a person will need an appendectomy are much higher than ever needing a prepuce amputation.  The pain from the appendicitis was excruciating for me and the recovery took several weeks.  Today we have better methods through laparoscopy, so recovery today would probably be much shorter.  However, the point is that this logic about the possibility that they will need it later in life can be applied to many things like the appendix.  You may be thinking "that's far more invasive than a prepuce amputation."  Maybe, but the appendix has far less value than the prepuce.  And, I bet they could perform a laparoscopic procedure on an infant that would have far fewer adverse effects than prepuce amputation.  It comes down to the views of the value of the prepuce.  Most men in the world would never consider removing it; thus, it clearly has value.  Those living in cultures where genital cutting is common, most males obviously hold it as something with little or no value.

Married someone that became a trauma therapist

I supported my first wife while she obtained her master's degree in behavioral science.  I was dragged through her learning process, thus, learning many things about human behavior myself.  As I have gone through my own cognitive dissonance, trauma, and grief from learning about my loss, I have been able to self-monitor and look at myself through the lens of someone that has received such education about human behavior.  I believe this has helped me stay sane and objective.

Married someone else who attended a Christian school

As I noted earlier, Jennifer attended a Christian school. She has also developed into a career that involves mental health and is working at a non-denominational church.

While I can get into the weeds with someone that considers themselves religious, I find myself very dismissive of the religious beliefs that drive people to harm others.

Became a father of sons

Being a father of two boys, who I changed diapers on and have had several candid discussions about this topic, I consider this my greatest value as an advocate.  I often jump into conversations between people where there is no one like me and let them know that I am a cut dad of two intact sons and those who think they know something suddenly stop interacting or quickly change their tune.  They have to be careful what they say around me because they will find themselves insulting me or insulting my sons if they are not.  Thus, I think it pushes people to stay more objective about the topic.

Dealt with cognitive dissonance and Stockholm Syndrome too

I watch so many people come up with the same arguments I did.  The main difference is that I'm an introvert and did not voice the arguments out loud; I simply asked people questions and did research to verify whether my arguments were good ones or based on lies.  And, it's not just one layer of cognitive dissonance that has to be dealt with, particularly when one holds strong religious beliefs.  It's particularly difficult to consider that the arguments are based on lies because it means that one has to acknowledge that those who you love and were supposed to love you are the ones that had it done to you (thus, Stockholm Syndrome).  Not everyone has the same number of layers of cognitive dissonance, thus, some move through it faster than others.  Those who went through the cognitive dissonance themselves seem more patient with those who are going through it now.

Vasectomy

Yes, I got the vasectomy after our youngest son was born.  *I* CHOSE IT!  The person that performed it made absolutely sure that I was not being coerced.  I just wish medical professionals were as careful when asking mothers of newborns (or not ask at all!)!

Vasectomy is brought up sometimes as a comparison.  I still have not seen a good reason for it to be brought up.  However, since I did get one, it puts me into a great position to address it along with all of these other things.

Technologist

My work as an IT guy has affected my ability to network and disburse information.  I could create a huge list here of all the things I have done on the internet, but I don't see the point.  Anyone that follows me closely knows.

Work in big pharma

Many consider intactivists anti-science and compare us to anti-vaxxers.  I worked in a pharmaceutical company for over 5 years.  For much of that time, I drove and rode a vanpool van with many PhD scientists.  Conversations often occurred discussing what made for "good science."

I don't want to get in trouble for talking bad about the company I used to work for, but, capitalism clearly drives people to do selfish things.  People sometimes bring up that the USA does more study and research to develop medical treatments.  When you consider that most other countries operate social healthcare programs, that makes complete sense.  When there is potential for great gains, investors WILL invest.  Bill Gates has made huge investments into biotech and is the largest contributor to the WHO second only to the USA government.  It's hard to trust anything when there are conflicts of interest like that.  I think that the COVID pandemic has highlighted how little trust people have for these entities and the governments due to financial interests.  And I have NO doubt that financial interests (as well as others) have negatively affected the information that is provided to the general public about "circumcision."

Summary

I have been wondering why I have become such an influence in the movement for genital autonomy.  Now that I have written it out, I see that there are many reasons.  It's as if I have been preparing for this my entire life (or divine intervention has been preparing me).

Are Lawsuits A Good Use of Resources to End Genital Cutting Rituals?

Georganne Chapin of Intact America recently wrote this:

https://intactamerica.org/dyk_why-lawsuits-wont-end-mgc/

If you read my blog posts, you may have read this one:

https://johnadkison.blogspot.com/2020/04/suit-against-usa-federal-government.html

as well as the preceding one related to it:

https://johnadkison.blogspot.com/2019/06/filed-suit-against-usa.html

Yes, I failed to get a settlement.  However, was it a complete waste of time and resources?  Not in my opinion.  In this case, I only spent a little more than $400 to file it.  The primary reason the case was dismissed is that the FTCA states that we cannot sue the federal government for things like assault.  I was not aware of that, were you?  You see, education alone is valuable and I passed it on to you for free!  But, that's not all! (are you sensing my sales voice?  😆)  Several individuals ALSO got educated about the fact that there are #mendocomplain!  At the very least, a judge, an attorney, and the individuals who handled the tort claim at the US Navy now know.  Also, fellow #mendocomplain, like David Wilson, who was also cut in the military as an infant now know that they will have to take a different approach if they wanted to take some sort of legal action.  If I would have known about the FTCA issue, I may have chosen to put down the US Navy instead of the Federal government.  If I knew who the individual was that did the cutting, I may have chosen to include that individual.  I may have been able to change the complaint.  However, I took on this legal action without legal representation.  Even if David Llewellyn (thecircumcisionlawyer.com) would have decided to represent me without financial support, I don't think he has any experience suing entities like the Federal government or a military entity either.

Thus, just like the attempts in San Francisco, Denmark, and Iceland to ban the practice (specifically MALE genital cutting rituals), I DO see efforts like mine as a step forward.  Even the Cologne (Germany) ruling that led to the creation of WWDOGA was a step forward (2 steps forward, 1 step back).  The determination by a federal judge in Michigan that the Federal anti-FGM law was unconstitutional has been useful in determining future steps (aim for the states, not the localities or the federal government).  Numerous numbers of people have been confronted with the fact that this is a serious issue and have been learning about the many reasons that genital autonomy is important.

