Intactivism News

March - April , 2015

News items are copied to Circumstitions News blog (which takes comments)

- thanks to Joseph4GI


The Swazi Observer

April 30, 2015

Soka Uncobe got more men on HIV services

by Winile Mavuso

WHILE most HIV positive Swazis do not enroll for pre-ART services because they feel well and don’t see the need to go to the clinic, the Soka Uncobe Male Circumcision campaign ran in 2011-12 saw more men enrolling for HIV care services.

This is contained in a study conducted by ICAP in 2011-2012 with support from the Centre for Disease Control (CDC) and the President’s Emergency Plan For AIDS Relief (PEPFAR). The study was presented to stakeholders during a breakfast meeting at Mountain Inn yesterday.

The objective of the study was to evaluate whether key linkage procedures were implemented in accordance with the new set of standard operating procedures on linkage and retention (National SOP) introduced by the ministry of health. The study explored early enrollment and retention in HIV care among clients newly diagnosed with HIV from two HTC settings (home- and MC-based HTC), as well as finding client, clinic and SOP characteristics that might be associated with early enrollment and retention in care.

Hence, the National SOP was implemented in the Soka Uncobe Male Circumcision campaign during which testing was facility based and the Swaziland HIV Incidence Measurement Survey (SHIMS) during which testing was home based.

HIV testing was a requirement for men to get circumcised and those who took up the services also got to know their HIV status. According to the study, from 13 Soka Uncobe sites visited, it was found that many MC files of HIV positive clients included completed readiness assessment forms.

“Interestingly, although similar enrolment rates were observed between study-gender groups overall and within 18 months of diagnosis, proportionally, more Soka than SHIMS clients enrolled in HIV care within three to six months,” reads part of the document.

This could be attributed to the fact that many Soka sites were co-located at HIV care facilities, hence clients were easily linked to expert client counselors.

[Or could this be because more Soca Uncobe ("Circumcise and Conquer") clients got HIV?]

Earlier story


April 29, 2015

Male Circumcision Curbs HIV Spread but Risk of Transmission High While Wound Heals
Real news: Male Genital Cutting INCREASES Risk To Women

by Bidita Debnath

While circumcision reduces the risk of human immunodeficiency virus (HIV) transmission by infected men [that has NOT been established], there is actually a possible increased risk of infecting female sexual partners while the circumcision wounds heal, warns a new research.

The World Health Organization (WHO) recommends male circumcision (the surgical removal of foreskin from the penis) [for consenting adults] which reduces HIV acquisition by 50-60%. [They have to include their mantra.]

"There is a window of a few weeks after circumcision when the risk that an HIV-infected man could transmit the virus to a female partner actually increases," said the study's first author Aaron Tobian, associate professor of pathology at the Johns Hopkins University School of Medicine. "During that time, more HIV-infected men are shedding the virus, and on average they are shedding greater amounts of it, than before circumcision," he noted.

However, scientists report that a new study of HIV-infected men in Uganda has identified a temporary, but potentially troublesome unintended consequence of the procedure: a possible increased risk of infecting female sexual partners while the circumcision wounds heal.

[See the weasel-words and euphemisms: infecting more women with HIV is exactly contrary to what this whole campaign is supposed to be about.] 

The study examined 223 HIV-positive Ugandan men who were medically circumcised. Circumcision reduced the number of HIV-positive men who were shedding the virus more than five-fold over the long term, but it had the opposite effect in the weeks right after the surgery. Case by case, the likelihood of HIV transmission from a newly-circumcised man to his female partner is less than one-tenth of one percent, the researchers estimated.

But with the WHO seeking to circumcise nearly 29 million men, the study projects that this small increase could add up to 17,000 new infections among female partners of newly circumcised HIV-infected men.

"Although we're counseling men not to have sexual intercourse while their wounds are healing, we know that they are," Tobian said.

The solution, he says, may lie in another one of the study's findings. "If the men are on anti-retroviral drugs, this reduces the risk of their shedding the virus by about 90%," he pointed out. The study was published in the journal PLOS Medicine.

[But if the men are known to be HIV-positive, WHY CUT THEM? It is TOO LATE. This just underlines how this whole campaign is not about preventing the spread of HIV/AIDS, but promoting the spread of male cutting.]

Source: IANS

[Wawer et al. started to find this six years ago, but they cut that study short "for futility" - it didn't find benefit - before it could be confirmed.]

And about time too!

Law 360

April 22, 2015

Circumcision Clamp Makers Sued Over Amputated Penis

by Y. Peter Kang

Los Angeles (April 22, 2015, 4:00 PM ET) -- Companies associated with the production of a clamp used in performing circumcisions were hit with a product liability suit in Pennsylvania state court on Wednesday alleging that the medical instrument's poor design led to the amputation of the tip of an infant's penis.

California resident Victoria Hoekstra, the mother of a minor child, filed the suit against Misdom-Frank Corp. and related entities Sklar Corp. and Medco Group Inc., accusing the Pennsylvania-based companies of negligence and product liability in connection with the partial amputation of her week-old infant's penis in 2010 in what was supposed to be a routine circumcision procedure, according to the complaint.

Hoekstra says that the companies' product, known as a Mogen clamp, has a design defect that does not provide any protection for the head of the penis, unlike other circumcision clamps, and contains a second defect that does not allow for the doctor to be able to visualize the head of the penis when applying the scalpel to the foreskin.

These design defects "are well known and have long been identified and published in medical literature," according to the complaint.

"The Mogen clamp, unlike other circumcision devices, has a long history of penile amputations," Hoekstra alleges. "Defendants have misrepresented the efficacy and safety of their Mogen clamp through various means and media, actively and intentionally misleading the medical community, patients and the public at large." 

[The Mogen Company went out of business in 2012 after losing two lawsuits to the value of $18.3 million. A subsequent suit was worth $4.6 million.]

Hoekstra says that her son has sustained permanent injury and will require future corrective surgeries and brings claims for strict liability, negligence and breach of warranty against the companies, seeking more than $50,000 in damages.

An attorney for the plaintiff told Law360 on Wednesday that the clamp should be pulled from the market.

"Circumcision is an ancient ritual that has been performed safely for centuries without incident [BS!]," said co-lead counsel Daniel Balaban of Los Angeles-based Balaban & Spielberger. "This case is about a defective product that has left our client mutilated and maimed. This dangerous device should be pulled off the market or fixed before another infant is harmed."


--Editing by Stephen Berg.

How is this not sexual abuse?

Daily Nation (Kenya)

April 22, 2015

Anxiety in Eldoret after NGO ‘forcibly’ circumcises 30 boys

by Copperfield Lagat

Anxiety has gripped Eldoret in Uasin Gishu after an estimated 30 children were forcibly circumcised by a non-governmental organization based in Kisumu and which has a clinic in Eldoret.

The Impact Research Development Organisation is alleged to have performed the circumcision on the school-going children last week in various parts of Eldoret, when learners came home for the April holiday.

The mood was tense Wednesday evening at Kapsoya Estate as mothers wailed uncontrollably after realising that their sons, some as young as six years old, were circumcised by the organisation without their consent.

Lucy Ekwong said she had gone to town but did not find her two sons upon arriving home in the evening.

She would later find out that they were nursing pains at a Sudanese neighbour’s house.

“I had gone to town but when I came back in the evening, my two children, aged six and eight were in my neighbour’s house.


“The young one said they were offered sweets and taken to a clinic in Langas where many boys were circumcised,” the bitter mother said.

“I was shocked but immediately took up to caring for them. I later talked to a police officer who denied knowing of such an activity.

