Friday, March 20, 2015

LONDON: Consented female genital piercing is mutilation

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

LONDON: FGC law should outlaw "designer vaginas" - MPs

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.”

SOUTH AFRICA: Successful (?) penis penis transplant after botch

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.

IOWA: "Taunting doesn't make males want to be cut": study

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.

NORWAY: Hospital ritually cuts first baby

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.

FLORIDA: Arrest ordered of mother protecting 4yo from cutting

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.

NEW YORK: Metzitzah: New regulations delayed

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.