Adverse Effects Of Male Infant Circumcision On Female Health

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A Woman’s Guide to Male Infant Circumcision “To delight in the human body without shame, to enjoy it without adulteration, is not a simple human prerogative: it comes only at the summit of human culture” Lewis Munford in The Conduct of Life Preface The information contained in this document was gathered from numerous sources including CIRC (Circumcision Information Resource Committee), The Association for Genital Integrity, The Intact Network, National Organization of Circumcision Information Resource Centers(NOCIRC), National Organization to Halt the Abuse and Routine Mutilation of Males (NOHARMM), Circumcision Resource Center, , Nurses for the Rights of the Child, Doctors Opposing Circumcision (DOC), Jewish Associates of the Circumcision Resource Center, Patients in ARMS (Advocates Reforming Medical Standards) PAC (Parents Against Circumcision), NAC (Nurses Against Circumcision), the Pacific Institute for Advanced Study and many others. Additional information can be obtained by sending an e-mail to: [email protected] Introduction “Circumcision is men’s way of getting women to use men to inflict harm on other women.” Paul Tinari Sex researcher Kristen O’Hara conducted a study of women who had had a number of normal and circumcised male sexual partners. Her study concluded that: “Women were twice as likely to have an orgasm, half as likely to experience pain during sex and nearly twice as likely to enjoy the experience with an uncircumcised man.” The study also showed that circumcised men were significantly more likely to prematurely ejaculate. What was made clear from this and from many other similar studies is that male circumcision adversely affects male sexual performance and negatively impacts their female sexual partners. The detail of these various negative impacts is the subject of this paper. A newborn male infant is circumcised about every two minutes in North America and every 15 minutes in Canada. These babies are not sick and they do not need surgery. Yet, circumcision consumes more than 17,520 hours of valuable medical time every year in Canada, and an estimated 30 times this value in the United States. This is occurring at a time when women with breast or cervical cancers are forced to wait six months or more for life-saving biopsies. Quite simply, women are dying while waiting for the urgent care they need. No male infant is made to wait for a circumcision. Every circumcised male infant represents a truly sick woman who has had vital care delayed, withheld or never delivered because she dies before getting the treatment she desperately needs. Instead of looking after her, doctors are busy performing useless surgery on healthy infants, often making these babies sick in the process, and setting them up to require further resource-consuming care later. Remember this when you listen to special interest groups who scream about their “right” to circumcise healthy infants. No one has the right to kill 60,000 women every year to support their cultural or religious beliefs. A second area of major concern is the rapid spread of antibiotic resistant bacteria in modern hospitals. Since circumcisions are carried out in “assembly line” fashion in order to maximize profits, many hospitals fail to completely sterilize all of the components of the circumrestraint (the apparatus used to immobilize an infant who is attempting to escape from the unbearable pain of an amputation of a significant portion of his penis). It must be mentioned that traditionally performed religious circumcisions are performed without gloves and without any attempt to maintain sterile conditions. Because of sloppy techniques, one out of every 20-hospital patients gets an infection while in the hospital. Women who have just delivered a baby are at particularly high risk. More than 100,000 patients die each year in North American hospitals from infections

2 caught while in the hospital. Circumcised infants are a particularly insidious, but rarely mentioned source of infection. Enhancing the rate of infection is the fact that funding cuts have forced many cash-strapped hospitals to reuse medical devices that are designed to be thrown out after one use. Many “one-use” devices are sometimes used 20 times or more, leaving behind a potential chain of infected patients in their wake. In response to the excruciating pain of circumcision, many infants will defecate explosively, covering the circumrestraint along with surrounding equipment and personnel with fecal matter. If the infant has been contaminated with a pathogen such as E. coli O157:H7, entire hospital wards can be infected. This particular strain of E. coli is resistant to alcohol, heat, detergent and most other disinfectants. Another pathogen that can be spread by circumcised infants is ExtendedSpectrum Beta-Lactamase (ESBL) bacteria that are resistant to virtually all known antibiotics. Infants can also suffer from and help spread necrotizing fasciitis (flesh-eating disease), pneumonia and septicemia – all involving highly virulent bacteria that aggressively multiply, producing toxins. In Vancouver, a healthy 33-year old woman died a few days after giving birth to a normal baby boy. She and four other women had been infected with invasive Group A Streptococcus (iGAS) that was carried by her newly circumcised son. In the fall of 2002, more than 50 newborn infants in the B.C. Children’s Hospital were infected with parainfluenza and/or Methicillin Resistant Staphylococcus Aureus (MRSA). The original source of the infection was found to be an infant that had been returned to the nursery after being circumcised. Circumcised infants are over 100 times more likely to be infected with and/or be carriers of various pathogens than normal infants. This is because about 3 out of 10 healthy people carry pathogens such as Staphylococcus aureus on their skin. Infection occurs rapidly once an open wound is made in the skin. Circumcision provides a huge gaping wound that is more than sufficient to almost insure infection by any available pathogen. In the series of hospital pictures shown below, the first photo (top left) shows a healthy and happy infant baby boy. The second photo (top right) shows the infant while undergoing a typical circumcision. The third photo (bottom left) shows the child one day after a routine circumcision. The child has been infected with a strain of necrotizing fasciitis that is rapidly spreading throughout the genital region, the lower abdomen and the buttocks. In the fourth picture (lower left), antibiotic treatment has failed to halt the spread of the infection, so surgical removal of the diseased tissue was attempted to save the infant’s life. This child eventually died, but not before infecting his mother and a number of other female patients in the hospital. Such needless infections will soon become a daily occurrence unless steps are taken immediately to ban circumcision from Canadian and American hospitals. Legislation to accomplish this has already been put forward in Scandinavian countries. A broad spectrum of other diseases can be spread to women and other infants including AIDS, West Nile Virus, Antibiotic Resistant TB, CJD, Hepatitis and Ebola. Infants are not systematically screened for these diseases before circumcision is performed in Canadian or US hospitals.

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Why Should Women Care about Male Circumcision? When confronted by the issue of male circumcision, most women usually respond with something like: “Who cares? This is a male issue that does not affect women.” The purpose of this brief guide is to present the reasons why women should take a more active interest in the issue of male circumcision. Fundamentally, the male penis is the only part of the male body specifically designed to penetrate deeply into the most delicate and intimate portion of the female body. For this reason alone, women should be greatly concerned about modifications to the male penis that will have adverse consequences on them. When asked: “Would you have intercourse with a man who belonged to a religious group that required him to dip his penis into fresh cow dung before penetrating you?” --most women would recoil in horror. Yet, many women are irrationally ready to ignore or dismiss other modifications to the male penis that may lead to equal or even greater female health risks. Another equally serious consideration arises from the rapid growth in the populations of religious and cultural groups that aggressively support and promote the various forms of female circumcision in North America. Such groups are increasingly pointing to the gender equality provisions in the legislated rights enjoyed by individuals in North American secular society. They point out that parents should have equal rights to circumcise both their male and female children, as dictated by their religious and/or cultural values. Because of this situation, North American women must be made aware that any support that they express for male circumcision will eventually also undermine the future security of unborn generations of female children. The vast majority of the women reading this have been able to live their lives with the bodies that they were born with, including all of the parts that nature intended them to have. Below is a picture of the foot of one of the few remaining women still alive who had her feet “bound” as an infant. The “ideal” length of foot was considered three inches. To accomplish this, the foot had to be destroyed as a wondrous, perfectly designed organ for locomotion and redesigned to satisfy the gratification of others while causing unimaginable pain to its owner for the rest of her natural life. No girl ever consented to having her feet bound – this was done “for her own good.” Just like female foot binding, male circumcision destroys the beautiful functionality of a perfectly designed organ. The mutilation is done purely for the perverted gratification of others and is designed to leave the owner with an organ with inferior functionality for the rest of his natural life. Every woman who says that she accepts male circumcision is also saying that she would accept the binding of her daughter’s feet. The ethics of both mutilations is the same.