“I am so confused because the surgery itself is not according to the requirements of the Kalenjin traditions.

“My people in the village, upon learning of that, are accusing me of doing it on my sons,” said Ms Ekwong.

Some of the children were from the South Sudan Nuer community which does not perform circumcision on their boys.

The community regards the act of circumcision as a taboo and anyone conducting it is banished.

Only two children, who were from Islamic Center, were Kalenjins while close to 30 others were those from South Sudan.

A Sudanese national, Madol Anyief said: “Our Dinka Bor community does not perform circumcision. Anyone who is circumcised is banished and disowned.

“It is said these people were going around saying the government has directed circumcision but we have later been assured that the county has no such programme,” Anyief said, adding that she did not question much because she was a foreigner and feared for her life.

According to reports corroborated by the circumcised boys, sweets were used by people who were in cars to lure them.


One of them said they were more than a hundred only that some were hiding in their homes.

Uasin Gishu County’s Chief Officer for Health Mr Silas Boit said the revelation came during a normal supervision at Kapsoya Health Centre on Tuesday when they met a young boy who was walking in pain.

“We asked further and we were told that there was a forceful circumcision that the NGO had conducted. The boy had a urinal retention complication due to the surgery,” Mr Boit said.

The health officer said they went round the estate and got over 30 other boys in pain in their various homes.

Some who were suspected to be developing infections were referred to Moi Teaching and Referral Hospital for medication.

Mr Boit said police and the county officials managed to arrest three officers from the NGO who were booked at Kapsoya Police Post.

Mr Boit said: “We were shocked after realising that the car in which the suspects had been arrested was released and was going around collecting the boys to ferry them to hospital,” Boit said.

He added that the OCS had promised to take the suspects to court.

Meanwhile, parents have been urged to keep a close watch on their children.

Science Daily
April 21, 2015

Babies feel pain 'like adults': Most babies not given pain meds for surgery

The brains of babies 'light up' in a very similar way to adults when exposed to the same painful stimulus, a pioneering Oxford University brain scanning study has discovered. It suggests that babies experience pain much like adults.

The study looked at 10 healthy infants aged between one and six days old and 10 healthy adults aged 23-36 years. Infants were recruited from the John Radcliffe Hospital, Oxford (UK) and adult volunteers were Oxford University staff or students.

During the research babies, accompanied by parents and clinical staff, were placed in a Magnetic Resonance Imaging (MRI) scanner where they usually fell asleep. MRI scans were then taken of the babies' brains as they were 'poked' on the bottom of their feet with a special retracting rod creating a sensation 'like being poked with a pencil' -- mild enough that it did not wake them up. These scans were then compared with brain scans of adults exposed to the same pain stimulus.

The researchers found that 18 of the 20 brain regions active in adults experiencing pain were active in babies. Scans also showed that babies' brains had the same response to a weak 'poke' (of force 128mN) as adults did to a stimulus four times as strong (512mN). The findings suggest that not only do babies experience pain much like adults but that they also have a much lower pain threshold.

The research was funded by the Wellcome Trust and is reported in the journal eLife.

'Up until recently people didn't think it was possible to study pain in babies using MRI because, unlike adults, they don't keep still in the scanner!' said Dr Rebeccah Slater of Oxford University's Department of Paediatrics, lead author of the report. 'However, as babies that are less than a week old are more docile than older babies, we found that their parents were able to get them to fall asleep inside a scanner so that, for the first time, we could study pain in the infant brain using MRI.

'This is particularly important when it comes to pain: obviously babies can't tell us about their experience of pain and it is difficult to infer pain from visual observations. In fact some people have argued that babies' brains are not developed enough for them to really 'feel' pain, any reaction being just a reflex -- our study provides the first really strong evidence that this is not the case.'

The researchers say that it is now possible to see pain 'happening' inside the infant brain and it looks a lot like pain in adults.

As recently as the 1980s it was common practice for babies to be given neuromuscular blocks but no pain relief medication during surgery. In 2014 a review of neonatal pain management practice in intensive care highlighted that although such infants experience an average of 11 painful procedures per day 60% of babies do not receive any kind of pain medication.

'Thousands of babies across the UK undergo painful procedures every day but there are often no local pain management guidelines to help clinicians. Our study suggests that not only do babies experience pain but they may be more sensitive to it than adults,' said Dr Slater. 'We have to think that if we would provide pain relief for an older child undergoing a procedure then we should look at giving pain relief to an infant undergoing a similar procedure.'

Dr Slater added: 'Recent studies in adults have shown that it is possible to detect a neurological signature of pain using MRI. In the future we hope to develop similar systems to detect the 'pain signature' in babies' brains: this could enable us to test different pain relief treatments and see what would be most effective for this vulnerable population who can't speak for themselves.'


MyJoy online
April 16, 2015

13-year-old girl banished for refusing to undergo circumcision

Despite efforts to combat the cultural practice of Female Genital Mutilation (FGM) in Ghana, reports indicate that some traditional leaders in some districts of the Brong-Ahafo Region are still encouraging it.

According to The Chronicle newspaper, some communities in the Tain and Banda districts of Brong-Ahafo indicates that the cruel act against girls is still ongoing under the charade of custom.

The daily newspaper reported in its April 16, 2015 issue that a 13-year-old pupil of the Brohani D/A Primary School security has been banished from Brohani in the Tain District by the queen mother for reporting to police an attempt to mutilate her genital.

Read the rest of the story as published in the newspaper below:

Narrating her ordeal to The Chronicle, the 13 year old pupil who is currently seeking refuge at the expense of a Good Samaritan at Nsawkaw said she was lined up with another girl waiting to have their genitals mutilated.

After hearing the cry of the other girl, who underwent the cruel act, she fled and went to inform her teacher, who subsequently reported the issue to the Girl Child Coordinator of the Tain District Directorate of the Ghana Education Service (GES), Ms. Comfort Maanu.

Ms. Comfort Maanu, together with the girl and the teacher, reported the case to the Department of Social Welfare, and subsequently, a formal complaint was lodged with the Nsawkaw Police, which led to the arrest of the alleged perpetrators, including the Queenmother of Brohani, a relative of the girl, and the executor of the FGM.

After the arrest of the three, the Nsawkaw Police referred the case to the Domestic Violence and Victim Support Unit (DOVVSU) of the Ghana Police Service in Wenchi and the alleged perpetrators have since been released on bail.

The Queenmother of Brohani is alleged to have threatened to have the girl killed anytime she steps foot in the community, a threat which has frightened the girl compelling her to seek refuge with a Good Samaritan at Nsawkaw.

Sources at the Department of Social Welfare and Community Development in the Tain District has hinted The Chronicle that some opinion leaders of the community, including politicians in the District, have been pushing for the case not to be sent to court, and hence, after almost two months of the incident, the matter has not been to court.

When the Deputy Regional DOVVSU Officer, ASP Setina Aboagye, was contacted, she said the regional office was yet to ascertain the case.

According to ASP Setina Aboagye, she would personally go to Nsawkaw on Friday, April 17, 2015, to follow up the matter.

However, investigations by The Chronicle has revealed that Brohani is the hub of FMG in the Tain and Banda districts, where young girls are sent for the practice to be undertaken, under the supervision of the Queenmother, hence the urgent need for the Ministry of Gender, Children and Social Protection to intervene.

WSBTV (Florida)

April 14, 2015

Woman filed federal suit to block son’s circumcision

by Jane Musgrave


A Boynton Beach, Florida, woman who went into hiding with her 4 1/2-year-old son rather than abide by a judge’s order to have him circumcised has filed a lawsuit in federal court, claiming a forced circumcision would violate her son’s constitutional rights.

