Intactivism news

Intactivism News
January - March 2003

More recent news
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Anavova, the British online new service
Thu, 20 Feb 2003

Sex may not be behind Africa's Aids problem

Poor medical practice may be to blame for the spread of Aids through Africa.

New research based on hundreds of studies suggests only about a third of HIV infections in Africa are sexually transmitted.

The authors suggest contaminated medical injections make up the biggest risk.

They said their findings have "major ramifications for current and future HIV control in Africa, whose focus has been almost exclusively on sexual risk reduction and condom use".

The study is in today's International Journal of STD and AIDS, published by the Royal Society of Medicine. The research team is led by Pennsylvania anthropologist Dr David Gisselquist.

They say HIV cases in Africa have not followed the pattern of most types of sexually transmitted disease.

Many studies reported young children infected with HIV even though their mothers were not.

Typically STDs are associated with being poor and uneducated but HIV in Africa is linked with urban living, having a good education and higher income.

The San Francisco Examiner
February 18 2003

The unkindest cut

BY ANGELINA MALHOTRA-SINGH
Of The Examiner Staff

For years, San Francisco lesbians have had a troika of rainbow flag-flying sperm banks ready to help them negotiate their obstructed path to motherhood.

This would seem at first to be a happy circumstance. After all, single and coupled lesbians from across the globe seek out the Bay Area's sperm repositories, flocking to our queer-oriented medicos.

"And the most we have to do is drive over the Bay Bridge," laughs Gretchen Lee, managing editor of Curve magazine, who is on her third round of insemination.

But a contentious mood has rolled in, and it's blanketed the community like a cold, chewy fog.

The issue at hand is circumcision -- not so much the act itself, but who gets to choose whether to cut.

For one of the lavender troika, Rainbow Flag Health Services, decided to take the option entirely away from its clients: Theirs is a snip-free donor zone.

The decision is in keeping with owner-founder Leland Traiman's personal politics, and it's a startling act in a community that embraces a your-body-your-decision philosophy. [Only if you don't know whose body the penis belongs to.]

"Rainbow is pretty unique," says lesbian author and film critic Diane Anderson-Minshall, who investigated the bank when she embarked on her fertility mission. "They clearly have a specific agenda in mind."

Rainbow is the only sperm bank in the country to actively recruit gay and bisexual sperm donors. It also puts donors in contact with mothers when their child reaches 3 months. Other identified-donor programs wait until a child turns 18.

And now, Traiman's clients are bound by contract not to circumcise children -- of either gender -- that they conceive.

It's not legally enforceable, but it's certainly perceived as a moral obligation, one that many lesbians have decided they want no part of.

"It's not a matter of being pro- or anti-circumcision. For (Rainbow) to say unequivocally that you have no control, to have the decision taken out of your hands, feels intrusive," says Anderson-Minshall.

Traiman, a survivor of what he calls 'ritual genital mutilation,' is definitely aiming to intrude.

"If lesbians don't like our policy, they can go someplace else. This is my sperm bank," he snaps.

"I run it in a way that is legally and ethically correct. I've seen penises turned into hamburger! I've seen boys who were raped, mutilated by their parents, because they bought into an agenda."

The voluble Traiman can speak at length about the "medical invalidity" of circumcision. In fact, he turned most of my questions into another opportunity to filibuster against the procedure.

"Leland feels incredibly strongly about circumcision," says Alice Ruby, executive director of the Sperm Bank of California (SBC).

SBC is the only nonprofit sperm bank in the nation. Some 65 percent of its clientele is comprised of lesbian singles and couples.

SBC has shared clients with Rainbow and maintains a friendly relationship with Traiman -- even rallying with him to oppose impending federal regulations against gay and bisexual sperm donors.

And yet?

"Our position is that we don't want to dictate anything for the parents," says Ruby. [...but they're happy to let the parents dictate circumcision for the babies.]

The negative reaction to Rainbow's dictum comes from non-queer feminist quarters as well.

"It's overstepping in the extreme for a sperm bank to seek to control parenting decisions. Aside from the obvious -- putting Jewish potential donees in conflict with their religious beliefs [not necessarily - especially when their religious beliefs don't forbid lesbian parenthood]-- there are tons of complicated issues at stake," remarks Lisa Jervis, publisher of Bitch magazine.

"Furthermore, this kind of policy opens the door for more intrusion into parents' choices. If (Rainbow] can make rules about circumcision, then why not other medical issues?"