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Placing a Shoe on a “Lilly Foot” – A Foot permanently Mutilated by Foot Binding – Inflicting Lifelong Pain on a Woman Purely for the sexual enjoyment of others Foot binding was so firmly entrenched into Chinese society that extraordinary measures had to be taken to eliminate it. When the Chinese Communist Government took power in 1949, they declared a death penalty for any parent who bound their daughter’s feet. Tens of thousands of parents had to be put to death before Chinese girls were finally protected from mutilation. If the foot binding of girls is unethical, then so is the circumcision of boys. Both crimes should be punished with the same firmness so that children around the world should finally be protected from all the evil that their parents are only too eager to perform on them. It is for this reason that the researchers who produced this document strongly advocate the banning of ALL genital alteration/mutilation of children in secular societies. What is Infant Male Circumcision? Male Infant Circumcision (MIC) is a mutilation of the healthy male penis. In the normal infant penis, the foreskin and the glans, or head of the penis, are not separate structures, but are tightly bound together to form one structure, like the fingernail and the fingertip. The head of the penis is not made of skin, but is mucous membrane, just like the inside of the vagina or the mouth, and the penis cannot develop or function normally without its protective covering. Circumcision consists of, firstly, violently ripping away the protective skin covering from the head of the penis, followed by the crushing, cutting or hacking away of the resulting raw and blood covered loosened ring of skin. A conservative estimate of the level of pain experienced by the infant during the procedure is that it is about equal to that experienced by an adult having a nail torn away from a finger using heavy pair of pliers. According to the widely accepted Gate Theory of pain, the level of pain experienced by the infants is actually greater than this because they have not yet developed the protective endorphin systems that act to limit the amount of pain perceived by the brain. No objective professional Medical Association in the world currently supports or recommends infant circumcision in healthy infants. All those individuals or groups that presently support MIC directly profit financially from it. Circumcision is a multi-billion dollar industry that exists only to exploit human infants by lying to parents about actual risks and alleged benefits.

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A Zen View of Circumcision Zen is not dogma, doctrine, or philosophy. Zen is life itself, lived out fully moment by moment. It is the direct experience of non-duality or wholeness that is completely integrated into everyday life. Non-duality is the experience that you are not separate or isolated from others or from life itself. Zen helps us realize that we become compassionate not from altruism which denies the self for the sake of others, but from insight that sees and feels one is the other. Zen is wholeness. From the perspective of wholeness, no part is separate from the whole and each part contains the whole. You, your baby and the universe are one. What you do to your baby you ultimately do to yourself and to the universe. Seeing your baby as nothing more than a set of “removable parts” is a rejection of the intrinsic wholeness of the human body, of the wholeness of your baby, of the wholeness of yourself and ultimately of the wholeness of the universe. Since circumcision treats human babies are nothing more than a set of disposable parts, it violates the fundamental concept of wholeness and thus, is not only a violation against the integrity of humanity, but also violates the integrity of the person performing the circumcision, of the parent, of the family, of the community, and ultimately, it violates the integrity of the universe itself. What is it Like to Witness a Circumcision? Circumcision continues because of ignorance. New parents are not allowed to witness what happens behind closed doors, so they remain ignorant about what is actually being done to their infants. In one U.S. hospital that introduced a rule requiring parents to witness a circumcision before they could request one for their sons, circumcision rates fell to zero. A descriptive account of an infant’s response to circumcision pain is provided by registered nurse Marilyn Milos, who witnessed a circumcision during her training in nursing school: We students filed into the newborn nursery to find a baby strapped spread-eagle to a plastic board on a counter top across the room. He was struggling against his restraints tugging, whimpering, and then crying helplessly. . . . I stroked his little head and spoke softly to him. He began to relax and was momentarily quiet. The silence was soon broken by a piercing scream—the baby’s reaction to having his foreskin pinched and crushed as the doctor attached the clamp to his penis. The shriek intensified when the doctor inserted an instrument between the foreskin and the glans (head of the penis), tearing the two structures apart. The baby started shaking his head back and forth—the only part of his body free to move—as the doctor used another clamp to crush the foreskin lengthwise, which he then cut. This made the opening of the foreskin large enough to insert a circumcision instrument, the device used to protect the glans from being severed during the surgery. The baby began to gasp and choke, breathless from his shrill continuous screams. . . . During the next stage of the surgery, the doctor crushed the foreskin against the circumcision instrument and then, finally, amputated it. The baby was limp, exhausted, spent. However, what really devastated me and what has stuck with me for all these years is what the doctor said as he turned to leave. He said with a smile: “There is no medical reason for this.” How did Circumcision Begin? The history of circumcision has been traced back to ancient Egypt, where tomb paintings clearly show that it was used as a convenient method for permanently branding slaves. Throughout the ancient world, a healthy elongated foreskin was seen as a mark of beauty in men, so circumcision was designed to seriously disfigure and disgrace the victims. However, after centuries of slavery in Egypt, a number of cultural groups such as the ancient Hebrews gradually incorporated circumcision into their religious practices as a means of attempting to negate the humiliation of the mutilation.

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Originally, circumcision consisted of removing only 1 or 2 mm of the tip of the foreskin, leaving the majority of it intact. During the Hellenistic age, the wide acceptance of public nudity meant that circumcised men were often exposed to disgust and ridicule. Consequently, many circumcised men undertook foreskin restoration procedures in an attempt to restore a more normal appearance. In response, religious authorities gradually increased the severity of circumcision, until eventually more than 50% of the skin of the penis was being removed. In some Muslim cultures, circumcision involves the stripping of all of the skin from the penis right to the abdomen. The goal of all of these rituals was to make foreskin restoration impossible. This also, unfortunately, greatly increased the risks to the victim. It has been estimated that among one religious group alone, more than 5 million otherwise healthy infants have died directly as a result of complications from circumcision. During the latter part of the 19th Century, a number of medical authorities noticed that many of their circumcised male patients suffered from a wide variety of sexual problems such as erectile dysfunction, premature ejaculation and impotence. At the time, the public and the medical profession were gripped by what can only be termed: ”masturbation hysteria”. It was falsely believed that masturbation was responsible for a host of illnesses, including insanity or, in extreme cases, death. It was therefore believed that any means used to stamp out masturbation were fully justifiable. The “treatment” for masturbation designed by 19th century physicians such as Dr. Kellogg, was a forced and painful circumcision for boys and the application of concentrated carbolic acid directly to the clitoris for girls. Both of these “treatments” were administered without the consent of the “patients” but with the full endorsement of the parents. While Dr. Kellogg’s masturbation “treatment” for girls has long been abandoned, shamefully, baby boys continue to be painfully circumcised by ignorant parents. Why Does Male Infant Circumcision Continue Today? In two words: ignorance and profit. There is NO medical reason to perform circumcision in a healthy infant, so anyone claiming a medical motivation is simply ignorant of the facts. Circumcision is the most common and the most profitable surgery performed in history. Circumcision is a $1 billion per year industry. It is possible for a doctor or religious practitioner to earn more than $500,000 per year just performing circumcisions. While in clear violation of laws preventing the harvesting or organs from non-consenting patients, if the amputated foreskins are sold to bio-technical companies, one foreskin can be worth millions of dollars. Massive profits such as these mean that circumcision proponents will say and do anything to preserve what for them is a lucrative source of income. As a result, a massive wall of silence has been built around the whole circumcision issue, silencing debate and preventing the truth from being uncovered by the public. What happens when parents are given all of the facts about circumcision? In one U.S. hospital that allowed parents to view other babies being circumcised before making their decision, the circumcision rate fell to zero. Another reason why circumcision continues today is the historical massive liability that it has created. Over 100 million North American men have been violently circumcised without their consent. This can be compared to the 275,000 women who received silicone breast implants. Every woman who received implants gave her full, informed, adult consent to the procedure before it was done. When women later sued claiming a variety of alleged adverse health effects due to their implants, the result was billions in liability and the bankruptcy of a major US corporation, DOW Corning. If it could be established that male infant circumcision has resulted in any medical harm to men and/or to their female partners, no matter how minor, the liability would be measured in the trillions of dollars. The liability would encompass doctors, nurses, hospitals, religious leaders, churches, mosques, manufacturers of circumcision “kits” and other equipment, parents and governments that acted, negligently, to protect baby girls but not boys.