In the lawsuit filed Monday in U.S. District Court, Heather Hironimus claims there is no medical justification to circumcise her son, identified as C.R.N.H., and many legal and medical reasons not to do it.

“(The) application of Florida law to impose unnecessary, elective, cosmetic circumcision upon C.R.N.H. at the age of 4 1/2 years old for no religious reason violates (the boy’s) fundamental right to privacy and bodily integrity secured by the due process clause of the 14th Amendment to the United States,” her attorney Thomas Hunker wrote.

Hunker also claims the circumcision, sought by the boy’s father, constitutes “assault, aggravated assault, battery and aggravated battery.” It would cause irreparable psychological damage and provide few health benefits, Hunker says in the suit to be heard by U.S. District Judge Kenneth Marra.

Heather Hironimus, 30, and her son have been in hiding since last month when Palm Beach County Circuit Judge Jeffrey Gillen ordered her to bring her son to court to turn him over to the boy’s father, Dennis Nebus. When she didn’t appear at the hearing, Gillen signed a warrant for her arrest.

The federal lawsuit is the latest volley Hironimus has fired in the long-running legal fight to block the circumcision.

Three months after the boy was born in 2010, Nebus, 47, of Boca Raton, filed suit to establish his parental rights. In 2012, Hironimus signed a parenting agreement, allowing Nebus to have the boy circumcised as long as he paid for it. Soon after, she said she had second thoughts about allowing her son to undergo the procedure.

She launched a court battle and one on social media seeking to persuade Gillen not to enforce the agreement. After various court hearings, Gillen in May ruled that the agreement trumped her reservations. The 4th District Court of Appeal upheld his decision without comment.

Protests by those who identify themselves as “intactivists" have been held throughout the county to support Hironimus’ efforts to spare her son from circumcision.
Earlier story

The Star Observer (Australia)

April 2, 2015

Malta the first country to outlaw forced surgical intervention on intersex minors

MALTA has become the first country in the world to outlaw medical practitioners or other professionals from conducting any involuntary or coerced surgical intervention on minors with intersex variations.

The Gender Identity Gender Expression and Sex Characteristics Act was passed through Maltese Parliament with cross party support, without a vote, in the early of the morning in Australian time.

A first of its kind around the world, the passage of the bill has been met with praise by Organisation Intersex International (OII) Australia, along with various European intersex and trans* organisations.

The new law officially recognises the right to bodily integrity and physical autonomy and protects intersex infants and children from non-necessary medical interventions. These sorts of medical procedures still take place in Australia and around the world, with parental distress or improving marriage prospects as common reasons for it.

Malta’s Gender Identity Gender Expression and Sex Characteristics Act also meets several other key demands of the intersex movement, including the 2013 recommendations of an Australian Senate committee report.

The relevant part of the act reads:

“It shall be unlawful for medical practitioners or other professionals to conduct any sex assignment treatment and/or surgical intervention on the sex characteristics of a minor which treatment and/or intervention can be deferred until the person to be treated can provide informed consent: Provided that such sex assignment treatment and/or surgical intervention on the sex characteristics of the minor shall be conducted if the minor gives informed consent through the person exercising parental authority or the tutor of the minor.

“In exceptional circumstances treatment may be effected once agreement is reached between the Interdisciplinary Team and the persons exercising parental authority or tutor of the minor who is still unable to provide consent: Provided that medical intervention which is driven by social factors without the consent of the minor, will be in violation of this act.”

The Interdisciplinary Team will be appointed by the government, alongside a larger working group that includes human rights experts, to establish improved treatment protocols “in line with current medical best practices and human rights standards”.

The new Maltese law also provides for an administrative mechanism for the recognition of gender identity, and protection from discrimination for intersex and trans* people.

While OII Australia president Morgan Carpenter said he “warmly” congratulated the Maltese government and parliament, he urged Australian parliamentarians to pass similar legislation, as well.

“This is legislation that Australian governments should be enacting, to implement the recommendations of the 2013 Senate committee report on the involuntary and coerced sterilisation of intersex people,” he said.

“Non-necessary medical interventions still take place on infants and children with intersex variations, across Australia, for rationales that include managing parental distress, social stigma and even ‘improving marriage prospects’.

“These violate international human rights standards and Australian governments must act.”

Intersex people are born with bodies that don’t meet stereotypical expectations for male and female, including a range of genetic, hormonal and anatomical differences in sex characteristics. People with intersex variations have as diverse a range of gender identities as non-intersex people.

Earlier story

The Guardian

April 1, 2015

In Thailand’s Muslim south, authorities turn a blind eye to FGM

Female genital mutilation, banned by the WHO, seems to be common in the
three Muslim-majority southern provinces, but officials are taking no action

by Gabrielle Paluch

Eight-week-old baby Amiyah grimaces when sunlight falls on her face as though she isn’t used to the idea of having been born yet. On a Saturday afternoon, in Thailand’s southern Pattani province, her Muslim mother has brought her to a small clinic so midwife Dah can slice her clitoris for sunat. The practice, a form of female genital mutilation (FGM), has been banned by the World Health Organisation.

In majority Buddhist Thailand, the public health department says FGM does not happen. But in the three southernmost provinces of Yala, Narathiwat and Pattani, ethnic Malay Muslims are a majority. Some are locked in an intractable conflict with the Thai government, which labels them insurgents. Here, midwife Dah says she has cut almost all female births she has attended.

“Her clitoris is so small,” says Dah, 64, who seems a little flustered as she swabs the crying baby’s vulva with alcohol with her gloved hands. Despite her experience, she is having difficulty finding the clitoris as the baby squirms on the operating table. She holds a sterile surgical blade, for which she has fashioned a handle out of tin foil.

After five long minutes, during which the baby cries relentlessly and the mother tries to comfort her, the incision is finally made. The midwife mops up a drop of blood with a cotton swab, recites the name of God, and declares the baby “circumcised”.

“I feel relieved that I have done my duty,” the mother says.

The conflict in the southern Thailand can make it hard for women to access healthcare, according to Dr Sudarat Teeraworn, a public health supervisor for maternal health in neighbouring Yala province. Sudarat says FGM isn’t on the health ministry’s agenda – though according to her, almost every Muslim baby girl in the south is cut.

“There are no laws about it because there are not many health consequences, and it’s a cultural practice,” she says.

Thai health authorities have taken a pragmatic approach, apparently turning a blind eye.

FGM as practised in Thailand falls under type IV in the WHO’s classification, which involves pricking, piercing, incising, scraping and cauterisation. Types I and II involve excision of either clitoris or labia or both, and type III includes a procedure where the vulva is sutured together after removal of the clitoris and labia. The WHO says the procedure has no known health benefits, arises from a deep-seated gender-bias, and amounts to a violation of both children’s and women’s rights.

Just across the border in Malaysia, a study conducted in 2011 showed 93% of Muslim women have been cut, including in Kelantan state on Thailand’s border, which is culturally and religiously similar to Pattani. Though the practice dates back centuries for Muslims living across the Malay peninsula, Malaysia’s highest religious authority did not issue a fatwa until 2009 requiring the cutting of all Muslim women.

Malaysia’s fatwa has put health workers in an awkward position. As women increasingly give birth in hospitals, mothers looking for a safe way to cut their female babies are essentially asking doctors to break WHO guidelines.