There are more and more individuals wanting to take legal action.  Many of those individuals have joined the ranks of GALDEF (Genital Autonomy Legal Defense and Education Fund).  Eric Anderson attempted to get an injunction in Florida to stop it (https://circumcisionisahatecrime.com/blog/).  Ron Goldman, Ph.D. has been leading the charge to end state funding of the rituals.  The Lavine family has been taking action (circumcisionisafraud.com) with much support from Peter Adler who wrote the book "Circumcision Is A Fraud: And The Coming Legal Reckoning."  David Llewellyn has been successful with many actions.  Has any of this ended the practice yet?  No, not yet.  Are they having an effect?  I certainly believe so.

Georganne's blog highlights the fact that very few lawyers are willing to take on cases.  I, however, believe that most of those are not willing because they don't have the knowledge to have the bravery and confidence that David Llewellyn has.  And, this is why I am co-founding GALDEF.  One of the desires of GALDEF is to educate legal counsel.

GALDEF has been ironing out many details to be founded as a well-organized and professional organization.  Please consider donating or notifying us that you will make a donation once specific goals are met.  Currently a Facebook page exists HERE.  A website is in the works.  I am the treasurer, so contact me for donation current donation information.

DISCLAIMER: Everything here is my thoughts and opinions, only my personal thoughts and opinions, and does not represent GALDEF.

American Circumcision Documentary

If you have not watched the documentary, please read no further and go watch it.  I have a very high regard for Brendon Marotta for spending over 5 years of his life collecting and assembling this excellent documentary and I believe he deserves compensation for that work.  I hope that, if he earns more than he needs, he will consider donating some to the organizations that were involved in the documentary.  Those organizations include Doctors Opposing Circumcision (John Geisheker), Intact America (Georganne Chapin), Genital Autonomy America (Marilyn Milos) and....

I decided to write this because I've been thinking lately that many people are probably watching this without the background knowledge I already had and are missing much of it.  This is one of those shows that has so much in it that you can watch it many times and continue to pick up more understanding.

The documentary starts out with an infant being strolled down a hallway and being strapped to an circumstraint.  Makes sense considering that you don't want the child flailing about while someone is about to cut off a part of their body and you don't want an accident to occur.  I think, however, that the intent is to make it clear that this child is not willingly going through with the procedure.

Before you see the procedure move forward, Brendon introduces the documentary.  He starts out saying that "Circumcision is the most common surgery in America."  I have multiple issues with this statement...

First of all, I know that "circumcision" is the term people think of, but, it's far from an accurate term.  "Neonatal preputial amputation" is the technical term.  Sometimes I refer to it as a "prepucectomy." The original term "circumcision" may be more appropriate for the original procedure performed during the Bible's old testament (or Torah's) times where they only cut of the part that is only forward of the penis.  The procedure typically practiced now involves the entire prepuce.  This is discussed more as we get deeper into the documentary.

Second of all, I don't know how this can be considered a "surgery."  Are surgeries not requisite of a medical diagnosis?!  OK, maybe one can all it a "cosmetic surgery."  In fact, that's what many of the states in the U.S.A. call it and why it is not a covered procedure under the state's healthcare insurance.  What other cosmetic surgery is allowed on a child where the parent consents to it?  Not sure if you can consider ear piercings cosmetic surgery, but that is the closest I can think of.  Personally, based on the simplicity of the procedure, I don't think of the procedure as more than what a butcher does for the meat that you may eat (if you're not a vegetarian).

He notes that it affects "the majority of American men in the most intimate way possible."  Marilyn Milos will identify why it's not just the men.

I also take issue with the term "American."  Are those in South America, Mexico or Canada "American?"  The majority of those Americans have not had their prepuce removed.

Georganne Chapin then discusses how people "might not ever want to talk about it..."   Well, I can't imagine why?  I mean, it's an extremely difficult thing to face up to.  We are talking about babies, we are talking about genitalia and we are talking about cutting part of it off.  Anyone that does want to talk about it may be thought of as pedophiles and not many people are OK with being thought of in that way.

And "it's not an important issue."  Why is it that female genitalia (FGM/female circumcision) an important issue and male genitalia (MGM/male circumcision) is not?  I believe it's due to the fact that females are usually put through a procedure (and there are many types) when they are old enough to remember and a larger percentage complain.  Maybe it would be thought of as an important issue if more men were complaining, but why is it that they aren't?  To understand better, check out my older article: Why more circumcised men aren't complaining.

Jonathan Friedman then defines "intactivism."  He frequently protests with www.bloodstainedmen.org and has been seen with Intaction.org.

Then, Norm Cohen expands on that.  Norm is the manager of NOCIRC of Michigan.

Andrew Freedman from the 2012 AAP task force on circumcision chimes in and validates that he understands the feelings of the intactivists.  He sums it up quite well.  More to come about him....

Georganne notes how "it might not have been the right thing" is "a mortifying feeling" for a parent. Think that may be why some get defensive?  Definitely not something one may want to face.

A demonstrator and a pedestrian that is unaware of the details of the procedure are talking.  The pedestrian thinks it's just an incision and the intactivist explains that "the five most sensitive parts" are removed.  As I understand it, it's 4 to 5, depending on the exact procedure.  One of the things I'm disappointed with is that those parts aren't covered.  I really think that if more men understood those parts, more would be upset.  To find out details, check out www.doctorsopposingcircumcision.org and look at the anatomy section.

Another pedestrian exclaims that "it's hygienic."  I never understood this thinking.  I guess, since it has to do with the part that you urinate from, it must need more attention to hygiene and it must be difficult to keep clean.  Believe me when I say, you're going to have much more trouble getting your children to keep their teeth brushed properly than making sure that area is kept clean.  Seriously, that is the person's favorite toy!  Cleaning it is FUN!  Feels GREAT!!!

The same pedestrian argues how females have "sensitive nerve endings."  It's really a shame how many people think of the "foreskin" as just "extra skin" or a "flap of skin" that doesn't have any value.  This pedestrian is a perfect example of a regular reaction I have seen more times than I can count on the topic.

