Saturday, December 6, 2014

Mary Jane Minkin, MD, FACOG, stigmatizes men and pathologizes a normal body part

In an interview in 2Dun's Spread, Dr. Mary Jane Minkin, MD, FACOG, clinical professor of obstetrics and gynecology at Yale School of Medicine and staff member at Obstetrics Gynecology & Menopause Physicians, violates the ethical principle of justice by stigmatizing 70% of the males in the world, those who are not circumcised, and by pathologizing a normal body part, the foreskin, in what only can be interpreted as blatant cultural prejudice.

This starts with the media circus around the CDC proposed guidelines, of which we spoke on our previous post. The Background document by the CDC also warned (page 40):
"Furthermore, recommendations to increase rates of male circumcision in the U.S. to reduce male acquisition of heterosexually acquired HIV infection may result in stigmatization of uncircumcised men or groups of men who are not routinely circumcised should they choose to not undergo circumcision." ~ CDC
And Dr. Minkin gives us a clear example of what that meant. Asked by 2Dun whether "doing the deed with an uncircumcised man puts you at a higher risk for contracting an STI?", Dr. Minkin replies: "To be exact, yes, if uncircumcised men are more likely to get infected with [an STD], then they'd be more likely to transmit".

Dr. Mary Jane Minkin, M.D., FACOG, stigmatizes normal men 

Dr. Minkin tells us two lies in this statement, first, that the mere presence of foreskin makes a man more likely to get infected, and second that the mere presence of foreskin makes a man more likely to transmit an infection.

 But some readers will say, "the science is sound". What the readers are forgetting, what the AAP and the CDC often would like people to forget, is that adult individuals can make lifestyle choices. Humans have a capability to make rational decisions, we are not bound by uncontrollable instincts, we can make decisions about whether to have sex or not, whether to engage in safe sex or not, whether to have multiple sex partners or follow a more monogamous lifestyle, and all those decisions are not reflected in the presence or absence of a normal part of the body.

A high risk male has a larger chance of contracting STIs than a low risk individual, regardless of their circumcision status. The risk attitude has far more priority on the chance of contracting sexually transmitted diseases than submission to circumcision.

If the presence of foreskin immediately implied a higher prevalence of HIV and STIs, how can we explain that most countries in Latin America and Europe, where circumcision is uncommon, have a lower prevalence of HIV than U.S., where circumcision rates are prevalent?

Dr. Minkin's second implication, that uncircumcised males would be more likely to transmit an STI, is again fallacious and stigmatizing. Infected males will transmit infection no matter what, as the virus pollutes the sperm. The presence or absence of foreskin does not alter the composition and presence or absence of virus in sperm.

Dr. Minkin then re-states her lie: "The data is certainly suggestive that circumcised males are at less risk of acquiring—and then transmitting—certain STDs" and then says the only fully true statement:"but not to the point of saying it's okay to not use a condom."
"All sexually active adolescent and adult males should continue to use other proven HIV and STI risk-reduction strategies such as reducing the number of partners, and correct and consistent use of male latex condoms, and HIV preexposure or postexposure prophylaxis among others. " - Recommendation #2 in the proposed CDC guidelines
It is sad and corrupt when doctors and university professors, particularly in such a prestigious university, abuse their positions to pass cultural prejudice and false beliefs as science, stigmatizing in the process the vast majority of males in the world and demonizing a normal part of the body. It is simply shameful.

We recommend that Dr. Minkin takes the time to read the full Background document and review those good old ethical principles.

P.D., would it be a surprise that Dr. Minkin is originally from New Jersey, an area with high prevalence of circumcision? And why is a doctor who is "interested in all aspects of women’s health, she has a special interest in menopause" speaking about men's health? Does she teach her students based on her beliefs on circumcision - or in real science?

Dr. Minkin, you had a chance to educate the public on the importance of safe sex and risk management, but you wasted it to promote a social surgery. We are so disappointed.

Wednesday, December 3, 2014

CDC, circumcision and misleading headlines

Also posted on CircWatch
 
For anyone following the issue of genital cutting of minors in the United States, yesterday brought a plethora of new and misleading headlines:

But are these guidelines really such endorsement?

Or is it that the media is hungry to present benefits and call for a universal endorsement, something that really hasn't happened?

It is our opinion that these headlines are nothing but a feeble attempt to manipulate the public opinion, under the assumption that everybody is too lazy to go to the source materials.

Anyone wishing to produce objective reporting on the CDC guidelines should start by fully reading and understanding the 8 pages draft document and the 60 pages technical report. It is unlikely that any of the reporters lending their names to the apparently carefully scripted articles, read any of the documents.