To reduce the prevalence of FGM in Malaysia , Saira Shameem, who works for the UN Population Fund (UNFPA) in Kuala Lumpur, is working with health authorities to make the practice symbolic, with a routine alcohol swab performed by obstetricians at birth. “What the fatwa does not do, is it does not specify what the procedure should be,” she says, “that allows us an avenue to define the procedure in a non-invasive, non-harmful manner and shift the practice accordingly.”

In southern Thailand women are also increasingly giving birth in hospitals. Traditional midwives who pass their trade on from generation to generation are disappearing, and mothers are increasingly having their babies cut by doctors.

Many women in southern Thailand don’t even know they’ve been cut until adulthood, when they read about it. The practice is not talked about.

Dr Patimoh Umasa is one of the only female doctors in Yala, where she runs a small clinic on the edge of the city’s Muslim quarter. She knows the WHO guidelines, and doesn’t believe what she does directly contravenes them. “If it is done by a doctor and they are using the right technique, then never mind,” she says. “It’s just a little. Just an incision, no excision.”

But doctors such as Nawal Nour, director of the Global Women’s Health Centre at Harvard Medical School, believes a “right technique” does not exist. “There are girls who suffer short and long-term consequences, even from type IV,” she says. “The clitoris on a baby girl is tiny, and in error, cutters can remove it completely. Also botched jobs can lead to haemorrhage, infection, sepsis and death.”

Back in Pattani, Peung, 33, has gathered her family together to watch her eight-month-old daughter, Mia, being cut by her mother-in-law, who is sterilising a pair of nail scissors with alcohol. Some of Mia’s cousins are playing on the floor in the living room.

Peung’s two older daughters are curious. “What are they doing? Will it hurt?” they ask. “Sunat, we all must do it,” Peung responds. “The children are so eager, but it is not good for them to watch this. It will become a phobia for ever.” She caresses her youngest infant, about to be cut. “At least she doesn’t know what’s going on here.”

The baby’s grandmother draws blood from the clitoris with the curved tip of the nail scissors, a technique she says she developed herself to be safer. Mia cries loudly.

Peung is pleased her daughter is now “complete”, but she isn’t sure why. “I don’t know what the benefit is behind it, but I believe there must be one. I know the prophet said it is desirable for the husband when women are cut. Actually in Islam we believe that women have more desire than men, so there must be something to control the women, give them humility and modesty – and this could be one way to do it. Maybe in the future the scientists will find out and then we will know the benefit. All the girls here in the south do it.”

Some names have been changed

The New Zealand Herald

March 30 2015

Baby pain can have later-life effects

Nervous system affected, says researcher.

by Martin Johnston

When newborn babies are subjected to pain from medical procedures, it shapes the development of the brain and can leave them with an altered pain response later in life, a conference has been told.

Premature babies often had more than 10 procedures a day and several hundred during their hospital stay, said children's anaesthetist and researcher Dr Suellen Walker, who addressed the NZ Pain Society conference in Auckland.

Dr Walker, of University College London, said the old belief that babies experienced pain less than adults had been disproved by techniques such as recordings of electrical activity showing responses to pain in the expected parts of a baby's brain.

Anaesthetic and pain-relief drugs were now widely used in neonatal intensive care units (NICUs), she said, but it was difficult to provide adequate pain relief for some of the brief procedures babies had to have and there was variable implementation of pain-relief guidelines.

"The developing nervous system is sensitive to changes in levels of activity. Increased pain exposure in early life can produce changes that are not seen after the same injury later in life, and which can produce long-term changes in sensory thresholds and response to future pain."

Her research group is periodically checking on about 300 children born very prematurely - before 25 weeks and six days' gestation - and treated in an NICU. Interviews and tests of the participants, who are now 19 years old, are being done at present. When they were 11 it was found they were less sensitive to hot and cold than a comparison group drawn from their school classmates.

"Researchers in Canada have shown associations between pain exposure in neonatal intensive care and alterations in brain structure and pain response later in life," Dr Walker said.

"A number of studies show the higher your pain exposure in ICU, the more likely you are to have structural changes in the brain.

"Our laboratory research ... is investigating the mechanisms that cause long-term changes following neonatal surgical injury and evaluating which analgesics are best for preventing or modifying these effects."

It was important for doctors to recognise that patients coming in for follow-up surgery, such as children with a congenital heart defect first treated in an operation soon after birth, might suffer greater pain than new patients.

She said that although the clinical evidence for persistent changes to sensory responses following early-life pain and injury was growing, the reported effects varied in the impact, degree and direction - some studies found decreased pain sensitivity, others an increase - because of varying research designs.

Is anyone surprised?

Swazi Observer

March 29, 2015

Soka Uncobe: Circumcision slogan gone wrong?

by Welcome Dlamini

A social and behaviour change communication campaign aimed at encouraging at least 80 percent Swazi adult males to circumcise within a one year period seems to have been misinterpreted by some of those it targeted.

A study by two university lecturers; one from the Department of Anthropology at the University of the Witwatersrand and the other from the Department of Theology and Religious Studies at the University of Swaziland, reveals concerns of how the slogan used in the campaign led people to behave in a way that could have put them at risk of contracting HIV/AIDS.

The campaign’s main aim was HIV prevention, seeing that Swaziland has one of the virus’ highest prevalence rates globally.

The slogan for the campaign was ‘Soka Uncobe’ – which should translate to ‘circumcise and conquer’.


It turns out that this slogan led people into believing that once they had been circumcised, they had conquered HIV/AIDS as well as their sexual partners and, therefore, could sleep around without using protection.

The campaign conducted awareness and advocacy with royalty, traditional leaders, unions, businesses, religious groups, schools, and government to create awareness of and understanding of MC, using interpersonal communications, mass media, especially radio, and educational print materials.

The project was a collaboration between the ministry of health (MOH), Swaziland National AIDS Programme (SNAP), National Emergency Response Council for HIV/AIDS (NERCHA), Population Services international (PSI) and Pulse.

The study by the two lecturers is titled ‘Christians’ Cut: Ecumenical Perspective on Male Circumcision amid Swaziland’s HIV Epidemic’ and it focused on Christian members of the kingdom’s three main church organisations, namely the League of African Churches in Swaziland (LACS), the Council of Swaziland Churches (CSC) and the Swaziland Conference of Churches (SCC).

Part of the study’s focus was on how the Christian religion (given that a majority, about 90% of Swazis are Christian) influences acceptance, rejection or understanding of male medical circumcision (MMC).

A number of those interviewed for the study pointed out to that people participated in circumcision because of the material incentives that were being handed out and the branding of the MMC campaign such as the free literature and gifts distributed at circumcision clinics and NGOs.

They said such gifts and literature “seductively clouded peoples’ own critical examination of the procedure and its effects on gender identities and sexual relations”.


States the study: “One Zionist LACS member noted, ‘some young men are drawn by pull factors such as T-shirts, juice bottles, tracksuits which are distributed as incentives to every male that visits the clinics to circumcise. These material pull factors are branded with the circumcising NGO or clinic, and more widely under the banner Soka Uncobe, which several people across churches saw as unappealing or dangerously inciting male sexual proclivities and broad licences to no longer use contraception.”

Quoting another study on socio-cultural aspects of MMC by Khumalo (2014, page 135), the study notes that there are those who argue that some men misinterpreted the Soka Uncobe slogan to mean once circumcised they had conquered HIV and AIDS or perceived themselves to be sexual conquerors of their partners.

This view, according to the study, was echoed across several church members and was strikingly highlighted by one woman from an SCC church who narrated the following: “I have a younger brother who is 18 and he is circumcised.