Georganne points out that "it's a potentially awful thing to think about."  Yep, it is!  I would not say "potentially."  When my first son was born, I started coming face-to-face with it myself.  When I look back on the dozen years between that time and my first blog article in January 2018 about the topic, I believe that I went through multiple rounds of grief over it.  The reason it was multiple rounds is because I would realize how it affected me in one way, then, later, another way, and another.  Grief can take time.  While I was in the denial stage of grief, I hunted and hunted for a good reason to justify what was done.

Georganne also points out how men will say "I don't remember."  Funny, I'm reminded every single day when I notice I don't have my prepuce protecting my glans, keeping it moist and providing lubrication for sexual activity.  Also, since it is not there to provide for the natural/normal elongation (like a telescope) during an erection, my scrotum is drawn up instead.  This causes for half my shaft to be hairy (scrotum skin) and for the scrotum to occasionally pull my balls up into my body, which mildly feels like getting kicked in the balls.  Sorry if this is graphic, but the whole topic is graphic.  If it's ever going to be put to an end, us adults need to face the graphic.

An intactivist describes how "it has ruined their life" and it "fundamentally changes you forever."  Personally, I often wish I was still blissfully ignorant on the topic.  However, if I wasn't, I wouldn't be speaking out for the next generation now.  Learning about the topic certainly has changed me.  The fact that I have a good idea of what I'm missing now, I imagine it's like losing other body parts half way through one's life.  Whether you become OK with being an amputee or not, you will always miss that body part.

John Geisheker (Doctors Opposing Circumcision) speaks about how he went "through an obsessive epiphany."  If you have a thirst of knowledge, this is one book that is hard to put down.  It's like reading the most thrilling horror ever.  I got to meet John at the screening of the film at the Social Justice Film Festival in Seattle.

He goes on about all the perspectives.  It's not just religious and medical, but, anthropological, sociological, legal and bioethical.  To me, this is a simple issue: unless there's an immediate medical need, you don't amputate a body part.  Even if someone wanted a body part removed just because they don't like it, an ethical doctor would send you a psychologist.  But, since there are all these other things, it's made complex.  Honestly, if it was never invented as a way to deal with slaves or as a religious covenant, I think it would be completely laughed at if someone suggested it even for the medical benefits that are purported today.

Dean Edell, MD, a physician and radio talk show host, points out how Marilyn Milos was a nurse at the time his fourth child was born.  Leonard Glick and Mark Reiss also note Marilyn Milos' intactivism.  Marilyn started NOCIRC, which was later renamed to Genital Autonomy America.  This is related to the Genital Autonomy organization based in Europe as Marilyn gave permission to use the logo with the circle covering the crotch.  Please note how these organizations are not limited to male genitalia.  I did create a website by the name of Genital Autonomy Society as a space for individuals and organizations to register as members and volunteers in the movement.

Note how Marilyn's last rotation as a nurse was in 1979.  This year, that marks 4 decades that she has been speaking out!

Marilyn speaks about her experience taking care of babies that went through the process.  While things may have changed since then, the improvements in technology still does not resolve the issue that the procedure removes a valuable body part.  There are many medical professionals, of recent, that are also intactivists.  A notable intactivist nurse is Jessica Rigdon.  There are groups on Facebook of medical professionals that support genital autonomy.  There are medical professionals registered at Your Whole Baby.

Marilyn quotes a doctor stating that "there is no medical reason..."  Please pay attention to the difference between medical benefits and medical need.  The regular go to is that there are medical benefits.  There are medical benefits to removing many body parts, but no others are suggested at infancy.  And, no, you can't claim that the umbilical cord is cut off because it falls off on its own if it is not cut off beforehand.

Marilyn goes on speaking about how she was relieved of duty because some parents were upset by the information.  I hope that the opposite will become the larger concern as more parents become upset by the LACK of information.  If you're a regret parent, I sincerely hope that you will take time to complain to the hospital or clinic that you were not provided sufficient information before providing consent.  You may even go as far as complaining to your government representatives that the "informed" in informed consent is completely lacking.

As early as 1982, there was a lawsuit in the U.S.A. to protect a child from the procedure.  Did you hear any reference to an actual law?  I didn't.  This must be what set the "parent's choice" precedence.

1989 - AAP circumcision statement with Edgar Schoen, MD chairing the committee: "reason they formed the task force was because the American Academy of Pediatrics actually put its foot in its mouth in 1971."  "Somebody wrote a single sentence..." "saying that there are no valid medical indications for newborn circumcision."  Make sure you're clear as to what "indications" means.  Unless an infant is born with a defect, an injury or disease, there is no "indication" that makes the amputation of the prepuce necessary.

John Geisheker notes how the 1971 statement captured the attention of those that had been performing the procedure.  Note that at that time, an extremely high percentage (somewhere around 90% from what I've seen) of newborn boys were getting their prepuce amputated.

Edgar Schoen states that the "anit-circs" go back to the 1971 statement.  The new statements only address what preputial amputation benefits exist and those benefits are about pre-emption against potential diseases and the benefits of satisfying religious and cultural practices.  Thus, the 1971 statement has not been deemed incorrect, just not included in the other statements.

John Geisheker points out that the AAP has a vested interest in not angering the 70 million men that are circumcised (prepuce amputees).  Hmmm, I wonder who would get sued if and where all the money would come from?  Is it the doctors that are completely culpable here?  Or, is it the colleges that failed to teach them properly?  Or, the makers of the text books?  If the doctors get sued, their insurance companies would be doling out a ton of money.  I wonder if they're doing anything to prevent that?  Conspiracy theory?

Edgar Schoen: "...function of the committee was to show that there are indications."  Does he understand the definition of "indications?"

Edgar Schoen: "Evidence has been accumulating in favor..."  In favor of the fact that removing a body removes the chances that the body part will ever become diseased.  Keep in mind that you can do a study on any body part and find that removing the body part will remove chances of disease.

Edgar Schoen:  "There's one guy who keeps sending me new papers."  Note how the video switches over to a presentation by Brian Morris.  I believe the idea is to show you that the papers were coming from Brian.  Also note that Brian is a professor at the University of Sydney.  Keep an eye out for studies that come from that University.   It's also quite interesting the stance on the topic by the healthcare in Australia (Sydney is in Australia in case you didn't catch that).