But we did, so let's share our interpretation.

The CDC guidelines refer to counseling. Counseling does not mean immediate and universal endorsement. Counseling means aiding a person through a decision-making process, and that is what the guidelines attempt to do, to counsel patients or parents through a decision-making process.
In this decision making process, the CDC considered 3 main categories of individuals based on the age range: neonates and children, adolescents, and adults.

The CDC also considered the sexual orientation and lifestyle choices as factors to be weighted during this decision making process. And for those willing to go deep enough (as deep as page 36 of the technical report), the CDC also gave consideration to the fact that parents deciding for a newborn raise concerns about autonomy, including the argument that "a man with a foreskin can elect to be circumcised but if circumcised as a newborn, cannot easily reverse the decision". The PHEC (Public Health Ethics Committee) subcommittee is, however, of the opinion that "both a decision to circumcise and a decision to not circumcise are legitimate decisions". This is one opinion that genital integrity promoters and people for the rights of the child would oppose though.

For those saying that the CDC is fully recommending circumcision, they probably need to read in detail where the technical report indicates that "There are advantages and disadvantages to performing male circumcision at various stages of life" and one of the listed disadvantages of neonatal circumcision is that "the newborn has no ability to participate in the decision".

The guidelines recognize that in the case of adolescents, both the adolescent and his parents should be involved in the decision-making process.

Let's make one thing clear. One of the main reasons for the CDC's discussion of circumcision has to do with the African trials on circumcision and HIV, considered to be evidence that circumcision could help reduce the risk of heterosexual transmission of HIV from infected females to males. The role of the CDC is not to discuss each one of those studies and their validity, strengths and flaws, but to make their recommendations based on currently accepted medical practices and standards. So of course an important premise of these guidelines is the so-mentioned potential benefit of reducing the risk of heterosexual transmission of HIV from infected females to males. As such, it is not within our current scope to discuss the African trials, something that has been already done by others in detail, but to discuss how the CDC interpreted those trials in reference to the U.S. conditions.

When discussing adult circumcision, the CDC recognizes both the documented benefits and limitations of circumcision as part of the prevention of HIV, that is:

  • that circumcision does not replace the need for condoms and safe sex,
  • that circumcision does not reduce the risk of male to female transmission
  • that circumcision does not reduce the risk or male to male transmission,
  • that circumcision does not reduce the risk of transmission through anal or oral sex, or for intravenous drug users.
In other words, that circumcision would only curb the transmission of HIV from females to males during vaginal penetration.


So, with those premises, the guidelines recommend a discussion of the person's HIV risk behavior, HIV status, sexual preferences and gender of the sexual partner, in order to provide proper guidance depending on individual circumstances.

"The PHEC subcommittee concluded that the disadvantages associated with delaying male circumcision would be ethically compensated to some extent by the respect for the integrity and autonomy of the individual."
And what are those "disadvantages"? A slightly increased risk of UTIs during the first year of life (risk of UTIs is low and they are generally easily treatable) and the possibility of the adolescent having a sexual debut prior to counseling and assessment of risks, which could potentially expose the adolescent to the risk of heterosexually transmitted HIV from infected female partners.
The CDC then states that:

"The prevalence of HIV infection in the United States is not as high as in sub-Saharan Africa, and most men do not acquire HIV through penile-vaginal sex. Targeting recommendations for adult male circumcision to men at elevated risk for heterosexually acquired HIV infection would be more cost effective than offering routine adult male circumcision. Men may be targeted according to sexual practices or an elevated prevalence of HIV within a geographic region or race/ethnicity group. "

Also, regarding sexually active individuals:

"All sexually active adolescent and adult males should continue to use other proven HIV and STI risk-reduction strategies such as reducing the number of partners, and correct and consistent use of male latex condoms, and HIV preexposure or postexposure prophylaxis among others."
So, are these guidelines an immediate and universal recommendation for circumcision? No, as much as biased media and individuals would like it to be, it is not.


The CDC gave slight consideration to sexual effects of circumcision. Again, we need to consider that they are reviewing existing medical standards, practices and publications (and it is noteworthy that proper discussion of the male foreskin is so absent from American health books that even pictorial representations of the foreskin are missing most of the times except in the context of its removal through circumcision). So, the guidelines devote the full length of a single paragraph to the discussion of sexual effects from circumcision:

"The foreskin is a highly innervated structure and some authors have expressed concern that its removal may compromise sexual sensation or function. However, in one survey of 123 men following medical circumcision in the United States, men reported no change in sexual activity and improved sexual satisfaction, despite decreased erectile function and penile sensation. Furthermore, a small survey conducted among 15 men before and after circumcision found no statistically significant difference in sexual function or sexual satisfaction. Other studies conducted among men after adult circumcision have found that relatively few men report that there is a decline in sexual functioning after circumcision; most report either improvement or no change."

