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Royal Australasian College of Physicians

December, 2022

New RACP policy a step backward

by Hugh Young

The 2022 policy statement of the Royal Australasian College of Physicians on "Circumcision of Infant Males" is a step backwards from its 2010 policy.

In 2009 the RACP foreshadowed a new policy that noted that

"ethical concerns have focused on recognition of the functional role of the foreskin, the non-therapeutic nature of the operation, and the psychological distress felt by some adult males circumcised as infants. The possibility that routine circumcision contravenes human rights has been raised because circumcision is performed on a minor for non-clinical reasons, and is potentially without net clinical benefit for the child." (I would maintain that this is much more than a possibility, but perfectly obvious.)
The policy, when it came out in 2010, considerably watered down those concerns, tending to throw the ball back in the parents' court. The 2022 policy winds the clock back still further:
  • mentioning the foreskin's functional role but saying no more about it, in fact removing a section about it that was in the 2010 policy.
  • mentioning those ethical concerns but thereafter ignoring them (begging the question in a conditional treated unconditionally: "if we agree that parents should be allowed to choose" when that is the very point at issue).
  • removing all mention of the considerable and justifiable distress felt by many cut men, especially when their sexual experience has clearly been impaired, as is not infrequently the case. This distress at such an intimate violation is so great that many go to considerable trouble and expense to regain what they have lost. Social media have caused the number of these men to grow exponentially as they realise that their concern is valid and they are not alone. (The 2010 policy tried to "balance" them against the (very few) intact men who wish they had been cut in infancy, but this was absurd.)
  • misrepresenting the enlightened policy of the Royal Dutch Medical Association (KNMG), which wholeheartedly condemns infant MGC.
  • ignoring the 2012 condemnation of infant male genital cutting by most of the medical associations of Europe, in a joint letter to the AAP's journal, Pediatrics.
The medical case the policy presents for genital cutting of normal, healthy babies (slight reductions in diseases that are rare and/or of late onset, better prevented by other means, or treated as they occur) is far too weak to seriously consider it.

The policy ignores the anomalous history of "medical" infant male genital cutting, introduced in the Victorian era for anti-sexual, anti-pleasure reasons, and continuing through cultural inertia and extraneous psychological factors (such as fathers' fear of sons looking "different") when those excuses faded.

The RACP policy shows no indication of acknowledging the position in Aotearoa New Zealand, where parentally elective infant male genital cutting is now almost extinct (and has not been prevalent among Māori since their arrival here). That which does happen is almost entirely cultural (Pasifika) or religious (Muslim or Jewish). The 2022 policy almost seems to encourage a reversion to the position in the 1950s, when it was hard for any boy to escape from neonatality with his foreskin intact. Nor does it acknowledge tikanga Māori, in which the kirimata (foreskin), as an integral part of the ure (penis), is extremely tapu (sacred).



Patch

July 22, 2022

MA Appeals Court Tosses Anti-Circumcision Lawsuit

Ronald Goldman, an anti-circumcision activist from Boston, argued MassHealth should not use taxpayer money to pay for the procedure.

by Dave Copeland

BOSTON — MassHealth can continue to reimburse doctors for infant circumcisions after the Massachusetts Appeals Court dismissed a lawsuit by anti-circumcision activists Friday who claim the procedure is "not medically necessary" and a waste of taxpayer money.

Ronald Goldman, an anti-circumcision activist from Boston, and 27 other plaintiffs filed the lawsuit challenging the way MassHealth pays for the procedure in 2020. Goldman's complaint argued taxpayer dollars should not be used to pay for religious and medically-unnecessary circumcisions.

In March 2021, Superior Court Judge Robert Gordon rejected the Executive Office of Health and Human Services's motion to dismiss the case, saying state law allows citizens to sue the state if they believe taxpayer money is being wasted. Goldman raised money for the lawsuit for the lawsuit through a GoFundMe campaign through the Circumcision Resource Center, the activist group he founded.

The Appeals Court ruling issued Friday said the plaintiffs did not have standing to file the lawsuit because none of them had been directly harmed by the action they were complaining about. The ruling also noted U.S. Supreme Court has ruled that individuals can't sue over Medicaid reimbursement rates set by states.

The plaintiffs had also argued MassHealth should review every infant circumcision to determine if it was medically necessary.

"No statute or regulation requires MassHealth to conduct prepayment review of all claims, nor would this be feasible given the sheer number of claims that MassHealth receives each year," Friday's ruling said. "Rather, it is within MassHealth's discretion to decide which services will require more individualized review for medical necessity and which services will be excluded from coverage."



NBC News

July 21, 2022

Greece bans ‘sex-normalizing’ surgeries on intersex babies

In the past, operations on intersex people have resulted in sterilization, loss of sexual sensation and other health problems, advocates say.
by Reuters

Greece’s parliament has banned “sex-normalizing” surgeries on babies born intersex, with atypical chromosomes that affect their bodies in a way that does not fit with the normative definitions of male or female.

Under a new law approved by parliament on Tuesday, surgeries that seek to ensure a child ascribes to traditional notions of male and female on people under the age of 15 years are banned in Greece, unless there is a court decision stating otherwise.

The bill stipulates fines and a prison term for doctors conducting such surgery. ...

Malta, Portugal and Germany have already banned such surgeries ...



Times of India

February 1, 2022

Ahmedabad: Infant loses glans in botched circumcision

Read more.



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