7 For this reason, the circumcision industry has aggressively worked to block all medical research grants to any groups investigating the various harmful effects of circumcision and, as much as possible, to prevent the publication of any scientific papers casting doubt on the safety of circumcision. The circumcision industry is now trapped in the web of its own misinformation: If it ever admits that circumcision results in harm to the victims, then it will be subject to massive liability. Consequently, it must continue to maintain a facade of lies by continuing to encourage ignorant parents to circumcise their sons. In the 21st century, many new parents of a healthy baby boy are still subjected to massive coercive pressure by medical staff to circumcise their child. At the same time, hospitals and religious groups diligently cover up and suppress the many adverse complications resulting from circumcision. At the height of the circumcision “epidemic” in the 1960s and 1970s, it is estimated that a half-dozen or so Canadian and more than 100 American children died each year because of complications from the procedure. Today, at least one Canadian male infant can be expected to die from circumcision complications each year. There is no other example of any other activity that results in the death of healthy infants that remains unaddressed and un-investigated. What are some of the Complications of Circumcision? The following inherent acute (immediate) risks are iatrogenic (doctor caused), and result directly from neonatal circumcision surgery. Significant acute complications from neonatal circumcision range from 10% to 30%. Chronic (long term) complications range from 36% to 60% and may occur more than 50 years after the initial trauma: Haemorrhage (bleeding): Serious haemorrhage occurs in about 2% of infants, resulting in shock and sometimes death. While death is a rare complication of circumcision, it does occur. Boys with unrecognized bleeding disorders are at risk for serious haemorrhage. Sons of mothers who took anticoagulants during pregnancy are at extreme risk of death, but are regularly subjected to religious circumcision. Deaths are accepted without investigation. Infections: Localized or systemic infections include bacteremia, septicemia, meningitis, osteomyelitis, lung abscess, diphtheria, tuberculosis, staphylococcal scalded skin syndrome, gangrene of the penis and scrotum, scrotal abscess, impetigo, necrotizing fascitis of the abdominal wall, tetanus and necrosis of the perineum. A realistic infection rate is probably as high as 10%. Serious infections can cause irreparable and lifelong harm. Many males become lifelong carriers of various blood-borne infections and they will pass these on to female sexual partners. Urinary Retention: Swelling from the trauma of the surgery, pain associated with attempts at urination, and sometimes the Plastibell device (if used) can cause the infant to retain urine, leading, at times, to acute obstructive uropathy, when the bladder distends to the point of rupture. Laceration of Penile Skin: Results in varying degrees of skin tone variance. Excessive Penile Skin Loss: This occurs when so much of the prepuce is drawn forward that the entire penile skin sheath is removed. From puberty on, penile bowing (curvature) and pain occurs at the time of erection. With erection, pubic hair can be pulled forward onto the penile shaft causing severe irritation in female partners. Bleeding during sex can occur from shaft skin tears increasing the risk that female partners will be infected with blood-borne diseases. Skin grafts are sometimes required. Bevelling Deformities of the Glans (head of the penis): Varying amounts of the glans are shaved off leaving a scarred, bevelled surface and, at times, the entire glans is amputated. The callused and deformed glans will cause severe irritation to delicate vaginal tissues.

8 Hypospadias: While more frequently a congenital defect, hypospadias can also result from circumcision. When the frenular area (underside of the penis) is drawn too far forward, the crushing bell may injure the urethra at the time the foreskin is removed, resulting in a urethral opening on the underside of the shaft. Epispadias: When one limb of the crushing clamp inadvertently is passed into the urethra and is closed, it crushes the upper portion of the urethra and glans, creating a urethral opening on the dorsum (top) of the glans. Retention of the Plastibell Ring: The Plastibell, which normally falls off in 10 days, may get buried under the skin, causing ulceration and/or necrosis. Loss of the glans is a common side effect of this. Chordee (permanent bowing of the penis): While often congenital, this can also result from circumcision. Dense scarring at the frenular area causes penile bowing upon erection and may require plastic surgery to repair. Penile bowing often leads to vaginal irritation and an increased risk of disease transmission. Keloid Formation: Prominent scars often occur where the skin-mucous membrane has been incised, crushed or sutured. Lymphedema: Chronic swelling of the glans due to infection or surgical trauma which can block lymphatic return. Concealed Penis: The circumcised penis becomes hidden in the fat pad of the pubic area, requiring surgery to bring the penis out again. Skin bridges and Penile Adhesions: A common complication consisting of one or more thick areas of scar tissue that form bridges between the coronal edge of the raw glans penis (head) and the raw circumcision wound on the shaft. For many men, these can be quite painful during erection, restricting the free movement of the shaft skin and pulling on the glans. The formation of skin bridges leads to permanent shelter sites for infectious bacteria and viruses that pose a significant risk for all female partners. Phimosis of Remaining Foreskin: When only a segment of the foreskin is removed, the remaining tip sometimes becomes tight and non-retractable, requiring a second, third or fourth surgeries. Preputial Cysts: Cysts caused by infection or mechanical distortion blocking the sebaceous glands. Skin Tags: Can occur at the circumcision line, representing an uneven removal of skin. Loss of Part or All of the Penis: This can be caused by constricting rings, such as the Plastibell, or by use of an electrocautery device. More frequently, the loss is the result of infection, with the penis becoming increasingly necrotic (dead tissue) until finally the entire organ falls off. The proposed solution in many cases is to raise the child as a girl. It is estimated that more than 100 “girls” in Canada, were actually born as males, but lost their penises due to botched circumcisions and so they were surgically transformed into “girls”. Meatitis: Inflammation of the urethral opening from the loss of protective foreskin, which can lead to ulceration and meatal stenosis (narrowing). The majority of infants and children suffer this after their loss of protective foreskin. Meatal Ulceration: Caused by meatitis and/or abrasions from dry diapers and from diapers soiled with urine and feces. Meatal ulceration occurs in more than 50% of circumcised infants.

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Meatal Stenosis: In advanced meatal ulceration, scar tissue can constrict the urethral opening causing urinary obstruction. Meatal stenosis is usually not apparent for several years, occurring in about one-third of all circumcised infants. It is never observed in normal, intact males. Progressive Loss of Glans Sensitivity: This is the most common complaint of adult circumcised men. Many men report that they must be stimulated to the point of pain to achieve orgasm. A significant number of men report complete loss of sexual function after age 50 - 60 because of the loss of sensitivity and sexual response caused by the loss of the protection afforded by the foreskin. Sexual Dysfunction: Studies have shown that impotence and premature ejaculation are significantly higher among circumcised men. Premature ejaculation is epidemic in the United States, a leading circumcision nation, while being almost unknown in Europe where circumcision is rare. Nonspecific Urethritis: This venereal disease is more common in circumcised adults. Gastric Rupture: Has been reported associated with prolonged crying during circumcision. Glans Necrosis: The head of the penis can lose its blood supply and begin to rot from the scarring that follows circumcision. Tachycardia, Heart Failure and Myocardial Injury: Have been reported associated with the procedure. Death: Occurs at a rate of roughly 1 in 40,000. While this rate is “acceptable” to those who order circumcision to be performed needlessly on someone else, few informed adults would voluntarily consent to undertake this level of risk themselves in exchange for the (non-existent) “benefits” of circumcision. Brain Damage: Swedish research demonstrated that the pain of circumcision is so intense that it produces long-term damage to the central nervous system of infants. Children tested more than nine years after circumcision remained hypersensitive to pain in comparison to normal children. Recent studies using functional MRI and SQUID brain scanning machines have been able to map the significant physiological damage caused by circumcision pain in the infant brain. No studies have been carried out to determine the possible adverse effects on adult behaviour of permanent brain damage suffered during infancy. Psychological Damage: The permanent psychological trauma of having the most sensitive part of a boy's anatomy removed shortly after birth without anaesthesia has not been fully investigated. However, as one example of evidence of psychological damage, studies carried out in Norway have shown that while less than 1% of Norwegian men undergo circumcision, more than 60% of the rapes in that country are committed by circumcised men. This study alone should give pause to those who continue to claim that the mutilation of non-consenting infants is “harmless.” Arteriosclerosis: The most significant effect of circumcision is to give a previously healthy child a large open wound. Many pathogens such as herpes viruses and Chlamydia pneumonia (a frequent cause of respiratory infections) can easily gain access to the body via the circumcision wound. C. pneumonia appears in many atheriosclerotic plaques and its constituents can evoke inflammatory responses by macrophages and by vascular endothelial and smooth muscle cells. In what is known as the echo effect, when the body fights the infections that commonly occur after infant circumcision, inflammatory mediators can escape into the blood and travel to distant sites. These substances can contribute to the initial formation of plaques, or can stimulate the white cells in atheriosclerotic plaques, thereby prompting plaque growth or rupture. Studies have