This paragraph acknowledges the histological studies of John Taylor and Sorrells' study on fine touch pressure thresholds, but not the European surveys of Bronselaer in Belgium and Frisch in Denmark (both of which showed sexual difficulties among circumcised males), preferring instead to refer to Krieger's Kenyan study (which does not show the same difficulties). This begs the question of why African studies are more relevant to the sexual function and satisfaction of American citizens than European studies, but we will leave such discussion for the readers to make their own conclusions.
Finally, missing from the guidelines is any discussion of the role and functioning of the foreskin, something that could be accomplished by simple observational studies of the sexual behavior of uncircumcised males. But one could argue that the role of the CDC is to counsel on control and prevention of diseases, and not on sexuality.

I can't avoid, however, citing this quote from the late Dr. Paul Fleiss, from his 2002 book:

"Accurate information about the foreskin itself is almost always missing from discussions about circumcision. How can parents make a rational decision about circumcision when they are told nothing about the part that will be cut off?" Fleiss. What your doctor may not tell you about circumcision.

Our conclusion is that the CDC draft is far from being the universal recommendation for circumcision that biased media, organizations and individuals may wish for, it is actually more balanced on its ethical aspects than the AAP's Policy Statement, however it is not unbiased as it still gives more relevance to African studies than European, in spite of the American circumstances being more comparable to those of Europe than to Sub Saharan Africa. The media however latches to key phrases like "benefits from circumcision" ignoring the harms and collateral effects and autonomy concerns, thus distorting the message and manipulating the public opinion.

Wednesday, November 12, 2014

#SavingChase - follow up on Judge keep your hands off my penis

In May we shared that a Florida judge had ruled that a mother must submit her 3 and 1/2 year old son to circumcision as required by the father, in spite of the mother’s fear of the risk of death related to general anesthesia, and in spite of admitting that the procedure is not medically necessary.

Back then the mother filed an appeal. Last Thursday, November 6th, the Court of Appeals denied her motion. Chase, now 4 years old, is now running out of time, but the mother continues fighting and the case might have to go all the way to the Supreme Court to protect the physical integrity of her son and his right to bodily integrity and genital autonomy.

You can help in any of these places

Fundraiser:
http://www.youcaring.com/other/saving-chase/259991

Photo and video campaign:
https://www.facebook.com/events/357342571110808/358327774345621

Petition:
http://tinyurl.com/l53w9rp

Youtube:
https://www.youtube.com/channel/UCqZFAkBXp5PdpVQ1Rp7cC7A

Facebook Page:
https://www.facebook.com/ChasesGuardians
Judge Jeffrey Gillen

Chase

Twitter:
https://twitter.com/savingchase4

Tuesday, October 7, 2014

Vernon Quaintance Sentenced

On October 3rd, 2014, Vernon Quaintance was sentenced to two years and four months in prision for targeting young boys and asking them to expose themselves under the pretense of inspecting whether or not they were circumcised. Judge Anthony Leonard QC said Quaintance used his interest in the surgical procedure to look at young boys. The judge took into consideration that this offending did not carried over into Quaintance's later years, and his less than perfect health, to offer some allowance.
Quaintaince recently confessed to a string of offences against five young boys as young as 10 in the 1960s and 1970s. Thousands of images were found in his computer, many showing bloody and ritualistic circumcisions in the Brazilian rainforest.
The Croydon Advertiser referred to Quaintance as "circumcision fetishist", paedophile, pervert, deviant, and stated that the Gilgal Society was just a facade for the 'distribution of images of young boys' for erotic and paedophilic use.

While the Gilgal Society's website has been removed, its content remains public as the Circumcision Helpdesk, which is openly registered to Quaintaince.

http://circleaks.org/index.php?title=Vernon_Quaintance#2014_Sentence

http://www.croydonadvertiser.co.uk/Upper-Norwood-circumcision-fetishist-jailed/story-23040107-detail/story.html

Thursday, July 17, 2014

Vernon Quaintance pled guilty (pro circumcision - Gilgal Society)

A former sacristan for the Knights of Malta has pleaded guilty to nine sex offences including those against boys as young as 11 he had met in the 1960s and 70s.

(...)