Ever since he performed this surgical procedure he has been sleeping around with many girls of his age. His friend partly attributes this behaviour to the manner in which circumcision is promoted in the schools.”

The woman informed the study that her brother’s friend told her that MMC promoters who visited their school would use a metaphor of a bush knife in their illustrations to explain that circumcision also strengthens your manhood.

There is the misconception that the ‘bush knife’ (penis) is sharpened by circumcision, and young men develop insatiable sexual appetite. Such language can be destructive because it dupes young men to think that they are justifiable to sleep around because their ‘bush knives’ are now sharpened,” further states the study.

It further found that the language used by the promoters and the advertisements as well as slogans for circumcision were also persuasive and indirectly manipulative.


“For example, ‘lisoka lisoka ngekusoka’, which implies that you are not a real man unless you are circumcised; and ‘soka uncobe’ which depicts a circumcised man as a conqueror. Some adverts would even state that once you circumcise you become ‘lichawe’- a hero,” study points out. It goes on to add: “For both women and men we spoke to, the branding of the MMC campaign was problematic. It potentially shored up male sexual supremacy and forms of violent masculinity, pointing to the otherwise ambiguous facets of general patriarchy, which in Swaziland endures as part of everyday life and “Swazi Culture.”

Times Live (South Africa)

March 26, 2015

Mother jailed for circumcision of 4 year-old daughter in Ivory Coast

A mother who took her four-year-old daughter to be circumcised was sentenced to one year in prison Wednesday in the north of the Ivory Coast, where such convictions are rare.

A relative who accompanied her for the procedure on March 11 received the same jail term, as well as a fine of 360,000 CFA frances ($600), in what prosecutors said was a "warning" to those still carrying out female genital mutilation on young girls.

Another mother, whose five-year-old daughter was also mutilated in the same village, was acquitted, while the person who carried out the circumcisions has gone on the run and is wanted by police.

The sentence is the lowest possible under Ivorian law.

"This is a warning," said prosecutor Hamed Diomande.

Despite efforts by aid workers to raise awareness, he said, "you continue to circumcise your children". "The next time, the punishment will be heavier," he continued.

Female genital mutilation is a "tradition", one of the defendants said in court, saying they had not known it was against the law and promising to never do it again.

Nine women were sentenced to jail terms in 2012 for the female circumcision of around 30 young girls in Katiola, in what the United Nations said was the first criminal prosecution of its kind in Ivory Coast.

Female circumcision affects around 38 percent of the female population in Ivory Coast, according to the UN Children's Fund (UNICEF). The practice is particularly prevalent among northern Muslims and animists in the west of the country where up to 80 percent of females are circumcised despite a 1998 ban and numerous initiatives aimed at eradicating it.

Wednesday's conviction is "a positive sign," said Louis Vigneault-Dubois, spokesman for UNICEF in Ivory Coast.

The elephant in the room is now trumpetting loudly, while the Double Standard flies high.

BBC News

March 18, 2015

Vagina piercings count as FGM, even if you're a consenting adult

by Amelia Butterly

All women who have a pierced vagina will be classified as having suffered female genital mutilation (FGM), the Department of Health says.

Even if an adult consents to having it done, she will still be said to have undergone a "harmful procedure".

The Department of Health says it'll take "every precaution" to record "abusive" genital piercings.

But the Tattoo and Piercing Industry Union (TPIU) has told Newsbeat body piercing is "in no way related" to FGM.

"It undermines the serious nature of FGM to in any way compare it to a consensual body piercing. FGM is often carried out on minors by force and clearly without consent," says spokesman Marcus Henderson.

More than 200 FGM-related cases were investigated by the police nationally in the past five years.

The government advises you to contact the NSPCC if you or someone you know is worried about FGM - and if there is immediate risk you should tell the police.

"Most responsible piercers won't do any intimate piercings on anyone under the age of 18," says Mr Henderson.

"Now we're faced with a situation where men are able to make up their mind and consent to an intimate piercing where women are not."

One London-based professional piercer, who wanted to remain anonymous, says his customers do not consider genital piercings to be at all similar to FGM.

"It's nothing to do with mutilation," he says. "I think [piercing] is more to do with adornment of the body or the discovery of new sensations."

A Department of Health spokeswoman said: "While there are challenges in this area and adult women may have genital piercings, in some communities girls are forced to have them.

"The World Health Organisation has quite rightly defined this as a form of FGM.


The government has said it has no plans to amend the Female Genital Mutilation Act 2003 to specifically include cosmetic surgery on the genitals.

In its report the Home Affairs Select Committee of MPs said the Act should be changed to make it clear these procedures would be a criminal offence if done on girls under 18, unless for mental or physical health reasons.

Earlier story

The Guardian

March 14, 2015

Outlaw 'designer vagina' surgery, say MPs

Home affairs committee says FGM Act should be expanded to cover cosmetic procedures that have no medical purpose, though government says this is already covered in law

by Alexandra Topping

Genital surgery to create so-called “designer vaginas” should be outlawed under legislation designed to prevent female genital mutilation, according to a group of MPs.

A report from the home affairs select committee has called the laws governing female genital cosmetic surgery ambiguous and said the 2003 FGM law must be changed so it covers the procedures, which have no medical purpose.

“We cannot tell communities in Sierra Leone and Somalia to stop a practice which is freely permitted on Harley Street,” said Keith Vaz, the chairman of the select committee.

[Strictly speaking, cosmetic surgery is already outlawed in England under the  Female Genital Mutilation Act, 2003: (2)But no offence is committed by an approved person who performs—
  (a)a surgical operation on a girl which is necessary for her physical or mental health..
- because it is a stretch to say that a "designer vagina"  is "necessary for her ... mental health"]

The government has previously stated that the Female Genital Mutilation Act 2003 does not contain any exemption for cosmetic surgery, and it had no plans to amend the act. But “evidence demonstrates that the police, midwives and campaigners would all like to see greater clarity on this point,” stated the report.

The select committee also risked creating a diplomatic spat with the Royal Colleges – which represent medical professionals – accusing their members of not doing enough “to encourage their members to report cases of FGM”.

The report notes that in Heartlands hospital in Birmingham, 1,500 cases of FGM were recorded over the past five years, with doctors seeing six patients who have undergone the procedure each week. “There seems to be a chasm between the amount of reported cases and the lack of prosecutions,” it says. “Someone, somewhere is not doing their job effectively.”

The first ever FGM case was brought to trial this year, but in February the NHS doctor Dhanuson Dharmasena, 32, was acquitted in less than 30 minutes amid claims that the Crown Prosecution Service had brought the case because of political pressure.

Given the failure of the prosecution, there may be an “even greater reluctance” to report, the study said, but it urged the Royal College of GPs to give training to every doctor about FGM: “Doctors are on the front line. Their professional organisations must do more to encourage their members to report cases of FGM. Without their active reporting of these cases, the full extent of FGM will remain hidden.”

Decrying the prevalence of FGM in the UK and the lack of prosecutions, the report accused the Crown Prosecution Service, police and health professionals of playing pass the parcel.

“The DPP informed the committee that she could only prosecute on the basis of evidence, the police said that they could only investigate on the basis of referral, and the health professionals told us that they could not refer cases because their members were not fully trained and aware of the procedure,” it states. “While agencies play pass the parcel of responsibility, young girls are being mutilated every hour of every day. This is deplorable.”

The select committee welcomed the government’s decision to make reporting FGM mandatory, but said it remained unclear what would happen in the event that a professional should fail to make a report. It called on the government to set out the sanctions that would apply and establish an advisory panel of FGM campaigners, to be consulted before any major policy decisions are taken.