10 indicated that circumcised children have a higher probability of having C-reactive protein in their blood, indicating that inflammation is occurring somewhere in the body. While circumcised males can develop arterial inflammation in childhood, females most often develop these conditions after they become sexually active, strongly supporting the belief that a pathogen is involved that is sexually transmissible from an infected male to a female partner. (See Libby 2002) Other Side-Effects: Circumstantial evidence gathered over many decades indicates that circumcised infants may experience higher rates of autism, SIDS (Sudden Infant Death Syndrome) ADD (Attention Deficit Disorder) and anti-social behaviours. It has long been known that the risk of SIDS in American babies is significantly higher for male infants than for female infants. This difference is not observed in regions where circumcision is not practiced. It is now known that the extreme pain experienced by the baby during circumcision causes damage to the delicate cells in the Brain Stem that control respiration and body temperature. It is precisely the failure of these systems that is thought to lead to the occurrence of SIDS. In the recent outbreak of SARS (Severe Acute Respiratory Disorder) in Toronto, it was discovered that infants could act as non-symptomatic carriers of the virus, and could subsequently go on to infect adults. In one notable case, an infant undergoing circumcision was infected with SARS by an attending medical worker and subsequently he infected more than nine other adults. Shamefully, even after the source of the outbreak was identified, the hospital did not act to stop circumcisions, presumable because of the adverse effect that this would have on the hospital’s income. Proper epidemiological studies must be conducted to confirm these observations, but this has so far been hampered by lack of funding. The Precautionary Principle, that applies to all medical procedures (i.e. when in doubt, one must choose the course of greatest safety) says that the only logical course of action is to stop all male infant circumcision until proper epidemiological studies can be carried out on all of the possible acute and chronic effects. It must also be kept in mind that epidemiology clearly states that the burden of proof is not upon opponents of a contentious procedure to prove harm, but rather, that proponents must scientifically prove safety. In the case of circumcision, safety has never been proven. A number of religious groups claim that the purpose of circumcision is to break the bond between mother and child so that later in life the boy will bond more closely with men and will avoid women. Is this true? Yes. Studies have clearly demonstrated that newborn infants are highly cognisant of their surroundings. For example, infants have a highly developed sense of smell. Normal infants will turn their heads towards a towel or item of clothing containing their mother’s scent, and will tend to turn away from items holding unfamiliar scents. Conversely, it has been observed that circumcised infants will turn away from items imprinted with their mother’s scent. One possible explanation of this is that the circumcised infant does not associate the horrific pain of circumcision with the unknown perpetrator, but will link it to the mother. Furthermore, while normal infants associate pleasure with the act of nursing from their mothers, the circumcised infant experiences the conflicting signals of the pleasure of nursing or feeding from the mother combined with the sharp pain from the circumcision wound. The acute and chronic effects of these conflicting signals affect the long-term psychological balance of the child in numerous ways that mostly remain unstudied. However, psychiatrist Rima Laibow reported: “Events which impact upon the child’s ability to trust mother may have long-term consequences in all areas of growth and development…When a child is subjected to intolerable, overwhelming pain, he conceptualizes mother as both participatory and responsible regardless of mother’s intent…The consequences for impaired bonding are significant…Circumcision is an enormous obstacle to the development of basic trust between mother and child.” (Laibow 1991)

11 The evidence indicates that if a new mother wishes to prevent her male infant from bonding firmly with her, circumcision is a good technique for increasing the probability of accomplishing this. Mohammed Gamil Gharbi was a normal, healthy boy born in Quebec. At age eight, he was violently circumcised against his will at the insistence of his Algerian born Muslim father. Circumcision is extremely rare in Quebec, so his grew up feeling different from all of his intact French Canadian friends. His anger and resentment increased as he grew older and in his diary, he blamed his French Canadian mother for not protecting him from his father’s assault. It is known that he wrote to a Quebec human rights group, complaining of the mutilation of his penis and of his wishes to bring assault charges against his father and the religious authorities who had actually performed the cutting. He was told by the female director of the human rights group that nothing illegal had been done to him and that men had no right to refuse to be circumcised under Canadian human rights laws. She also told him that circumcision had probably been “beneficial” to him. A little less than a year later, he walked into an engineering classroom and proceeded to shoot fourteen women. His real name was never reported by the Canadian press, apparently so that the news stories would not cause “offence” to any religious or cultural group. Only the French name that he had adopted later in life was ever reported: Marc Lepine. What do animal studies show? Human females are the only mammals that will allow themselves to be penetrated by a circumcised male penis. Studies have shown that female rats will flatly refuse to mate with circumcised males. It is suspected that the head of the normal penis produces a number of hormonal secretions that stimulate the female to mate. The glands in the circumcised penis dry out and cease to function. Dissection of the brains of recently circumcised rats indicated that they are saturated with high levels of cortisol, a hormone only secreted in the brain during periods of high stress. It is known that high concentrations of cortisol will affect the development of the immature vertebrate brain. A number of studies have observed significant behavioural changes in circumcised rats. For example, these rats were found to be far more likely to be violent to female and immature rats in comparison to normal male rats. Similar results have been observed in other vertebrates. What are the specific health risks of male circumcision to women? It should be mentioned that the human male penis and the female vagina have evolved together as complementary structures for more than 10 million years. All aspects of their respective morphologies therefore serve a specific natural purpose, most of which are as yet unknown to science. Vaginal Irritation and Painful Intercourse: Circumcision converts the glans of the penis from an internal organ made of mucous membrane, to an external organ covered in abrasive skin. The interior walls of the vagina are made of delicate mucous membranes that were designed to tolerate contact with other lubricated mucous membranes (i.e. the head of the normal male penis). Contact with the dry, calloused head of the circumcised penis can lead to painful abrasion of the labial lips and of the vaginal walls. Repeated abrasion of these delicate structures has been linked to cancers in women. This problem often increases in severity in older women whose natural lubrication has declined. Women with normal male sexual partners are far less likely to report painful intercourse than are women with circumcised partners. Vaginal Infections: Researchers have recently found indications that the secretions from the head of the normal penis have powerful antibiotic and anti-fungal properties that serve to protect the female reproductive organs from infections. These glands dry up and die in the head of the circumcised penis. An important point is that the head of the normal penis is not made of skin; it consists of sensitive mucous membrane that supports a specific bacterial population that is compatible with the female vagina. In the circumcised penis, the bacterial populations are more