But not everyone thinks Traiman is wrong. And he does have lesbian fans -- including Lee and popular baby book author Rachel Pepper -- as well as straight supporters.

"I think what Rainbow has done is exceedingly brave," says Greg Dervin, director of the SFSU chapter of Students for Genital Integrity. "Knowing the fact that they are likely to lose some business with this policy, they still choose to not let their ethics of what they know to be wrong be compromised."

Rainbow has, indeed, lost business. Anderson-Minshall and her wife Susannah, a parks ranger and environmentalist, ultimately decided to go elsewhere.

"Seventy percent of American boys [but fewer than 60 percent of American babies] are circumcised. Being a child with lesbian parents, that can be hard enough. I wasn't sure I wanted to add one more (hurdle) to the kid's list," Anderson-Minshall said.

"We talked to a ton of male friends -- all gay men who had been circumcised [exactly - if they'd talked to some intact men, they might have heard a different story]. I just wasn't comfortable signing my option away [but quite comfortable to sign away the baby's option]."

The Anderson-Minshalls used a sperm bank in Spokane, Wash., for several inseminations. Later, they switched to The City's only lesbian-owned and operated clinic, Pacific Reproductive Services (PRS), whose clientele is 85 percent to 95 percent lesbian.

Sharon Mills, PRS's lesbian founder and director, echoes Ruby and Jervis.

"I would never make such a requirement of my clients. Parents should be making that choice along with their pediatricians," she says. "Circumcision is a religious and cultural issue. I can't dictate something like that."

Rainbow's ultimatum has added yet another twist to a procedure already laden with challenges and emotions.

Some lesbians are considering using straight local banks, in spite of any real or imagined hostility they might face.

Still others who have been turned off by Rainbow's contract now find themselves unable to get their first or second (or sixth, or seventh) donor choice elsewhere, because of increased demand.

So like the Anderson-Minshalls, they have begun to ship sperm in from out of state. It's an ironic twist, as well as what one single lesbian calls a "big pain in the ass."

"It feels crazy to be looking for lesbian-friendly sperm banks elsewhere when you're supposedly living in Dyke Heaven," she says.

"I guess personal politics trumps community -- gay or straight."

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the Sydney Morning Herald

Medical circumcisions rate rising 'needlessly'

Date: February 17 2003
By Julie Robotham, Medical Writer
Boys are being circumcised unnecessarily because doctors do not understand that being unable to retract the foreskin is part of normal child development, an Australian survey has found.

The study found a large majority of circumcisions for medical reasons were performed because of phimosis - a condition in which scar tissue grows between the foreskin and the tip of the penis. But it concluded most cases were unlikely to be true phimosis, because the condition occurs rarely in children and almost never in boys under five.

Katrina Spilsbury, a research associate from the University of Western Australia's School of Population Health, found circumcision rates had crept up steadily since the early 1980s, their all-time low.

For boys aged 10 to 14, rates had doubled in the past two decades, while they rose by two-thirds among five- to nine-year-olds and by one-third among the under-fives. During that time, phimosis was also increasingly likely to be cited as the reason. [These figures are entirely consistent with a steady rate of circumcision for no reason at all - merely because intact boys are increasingly available.]

"If the 1999 rate remains stable, it is estimated that 4 per cent of all boys will be circumcised for phimosis by the time they reach 15 years," Dr Spilsbury wrote in the Medical Journal of Australia. "This is seven times higher than the estimated rate of pathological phimosis. Over half of these boys will be circumcised for phimosis before they reach five years of age, despite the condition being rare in early childhood."

It was most likely doctors were mistaking the normal development of the penis for phimosis, Dr Spilsbury said. But it was also possible doctors were recording a medical reason when it was really required by parents for religious or cosmetic reasons.

Paddy Dewan, a pediatric urologist not involved in the research, said parents might also be inventing symptoms to persuade doctors to circumcise.

"Such manipulation is not surprising when dealing with such an emotive topic. Nor is it necessarily improper given the differing cultural and medical views on the value of circumcision," said Professor Dewan, from Melbourne's Royal Children's Hospital.

The Courier Mail 17 February 2003

Circumcision 'often unnecessary'

Judy Skatssoon

YOUNG boys might be undergoing unnecessary circumcisions for a condition that can be effectively treated with creams, according to a new study. ... Boys aged five and under had the highest rate of surgery for phimosis, representing about 300 circumcisions each year. ...