Equality Now, a campaign group, said the focus should not be on prosecution, but prevention.

“Mandatory reporting should go hand-in-hand with mandatory training of those professionals who have a child safeguarding obligation,” said Mary Wandia, the FGM programme manager at Equality Now. “Such training is urgently needed and is the next step. It should come before holding those people to account.”

The Guardian
March 13, 2015

Man gets world's first successful penis transplant after botched circumcision

by David Smith in Johannesburg

A 21-year-old man in South Africa has received the world’s first successful penis transplant and accepts the organ as his own, doctors said on Friday.

The operation took a team of surgeons nine hours and has allowed the patient to become sexually active.

The man’s penis was amputated three years ago after a circumcision went wrong at a traditional initiation ceremony. The patient, who has not been named, received the new organ from a deceased donor on 11 December and has regained all functions.

Professor Andre van der Merwe, head of the urology division at Stellenbosch University, whose staff carried out the operation at Tygerberg hospital in Cape Town, said the recipient is doing “extremely well” both physically and psychologically.

“The patient accepted the penis as his own,” he told the eNews Channel Africa (eNCA). “He told me in no uncertain terms that the fact it belonged to somebody else is completely out of his mind and he’s moved on with this as his own penis. That’s absolutely the way we want it.”


“We repaired a small hole in his urethra, the pee pipe, last week so we could remove his catheter and just that induced an erection on the operating table. We were so surprised at that erection that he certainly is getting very good results for his transplant.”

Van der Merwe described the groundbreaking operation as “very, very difficult”. He told eNCA: “What we did was to manage the small blood vessels in the penis, which are really only a little bit more than a millimetre wide, to existing blood vessels in the abdomen that has come down, and we could connect that up.
“So many things could have gone wrong. Actually one of the blood vessels did clot up for a few hours. We could relieve the clot, thankfully.”

Immediately after the operation there was an “oozing” that led to bleeding, he continued. “We were dealing with infection and clot formation and bleeding. That was the most difficult thing initially.”

But the patient is “a very fit young man” and making “a good recovery”.

...the South African man and his partner are coping well, according to Van der Merwe. “Huge psychological effects. If you add an organ you make a ripple effect on somebody’s ego, you can even induce psychosis …
... bogus surgeons are blamed every year for numerous deaths and injuries, including gangrene caused by unsterilised blades. Experts estimate that around 250 lose their penises each year to medical complications.

“There is a greater need in South Africa for this type of procedure than elsewhere in the world,” Van der Merwe said in a statement. “For a young man of 18 or 19 years, the loss of his penis can be deeply traumatic. He doesn’t necessarily have the psychological capability to process this. There are even reports of suicide among these young men.” ...

But not so fast:
March 13, 2015

The Penis Transplant Is Not A Breakthrough Yet

by Benjamin Davis

The news of the first penile transplantation washed across Twitter  feeds this morning and the usual casually assertive statements were made. One of the surgeons involved in the operation even trumpeted the results as “a massive breakthrough” in a press release from his institution.

Allow me to deflate the party somewhat on this “breakthrough.” As described, the surgeons sewed very small nerves and vessels together. This is done every day, in every hospital in the US (think vasectomy reversal). There is nothing surgically novel about sewing two ends of a urethra together or really small blood vessels either for that matter (remember that John Wayne Bobbitt’s severed penis was sewn back on relatively quickly).

But long-term function is a different — and major –  issue. The penis in question has only been functioning for a few months. It is the long-term function that is important, particularly in light of the fact that rejection of transplanted organs often takes years, not months. Would the headlines be different if the patient loses his penis next month? Or if he develops a post-transplant lymphoproliferative disorder, which is commonly deadly?

The good news: The patient appears to be doing well and has erections. ...  One media misconception laid to rest: If he had a 1 cm penis to begin with (as described) then his ability to orgasm and ejaculate were already preserved. It is the erection and urinary ability that is new.

But similar, albeit perhaps more strident sentiments, were expressed when the first double-hand transplant and face transplant patients were announced. And how is that going? Well, I would say extremely slowly but with some limited success....

My larger concern for these patients is that most of these young men whom the operation could be helpful for are not living in medically accessible regions. As outlined by reports from the CRL Commission in South Africa, over 500,000 men were hospitalized from ritual circumcisions.

Transplanting the penis was the easy part. Taking care of it will be the really hard part. Transplant patients need constant blood work, medication changes, biopsies, and exams (remember the first hand transplant patient refused to take his meds – and his hand was removed). For patient’s who live in remote areas of the world with limited medical care a penis transplant is not going to help and unlikely to be a common procedure in the future. Sorry. I wish I thought differently.

KDAL radio

March 10, 2015

Surgery may not stop locker-room taunts about penis appearance

by Madeline Kennedy

(Reuters Health) - Surgery to change penis appearance may not do much to stop locker-room teasing in high school, a new study suggests.

The urologists who conducted the study say parents who bring their young sons to be circumcised - or to get rid of some leftover foreskin after a circumcision - often say they're worried that their child may be teased later in life because of the appearance of his penis.

“We were looking to find out if the parents’ concerns about teasing in the locker room were valid,” said Dr. Chris Cooper, the study’s senior author from the University of Iowa.

As reported this month in The Journal of Urology, the researchers surveyed 290 undergraduate men at the University of Iowa about their high school gym classes and sports and any teasing they witnessed or experienced in the locker rooms.

Overall, 47 percent had seen others being teased about their penises - usually on a weekly basis.

Penis size was the reason for 83 percent of the taunts, the researchers found. A third of taunts focused on not being circumcised or having a “strange” looking penis.  [So which is it? The two are not synonyms - and what do they propose to do about the strange-lloking penises - especially the ones whose strangeness is dure to a botched circumcision?]

Only 10 percent of the students reported actually being teased themselves, but Cooper said that may be an underestimate. Again, though, penis size and being uncircumcised were commonly to blame for the teasing.

The vast majority of the college students in the survey were circumcised, the researchers write. There was no difference between the uncircumcised and circumcised groups when the students were asked if they wished their penis had a different appearance. [But there is a big difference in the practicability of changing it, so the question is hardly equivalent in the two groups.]

The researchers found that the experience of being teased or witnessing teasing also did not have a significant effect on whether students wished for a different penile appearance.

Furthermore, being uncircumcised did not increase a student’s overall odds of being teased.

“The question then becomes: for those young men who were teased, would corrective [?] surgery have made a difference?” Cooper said in a phone interview. [His cultural bias is showing.]

The answer, he said, is that while some children might benefit from having surgery to correct the appearance of their penis, the main subject of teasing - size - is not correctable by surgery. 

Cooper said the study's results are limited, because they only surveyed one group of men from one Midwestern college, with higher-than-average circumcision rates.

Charbel El Bcheraoui, a global health researcher at the University of Washington in Seattle who was not involved with the new study, told Reuters Health by email that teasing "is a form of verbal bullying which can have long-term and short-term psychological effects on the victim."

Those risks include social isolation and decreased self-esteem, said El Bcheraoui.

This type of teasing should be addressed using social and educational strategies, he said.

As for whether an individual should undergo surgery to alter the appearance of his penis, Cooper said it's ultimately a judgment call. [...raising the question of whose judgement we are talking about.]

SOURCE:   The Journal of Urology, published March 2015.

The Local (Norway)

March 10, 2015

Norway hospital does first ritual circumcision

A newborn baby had his foreskin surgically removed on Monday under local anaesthetic, while his Muslim parents waited outside the operating room. 