12 similar to those on exposed skin, and problems arise because these bacteria are not compatible with those in a normal vagina. With the rise in male circumcision rates in North America after the Second World War, a corresponding increase in the incidence in female vaginal yeast and UT infections was also observed. The lowest incidences of vaginal yeast infections in the developed world are now found in the Scandinavian countries, areas where circumcision is virtually unknown. The highest rates are found in the United States and Israel, where circumcision rates are very high. It should be mentioned that the sale of over-the-counter yeast infection treatments is a multi-billion dollar a year business in North America. Post-Delivery Infections: Hospitals throughout the world are facing rapidly spreading epidemics of antibiotic resistant infections. Infants with immature immune systems are particularly susceptible. The plastic restraint chair, Velcro straps and metal circumcision clamps are particularly hard to disinfect. Moreover, since circumcisions are commonly performed “assembly line fashion” in order to maximize revenue, equipment may not even be properly sterilized between each procedure. Consequently, increasing numbers of infants are suffering from post circumcision infections. Of greater concern to women, significant numbers of infants may become infection carriers and can pass infections on to their mothers or to other children. Mothers with circumcised infants are far more likely to suffer from milk duct infections throughout the period of lactation. The risks that circumcised infants pose to other children should not be underestimated. In a typical case, a nine-year-old female went to her family physician complaining of skin boils on her upper legs. An examination of the fluid in the boils indicated that they represented a particularly virulent infection of antibiotic resistant bacteria. A follow-up history indicated that the only risk factor was that the girl had regularly sat her infant brother on her lap when she was wearing shorts. The boy, who had been circumcised a few weeks earlier, was found to have been harbouring the bacteria in the folds of his skin. The girl’s infection resisted all attempts at antibiotic treatment. Breast Cancer: Recent research has indicated that there is a high probability that many breast cancers are in fact caused by a virus. It has long been known that women, such as Jewish and Moslem women, who only have male sexual partners who where circumcised under ritual, unsterile conditions, suffer from breast cancer at rates that are significantly higher than women who only have intact men as sexual partners. It has been hypothesized that infants and children who are circumcised under conditions that are not sterile have a high probability of being infected by a viral and/or bacterial pathogen that can later be passed on to female sexual partners. Note that religious groups and other interests within the circumcision industry are aggressively lobbing to block all research into the adverse effects of male circumcision on woman’s health. Violence Against Women: The world of the newborn infant centers on the mother. As a result, even though someone else usually does the mutilation, the newborn automatically connects the experience to the mother in particular, and often to women in general. Because the experience is repressed, the connection between the event and the mother is also repressed. The loss of trust and the disruption of bonding are connected. Furthermore, distrust is associated with neurobiological changes (Hartman & Burgess 1993). Many infants exhibit behaviour after circumcision that suggests distrust. Circumcised infants will cover their genitals with their hands when their diapers are changed. Normal infants do not do this. This behaviour indicates that circumcised infants may fear further damage to their genitals and do not trust their caretaker to protect them. Trust is a prerequisite for intimacy. If circumcision and its traumatic effects disrupt the development of basic trust in infancy, the potential for intimacy in later life may be impaired. According to the psychological literature, the effects of the circumcision experience on the child’s feelings toward the mother may be more than withdrawal and distrust. A thirteen-year-old boy in psychoanalysis was profoundly affected by his circumcision and he regarded his mother as a malicious attacker (Kennedy 1986). Similarly, in a study of twelve circumcised Turkish boys, the

13 boys perceived their mothers as the mutilators and directed aggression at them (Cansever 1965). Marc Lepine, the male responsible for the murder of fourteen university women in Montreal, often told others how much he resented being circumcised and he blamed his mother in particular and women in general for the rage that he felt. Interviews with convicted rapists have indicated that a significant number of the most violent rapists have expressed the view that the hardened and heavily callused head of the circumcised penis is a far more effective weapon than the soft, sensitive and moist head of the normal male penis, for inflicting the maximum pain and suffering on their female victims. Do Men Experience Psychological Effects Because of Circumcision? Because of the atmosphere of denial surrounding the issue, there are no published formal studies of the long-term psychological effects of circumcision. However, there are signs that such effects exist in at least some men. A number of organizations such as the Pacific Institute have interviewed thousands of men over several years. The results of these interviews indicated that a significantly high percentage of men expressing dissatisfaction with their circumcision. Following are some statements excerpted from letters and interviews with men and boys ranging in age from fourteen to over sixty-five years of age: “Circumcision has given my life a much diminished and shameful flavour.” “My penis feels incomplete, deformed, maimed.” “Being circumcised has ruined my sex life.” “I have felt a deep rage for a long time about this.” “I’ve always felt I’m missing normal male experience, and I’m embarrassed when in public dressing rooms.” “I feel violated and abused.” “I have felt unhappy about it all my life.” “I am very angry and resentful about this. I’ve had many physical, psychological, and emotional problems all my life.” “No one had the right to cut my foreskin off.” “I feel cheated at having been robbed of what is my natural birthright.” “I never mentioned my feeling of anger to my parents.” “The single most traumatic event of my life with the greatest psychological damage was my circumcision as an infant.” “This undermined all of the trust that I should have had in my parents. If they were capable of doing this to a helpless baby, what other horrible things are they capable of doing?” “Circumcision taught me that it is alright to physically hurt someone if you are bigger and stronger than they are…I learned that you can ignore someone when then say no if you think that you are right.” “The Bible says that I was created in the image of God. When I was circumcised against my will, this represented the mutilation of the perfect image created by God…There can be no greater evil than this.”

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“I express the anger that I felt throughout my entire life about circumcision by using my mutilated, dry, callused and insensitive penis as a weapon to inflict as much pain as possible on women.” “As far as I am concerned, there is no difference between branding someone by circumcising them against their will, or by tattooing them with an identification number on their arm. In both cases, the human beings concerned are being shown that they are possessions with no right to say “no”. The written and oral responses of men dissatisfied with their circumcision tend to include at least one of the following feelings: anger, resentment, revenge, rage, hate, sense of loss, violation of human rights, deficiency, diminished body image disbelief, lack of understanding, confusion, embarrassment, shame, sense of having been victimized, cheated, robbed, raped, violated, abused, mutilated, deformed, fear, distrust, withdrawal, grief, sadness, pain, envy of intact men and desire to strike back against circumcisers including murder Similar feelings were reported in a preliminary survey in which over 300 self-selected circumcised men responded to a request to document the harmful effects of their circumcision. Over 80 percent of respondents cited emotional harm. Moreover, in a recent issue of a major medical journal, twenty men signed a letter saying, “We are all adult men who believe that we have been harmed by circumcision.” These reports do not tell us how widespread the discontent is but that these feelings are being expressed at all is a noteworthy development and reason for concern. Reports of negative reactions to circumcision are surprising to those who assume that circumcision is a benign procedure. How can we reconcile the existence of such reports with the fact that the majority of circumcised men do not express these feelings about their circumcision? The following factors reduce the likelihood that circumcised men will express dissatisfaction with their circumcision: Accepting North American circumcision beliefs and cultural assumptions prevents men from recognizing and feeling their dissatisfaction. A typical response is: “When I was young I was told it was necessary for health reasons. I guess I just didn’t question that. I assumed that was so.” The emotions about circumcision that may surface are very painful. Repressing them protects men from experiencing pain. A circumcised man recalled, “It was something I just didn’t examine. I put it away in the back of my mind like a lot of guys do.” If the feelings do become conscious, they can still be suppressed. After learning about circumcision, another man said, “I don’t want to be angry about this.” Those who have feelings about their circumcision are generally afraid to express them because they are afraid that their feelings may be dismissed or ridiculed. When asked why he had not revealed his feelings about circumcision before, one man said, “I would be looked upon as strange or else people would toss it off lightly.” Another said, “It’s not something that anyone talks about. If it is talked about, it’s in a snickering, comical way that I find disturbing. People laugh about it as if there is something funny going on.” Verbal expression of feelings requires conscious awareness. Because early traumas are generally unconscious, associated feelings are expressed nonverbally through behavioural, emotional and physiological reactions. Attitudes about people, life and the future may also be affected. An example of an attitude resulting from childhood trauma is “You can’t count on anything or anyone to protect you.” Lack of awareness and understanding of circumcision, emotional repression, fear of disclosure, and nonverbal expression help keep feelings about circumcision a secret. The overwhelming