Brian Morris:  "...I'm passionate about science and evidence-based medicine."  "...individuals in society that are anti-science."  I spent 5 years working for a pharmaceutical organization and spent much time around scientists.  There's one thing that was commonly discussed: good science vs. bad science.  The intactivists aren't anti-science, they just consider Brian's kind of science bad science.

Brian Morris:  "...retaining the foreskin..."  Note the complete lack of consideration for the anatomy and function of the prepuce (foreskin makes it sound like it is just skin).  I often use this sentence when discussing this topic:  "The only person that should be promoting circumcision is a doctor trained in these things that both enjoyed sex before their foreskin was removed and after - I bet you can't find one!"  I'm pretty sure Brian does not fit the description.

Brian Morris:  "...those who oppose circumcision are causing needless deaths..."  Those supporting/promoting genital mutilation is causing needless genital mutilation, needless preputial amputation, needless reduction of sexual enjoyment and needless discomforts of people's genitalia.  He goes on to refer to deaths from HIV/AIDS, but people who had their prepuce removed as infants have died from HIV/AIDS.

Brian Morris:  "Deaths from penile cancer."  Males have a higher chance of dying from breast cancer (yes, men get that too).  More to come on this....

Brian Morris:  "...deaths from cervical cancer."  In case you are unaware, cervical=cervix, which is the female anatomy.  I understand this is due to HPV transmission, which has a vaccine.

Brian Morris:  "All preventable from circumcision."  You can still get these things! Thus, not preventing them, are they?

Andrew Freedman: "call that cultural, religious, aesthetic, family tradition, personal experiences..." Is the AAP in the business of making medical recommendations on the basis of these items? "...non-medical consideration are a valid part of their making this decision." What other non-medical considerations can we use to justify removing body parts? How about the same sorts of considerations to justify scarification, foot binding or putting rings around girls necks to stretch them out?

Leonard Glick, MD, PhD, is a cultural anthropologist with a medical degree and author of Marked in Your Flesh: Circumcision from Ancient Judea to Modern America. "...may have evolved as a substitute for child sacrifice." There is much evidence that the practice started before Abraham in the Bible or Torah.

Leonard Glick: "...a fairly simple removal of the front part of the foreskin and no more. It was only later that that practice evolved further, first because Jewish men during the Hellenistic period wanted to perform an athletic contest naked, and they didn't want to seem to be circumcised, so they pulled the remaining foreskin back -- what's now called restoration -- they pulled the remaining foreskin back and clipped it, actually, in front so as to have a normal-looking penis again." "...the Rabbis then instituted a second phase..." "identical to what is done in the United States." So, it used to be just the part "fore," in the word "foreskin," the penis. Later, the part that is attached to the glans during much of childhood (I consider it the prepuce as indicated in medical texts), started getting separated from the glans (the head of the penis) and cut away below the Coronal Ridge. Why? How? Keep watching.

Leonard and Marilyn go into the New Testament. While it may be important to some religious people, it's very simple to me. Everyone deserves the right to choose their own religious beliefs and taking away a body part that does not grow back because they were born into a family that chooses a particular religion for themselves is giving that person a life sentence. That does not meet the religious freedom rights promised to us in the Constitution of the USA as well as laws in many other nations.

Leonard: "Circumcision is an American procedure." Again, why? How? "...late 19th century..." I find it fascinating how some things just stick around no matter how old those ideas are. There are many other old medical ideas that have been done away with: bloodletting and lobotomies, for example. How is it that this procedure has hung on so long?

John Geisheker: "In the 1960s, it began to disappear as an idea." (referring to curbing masturbation as a reason for the procedure) So, again, why didn't the routine stop there?

Edgar Schoen: "...benefit to risk ratio ... is 14:1" If you do some digging, you'll find that the risks are unknown. And, I always find it interesting that they don't say "benefit to harm." They pretend that there is no cost in doing the procedure. One thing I wish was better covered in this documentary is the harm.

Edgar Schoen: "10x the risk you're gonna get a urinary tract infection as a baby." Let's keep this in perspective. Even if this is true, females still get far more UTIs and as Marilyn pointed out, anti-biotics are used.

Edgar Schoen: "...lower risk of HIV..." "less human papillomavirus." Are babies at risk of these things? Not likely, and if they are, probably a higher chance of getting it through a blood transfusion or dirty needle. Do we know the sexual habits of this person when they are an infant? Is HIV the death sentence it used to be? Isn't there a vaccine for HPV? Maybe better solutions will be available for HIV before the child is old enough to have sex?

Edgar Schoen: "...some of them life threatening." There are parts of the body that are more likely to kill your child than their penis: appendicitis and breast cancer, for example. Why aren't we removing those body parts? The appendix supposedly has less value/function than the prepuce of the penis.

Mark Reiss, MD, Doctors Opposing Circumcision: "These claims are irresponsible, and it's a scare tactic." I don't know about you, but when doctors do not agree on the value of a procedure that involves removing a functional body part, I have to question the validity of that procedure. This IS an MD. Maybe your MD recommends it, but, if you were being suggested by your doctor to have a part of you removed, would you get at least a second opinion? Would you consider that more doctors oppose the suggestion than those that support it?

Dean Edell, MD: "I don't think there's a lot of evidence for benefits, and even if there were some benefits, this is a radical-- a radical solution." Once again, this is from an MD! Be sure to pay attention to the words "benefits" and "need." All the benefits refer to things that MIGHT happen. There are benefits to having all the fingernails removed to avoid potential infections. It would definitely be much cleaner (better hygiene). Fingernails don't even have sensitive nerve endings. The child won't remember it if we get them removed early. We can use anesthesia so they don't feel pain. Oh, but they have function? Have we not discussed the functions of the prepuce?

Leonard: "Medical justification for this is a very interesting subject .... that it's the disease that is most of interest at the moment ..." I would think that this would make people skeptical of the claims that are made. Why would scientists and doctors continue fabricating reasons to support this as a medical practice? Is it, potentially, the desire to be able to say "hey, I found a cure" so they can further their own career?

Marilyn: "...penile cancer is a rare disease of elderly men." Knowing what I know now about how the natural/normal/intact/whole penis works, I would rather take my chances that I'll catch this cancer as an elderly man and enjoy the best years of my sexual life with my entire package vs. not. I know some women get their breasts removed when they are considered high-risk for breast cancer, but, that's normally after they're done using them for bearing children. Males even have a higher chance of breast cancer than penile cancer.