“They were very happy,” Ole Tysland, head of surgery at Sørlandet Hospital in Kristiansand, said of the couple. “Most people are glad that we now have the possibility to do this in the hospital.” 

Tysland said that several doctors in his hospital believed carrying out the operation was unethical. 

“They would say that this is a type of surgery that is not indicated. It’s more a tradition than a necessary operation,” he said. “But they don’t have to do it. We have found other doctors that don’t mind, so we use a doctor who thinks this is OK.” 

He said that the hospital did not allow religious officials, or even the children’s parents, into the operating theatre while the circumcision was taking place. 

“They stand outside the door and they take the child when we come out with it, and I don’t think it’s a problem. They accept this way of doing it.” 

Ritual circumcision has in theory been available under Norway’s public health system since January 1st, following a bill in parliament in 2013. 

But it has taken several months for hospitals to start carrying out the operation. 

Dr Tysland said that Sørlandet was only offering ritual circumcision to boys under four weeks old, as otherwise the child would require an expensive general anaesthetic. 

Norwegian Health Minister Bent Høie caused an uproar in the international Jewish community when he first proposed regulating circumcision, known as Brit Milah in the Jewish community, at the start of last year.

In the end, Norway’s government stopped short of mandating hospital circumcision, instead only insisting that a doctor must be present. 

It did, however, rule that public hospitals must start offering the operation to encourage Jewish and Muslim parents to have it done in the safest possible way. 
Earlier story

Sun-Sentinal (Palm Beach, Florida)

March 10, 2015

Judge orders West Boynton mom's arrest in circumcision case

by Mark Freeman

Despite the threat of being jailed Tuesday, a West Boynton mother hid with her 4-year-old son in a domestic violence shelter, the latest twist in a widely reported court fight to stop the boy's planned circumcision.

But Palm Beach County Circuit Judge Jeffrey Dana Gillen still signed a warrant for Heather Hironimus' arrest, refusing requests from her lawyers to first consider a mental health exam of the boy and appointing an independent guardian to speak on the child's behalf in court.

"The child is scared to death of the procedure and doesn't want it," said attorney Thomas Hunker. "There have been no safeguards put in place to protect the child's psychological and emotional condition with regards to this surgery."

Attorneys for the child's father, Dennis Nebus of Boca Raton, requested the crisis shelter's name and location during a brief hearing Tuesday, so the mother could be served with a court order for Nebus to pick up his son. But Gillen said he would not order the disclosure of the shelter's name.

The mother and son "sought refuge" at the shelter on Feb. 23, when it was her regular time to have custody of the boy, Hunker said. Nebus then was attempting to make arrangements for a Broward doctor to remove the child's foreskin.

The warrant authorizes law enforcement to take Hironimus into custody, on the grounds that she failed to appear before the court Tuesday as ordered. Such warrants typically require apprehended individuals to be brought before a judge within 24 hours.

"She doesn't believe she should be incarcerated for protecting her child," Hunker said.

On Friday, Gillen declared the mom in contempt of court for violating an order enforcing a 2012 parenting plan, which makes the dad responsible for arranging the circumcision. The mom and dad did not marry either before or after the boy's birth on Oct. 31, 2010.

After Nebus testified Friday that he can't find his son, the judge ordered the mom to appear in his courtroom with the child by 2 p.m. Tuesday.

"I was hoping the mother was going to be here," Nebus' attorney May L. Cain said after learning Hironimus remained at the shelter.

"I was, too, obviously," Gillen replied.

The judge last week called it "reprehensible" for the mother to spirit away the boy.

"I will allow her to avoid incarceration or get out of jail if she signs the consent to the procedure," Gillen said Friday.

The judge found the mom had willfully violated the plan she signed when the boy was 1. The judge also said Hironimus had committed a "direct, contemptuous violation" of court orders by continuing to team with circumcision opposition groups — called "intactivists" — that have "plastered" the child's photos and name "all over the Internet."

After a state appellate court in December held up Gillen's earlier ruling enforcing the parenting plan, the judge instructed Hironimus and Nebus to "protect the child from any exploitation."

Gillen has ordered the media not to release the name or photo of the child, and the Sun Sentinel has filed a motion seeking to vacate the order. A hearing on the matter is scheduled before Gillen on Wednesday.

More than a dozen protestors stood outside the county courthouse in Delray Beach on Tuesday. Some carried signs reading, "His body his rights" and "circumcision is a sex crime."

"It's outrageous that this could actually be happening," said Jennifer Cote of Pembroke Pines, a mother of a 2-month-old son and a 4-year-old girl. "We think this is a choice [Hironimus' son] should make for himself."

Kristen Shockley, of Boynton Beach, one of Hironimus' longtime friends, said it's important to consider the boy is well "past the infancy stage." Shockley said her 9-month old and 4-year-old sons were not circumcised since there was no medical reason for it, nor any cosmetic or religious purpose.

Neither Nebus nor Hironimus is Jewish, but the dad testified last year he thinks circumcision is "just the normal thing to do" and he decided late in 2013 to press for it after noticing his son was urinating on his leg. The father says the boy has a condition called phimosis, which prevents retraction of the foreskin, but the mother has said there is no such diagnosis. 

The American Academy of Pediatrics says the benefits of newborn male circumcision are lower risks of urinary tract infections; getting penile cancer; and acquiring HIV, the virus that causes AIDS.

Judge Gillen mentioned these benefits in court last week, and called the procedure "very, very safe."

Still, the most recent federal statistics indicate circumcision has been waning in popularity across the country.

For Jewish families concerned about following the ancient tradition of circumcisions, a group called Doctors Opposing Circumcision advocates an alternative ceremony called a Brit Shalom, "which does not cut the genitals or risk physical or psychological harm to the child."

In an emergency motion filed last week, Hunker wrote the boy "is aware of what is happening and is terrified by the procedure. He is also angry that the procedure is being forced upon him."

The attorney said the boy needs to be examined a by mental health expert so the court can "consider the child's emotions and feelings on the matter."

"This is not a situation where [the child] is a newborn; he is old enough to remember the procedure and what his body looked like before," Hunker wrote. "Removal of part of the most private part of his body could emotionally scar [the child] for the rest of his life."

Nebus has accused the mother of putting fear into the boy.

"My son has mentioned things to me that he's scared to have his penis cut off," he testified.

Earlier story

Wall Street Journal

March 9, 2015

NYC Delays Decision to Repeal Mandatory Parental Consent for Jewish Ritual

by Michael Howard Saul and Melanie Grayce West

Mayor Bill de Blasio’s administration has delayed plans to repeal a city regulation requiring parental consent before a Jewish circumcision ritual is performed.

The ritual can cause herpes infection in infants.

Last month, administration officials announced a tentative agreement with a group of Jewish leaders in which parental consent would no longer be needed to perform the ritual known as metzitzah b’peh in which the mohel, the person who performs the circumcision, sucks blood from the baby’s wound.

Administration aides initially said the proposal would be presented to the Board of Health this month. Officials said Monday the proposal is now slated to be presented to the board in June and voted on at the panel’s next meeting.

“The administration and the coalition of religious leaders are formalizing specific terms of the agreement around metzitzah b’peh,” the city said in a statement from the Department of Health and Mental Hygiene released Monday.

The parental consent policy, approved by the board in 2012 when Michael Bloomberg was mayor, drew outcries from some in the Jewish community who lambasted the regulation as an attack on religious freedom. The ritual is practiced mostly by ultra-Orthodox Jews.