15 majority of circumcised men were circumcised as newborn infants. The memory of this event is not in their conscious awareness. Consequently, the connection between present feelings and circumcision may not be clear. For example, a circumcised man wondering about the effects of being circumcised said, “It seems to me that there’s got to be a connection between circumcision and how I feel about my genitals and my sexuality. It just isn’t reasonable to me that there wouldn’t be a connection there. I think it’s something that’s so deeply buried that it’s going to take more exploration on my part for me to get in touch with it. It’s pretty disturbing that circumcision was the first sexual experience that I ever had.” The men quoted earlier attribute many negative feelings to their circumcision. Is this an accurate connection to make and how did it originate? In interviews, men were asked when and how they first recognized their feelings about circumcision. Based on their responses, the answer lies in the impact of discovering one’s circumcision as a child. If a child grows up in a community that has children of differing circumcision status, it is probable that the day will come when a circumcised boy will notice the difference. Under certain circumstances, this realization can have trauma-like consequences such as recurrent unwelcome thoughts and images. One man told of an indelible scene when he was four. He was with an intact boy who showed him his penis and explained circumcision to him. He was shocked and ashamed at what had been done to him and thought, “Why would somebody want to do that to me? They just chopped it off. It didn’t make any sense to me.” As an adult he thinks about it “every time I take a shower or urinate.” The man who stated earlier in this chapter that his circumcision was “the single most traumatic event of my life” related this experience: “My initial awareness came when I was about five years old and playing with the boy who lived down the street. I discovered that he had that skin and I didn’t. I don’t remember anything in terms of verbal exchange. It’s now sixty years later, and the memory is still very vivid, the two of us sitting on his bathroom floor. It had a profound effect, an imprinting on my mind. Then, when I was about thirteen, I went swimming with a friend at one of the local lakes. When we were changing into bathing suits, I realized that he was uncircumcised. That, again, was a strong imprint. Probably those two early experiences were enough to create a very strong picture in my mind and cause a realization of my loss. I had no idea at the time of how traumatic it was. I only knew that there was something different and I was thinking about it so much every day.” Another man remembered his childhood discovery: “I’ve been angry about being circumcised since I was six years old. I was taking a hike in the woods with my older brother and his friend. We all had to use the tree. My brother said to his friend, “What’s wrong with you?” His friend said, “It’s not what’s wrong with me, it’s you guys.” His mother was a nurse and she knew better than to do it to him. We didn’t know the terminology. We didn’t understand it, but he told us that we were born the way he was and then someone cut part of us off. I haven’t talked to my brother about it over the years, but all my life I’ve been just dying for the chance to get my hands on the doctor that did it to me.” The following story is typical: “The shock and surprise of my life came when I was in junior high school and I was in the showers after gym. . . . I wondered what was wrong with those penises that looked different than mine... . I soon realized I had part of me removed. I felt incomplete and very frustrated when I realized that I could never be like I was when I was born—intact.

16 That frustration is with me to this day. Throughout life I have regretted my circumcision. Daily I wish I were whole.” A man who first recognized his dissatisfaction with circumcision as an adult reported: “What changed my feeling about circumcision was recognizing that this was done to me without my consent at a time when I couldn’t do anything to stop it. I don’t see anything wrong with having the option. I just don’t like the idea that someone made this decision for me. I’ll never know how it feels to be uncircumcised.” Another expressed the following powerful feelings: “Feminists say that viewing pornography is harmful to children. I agree. Every day I am forced to view the pornographic image of my mutilated penis. It is an image that disgusts and infuriates me and one that I cannot escape. Every day I boil with hatred and resentment against the sick, child-hating pervert who did this to me. When I get into fights, I imagine that that face of the person I am pounding to mush with my fists is the cowardly bastard who cut me when I couldn’t fight back.” Of significant concern is the fact that about 4 percent of the men interviewed stated that they held such high levels of repressed anger within themselves because of circumcision, that if given the opportunity, they would without hesitation kill the individual (doctor or religious practitioner) who was responsible. If extrapolated to the entire North American population, this would mean that more than 4 million adult men are prepared to respond with some type of violence to the fact that they were circumcised as infants without their consent and without being able to fight back. This statistic alone should give pause to circumcision proponents who continue to claim that what they do to helpless infants is completely harmless, and that no one suffers any physiological harm from circumcision. Conclusion Male Infant Circumcision: Never before in history has there something that is so common in society, but about which there is so much ignorance. Based on solid medical and scientific evidence: Circumcision is a CRIME against children Circumcision is VANDALISM Circumcision is NOT beneficial for male or female infants Circumcision is NOT required for healthy infants Circumcision is NOT required for penile hygiene Circumcision is NOT required for female health Circumcision WILL NOT prevent masturbation Circumcision WILL NOT prevent homosexuality Circumcision WILL NOT prevent AIDS or any other venereal disease Circumcision SHOULD NOT be performed on ANY individual who has not given his/her informed adult consent. Circumcision DOES present a number of real threats to women’s health Circumcision IS child abuse, and should be seen and reported as such There are a number of steps that women can take to protect their health and the health of their normal children: •

Just say “NO” to circumcision and encourage your friends and family to reject this as an option for their children

•

When in the hospital, do not allow your infant to be placed in any room where circumcised infants have been located

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•

When at home, do not allow healthy infants or older children to come in contact with infants who have been circumcised. If such contact occurs, immediately disinfect the skin with alcohol or some other powerful dermal disinfectant

•

Minimize the amount of sex that you have with a circumcised partner without using a lubricated condom. This becomes increasingly important for women above age forty.

•

Women who have had sex with circumcised partners and who smoke must take special care to have themselves regularly tested to detect the early stages of arterial inflammation, heart disease and breast cancer.

References Cansever, G. (1965) “Psychological Effects of Circumcision,” British Journal of Medical Psychology 38:328. De Bellis, M.D., Keshavan, M.S., Clark, D.B., Casy, B.J., Giedd, J.N., Boring, A.M., Frustaci, K., Ryan, N.D. (1999) “Developmental Traumatology, Part 2: Brain Development,” Biological Psychiatry, Vol. 45, No. 10, pp. 1271-1284, May 15. Hartman, C., Burgess, A. (1993) “Information Processing of Trauma,” Child Abuse and Neglect 17: 47-58 Kennedy, H. (1986) “Trauma in Childhood: Signs and Sequelae as Seen in the Analysis of an Adolescent,” Phychoanalytic Study of the Child 41: 209-19. Laibow, R., (1991) “Circumcision and its Relationship to Attachment Impairment,” in Syllabus of Abstracts, The Second International Symposium on Circumcision, San Francisco, 14. Libby, P. (2002) “Arteriosclerosis, The New View,” Scientific American, pp. 46-55, May. Milos, M , “Infant Circumcision ‘What I Wish I Had Known,” The Truth Seeker (July/August 1989), 3. Teicher, M.T. (2000) “Wounds that Time Won’t Heal: The neurobiology of Child Abuse,” Cerebrum (Dana Press), Vol. 2, No. 4, pp. 50-67, Fall. Teicher, M.T. (2002) “Scars that Won’t Heal – The neurobiology of Child Abuse,” Scientific American, pp. 68-75, March

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Appendix 1

What is Lost in Circumcision Many people think circumcision removes nothing more than a little extra skin. However, the fact of the matter is that circumcision removes several critical components of male sexual anatomy. This list enumerates everything currently known to be lost when one is circumcised. Included are notes on whether these losses can or cannot be amended by foreskin restoration. The information contained in this list may be upsetting to some, but we feel it is important and necessary for those considering restoration to understand as fully as possible the anatomy/biology/neurology of what has been removed and/or destroyed. It should be pointed out that circumcisions performed in North America may be more severe than those done elsewhere. In the United States, most hospital circumcisions are done to the Bris Periah standard of removing every ounce of foreskin and, in a large percentage of cases, some shaft skin. Although several of the items in this list are not restorable, there are many significant gains to be realized by restoring one's foreskin. For information on these gains, please see the Benefits page.