Dr Spilsbury said if the current rate continued, about 4 per cent of boys would be circumcised for phimosis by the age of 15. This rate was seven times higher than the estimated occurrence of the condition, she said. "These findings imply a high rate of unnecessary surgery," writes Dr Paddy Dewan of the Royal Children's Hospital in Melbourne in an accompanying editorial.

Dr Dewan suggests the high rates might be the result of "manipulation", either by parents who want to circumcise their child for cosmetic reasons or GPs who expect resistance from surgeons unless they give a medical reason for circumcision. She said phimosis could cause pain and urinary tract infections and was associated with sexual dysfunction and cancer in later life.

However, there was evidence the use of steroid creams could reverse the situation in about four to six weeks. ... "Our findings indicate that a review of current practice guidelines for the paediatric management of phimosis in Australia may be warranted," she concludes.

KENYA: Hundreds of girls run away to evade FGM
IRINnews Africa, Fri 7 Feb 2003
NAIROBI, - As the world marked the international day against female genital mutilation (FGM) on 6 February, hundreds of girls in Kenya's Rift Valley Province were running away from home to escape the practice, according to media and human rights sources.

Several hundred primary schoolgirls are said to be "holed-up" in churches in Narok and Kajiado districts after escaping FGM being practised in their communities.

FGM was formally outlawed in Kenya with the introduction of the Children's Act, passed by parliament in 2001, but it is still widely practised in secret by a number of communities, particularly in the vast Rift Valley Province.

According to the women's umbrella body, Maendeleo ya Wanawake [Kiswahili for women in development], the Rift Valley region has the highest incidence of FGM in the country.

Rosemary Moraa, who runs Maendeleo ya Wanawake's anti-FGM programme, told IRIN on Friday that most of the girls were running away as a result of awareness created by widespread anti-FGM campaigns throughout the country, and urged the government to establish an institution which could provide shelter for such girls.

"The girls have known they are not going to benefit from FGM, so they run away," Moraa told IRIN. "For now, we are still debating what to do with them."

The ubiquity of FGM in the province was highlighted further by a case in which two sisters took their father to court to avert forcible circumcision. The girls won the case.

One human rights organisation in the region has urged the Kenyan authorities to introduce medical check-ups on schoolgirls in such communities as part of the fight against FGM, the East African Standard reported.

Ken Wafula, who runs the Centre for Human Rights and Democracy (CHRD), an NGO in Eldoret, Rift Valley Province, said since the enactment of the Children's Act, the communities still practising FGM were doing so secretly to avoid arrest.

"We are currently making visits to various primary schools to educate young girls against the dangers of the rite, and encouraging the formation of anti-FGM clubs in schools," the East African Standard quoted Wafula as saying.

However Maendeleo ya Wanawake says it opposes this approach and prefers advocacy. "Our work is advocacy, so parents can be convinced that FGM is wrong," Moraa told IRIN.

The material contained in this article is from IRIN, a UN humanitarian information unit, but may not necessarily reflect the views of the United Nations or its agencies. If you re-print, copy, archive or re-post any item on this site, please retain this credit and disclaimer. Quotations or extracts should include attribution to the original sources. All graphics and Images on this site may not be re-produced without the express permission of the original owner. All materials copyright © UN Office for the Coordination of Humanitarian Affairs 2003

AllAfrica.com

Writers Union Promotes Seminar About Female Circumcision

Angola February 3, 2003
A seminar about "Circumcision of Luvale community woman" will take place Wednesday, at the Angolan Writers Union (AWU), in Luanda.

Being led by the writer José Samwila Kakweiji.

Luvave people is located in Moxico province regions, in the high part of Alto Zambeze township, part of Zambian Republic and Democratic Republic of Congo.

According to the writer, for this people, female circumcision is not a threat and is not considered as a violent act. Mukanda, as [it is] known, is considered as a school of training for future woman that wishes to become a mother.

Luvave people believes that Mukanda serves to develop feminine genitals organs, giving them consistence, size and length.

Benin
Jan 21 2003

Another country bans FGM

COTONOU, Jan 29 (IPS)
- Rights groups have welcomed a new law, banning all forms of female genital mutilation in Benin. "I am pleased with the passage of the law, because, of all the countries in the sub-region, Benin was the last to outlaw female genital mutilation," says Genevieve Boko Nadjo, president of WILDAF-Benin, a non-governmental organisation (NGO) dealing with women issues.

New York Times
January 23, 2003

Circumcision Opponents Use the Legal System and Legislatures

By ADAM LIPTAK
FARGO, N.D., Jan. 16 - Josiah Flatt, like about 60 percent of other newborn American boys, was circumcised soon after he was born here, in the spring of 1997. Two years later, his parents sued the doctor and the hospital.