Marilyn: Discussing the purported benefits for STDs - "... high rate of all of them in America, as you know, where most men are circumcised, so that's ridiculous." I am without my prepuce (aka circumcised), I got an STD and it was easily treatable. I guess it didn't protect me, now did it? I wonder what percentage of men that contracted HIV/AIDS didn't have a prepuce before contracting it. Even if the chances of getting a deadly STD was 1 in 10, I still think I would rather take my chances. According to the CDC "Deaths per 100,000 population: 1.9" of HIV in 2016. Do you think those are high enough odds to warrant having a functional body part amputated? From things I've read, HIV/AIDS is on the decline due to antiretroviral therapy.

Leonard: "But as soon as one claim disappears, the next one appears." Since there's a vaccine for HPV and antiretroviral therapy seems to work for HIV/AIDs, I wonder what excuse is going to pop up now.

Leonard and Marilyn discuss the UTIs excuse and how we don't cut off parts of girls to avoid them. Well, I have heard this reason by the cultures that do perform female genital mutilation.

The documentary points out the three randomized controlled trials that were conducted in Africa to see if circumcision could reduce HIV transmission. Maria Wawer, MD MHSc, Professor, Johns Hopkins Bloomberg School of Public Health and Ronald Gray, MD MSc, Professor, Johns Hopkins Bloomberg School of Public Health: Discuss these randomized trials where they identified men that are not infected with HIV and how circumcision gained a 60% lower infection rate. The documentary uses multiple voices to connect how a large amount of money influenced these studies; particularly with the involvement of Bill Gates (Microsoft co-founder and multi-billionaire). Hillary Clinton touts how "PEPFAR will provide $40 million." I think that's plenty of money to convince people to go cut off parts of men's dicks.

These African studies are publicly available. I looked at one of them. I'm shocked that anyone can consider them good science. People in the documentary go into some of the flaws. I am particularly dubious considering the fact that these men thought that they would be protected from HIV/AIDS since they were circumcised and didn't need condoms any longer. Even if that wasn't the case, since they weren't getting as much feeling from sex, there's even less desire to use condoms considering the fact that they reduce sexual pleasure as well. Go check them yourself, if you need. Also, consider the environment in Africa compared to the environment in the USA. Even if you found the methodologies of the studies to have merit, the ability to keep oneself cared for in the USA is much better than Africa.

Ryan McAllister, PHD: "99% of the people who get the measles vaccine and its boosters become permanently immune to measles." In the many discussions I've been involved in, I'm constantly surprised by how many people put the procedure on par with vaccines. The effectiveness (if you even believe that there is any) is no where close. Ryan is the man that speaks in the video "Elephant in the Hospital" easily found on YouTube.

Jonathan Friedman, Intactivist: "Researchers attempted to dispel this claim and did a study showing that 'No, actually the men who were circumcised are -more likely to use condoms." Ronald Gray, MD MSc: "-If anything, what we're finding is that the men who choose not to come for circumcision have a higher risk profile. They tend to be the cowboys who don't take care of themselves and then try to mitigate risk." Jonathan: "Well, if the men who were circumcised are more likely to use condoms -- go back to those original three studies -- isn't that what's preventing the HIV?" You see, no matter which side of this discussion you attempt to argue for, using correlation to determine whether circumcision is effective or not is highly problematic. Correlation does not identify causation. The theory is that the fact that there is more space for the virus to grow increases the likelihood of it being transmitted. Wouldn't that make the vagina the largest space for the virus to grow? What about the mouth for oral sex?

John Geisheker is going through flaws of the studies. Note how the documentary jumps from flaw numbers all the way up to flaw number 13 as there's not enough time in the show to include all of them; it's just to give you an idea. Remember that John is with Doctor's Opposing Circumcision and you can check out the website if you want to go further down the rabbit hole.

J. Steven Svoboda, MS JD: Echoes that the USA has "the highest rates of HIV among any industrialized country" while also having the highest percentage of males without their prepuce (aka circumcised). Mr. Svoboda is part of Attorneys for the Rights of the Child.

John Geisheker discusses how they have gone from "voluntary circumcision for men to semi-voluntary circumcision for young men to involuntary circumcision for infants..." I hope that gets you thinking. Isn't it easier to keep people from complaining about something that they're not even going to remember compared to something where the people have an idea of what they are missing afterward?

J. Steven Svoboda: "... a study that found ... that female genital cutting might possibly help in the fight against HIV." Why wouldn't that be true? If the basis is that there's a breeding ground for the virus to grow under the prepuce, there's easily a basis that there's plenty of breeding ground in the flaps and under the clitoral hood too! Why would this be a surprise to anyone that understands a vagina?

John Geisheker references other studies that found the reduction in HIV/AIDS to be much lower. Georganne Chapin shows little regard for the HIV claims. At this point, I hope you, like me, are well past the whole STD reduction reasoning at this point.

Glen Callender, Founder of the Canadian Foreskin Awareness Project, goes into how people look at benefits and risks (which the AAP refers to in its 2012 statement) but fail to factor in the harm/damage/loss, or, in his words "the lifetime of pleasure" lost. He's also pictured providing a speech on the benefits. I have heard from some that they don't believe this guy. Fine, don't believe him, go ask other men that have their whole penis still intact - however, I would recommend you check with men that grew up in areas where intact males are the norm as I believe too many intact males in the USA were damaged due to the idea that their prepuce must be forcefully retracted to clean underneath it during childhood.

Glen Callender: In his speech, he refers to a couple parts of the prepuce: the frenulum and the ridged band. This is only a sample of the 5 parts. I hope this gives you the curiosity to understand the anatomy better. Again, I linked earlier to the Doctors Opposing Circumcision site to dig deeper.

Brian Morris: "A claim like that is just in the imagination" - I assume this is referring to Glen's statements about the benefits of the prepuce. I wonder how he knows? The only person that should be promoting "circumcision" is a doctor trained in these things that both enjoyed sex before their foreskin was removed and after - I bet you can't find one! "...it's not supported by any form of evidence." We're going to get into the evidence next, but, seriously, how many men with their natural penis do you need to agree with Glen to be considered "evidence?"