On Wednesday this week a court heard that Quaintance, 71, was a paedophile who also ran a pro-circumcision group. Southwark Crown Court heard he accumulated images as recently as 2011.

He was also a leader of the Gilgal Society, a group claiming to promote male circumcision and “its benefits in terms of health, sexual satisfaction and self-image.”

In 2012, he was found guilty of possessing nine hours of child pornography on video tapes. This week he pleaded guilty to five counts of indecency with a child between 1966 and 1976 and four counts of possession of indecent images. An additional count of sexual assault alleged to have taken place in 2011 on a child was left to lie on file.

http://www.thetablet.co.uk/news/981/0/former-knights-of-malta-member-pleads-guilty-to-abuse-of-young-boys

* The Gilgal Society's website has now been rebranded The Circumcision Helpdesk

Tuesday, July 15, 2014

A sport-based intervention to increase uptake of voluntary medical male circumcision

Last year we heard a story about HIV researchers / circumcision advocates in Africa. Of course, being just a story, having no evidence, we didn't mention it. But the story seems to be now corroborated and will be presented at the AIDS 2014 Conference in Melbourne, Australia, July 20 to 25.

So this is what we heard:
"In one presentation I sat through at a world AIDS conference (summer of 2010), a young doctor with these circumcision campaigns [in Africa] (he was marketing chief) took to the podium and explained a "successful" program. They went into the poorest communities, where the boys were mad for soccer, and bought them all new equipment and uniforms. Built them beautiful pitches to play on. Brought in well-known soccer players to inspire the boys, and got coaches. Let the boys play and get to love it. And when it came time to play in the regional tournaments, the bar came crushing down: they'd be sponsored to travel and play only if the team captain could convince most of the boys on the team to get circumcised. The peer pressure was tremendous not to let the team and community down. This doctor was positively gleeful at how successful this strategy was."
This story might come to be corroborated here: http://pag.aids2014.org/Abstracts.aspx?SID=1104&AID=5834

Abstract

MOPDC0106 - Poster Discussion Session

A sport-based intervention to increase uptake of voluntary medical male circumcision among adult male football players: results from a cluster-randomised trial in Bulawayo, Zimbabwe

Presented by Zachary A Kaufman (United Kingdom).

Z.A. Kaufman1, J. DeCelles2, K. Bhauti3, H.A. Weiss1, K. Hatzold4, C. Chaibva5, D.A. Ross1

1London School of Hygiene and Tropical Medicine, Epidemiology and Population Health, London, United Kingdom, 2Grassroot Soccer, Curriculum and Innovation, Cape Town, South Africa, 3Grassroot Soccer Zimbabwe, Bulawayo, Zimbabwe, 4Population Services International Zimbabwe, Harare, Zimbabwe, 5National University of Science and Technology, Bulawayo, Zimbabwe
 The title of the abstract reads "adult male football players". We are definitively interested in reading all the details.

We will be waiting for the full abstract, to be made public next Friday. But now you know what to wait for.

Manipulation. Peer pressure.

Grassroot Soccer


PEPFAR, the U.S. President's Emergency Plan for AIDS Relief, shared this photo a few hours ago through their facebook page:

In the Mchinji District of Malawi, local Peace Corps volunteer counterpart and Grassroot Soccer coach Henry Ching'ombe, works with the Kamwendo Youth Group on the GRS activity "Cut and Cover," which addresses medical male circumcision.

Notice that the photo mentions "Grassroot Soccer". This is an organization with the following explicit goal, according to their facebook page: "Using the power of soccer to educate, inspire, and mobilize communities to stop the spread of HIV"

Combing through Grassroot Soccer's website, the Bill & Melinda Gates Foundation makes its apparition:

The Bill & Melinda Gates Foundation and the Doris Duke Charitable Foundation (DDCF) are supporting Grassroot Soccer (GRS) in a unique and innovative randomized control trial in Zimbabwe that will assess the impact of an educational intervention using the power of soccer and its role models to increase awareness and uptake of medical male circumcision (MMC) as an HIV prevention measure. The trial, known as MCUTS (Male Circumcision Uptake Through Soccer), will target men ages 18-35 with educational outreach through soccer-related messages.

http://www.grassrootsoccer.org/2012/10/15/mcuts/
While this target age should be 18-35, some other articles on the website show a different panorama:

[May 12th 2012, GRS Zambia] for the first time ever at GRS, we held mobile Medical Male Circumcision (MMC) at the school grounds. The procedure was conducted by Marie Stopes International (MSI), and was sanctioned by the Ministry of Health for outreach service delivery.  There were four boys, between the ages of 16 and 24, who elected for the medical procedure. The operation takes between 25 to 30 minutes, and there is an additional pre and post counseling session dedicated to MMC. Each boy left the post counseling session knowing they now had 60% more protection against acquiring HIV.

http://www.grassrootsoccer.org/2012/05/25/grassroot-soccers-first-mobile-mmc/

"Make The Cut" (MTC)


Navigating more through the website we found a poster/report of just the very same abstract discussed above, the one that is still embargoed until next Friday. But now you can read it here: http://www.grassrootsoccer.org/wp-content/uploads/ICASA-Poster_MCUTS-Qual_6-Dec-2013_FINAL.pdf

Participants found MTC (in particular the Coach’s Story) persuasive because the MTC coaches had been circumcised and could discuss the procedure.

Future implementation should incorporate home-based follow-up and small incentives while avoiding delivery during the holidays and mid-season for professional soccer players.
http://www.grassrootsoccer.org/wp-content/uploads/ICASA-Poster_MCUTS-Qual_6-Dec-2013_FINAL.pdf

Goal Trial: targeting teenagers


Generation Skillz is an eleven-session sport-based HIV prevention intervention delivered in secondary schools in South Africa, primarily focusing on age-disparate sex, multiple partnerships, gender-based violence, and male circumcision

http://www.grassrootsoccer.org/wp-content/uploads/GOAL-Trial-IAC-Poster_Final-A4.pdf

Katharina von Kellenbach - feminist? religious? pro-circumcision?

Katharina von Kellenbach
Katharina von Kellenbach is Professor of Religious Studies at St. Mary’s College of Maryland. A native of West Germany, she studied Evangelical Theology in Berlin and Göttingen (1979-1982) and received her PhD in 1990 at Temple University. She became active in Jewish-Christian dialogue and Holocaust Studies while studying in Philadelphia and completed her dissertation on Anti‑Judaism in Feminist Religious Writings (Scholars Press, 1994). Her areas of expertise include feminist theology and Jewish-Christian relations, the ordination, life and work of the first female Rabbi Regina Jonas of Berlin (1902-1944), who was murdered in Auschwitz, as well as the theological, ethical, personal and political issues raised by the Holocaust.

Article: What's wrong with the movement for genital autonomy

On July 9th of 2014, Katharina von Kellenbach published an article on Feminist Studies on Religion, titled "What's wrong with the movement for genital autonomy". In this article, Katharina attributes the creation of the Genital Autonomy to the Cologne case of 2012 which led to temporary age restriction of circumcision in Germany. In this regard, Katharina is wrong, as the genital autonomy movement can be formally traced at least to 1970 in Florida (Van and Benjamin Lewis), although there are individual books and articles (mostly by physicians but also by humanists) prior to this time, mostly in the countries where secular circumcision had become a custom (United Kingdom - Gairdner, 1949, United States - AP Morgan Vance, 1900, and Joseph Lewis, 1949), some as old as 1894 (Elizabeth Blackwell).

Katharina uses double quotes when the descriptions do not match her ideal view of reality. For example in reference to the Cologne case, she uses double quotes when she writes the words "grievous bodily harm". These were the words used by the local judge in Cologne to describe the condition of the Muslim child, who had to be put under general anesthesia and operated as a result of the injuries sustained during and as a consequence of his circumcision.

Genital Integrity in Europe

Von Kellenback's article states that "By December 2012, German lawmakers passed a law defending the right of Jewish and Muslim religious communities to circumcise their sons—though not their daughters."

The law however required a physician or trained practitioner to perform the surgery and limited the maximum age for the surgery (which could be a problem for some Muslim communities). The law allows non-physicians to perform the procedure until the 6th month (something definitively oriented to allow Jewish religious practitioners to perform the procedure). The Bundestag ignored the opinions of the German Academy for Child and Youth Medicine (DAKJ), the umbrella organization of all pediatric associations in Germany (German Society for Child and youth medicine DGKJ, Professional Association of the Child and Youth doctors, German Society for social pediatrics and youth medicine DGSPJ) and relied on the recently released statement of the American Academy of Pediatrics, in spite of the harsh critique by most European medical associations.

Von Kellenback then writes: "This spurred a movement across Europe that demanded the protection of boys’ bodily integrity in the name of gender equality. Their declarations and websites use gender-neutral language and declare “genital autonomy” a “fundamental right of each human being,” which includes “personal control of their own genital and reproductive organs; and protection from medically unnecessary genital modification and other irreversible reproductive interve."