They did not contend that the circumcision was botched or deny that Josiah's mother, Anita Flatt, had consented to the procedure in writing. They said, instead, that the doctor had failed to tell them enough about the pain, complications and consequences of circumcision, removing the foreskin of the penis.

The suit will be heard by a jury next month. In declining to dismiss the case here before trial, Judge Cynthia Rothe-Seeger acknowledged that the case was unusual in that nothing "went `wrong' during the procedure." The main harm Josiah seeks compensation for, Judge Rothe-Seeger noted, is "diminished sexual sensation injury." ...

See the rest of the article.

Other legal stories

TIMES ONLINE
January 13, 2003

The unkindest of cuts

By SIMON CROMPTON

Circumcision is often unnecessary, damaging and performed without consent, says our correspondent

THERE IS ONE OPERATION being carried out on thousands of British children by NHS doctors without any clinical need — and without the patient's consent. This procedure has an irreversible physical effect, yet there has been minimal public debate about the extent to which it is being performed.

The procedure is non-religious circumcision, carried out on "therapeutic" grounds on 4 to 6 per cent of boys under 15. Increasingly, the expert consensus is that most non-religious circumcisions are carried out for reasons of family history, medical myth and professional laziness. Some campaigners claim that as many as five in six of these circumcisions are unnecessary and potentially traumatising.

Circumcision has become the subject of bitter debate in the US, where 80 per cent of men are circumcised. Doctors Opposing Circumcision is one of a range of groups challenging the medical orthodoxy of circumcision at birth; their campaign has been buoyed by a statement from the American Medical Association that there is insufficient evidence of benefit to recommend routine neonatal circumcision.

Here, the British Medical Association is reviewing its guidelines and is due to announce its findings in March; current guidance makes it clear that it is unethical to circumcise for therapeutic reasons where research shows that less invasive techniques are available.

Norm-UK, an organisation which campaigns against circumcision, estimates that fewer than 1 per cent of boys require the operation, and that most of those performed on the NHS are unnecessary. Dr John Warren, a consultant physician and founder of Norm-UK, says that the main problem is that GPs and general surgeons are unaware of research indicating when circumcision is medically required. Specialist paediatric urological surgeons are better informed, but not all children are seen by these experts.

Most non-religious circumcisions are performed on children whose parents are concerned about a tight foreskin that will not retract, a condition known as phimosis. "They think there is something wrong, even if it's causing the child no problems," says Warren, who works at the Princess Alexandra Hospital in Harlow, Essex. Yet research published as long ago as 1968 showed that 90 per cent of tight foreskins had resolved themselves by the age of four, and 99 per cent had developed normally by 17. "The message never filtered through, and a lot of people didn't accept it," says Warren.

Family tradition also plays a part. Fathers and grandfathers who were circumcised may want their boys circumcised too (often on the basis that it is "cleaner"), and use the possibility of phimosis to get doctors to perform the procedure. Duncan Wilcox, consultant paediatric urologist at Great Ormond Street Hospital and Guy's Hospital in London, believes that this is the main reason why so many circumcisions are carried out unnecessarily.

"As many as half of the parents who come to see me want their child to have a circumcision," he says. "But when I tell them that there is a risk, as with all operations, the majority are happy to wait and see if the foreskin retracts normally. Doctors are certainly pressurised, and there is always the occasional parent who will get through with pure persistence, or by saying that their child keeps getting infections." The issue would be less important if foreskin removal did not have physical and social implications which carry on into adulthood.

Alex was circumcised at 25 during an operation to correct a bend in his penis. The surgeon decided — without Alex's consent — to remove the foreskin, an action that other surgeons have subsequently confirmed as unnecessary. "There was a huge reduction in erogenous tissue," says Alex, now 29, a systems analyst from Oxfordshire. "The feeling of pleasure has changed so much that I haven't been able to achieve orgasm since the operation. It had a disastrous effect on my relationship: my partner wondered whether it was her fault, and that contributed to the end of our relationship. Since then I've found it hard to get into a new relationship.

"I am conscious of how I look, and girlfriends have given me quizzical looks. They are not used to seeing circumcised men. I haven't had the confidence to go into a public changing room since the operation."

The foreskin contains a rich variety and concentration of specialised nerve receptors. In May 2002, a study in the British Journal of Urology reported that circumcision appears to result in decreased erectile function and penile sensitivity: 38 per cent of men circumcised as adults reported harm to sexual function.