A person familiar with the negotiations between the religious community and the city said Monday the delay in presenting the proposal to the board was largely related to the city working out the specifics on how public health investigations will be conducted. There were some other legal issues, as well, the person said.

Another person familiar with the matter said city officials were concerned about rushing the proposal. Officials want the proposal to be as strong as possible, this person said, because the administration is asking board members, many of whom were appointed by Mr. Bloomberg, to reverse themselves.

The delay was not a concern at all to David Niederman, the president of United Jewish Organizations of Williamsburg and North Brooklyn, and a rabbi involved in the negotiations with the city over the policy.

“The mayor has personally committed to ensure public safety in a very responsible and collaborative way with the community,” Rabbi Niederman said. “These delays, I understand, are procedural stuff with the city. I have no doubt that everyone is on the same page and that this issue is going to be resolved to the satisfaction of all concerned.”

The Wall Street Journal
February 27, 2015

A Bad Call on Risky Circumcisions

by the Editorial Board

The herpes simplex virus, common and relatively harmless in adults, can be deadly to babies. Such infections in newborns are blessedly rare, but one thing is known to increase the risk significantly: the circumcision ritual called metzitzah b’peh, practiced by many ultra-Orthodox and some Orthodox Jews, in which a circumciser, or mohel, sucks blood from a newly cut penis with his mouth.

The New York City Health Department, American Academy of Pediatrics, Centers for Disease Control and Prevention and other authorities have long warned about the dangers of the practice. The Health Department has linked it to more than 12 herpes cases, and two deaths, since 2000, and has tried to get mohels to stop doing it.

That is why it is distressing to see Mayor Bill de Blasio and Orthodox leaders celebrating a deal they made this week to abandon the city’s modest effort to regulate the practice, and instead leave it to the ultra-Orthodox community to help limit the damage metzitzah b’peh does — but voluntarily, and only after babies get sick, not before.

Mr. de Blasio wants to stop requiring parents to sign a waiver acknowledging the risks of metzitzah b’peh. Rabbis called that policy, begun under Mayor Michael Bloomberg, an unconscionable infringement on religious freedom. They refused to use the forms and sued the city.

And so Mr. de Blasio, who has pleased the potent Orthodox voting bloc by ridiculing the policy as unenforceable while making no visible effort to enforce it, has decided simply to let the mohels do their thing, until a baby gets sick. The plan then is to do a series of DNA tests; if the baby’s mohel has the same herpes strain as the infected baby, he will be forbidden to do circumcisions.

The plan needs Board of Health approval. The board should say no and take a stand for basic hygiene and common sense. Otherwise, this will be a city that requires tattoo artists to take infection-control courses and use sterile tools but tolerates an amateur surgery in which infection is fought with no more than perhaps a swig of Listerine.

The administration says it will ask hospitals and doctors to distribute information about the risks of metzitzah b’peh, which should include accurate descriptions, including photographs, of the lesions and brain injuries suffered by babies whose safety their rabbis — and mayor — have allowed to be jeopardized.

Earlier Story

Broward Palm Beach New Times (Florida)
March 6, 2015

Mother of Boy in Circumcision Case Has Vanished With Child; Judge Orders Her to Return

by Chris Joseph
(Note: Judge Jeffrey Dana Gillen has requested the media to withhold the name of the child and the names of the doctors in this case, due to the nature of this story. New Times has published these names in past stories.)
Heather Hironimus, the mother of a 4-year-old boy caught in the middle of a circumcision case, has been ordered to appear before Judge Jeffrey Dana Gillen of the 15th judicial district in Palm Beach County on Tuesday or be found in contempt.
In a hearing held Friday, Gillen heard testimony from the boy's father, Dennis Nebus, over how Hironimus has fled and vanished with their son. Nebus also asked the court to have Hironimus stop allowing anti-circumcision activists to continue using their son's name and likeness on the internet. She had been ordered to do so in the past but has disobeyed that court order.
The case revolves around the separated couple's fight over whether the child can be circumcised. The couple had previously agreed that Nebus would pay for and schedule the child's circumcision. But Hironimus has been arguing that there is no medical reason for her son to be circumcised and that the procedure could harm or even kill the boy. The practice is even more scrutinized now that the boy is no longer a newborn.
However, Nebus testified that three doctors who were supposed to perform the procedure on the boy had removed themselves from doing so after apparently receiving what he called "threatening letters" from activists calling for the father not to have the boy circumcised. Nebus claimed that he too had received death threats.
During his testimony, Nebus detailed an incident where Hironimus burst into a doctor's office where the child was being examined in order to schedule a procedure. Nebus said she "threw a tantrum," and yelled at the medical staff that she had not given consent for the boy to be examined by the doctor. Nebus said that their son, who had witnessed the outburst, was "visibly shaken." He also claimed that the boy had expressed fear over getting a circumcision. Nebus hinted on the stand that this was due to Hironimus using "scare tactics" on the boy, though he didn't make clear what those tactics might've been.
Nebus also testified that the mother had been allowing the anti-circumcision activists to use the child's likeness and name on their websites, as well as on posters and picket signs during protests outside the courthouse as well as at CityPlace.
Gillen said he expected that, although Hironimus was ordered not to allow the boy's name and likeness to be taken from her personal Facebook and used on these websites, she did anyway. "I expected this to happen," Gillen said during his ruling, "that the child's likeness would be used, making him an object of curiosity on the Internet."
More pressing, however, is that Hironimus and the child have gone missing since the last scheduled doctor's visit on February 19. Nebus testified that he visited the home of the mother to take the boy for his prearranged visiting time and found no one home. The car was also gone, and when he tried calling Hironiumus, he said the phone was turned off.
Hironimus was not present during Friday's hearing, and the judge ordered that she and the child report to court on Tuesday by 2 p.m. or face the consequences.
Gillen had ordered a gag order on Hironimus to not speak to the media at a previous hearing. The case has made headlines, has been the cause of much debate on the internet and has even caught the attention of actor Russell Crowe. Anticircumcision activists -- sometimes called "intactivists" -- have been extremely vocal about the case and have befriended Hironimus on Facebook and social media. They've also launched several websites with the boy's name.
Nebus testified that the boy's likeness had been used as early as December, when the mother allowed the groups to take a recent photo of the child with Santa Claus taken at a department store. They were also given access to the mother's Halloween photos of the child.
"It's unfortunate that due to the mother's actions, the child has been placed in this position -- the light of too much scrutiny for a little boy," Gillen said. "I blame the mother for this. She has willfully denied a court order and has provided the father with no information of their son's whereabouts. Leaving the father to wonder where his son is is reprehensible."
Gillen put a pickup order into effect for Hironimus.
"If she does not [appear with the child on Tuesday], I will sign a writ of bodily attachment."
This means if Hironimos and her son do not obey the court's order, she'll be hunted down by authorities. Gillen also said he would have her passport suspended and not allow the boy to have a passport issued.
Moreover, Gillen said that he had heard enough testimony from doctors that circumcision is safe. "I have heard testimony from doctors that there are zero cases of penile cancer in circumcised males, but there have been some cases in uncircumcised males," Gillen said. "I've also heard testimony from doctors that there are less cases of STDs in circumcised males than in uncircumcised males."
Gillen, saying he wanted to "rein in this case," also added that circumcision is "short, under local anesthesia, and, at this stage of the boy's life, very, very safe."
Gillen found Hironimus in contempt of court for allowing the use of the boy's likeness on the internet and said that Hironimus is responsible for Nebus' attorney fees. Gillen reserved ruling on how much that fee is.
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