In this paragraph we can see again the use of double quotes around the words "genital autonomy" and "a fundamental right of each human being" which seems to denote her disagreement with those expressions.

Ayan Hirsi Ali

Von Kellenbach extends her critique to "Somali anti-Muslim activist Ayan Hirsi Ali, never known to shy away from controversy". Apparently the feminist branch of Von Kellenbach does not extend its compassion to women who have been subjected to female genital mutilation and death threats by religious extremists from patriarchal groups, if said women criticize male circumcision. (Shortly after posting the article online, the comments section was closed due to "continued ad hominem attacks" - this didn't prevent Katharina from employing ad hominem attacks and generalizations throughout her article, most notably this one on Ayan Hirsi Ali).

While von Kellenbach initially quotes many scientific facts from intact positive websites, she then goes on a religious-politic tirade, neglecting to address rationally any of the facts she previously quoted.

Ironies

In ironic terms, Von Kellenbach assumes that the Genital Autonomy movement "aims to outman the political battle against FGM" and seems to mock the movement by saying that "suddenly, men must be rescued from marginalization and traumatization". In this she ignores that the Genital Autonomy movement aims to protect all children, not adult men (or women for the matter). The Genital Autonomy movement also aims to protect intersex children, often the victims of horrific medical experiments. In fact, in the United States, the Genital Autonomy movement represented in Intact America, was one of the first organizations to oppose the Policy Statement on Ritual Genital Cutting of Female Minors of the American Academy of Pediatrics in 2010, one statement that tried to argue for allowing American pediatricians to perform a ritual nick on the genitals of female minors to appease parents from regions where female genital mutilation is practiced.

Von Kellenbach commits a logical fallacy frequently repeated by critics of the Genital Autonomy movement, in misrepresenting that male circumcision is considered by intactivists to be biologically equivalent to female genital mutilation. The intactivist argument is explained to be on an ethical level: non-medically indicated procedures that remove part of the external genitalia of a minor who has no need for the procedure, did not consent to it and cannot remove himself or herself from the situation, performed mostly to appease the cultural or religious traditions of the parents, in spite of real existent risks and harms.

Feminism?

Von Kellenbach goes on to say that "The gender-neutral code of “genital autonomy” serves to conceal the “seamless garment” of coercive violence that aims to control women’s sexual and reproductive bodies.". In this she ignores that historically secular circumcision and secular female genital mutilation were implemented in English speaking countries during the 19th century to punish children for touching their genitals (control of their sexual bodies) and that it was known, even to ancient Jewish philosophers and physicians, that circumcision "excised the superfluous pleasure" and "weakened the organ of generation".

She then takes a skewed point of view in writing that "The religious reasons for men’s “mutilation” are fundamentally different from the arguments that drive the wounding of women. Women are cut for aesthetic reasons in order to purify and protect men from promiscuous female sexual pleasure. Women’s pleasure and agency is the target of the knife and it serves no religious signification. Men’s circumcision, on the other hand, does not aim at sensation and potency. On the contrary, men’s virility is enhanced by circumcision and loaded with religious meaning."

First, groups which "circumcise" girls often give a religious meaning to the ritual. It may be the Western position to deny this (perhaps for political correctness), but Muslim women have argued that it is "an honor" and a "purification", in other words, religious values denied by von Kellenbach.

In arguing that women are cut for aesthetic reasons, Von Kellenbach also ignores the globality of the debate. It is often heard from pro-circumcision women in the United States especially, that circumcised penises look "prettier", that "uncircumcised" (intact) penises "look weird, gross, ugly, dirty, like an anteater, like an elefant trunk, are smelly", etc, in other words, aesthetic reasons, and intact males are ostracized in some communities, i.e. considered children in Africa, called "supot" to ridicule them in Philippines, and supposedly made fun of in the locker room in the United States.
Katharina argues that "Men’s circumcision, [...] does not aim at sensation and potency. On the contrary, men’s virility is enhanced by circumcision". In this she ignores not only the writings of Philo and Maimonides, but also scientific studies by John Taylor, Sorrells, Bronselaer and Frisch.
In stating that "God seals the covenant with Abraham promising him progeny, land, and everlasting life" von Kellenbach seems to ignore that not all the world ascribes to the Judeo Christian tradition and that babies are not aware of these dogmas when they are subjected to such "covenant".

Von Kellenbach then compares "The sacrifice of (fore)skin" to "the pain and blood of breaking the hymen", comparison that ignores that women have a right to choose if, when and with whom they will break their hymen, a right to genital autonomy not granted to baby boys who unwillingly undertake their "sacrifice".