The practice of medical (as distinct from religious) circumcision began in Victorian times as a deterrent to masturbation, then thought to be the cause of insanity, epilepsy, hysteria, tuberculosis, short-sightedness and death. The practice became popular in the 1920s for reasons of hygiene and peaked in the 1940s. In 1949, researchers began to question whether a nonretracting foreskin was abnormal, and numbers have declined.

Norm-UK has received hundreds of calls from men who feel ashamed or mutilated by the procedure. For young boys, the potential embarrassment of having a penis that looks different from those of their friends is obvious. Yet the psychological issues are complex: in a largely Jewish or Islamic community, this argument works as much in favour of circumcision as against it. Dr Lotte Newman, a former president of the Royal College of General Practitioners who chairs the circumcision working party of the Board of Deputies of British Jews, is troubled by developments in Sweden which may lead to a ban on child circumcision there. "The trend against circumcision affects those religions which practise it traditionally," she says.

Such sensitivities may account for the neutral stance of mainstream medical organisations such as the General Medical Council, which states only that its soundings "demonstrated widely conflicting views in society, which neither doctors nor the GMC can resolve".

But perhaps the issue ultimately comes down to one of consent. Adults need to know about the alternatives to have an accurate basis for decision-making. But Norm-UK's concern is that no one should consent to a circumcision on someone else's behalf, even if it is their own child. That means doing everything possible to treat conditions non-invasively until the patient can make an informed choice.

"When I was a kid I had a circumcision and my brother didn't," says Warren. "It made me conscious of the issue as a medical student. Then I had to conduct the operation myself, and was horrified at what I was doing. I thought, one day I will stop this ridiculous practice."

CIRCUMCISION LINKS

Norm-UK: www.norm-uk.org
NHS Online: Information on circumcision and balanitis www.nhsdirect.nhs.uk/nhsdoheso

Boston Globe
January 15, 2003

Court says rite for child must wait

Separated couple disagree
on Hindu ceremony for girl

By Kathleen Burge,
Globe Staff,
1/15/2003

Their marriage was arranged in their homeland of India, but when they moved to the United States, it didn't last. In November 1998, five months after their daughter was born, they separated.

Although both Sejal and Mahendra Sagar remained practicing Hindus, they disagreed on one religious ceremony performed on young children: Chudakarana, a ritual where the child's head is shaved and locks of hair are offered as a sacrifice. The father, Mahendra Sagar, asked a judge for permission to perform the ritual.

Middlesex Probate and Family Court Judge Spencer Kagan ruled that the ceremony should wait, and the young girl should eventually decide whether she wanted to take part. Yesterday, the state Appeals Court upheld the decision, ruling that the father's right to freedom of religion had not been violated. ''The order neither imposes any limitation upon nor favors either parent's ability to communicate beliefs concerning Chudakarana or to participate in any other beliefs or practices of their shared Hindu faith,'' Justice Joseph A. Grasso Jr. wrote for the three-judge panel. ''The order does not coerce the father to believe as the mother does; nor does it compel him to practice his religion in a particular way.''

Chudakarana is a ceremony of prayer, in which a priest removes hair from five parts of the child's head, offering some as a sacrifice. The child's head is shaven in the ritual, which is believed to contribute to longevity and ward off illness. The parents share joint legal custody of the girl, who lives primarily with her mother. The decision - joined by Justices Elspeth B. Cypher and Kent B. Smith - relies heavily on previous decisions from the state Supreme Judicial Court on religious disputes among divorced parents.

In 1997, the SJC ruled that a fundamentalist Christian father could not take his children - who were being raised by their mother as Orthodox Jews - to his church services. The justices reasoned that the children's best interests should prevail in such disputes, and the church services might stir emotional conflict within the children and wrongly force them to choose between their parents.

But Mahendra Sagar's lawyer, who says his client will appeal to the SJC, argues Kagan's decision forced Sagar to perform a ritual atonement because the ceremony was not done on his daughter by the age of 3, as required by Hindu teaching. As part of the atonement, Sagar shaved his head, said the lawyer, Chester Darling. Sejal Sagar's lawyer could not be reached.

''What the probate court did was change the character and nature of my client's practice of religion,'' Darling said. ''He compelled him to perform his atonement.''

Kathleen Burge can be reached at kburge@globe.com
This story ran on page B2 of the Boston Globe on 1/15/2003.