Foreskin The foreskin comprises roughly 50% (and sometimes more) of the mobile skin system of the penis. If unfolded and spread out flat, the average adult foreskin would measure about 15 square inches - the size of a three-by-five index card. This highly specialized tissue normally covers the glans and protects it from abrasion, drying, callusing (also called keratinization), and contaminants of all kinds. Click here to view an animated graphic illustrating foreskin mobility. We refer to the process we undergo as foreskin restoration but we don't actually grow new foreskins. What we do instead is to extend the remaining skin on the shaft of the penis. The non-surgical techniques we use induce the skin to grow additional cells, and over a period of time the shaft skin will gradually extend to cover the glans. The extended skin looks and behaves and functions much like a natural foreskin. [Sources: 1. M. M. Lander, "The Human Prepuce," in G. C. Denniston and M. F. Milos, eds., Sexual Mutilations: A Human Tragedy (New York: Plenum Press, 1997), 79-81. 2. M. Davenport, "Problems with the Penis and Prepuce: Natural History of the Foreskin ," British Medical Journal 312 (1996): 299-301.]

Frenar Band, or Ridged Band The frenar band is a group of soft ridges near the junction of the inner and outer foreskin. This region is the primary erogenous zone of the intact male body. Loss of this delicate belt of densely innervated, sexually responsive tissue reduces the fullness and intensity of sexual response. There is no known method of restoring the frenar band. [Source: Taylor, J. R. et al., "The Prepuce: Specialized Mucosa of the Penis and Its Loss to Circumcision ," British Journal of Urology 77 (1996): 291-295.]

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Gliding Action The foreskin's gliding action is a hallmark feature of the normal, natural, intact penis. This non-abrasive gliding of the penis in and out of its own shaft skin facilitates smooth, comfortable, pleasurable intercourse for both partners. Without this gliding action, the corona of the circumcised penis can function as a one-way valve, making artificial lubricants necessary for comfortable intercourse. The return of this natural gliding action is one of the primary benefits of foreskin restoration. In many cases, wives of restoring men were initially doubtful about restoration but came to value it highly when their husbands had grown enough new skin to effect greater levels of comfort and pleasure during intercourse. [Source: P. M. Fleiss, MD, MPH, "The Case Against Circumcision ," Mothering: The Magazine of Natural Family Living (Winter 1997): 36-45.]

Meissner's Corpuscles Circumcision removes the most important sensory component of the foreskin - thousands of coiled fine-touch receptors called Meissner's corpuscles. Also lost are branches of the dorsal nerve, and between 10,000 and 20,000 specialized erotogenic nerve endings of several types. Together these detect subtle changes in motion and temperature, as well as fine gradations in texture. There is no known method of restoring Meissner's corpuscles or other specialized sensory nerve cells. However, restoring and restored men almost universally experience tremendous increases in sensitivity, in part because the highly sensitive nerve cells in the glans are no longer buried under several layers of keratinized skin. [Sources: 1. R. K. Winkelmann, "The Erogenous Zones: Their Nerve Supply and Its Significance ," Proceedings of the Staff Meetings of the Mayo Clinic 34 (1959): 39-47. 2. R. K. Winkelmann, "The Cutaneous Innervation of Human Newborn Prepuce ," Journal of Investigative Dermatology 26 (1956): 53-67.]

Frenulum The frenulum is a highly erogenous V-shaped structure on the underside of the glans that tethers the foreskin. During circumcision it is frequently either amputated with the foreskin or severed, which destroys or diminishes its sexual and physiological functions. If the frenulum is amputated, there is no known method of replacing it. If only a small portion of the frenulum is left, it is probably no longer functional as a tethering structure. There is no known method of attaching it to a restored foreskin, but some men have reported stretching the frenulum remnant as they stretched their foreskin. [Sources: 1. Cold, C, Taylor, J, "The Prepuce," BJU International 83, Suppl. 1, (1999): 34-44. 2. Kaplan, G.W., "Complications of Circumcision ," Urologic Clinics of North America 10, 1983.]

Dartos Fascia Circumcision removes approximately half of this temperature-sensitive smooth muscle sheath which lies between the outer layer of skin and the corpus cavernosa. There is no known method of restoring amputated portions of the dartos fascia. However, the new skin may duplicate dartos fascia muscle tissue if it is present in the remnant skin that is being stretched. [Source: Netter, F.H., "Atlas of Human Anatomy

20 ," Second Edition (Novartis, 1997): Plates 234, 329, 338, 354, 355.]

Immunological System The soft mucosa (inner foreskin) contains its own immunological defence system which produces plasma cells. These cells secrete immunoglobulin antibodies as well as antibacterial and antiviral proteins, including the pathogen killing enzyme lysozyme. Once removed with the foreskin, there is no known method of restoring this immunological defence system. [Sources: 1. A. Ahmed and A. W. Jones, "Apocrine Cystadenoma: A Report of Two Cases Occurring on the Prepuce," British Journal of Dermatology 81 (1969): 899-901. 2. P. J. Flower et al., "An Immunopathologic Study of the Bovine Prepuce," Veterinary Pathology 20 (1983):189-202.]

Lymphatic Vessels The loss of these vessels due to circumcision reduces the lymph flow within that part of the body's immune system. While some lymphatic vessels remain, there is no known method of restoring those that were removed during circumcision. [Source: Netter, F.H., "Atlas of Human Anatomy ," Second Edition (Novartis, 1997): plate 379.]

Estrogen Receptors The presence of estrogen receptors within the foreskin has only recently been discovered. Their purpose is not yet understood and needs further study. There is no known method of restoring the foreskin's estrogen receptors. [Source: R. Hausmann et al., "The Forensic Value of the Immunohistochemical Detection of Oestrogen Receptors in Vaginal Epithelium," International Journal of Legal Medicine 109 (1996): 10-30.]

Apocrine Glands These glands of the inner foreskin produce pheromones - nature's powerful, silent, invisible behavioural signals to potential sexual partners. The effect of their absence on human sexuality has never been studied. There is no known method of restoring apocrine glands to the penis. [Source: A. Ahmed and A. W. Jones, "Apocrine Cystadenoma: A Report of Two Cases Occurring on the Prepuce," British Journal of Dermatology 81 (1969): 899-901.]

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Sebaceous Glands The sebaceous glands may lubricate and moisturize the foreskin and glans, which is normally a protected internal organ. Not all men have sebaceous glands on their inner foreskin. There is no known method of restoring sebaceous glands if they were present. [Source: A. B. Hyman and M. H. Brownstein, "Tyson's Glands: Ectopic Sebaceous Glands and Papillomatosis Penis," Archives of Dermatology 99 (1969): 31-37.]

Langerhans Cells These specialized epithelial cells are a component of the immune system in the penis. There is no known method of restoring Langerhans cells to the penis. [Source: G. N. Weiss et al., "The Distribution and Density of Langerhans Cells in the Human Prepuce: Site of a Diminished Immune Response?" Israel Journal of Medical Sciences 29 (1993): 42-43.]

Natural Glans Coloration The natural coloration of the glans and inner foreskin (usually hidden and only visible to others when sexually aroused) is considerably more intense than the permanently exposed and keratinized coloration of a circumcised penis. The socio-biological function of this visual stimulus has never been studied. The glans ranges from pink to red to dark purple among intact men of Northern European ancestry, and from pinkish to mahogany to dark brown among intact men of Color. If circumcision is performed on an infant or young boy, the connective tissue which protectively fuses the foreskin and glans together is ripped apart. This leaves the glans raw and subject to infection, scarring, pitting, shrinkage, and eventual discoloration. Over a period of years the glans becomes keratinized, adding additional layers of tissue in order to adequately protect itself, which further contributes to discoloration. Many restoring men report dramatic changes in glans color and appearance, and that these changes closely mirror the natural coloration and smooth, glossy appearance of the glans seen in intact men. [Source: P. M. Fleiss, MD, MPH, "The Case Against Circumcision ," Mothering: The Magazine of Natural Family Living (Winter 1997): 36-45.]