Mark Reiss, John Geisheker and Marilyn Milos get into a study that was done to identify the sensitivity of various parts of the penis. Surprise, surprise, there's sensitivity! It's live tissue! It has nerve endings!

Edgar Schoen refers to another study about sensitivity, but, John Geisheker identifies that they only tested "the glans, the little fireman's hat..." Marilyn echoes John. How much more do you need to be convinced that the prepuce (aka foreskin) is an erogenous zone? In John Geisheker's words "main erogenous zone..." Dean Edell backs this up. OK, so, we're up to 3 doctors, an RN and a man with an intact penis against Edgar and Brian (probably both without their prepuce since infancy).

Brian Morris attempts to shut down the idea that the touch receptors (Meissner's Corpuscles) have "anything to do with sexual sensation. They just touch." I don't have my prepuce, in fact, I believe I got more removed than the average male, but I completely do not believe this guy. This totally destroys any credibility I have for this guy. Does he even understand the word "sensual?" A word that is regularly used when it comes to physical intimacy? It is ALL about touch! This guy strikes me like a man that says sex is only for pro-creation and not for enjoyment at all. I have to believe that someone like that probably does not enjoy sex at all. That actually makes me feel sad for them.

Jonathon Cone, Bay Area Intactivists: "...it's not just about sensation. The foreskin allows the penis to glide in and out of itself in a way that minimizes friction, so it decreases drying during intercourse, and it decreases friction for both the man and his partner." Wait, what? You mean there's more?! Jonathon, Marilyn and Glen continue explaining the big impact of this aspect. You'll have to see the show or find other sources to understand this better - remember: you weren't supposed to read this before watching the show!

I love this part because Edgar Schoen and Brian Morris is not even in agreement on this... The documentary brings female genital cutting (FGC/M) into the mix.

Yes, the word "circumcision" is also used in this. And, can you guess where that word came from when referring to it? Abrahamic religion. From what I've read, it's only certain Islamic tribes/sects that perform it.

Pay attention to how Edgar doesn't see it as a "public health measure" while Brian appears to support it as such. Pay attention to how the AAP even supported it for a short period.

Soraya Mire, FGM survivor and activist, sides against while Fuambai Sia Ahmadu, PhD Anthropologist argues that women should be free to choose it even after sharing how she remembers the pain. Aubrey Terron, intactivist, and Georganne discusses the relationship between genital cutting of males vs. females. Brian Morris discusses how it's (FGC/M) is "minor ... it's not gonna have any long-term...harmful effects." I don't think Brian even understands the various kinds of FGC/M that occurs. If the AAP was a political figure, they'd be called a flip-flopper. Brian Earp has done some speeches more recently about this; here's one: https://youtu.be/_D1LPT_P7_o

Ronald Goldman, PHD, Psychologist, Director of the Circumcision Resource Center and Marilyn go into how it's been proven that infants DO feel pain. Edgar Schoen acknowledges this, but, still justifies it as "they get over it very quickly..." and then he says "...the procedure is painless." I've watched this documentary dozens of times and while writing this, I actually just now caught the inconsistency! I guess he's saying that yes, babies feel pain, but, they cry for all sorts of things and still claims that the procedure is painless. Personally, I don't care if there's pain or not; sometimes we have to go through pain to end up with something better afterward. It's the fact that I do not get to experience what nature intended for me!

Edgar Schoen brings up "the baby sleeps through the procedure" piece I often hear. I wish there was a test that could identify when someone goes into shock. I've watched many television shows where doctors say "they're going into shock." I full believe that's what happens. A fellow intactivist has a mother who performs the procedure. She explained in one of her YouTube videos how she watched as a baby boy went through the procedure. The baby was asleep at the beginning, woke up during the procedure and then fell back to sleep. Sounds like a horror movie to me!

Ronald Goldman speaks about how men (MGM victims) avoid information on the topic. He said that he asked "Please estimate the size in square inches of an adult foreskin." He got a range of responses from one-half square inch to up to maybe about six or eight square inches. He goes on explaining why there was such a spread, but, really, do you need it explained? Ronald Goldman is the author of Circumcision: The Hidden Trauma It's sitting in the background alone on his bookshelf, in case you didn't catch that.

Multiple men explain why men are afraid to talk about it. Again, I wrote an article previously about it: Why more circumcised men aren't complaining

The documentary jumps into restoration. I'm not going to get into this section other than the fact that, as William Stowell puts it: "...doesn't actually have any of the sensory and neurological benefits that a real foreskin would have."

Brian Morris says that foreskin is not important for sex and that "men that got circumcised as adults can tell the story best..." Then, Nickolas Kusturis goes on to explain, as one that was circumcised at age 18, that he is NOT happy about his. I have spoken to multiple other men that got cut later in life as well and, also, are NOT happy. There have been some men that I have come across that are good with the results. I think this continues to support the idea that it should be left up to the individual and that doctors should provide plenty of information before accepting the request.

The film continues on into botches, side effects, yada yada yada. Edgar Schoen presents some numbers, but John Geisheker also points out that there's no standard for reporting. IMHO, 100% of neonatal preputial amputations are botched from the get go because they are not medically needed. There are tons of horrible and sad stories, you don't have to look very far to find them. Let's just not do it any longer; isn't that a good solution?

They show the procedure. It's censored/blurred out on Netflix, but you can see the non-censored version on other options. The doctor performing the procedure points out that another doctor told him that "...you don't really need to do anesthesia because they just go into shock..."; but, don't have the nurses tell the parents that. Tell the parents that he just slept through it. That might make the parents feel better about doing it, but, is that the job of the medical professional? Are they supposed to tell the truth or attempt to control the parent's feelings?

Doctor: "That's where he felt me teasing it off the glans." If you haven't learned at this point, here it is: The prepuce (aka foreskin) is adhered to the glans (the head) during the child's early years. The medical professionals give parents directions to put Vaseline on the glans every time they change the diaper. Why? To keep any tissue that is left from attempting to re-adhere; which is the bodies attempt at healing itself. I think about a newborn kitten's eyes when they aren't open yet. You're not supposed to force the kitten's eyes open before they are fully developed and ready to open. I believe this is the same for the human penis. It might not be until the child reaches puberty. This gets to another issue: Phimosis. Phimosis, for a natural penis, cannot be diagnosed on a prepubescent because it's supposed to be attached. If you have Phimosis as an adult, that may be a different issue and resolving it may or may not require the partial removal of the prepuce. If you look at many of the textbooks that are used in colleges, there's very little (if any) about the detail of the prepuce. I've heard of some that even ASSUME that every penis the healthcare professional will encounter will be prepuceless (aka circumcised)! Is it any wonder they forcefully retract it?