Strange for a feminist, von Kellenbach then writes that "Male circumcision and the penetration of women constitute the basis of the “covenant between me and you, and your offspring after you throughout their generations as an everlasting covenant.”". In this statement women are sexually objectified and conceptualized as valuable only for their reproductive power.

Uncircumcised men?

In her opinion, "The movement to criminalize ritual circumcision is spearheaded by uncircumcised men who feel morally obliged to protect innocent boys from “ancient stone age rituals”". This, of course, ignores the testimonials of men of all nationalities who were hurt physically and psychologically by their circumcision and continue to push for the age restriction of the procedure, such as Richard Duncker of Men Do Complain (UK), Christian Bahls, president of Association of Children Victims Affected by Violence Against their Physical Integrity (MOGiS eV), Eran Sadeh Israeli founder of "Protect the Child" and many others.

Von Kellenbach goes on to say that "It is Christian men who want to prevent the medically unnecessary suffering of Muslim and Jewish boys" - Again, this is an attempt at creating a division that does not exist. There are Jewish, Muslim, African, Christian, American, Atheists, Pagans and men and women of all races, nationalities and faiths, expressing their opposition to circumcision. The attempt to re-frame and create this division is simply an attempt to frame the opposition to circumcision with anti-Semitism, something far from the truth.

Another common way to derail the discussion, used also by von Kellenbach, is to argue that the arguments against circumcision are simply emotional. This is simply countered by the opposition of medical associations, the existing studies showing the negative effects, not only the sexual effects, but also the traumatic effect of neonatal pain.

Von Kellenbach keeps trying to divide the readers by arguing that "Feminists, who work against sexual violence, such as FGM, are recruited into campaigns to outlaw gender-neutral ritual circumcisions". In other words, feminists do not join the movement for genital integrity, they are recruited, they are deceived, with the purpose of "criminalizing Muslim and Jewish minorities" (and she still has the nerve to say that the arguments against circumcision are emotional!)

So basically, in von Kellenbach's view, the genital integrity movement is created by European uncircumcised Christian men who recruit feminist women with the purpose of criminalizing Muslim and Jewish minorities. Perhaps Ms. von Kellenbach should visit the United States and speak with some of the intactivists here before writing about a movement that she evidently didn't take the time to understand and learn about.

Conclusions

She concludes that "Feminists should insist on the fundamental difference between male and female circumcision and speak out against criminalizing male circumcision in countries where such bans serve to marginalize religious minorities." So feminists should insist in denying the rights of male baby boys to their physical integrity.

It is sad when one has to argue for the physical integrity of children against political and religious entities and individuals who insist on being dense in ignoring the pain, trauma and vulnerability of babies. Of all babies, regardless of their gender.

Monday, July 14, 2014

Vernon Quaintaince's trial starts - Gilgal Society website is down

Vernon Quaintance


The founder of the Gilgal Society, Vernon Quaintance, accused of a string of child sex offenses, is scheduled to start trial today July 14th of 2014.

The Gilgal Society's website has suddenly gone blank. But it has been rebranded.

Vernon Quaintance also owns the International Circumcision Information Centre's website (circinfo.com), which used to read "The International Circumcision Information Reference Centre is sponsored by The Gilgal Society". Today it reads: "The International Circumcision Information Reference Centre is sponsored by The Circumcision Helpdesk"

Sure enough, The Circumcision Helpdesk website (registered since 2003 by Vernon Quaintance) now contains the information formerly on the Gilgal Society's Website.

What is this guy playing? Who does he want to fool?

Friday, May 23, 2014

Success stories

We are glad to report that Moreno Valley Urgent Care has been made aware of our report that their website included information about circumcision from a wrong source, and they proceeded to remove the offending information.
We are also glad to report that a Canadian doctor previously profiled on circleaks, contacted us to let us know that he no longer performs circumcisions and opposes infant circumcision now. He wishes to remain anonymous at this time but he may write against circumcision in the future.

Monday, May 12, 2014

Judge, keep your hands off my penis

Judge Jeffrey Dana Gillen
A Florida judge has ruled that a mother must submit her 3 and 1/2 year old son to circumcision as required by the father, in spite of the mother's fear of the risk of death related to general anesthesia, and in spite of admitting that the procedure is not medically necessary.

Circwatch has compiled lists of documented catastrophic complications of circumcisions during 2013, and prior to 2013 here.

The mother is currently filing an appeal to the ruling and has setup a GoFundMe page to accept donations towards the protection of her son.

