CIN (Circumcision Information Network) 2:17

Introduction
This weekly bulletin is a project of CIN, the Circumcision Information Network (formerly CIN CompuBulletin). The purpose of this weekly bulletin is to educate the public about and to protect children and other non-consenting persons from genital mutilation. Readers are encouraged to copy and redistribute it, and to contribute written material.
--Rich Angell, Editor.

SPEAKING OUT FOR THE HELPLESS
On 8 May, children's rights advocates from NOHARMM gathered outside Moscone
Center in San Francisco to protest non-consensual circumcision at this year's
convention of the American College of Obstetricians and Gynecologists (ACOG).
 The adults carried the NOHARMM banner and signs while the children passed
out flyers to the doctors asking them to support Dr. Leo Sorger's petition
that ACOG recognize the inherent rights of all children to intact bodies (not
just girls).  As they passed out flyers the young boys asked "don't boys have
rights too?" ACOG recently passed a position statement condemning female
circumcision while their members continue to make money mutilating boys.
 Some protesters wore "duck hats" and carried signs saying "Only quacks
mutilate babies," and "Examine your fowl ethics," in a lighthearted attempt
to raise the moral questions.

It would have been unreasonable to expect a warm reception from a crowd with
a financial interest in circumcision, but many doctors did express support,
and one even wanted his picture taken in front of the NOHARMM banner.  Most
just walked past with their eyes firmly fixed forward.  A few laughed,
although it is hard to imagine what they thought was funny about the picture
of the baby with a Gomco clamp on his penis and circumcision screams coming
from the loudspeaker.

One highlight was the interest and support shown by some of the "city's
finest."  The policemen presumably assigned to make sure we didn't cause
trouble were uniformly interested and supportive.  It seems the regular guy
on the street does indeed understand the baby screams, and many of the
non-medical convention delegates expressed horror at the revelations NOHARMM
was presenting to the public.  NOHARMM members felt that the day was well
spent making points and supporting Dr. Sorger with his advocacy inside the
convention.

JUST WHAT IS AMPUTATED, ANYWAY?
Contributed by franc@gun.com (Franc Garcia)
Part two of a two-part series.

The following is copyrighted text from an upcoming book by Garcia
Communication.  Copyright 1994 Garcia Communication, all rights reserved. 

THE MOBILITY OF THE SKIN SYSTEM
The entire skin system moves freely.  In the intact (uncircumcised) male, the
penis has a low friction gliding plane immediately beneath the surface of the
skin which is like no other body structure.  This means that the skin of the
penis does not adhere to the underlying tissue the way that skin adheres to
other parts of the body.  This unique quality allows the entire skin of the
penis to move as a unit back and forth longitudinally or around the shaft
circumferentially making it the most mobile skin in the intact male.  

The skin system covers the head of the penis to varying degrees depending on
moment-to-moment factors such as the state of erection and temperature.  The
free fold of the skin system which we call "foreskin" unfolds and re-folds
constantly to varying degrees, adjusting to the current state of the penis.
 It is a very dynamic system.  The foreskin, among other functions, provides
the penis with  a reservoir of skin which is needed during erection.  The
skin of the erect, intact penis is still mobile and loose, allowing the
mucosal inner foreskin to roll back and forth over the glans (see figure 7).
 Thus, the dividing line between what we call the skin of the shaft and
foreskin is regularly crossed by the "shaft skin" or "foreskin."  The
delineated "foreskin" may become entirely "shaft skin" when the penis becomes
more erect because it is now around the shaft.  And if  
the penis shrinks momentarily beyond its usual flaccid state, perhaps due to
a cold swim at the beach, some of the "shaft skin" is now "foreskin" because
it covers the glans.  The skin system is a dynamic, mobile and flexible skin
sheath that moves and adjusts to the momentary needs of the penis (see figure
7).  Such a system is not normally observed in the circumcised male.

Another anatomical error is committed in describing the foreskin as a flap of
skin protruding from the shaft skin (figure 6a).  This notion presumes that
the foreskin is a single layer of skin, like the skin of the shaft, which
grows from the shaft to cover the glans.  In describing the foreskin this way
it is easier to see it as redundant  or "extra skin" and it is more difficult
to see how removing it might impact the rest of the penis.  This description
of the foreskin is inaccurate.  The foreskin is not "extra" skin which
protrudes from the shaft.  There is no extra skin on the body - this is a
silly notion.  Instead, it is a free, double-layered fold - an integral part
of the skin system.  The foreskin extends from a point on the shaft behind
the glans to cover the glans then folds back underneath itself to the same
attachment point on the shaft, usually near the glans (see figure 6).  The
eyelid works much the same way.  The eye lid is not a single flap of skin,
but rather two freely moving layers of a fold of skin, so that both the
foreskin and the eyelid have two layers.  That's why it is more appropriate
to refer to the "foreskin" as the forefold of the skin system.

In reality then, infant circumcision does not remove the "tip of the penis"
or "redundant skin" nor does it remove a separate structure called "the
foreskin."  Rather, infant circumcision deletes a  
significant percentage of the skin system of the penis, rendering the skin
system relatively dysfunctional and rendering the penis less dynamic.

"I welcome any and all comments about this text."  franc@gun.com

A PEDIATRIC PERSPECTIVE
Finally, a word from a pediatrician who no longer performs routine infant
circumcisions:  

 "In my career, now 15 years of general pediatrics, I have only seen one
intact male neonate with a well-documented urinary tract infection, which, by
the way, responded nicely to antibiotics and the child went home in two days.
 The only other males I have seen in infancy with UTIs, (all circumcised at
birth) have had congenital urinary tract anomalies which contributed to their
infections.

Diaper rash in circumcised males almost always includes the shaft and glans
of the penis.  Often there is associated meatal ulceration.  In intact males,
diaper rash typically spares the area covered by foreskin.  I have yet to see
in my general pediatric practice, meatal ulceration or stenosis in an intact
infant , child, or adolescent.  In infancy the foreskin serves the purpose of
protecting the infant's glans from bacteria, feces, and abrasion from
clothing.   It continues to serve a protective function, as well as a sexual
one, throughout a male's life. 

If a normal foreskin were truly a health risk, wouldn't we see that
documented in medical journals from around the world, where infant
circumcision is virtually nonexistent?  We do not see it, in terms of UTIs,
penile or cervical cancer or AIDS.  In fact, the United States not only has a
high rate of circumcised males but also has the highest rate of AIDS cases in
males.  

Beyond being medically unnecessary and damaging to the child and grown man, I
see infant circumcision as a children's rights issue.  When parents ask me
about piercing ears, I advise them to let the children grow up and decide for
themselves.  I feel the same way about circumcision-- it should be decided by
the individual, especially considering the fact that unlike ears, which
suffer only piercings which can later be allowed to close, the penis is
PERMANENTLY diminished by an irreversible loss of nerve endings."  --Colleen
M. Hogan, M.D.  

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