The next thing is the 2012 AAP statement. You can look at the old statements too and look at how they changed over time. The thing that bugs me the most, and clearly bugs Eric Clopper (see his video "Sex and Circumcision: An American Love Story"), is the fact that they bring up religion and culture. Andrew Freedman clearly supports this part of the policy. Is the AAP supposed to be a medical organization? One that sticks to science and not social issues? Again, "benefits outweigh the risks..." What about the harm? The only benefit that applies while the individual is a child would be UTIs, which, again, can be treated with anti-biotics. The other benefits can easily be weighed by the individual when they are of age to look at the benefits, risks and harms themselves. And, who knows, by that time there may be some super medical breakthrough that throws the whole idea out the window anyway. Even Andrew states the AAP is about the science; then, why talk about a tribe? Just because someone is born into your tribe, they don't deserve the right to choose their own body modifications?

Oh, how I wish more young men would jump on this bandwagon: Remember William Stowell? He's shown up in this many times. Guess what! He sued and got a judgement! There's a couple big challenges with doing this successfully. 1. Statute of limitations. You may only have a couple years or so (depending on your state) to take action upon turning 18. You may be able to request a stay for that statute considering that you had only learned what happened to you recently. 2. Your parent probably signed a consent form. In his case, his mom signed it while under the influence of medications. No matter what, I strongly urge men to submit a complaint to the hospital or clinic where it was done and maybe even file a criminal complaint with the local law enforcement. Maybe they'll just laugh at it, but, that doesn't matter. The fact that people will see it means that they will think about it every time they do it again. Maybe they'll start questioning the practice. Hopefully, they'll think "there are more important things that doctors need to be doing."

On to the legislative piece. Lloyd Schofield attempts to pass a law in San Francisco. Well, that didn't make it to the voting booths. Let us look at something else that has happened since the documentary was made: the Federal anti-FGM law was struck down as unconstitutional. Why? Because the judge felt that this sort of law should only be enforced by the states such as assault and rape cases are. Hmmm, "assault and rape..." Could the procedure be considered rape? Battery? Child abuse? Why not? It fits the definitions and there's no laws that give explicit permission for doctors to perform these procedures just because doctors deem it a medical practice. I've certainly not seen laws permitting it due to religious beliefs. But, what prosecutor is going to be gutsy enough to tackle such a case? Many states (just over half) have their own anti-FGM laws. I have been pursuing, along with several of my co-residents, the state legislature to pass a law that protects everyone. Well, you can imagine how that's going

Edgar Schoen: Brendon (the director) asks him what does he say to the men that are unhappy with being cirumcised and Edgar's response is "...get a life!" "There's a 120 million males in this country that have been circumcised and are perfectly fine." Hmmm, I wonder how many of those have intimate knowledge of the natural penis. Brian Morris: "All emotional, not good." Maybe Brian should work with machines. Once again, check out my article: Why more circumcised men aren't complaining

Why Outdoor Demonstrations are Currently Necessary to END Genital Mutilations

I'm currently on tour with the Bloodstained Men across the Southwest part of the USA.

It is very frustrating that THIS is what the genital autonomy movement is relegated to.  We hear things like "this is inappropriate" because children see the protests.  I imagine parents telling their children "they are talking about a procedure where a nasty part of your penis was removed" to start the indoctrination.  Of course, I hope they are more honest and apologize for making a mistake.

So, why are we relegated to this?  If you follow me, you already know that I've been involved with this effort for many years now.  I am familiar with the many ways that fellow advocates have attempted to change things.  This includes, but is not limited to:

• Attempts to change the medical industry.
• Requests to improve education.
• Outreach via social media.
• Documentaries.
• Books.
• Legal action.
• Political lobbying.
• Requests that religious institutions educate their congregation.

Put simply, none of these are going to work without raising awareness that genital cutting rituals are an issue that society cares about.  As it stands, according to Intact America, only approximately 1 in 4 people in the USA oppose "circumcision."  Even if we hit half, politicians would still take a big risk to take a stand.

While some in the medical industry clearly oppose non-therapeutic procedures on children, many admit to continuing to perform them simply because parents request them.  And, medical professionals are afraid of educating people due to risks of losing their jobs, liability issues, and general fear of offending people.  The American Academy of Pediatrics reversed its recommendation that nicks of the clitoral hood on girls be allowed after they got an outpouring of social backlash.  As David Llewellyn put it: "the law follows society more than society follows the law."

While several resources (books, documentaries, and websites) exist, those resources are not accessed in sufficient numbers.  I have personally worked with the creators of many of these resources and have found that they are referred to in very small numbers.  I'm not saying that these resources are not valuable; in fact, quite the opposite.  When discussing the issue with people, it is extremely helpful to be able to refer them to those resources.  Unfortunately, the number of advocates communicating with people is still far too small to make a quick change.

I have friends who are religious leaders and they have directly told me of their concerns about offending the Jewish community.  I think there are ways to educate their own congregation without being offensive toward the Jewish community.  I think that it is unfair to their congregation to leave them in the dark.

I have seen many individuals get canceled on social media platforms over this issue.  I myself have had several posts removed.  I actually agreed in most cases about the reasons for the posts being removed as that supports the belief that "circumcision" is a harmful thing.  Unfortunately, it makes it much more difficult to raise awareness and have a dialogue.

I have reached out to several public educators that provide information about "circumcision."  It seems to me that they are too afraid of parents to expand on what they currently provide.  One sex ed teacher, when asked how she would respond to a child asking, she responded to me "we all come in different sizes and shapes."  That is clearly an attempt to make the child feel ok with the fact that he looks different than others without actually addressing the fact that everyone is normally born with the part that was cut off.

This current tour has clearly gotten more attention from the media than previous tours and has created much buzz on social media.  However, I still have not seen the topic get to a "trending" status.