Length and Circumference Circumcision removes some of the length and girth of the penis - its double-layered wrapping of loose and usually overhanging foreskin is removed. A circumcised penis is truncated and thinner than it would have been if left intact. Many men have kept detailed records of their measurements before, during, and after restoration. There is an increasing consensus that foreskin restoration enhances penile length and circumference. [Source: R. D. Talarico and J. E. Jasaitis, "Concealed Penis: A Complication of Neonatal Circumcision," Journal of Urology 110 (1973): 732-733

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Blood Vessels Several feet of blood vessels, including the frenular artery and branches of the dorsal artery, are removed in circumcision. The loss of this rich vascularization interrupts normal blood flow to the shaft and glans of the penis, damaging the natural function of the penis and altering its development. There is no known method of restoring arteries and vessels that were removed during circumcision. However, many restoring men have noticed that the new skin is more richly vascularized than the older skin of their penis. We have no medical explanation for this phenomenon. [Sources: 1. H. C. Bazett et al., "Depth, Distribution and Probable Identification in the Prepuce of Sensory EndOrgans Concerned in Sensations of Temperature and Touch; Thermometric Conductivity ," Archives of Neurology and Psychiatry 27 (1932): 489-517. 2. Netter, F.H., "Atlas of Human Anatomy ," Second Edition (Novartis, 1997): plates 238, 239.]

Dorsal Nerves The terminal branch of the pudendal nerve connects to the skin of the penis, the prepuce, the corpora cavernosa, and the glans. Destruction of these nerves is a rare but devastating complication of circumcision. If cut during circumcision, the top two-thirds of the penis will be almost completely without sensation. There is no known method of restoring dorsal nerves. [Sources: 1. Agur, A.M.R. ed., "Grant's Atlas of Anatomy ," Ninth Edition (Williams and Wilkins, 1991): 188-190. 2. Netter, F.H., "Atlas of Human Anatomy ," Second Edition (Novartis, 1997): plate 380, 387.]

Other Losses • Circumcision performed during infancy disrupts the bonding process between child and mother. There are indications that the innate sense of trust in intimate human contact is inhibited or lost. It can also have significant adverse effects on neurological development. Additionally, an infant's self-confidence and hardiness is diminished by forcing the newborn victim into a defensive psychological state of "learned helplessness" or "acquired passivity" to cope with the excruciating pain which he can neither fight nor flee. The trauma of this early pain lowers a circumcised boy's pain threshold below that of intact boys and girls [Sources: 1. R. Goldman, Circumcision: The Hidden Trauma (Boston: Vanguard Publications, 1997), 139-175. 2. A. Taddio et al., "Effect of Neonatal Circumcision on Pain Responses during Vaccination in Boys ," Lancet 345 (1995): 291-292.]

• Every year some boys lose their entire penises from circumcision accidents and infections. They are then "sexually reassigned" by castration and transgender surgery, and are expected to live their lives as females. [Sources: 1. J. P. Gearhart and J. A. Rock, "Total Ablation of the Penis after Circumcision with Electrocautery: A Method of Management and Long-Term Followup," Journal of Urology 142 (1989):799-801. 2. M. Diamond and H.

23 K. Sigmundson, "Sex Reassignment at Birth: Long-Term Review and Clinical Implications," Archives of Pediatrics and Adolescent Medicine 151 (1997): 298-304.]

• Every year many boys in the United States and elsewhere lose their lives as a result of circumcision - a fact that is routinely ignored or obscured. [Sources: 1. G. W. Kaplan, "Complications of Circumcision ," Urologic Clinics of North America 10 (1983): 543-549. 2. R. S. Thompson, "Routine Circumcision in the Newborn: An Opposing View," Journal of Family Practice 31 (1990): 189-196.

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Appendix 2 Vulvo-Rectal Fistula from Violence during First Coition The patient, a young woman of 22 years, presented herself at the gynecological clinic of the Philadelphia Dispensary, with the following history: Previous to her marriage, which had taken place eighteen months ago, she had been a perfectly healthy woman. She dates all her trouble from the first attempt at sexual intercourse with her husband, which caused her to suffer such acute pain that she almost fainted. The sexual act was also followed by severe haemorrhage, which persisted for a month; the passage of faeces and flatus per vulvam was at once noticed. Every repetition of the sexual act for the next two or three weeks was followed by renewed bleeding, and even at the present time she suffers severely during intercourse. The passage of the faecal matter through the vulva gradually increased in degree until the rectum was evacuated entirely through the vulva. There has been an entire inability to retain flatus and faeces. Examination: The finger on entering the vulva passes at once into the rectum through a patulous opening of sufficient size to admit two fingers. Inspection shows a perfectly intact crescentic hymen of moderate thickness and rigidity, having a small anterior opening. Immediately in front of its posterior attachment is an irregular transverse tear, an inch and a half in its longest diameter, with thickened and everted edges, extending backwards and upwards for about one and one-half inches, exposing to view the mucous membrane of the bowel. The vagina is small and has evidently never been entered ... The case here reported is of special interest from the fact that the trauma undoubtedly occurred during first coition; from the virginal condition of the hymen and from the long time during which sexual relations were maintained under conditions which must have been disagreeable to both husband and wife ... But for the fact that the husband had been deprived of his prepuce in infancy, thereby rendering the penis callous by the exposure of the glans to the air, it is hardly possible that he could have forced the organ through the flesh as he did, without so much personal suffering as to compel him to desist. Journal of the American Medical Association, vol. 6, no. 23 (June 5, 1886): pp. 638-639

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Appendix 3 Does Male Circumcision Victimize Women? To Dr. Ruth Westheimer, sex therapist (9/5/86): The other night on Larry King Live, when a woman called in and said her vagina hurt after intercourse with her husband, you advised her to see a doctor. Why did you assume something was wrong with her? Isn't it possible -- even likely -- that the pain she feels is the result of friction caused by the absence of a slick, sensitive, self-lubricating, movable sheath of skin -- a foreskin -- from the penis of her circumcised husband? To Dr. Irene Kassorla, psychologist (8/6/86): Could there be a connection between the continually recurring theme on men's "detective" magazine covers -- the bound and gagged woman shrinking from a man with a knife -- and the fact that most men in this country had a similar experience when they were babies, when someone restrained them, ignored their screams, and cut part of their penises off? To Gloria Steinem, feminist (9/8/86): Has anyone investigated the possibility of a connection between all of the unnecessary amputations and other unnecessary surgery performed on women in the U.S. (Caesareans, episiotomies, hysterectomies, mastectomies, etc.) and the fact that most of the doctors who perform those operations are themselves the victims of an unnecessary amputation: circumcision -- requested, consented to, or allowed by their mothers?

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Is There a Link Between Male Circumcision and Vaginal Yeast Infections?

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For generations, women have been told, without medical evidence, that the circumcised penis is more “hygienic”. Modern evidence indicates that the opposite may actually be the case. The head of the normal male penis secretes a substance containing hundreds of unidentified chemical compounds that is now known to have antibiotic and antiviral properties. The normal penis therefore actually helps protect the female reproductive system from bacterial, viral and yeast infections. The sale of medications for vaginal yeast infections is a multi-billion dollar business in North America, so there is a powerful vested business interest to keep circumcising. The untold suffering of millions of innocent women is, of course, considered irrelevant.

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Does the Trauma of Circumcision Lead to Greater Levels of Male Violence?

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Because of the potential for massive liability, no significant funding has been made available for any studies attempting to find a link between the extreme trauma suffered by infants undergoing circumcision and greater levels of violent behaviour later in life. The following facts are known, however. In general, cultures that circumcise, such as the United States and the nations of the Middle East, are relatively more violent than cultures that do not, such as Scandinavia. No definite conclusions can be reached until long-term epidemiological studies have been conducted. Work conducted with rats and mice has indicated that male rodents circumcised as infants are generally more prone to abnormal violent behaviours as adult rats. The graph below shows Infant Circumcision and US Crime Rates vs time plotted on the same graph. The evidence is circumstantial, but it is interesting to note the fall in crime rates 15 years after the decline in circumcision rates. Is there a link? Additional study is urgently required.