I keep hoping that the dam is going to break and people are going to see why this is an important issue, but it just hasn't happened yet.  Definitely growing, but it can never grow fast enough for me.

Thus, I implore you to support organizations such as Bloodstained Men, Cock Fight, Intaction and NOCIRC of Michigan. I know several other small groups/leaders who also perform outdoor demonstrations and if you register at GenitalAutonomySociety.org as a philanthropist, you will be notified when they are mobilizing.

Questions for the Medical Industry

 "I would like to ask questions about your policies and procedures for infant circumcisions."

1. Do you ask the new parents whether they want their child to be circumcised?
1. When do you ask?
2. How often might they get asked (by different doctors or nurses)?
3. What information are they provided?
1. Does that information include the anatomy, physiology, and functions of what is removed? (including innervation that the Sorrells study shows)
2. Is EMLA cream used for an anesthetic and are they told about the dangers?
3. Is the tool used (i.e. Gomco, Mogen, Plastibell, etc.) explained?
1. Are they provided information on how the different tools have a different effect on what is removed?
2. Are they provided information about why the practitioner prefers one over the other?
4. Are they told about the incidence rates of:
1. Skin bridges and adhesions?
2. Tight erections (which may not be noticed until puberty or later)?
3. Meatal stenosis or meatitis?
2. Genitalia develops into male or female parts in utero.  Is it likely that the development is not complete after the individual is born?  Is the practitioner able to determine whether the clitorophallus will be 3 inches or 6 inches when they finish growing?
3. Is there any reason that the procedure can't be done at a later age?
1. If there is, what reason is that
1. if they refer to it being more complicated, ask why.  If they say there are more chances for mistakes, ask if they are referring to the study that found that the number of adverse events (AEs) that are reported are higher and ask if that might only be because, the older they are, the more likely they are to complain using their words instead of just crying.
2. How old does an individual need to be before you would consider putting them under full anesthesia (with an anesthesiologist attending)?
4. Is it harmful when removing the prepuce from a healthy person?

What to ask a clinic (where the baby is NOT born):

"We are going to have a baby boy soon.  I am shopping around for places to get him circumcised.  May I ask some questions about how you perform the procedure?"

1. What tool do you use? (e.g. Gomco, Mogen, Plastibell, free-hand)
2. How do you know how much to remove?
3. What anesthetic(s) do you use?  If EMLA, ask whether they are aware of the FDA concerns like how mucosal tissue reacts.  And, how does the EMLA reach the inner layer of the prepuce?
4. How old/young does the child have to be and why.
5. What are the pros and cons?
6. If I were to bring in my 15yo and requested that it be done against his will, would you do it?  Where does proxy consent stop?

What does "Genital Autonomy" mean

One of the concerns that come up regularly when speaking about multiple genital autonomy issues is that it "waters down" (credit: Hibo Wardere) one or many of the issues.  I see it differently.  I see it as bringing people together to make the message louder.

I see genital autonomy removed not only when genitalia are modified, but when genitalia are touched or controlled without the individual's consent.  Let me elaborate:

• LGBTQIA+ (Gay Pride): When society tells people that there is something wrong with their sexuality, this is an attempt to control those individuals and that takes away autonomy.  It tells these individuals that they are not free to express themselves in the ways that they desire and that their own body is not their own.

• Childhood Sexual Abuse: When an individual's genitalia are touched in an inappropriate way by someone that has power and control over that individual, it can lead to psychological confusion about sexuality.  For example, the individual may feel powerless about their sexuality as a child and that powerlessness may lead into adulthood.  Again, this takes away an individual's autonomy.

• Rape: Even though the individual's genitalia are not modified physically, the individual can be psychologically affected.

• "*GM:" I use the asterisk to identify the letters "F," "I," and "M" for "female," "intersex," and "male."  I bundle these together because I see genital mutilation as genital mutilation regardless of what sex someone is assigned at birth.  If your genitalia is modified as a child (or even as an adult under social pressure), you are being told that you were not perfect when born.  You are told that there was something wrong with your genitalia, and many actually end up believing it (Fox Without a Tail).  I disagree.  Mutilation makes genitalia "damaged, not perfect."  This is not to say that it isn't possible that you were born with a defect that needed to be fixed, but that would not be mutilation.

I imagine you want to fix at least one of these.  What are the chances that one of these affects one or more of the other?  Consider reading "Circumcision: The Hidden Trauma" by Ronald Goldman, Ph.D. (https://circumcision.org/circumcision-the-hidden-trauma/).  While I highly recommend reading the book from the beginning, page 156 "Antisocial Behaviors" explores connections between sexual harassment and assaults of adults with the genital mutilation of children.

200 million females are believed to live with FGM.  Over 1 billion males are believed to live with MGM. 81% of women are believed to be SA victims in the USA.  25% of men are believed to be SA victims in the USA.  3.5% of adults in the US identify as LGB.  You see, when we only talk about one of these, we could only be including as little as 0.1% (intersex) of the population, while we could easily be talking about half the population when we include all of these.  Gaining sympathy from one to gain autonomy for all could be a useful tactic.  If #consentmatters for one case, why wouldn't it for the others?

Pronouns and sexist verbiage

Before I get started on this topic, I want everyone to know that I want to give everyone the highest amount of respect possible.  My thoughts on this topic are grounded in that desire.

As I have gotten to know people with intersex traits and trans individuals, I have been finding myself avoiding the use of binary pronouns (he/him, she/her) and using they/them and/or people's names more often.

My youngest son is taking Spanish in high school and I have been studying with him every chance I get.  As you may know, Spanish is extremely sexist.  I have nothing against Hispanics, but I find the language very frustrating due to that.  I don't mean to single out Spanish here, it just happens to be what I'm studying at the moment.

While I have what is considered an average size clitorophallus (a penis) and present as a typical male, I am tempted to say that I go by "they/them" pronouns!  Does that come across as disrespectful?  As progressive and supportive as I consider myself to be, I still find myself confused and challenged by this issue.

Why do we need sexist pronouns in the first place?  Just so we can segregate ourselves into separate restrooms?  I know they have been useful for segregating ourselves into different roles in society in the past, but those roles have been torn down in recent history as many people don't want to be pigeon-holed.