It is important to remember that in Israel, a rabbinical court last year ruled that a mother should submit her son to circumcision or be fined US$140 daily, as part of divorce proceedings. The Supreme Court accepted an appeal and the Attorney General has argued that the rabbinical court overstepped its jurisdiction in this case.

There is a legal precedent in the United States, in the case of Boldt vs. Boldt, where a father wanted to have his 9 year old son circumcised as part of his own conversion to Judaism. The son argued that he did not want to be circumcised, did not want to join judaism, and did not want to live with his father. The court finally recognized that the child's preferences should be considered.

At 3 and 1/2 years of age, the child will remember. Furthermore, he is already aware of his body, so any irreversible decision that is not medically necessary should be consulted with him.

The circumcision status of the judge is of relevance, as men circumcised during the neonatal stage may fail to recognize the loss and harm of circumcision. If the judge is biased towards circumcision, a different judge should take the case.

Courts have a duty to protect those most vulnerable. In this case, the one more vulnerable is not the father, but the child, who will be faced with a painful disfigurement procedure.

Given the potential risks and the harms of circumcision, a court-mandated circumcision is nothing but legally mandated child endangerment. Should anything go wrong, it is not the judge nor the father who will have to live with the consequences.

Circwatch will keep an eye on this proceeding and sincerely hopes that this Floridian court will see the light and leave the child's genitals alone.

Thursday, May 8, 2014

Update on Rebeca Plank's circleaks dossier

We updated the circleaks page on Rebeca Plank to include information on the 3 deaths during the 2013 Mogen vs. Plastibell trial, particularly one death from suspected sepsis within 24 hours of the procedure, yet dismissed as most likely not resulting from the procedure - even though no autopsy was performed.

Tuesday, May 6, 2014

Thursday, May 1, 2014

Clinic cuts off boy's little manhood during circumcision

Zimbabwe, April 29th, 2014. 12-year-old Bulawayo boy's penis was cut off during circumcision. Although the boy was under local anaesthetic, he screamed as blood gushed out of his organ. The boy was admitted at the United Bulawayo Hospitals (UBH) where the cut off organ has been sewn back on. A source at UBH said while he was in stable condition, it was too early to know if his penis would be normal again. Population Services International (PSI) spokesperson Paidamoyo Magaya was unreachable for comment. PSI sponsors the circumcision drive in Zimbabwe.

Complete article: http://www.crazynews24.com/news/4856-clinic-cuts-off-boy-s-little-manhood-during-circumcision.html

Also posted on http://www.circwatch.org

Thursday, April 24, 2014

On The Stream: To Cut or Not To Cut – Brian Morris, Richard Wamai on circumcision

Spotting contradictions between circumcision promoters on Al Jazeera’s “On The Stream: To Cut or Not To Cut”

In Richard Wamai’s view, condom use rate cannot be increased significantly, so it seems better to go on a crusade to circumcise millions of men, even though men are not running to take the offer. And while Wamai denies risk compensation, he also denies that condom use rate can be increased (which is a risk compensation behavior on its own). And yet he seems to put hopes on hypothetical future gels for women to use, when men cannot (in his mind) be expected to use condoms.



Please read article on our new page. http://circwatch.org/on-the-stream-to-cut-or-not-to-cut-brian-morris-richard-wamai-on-circumcision/

Thursday, April 10, 2014

Did a Mayo clinic study confirm health benefits on circumcision? Or how to manipulate public opinion on circumcision using clever headlines

"To call this article a “Mayo Clinic study” is misleading and manipulative. Independent authors submitted the article to the journal of Mayo Clinic, Mayo Clinic Proceedings. The Editorial Board procured peer reviewers, who then approved the article for publication. This is very different from having actual staff researchers or commissioned experts performing a study at the Clinic’s request. The article was not written at Mayo Clinic’s request or by Mayo Clinic personnel."
Read complete article

Thursday, April 3, 2014

Why does Brian Morris links his site to a circumfetish page?

The casual observer, landing on Brian Morris’ website (circinfo.net) may believe that it is in fact “an evidence-baised appraisal”. However, as one advances through it, one can’t stop but wonder why Brian Morris includes links on his site to a circumfetish page.

A circum… what?


Please read this article on our new website:

http://circwatch.org/why-does-brian-morris-links-his-site-to-a-circumfetish-page/

Tuesday, March 11, 2014

Circumcision Goes Wrong: 1-yr-Old Loses Manhood to Cutting

Posted: http://frontpageafricaonline.com/index.php/news/963-circumcision-goes-wrong-1-yr-old-loses-manhood-to-cutting

1 year old boy loses his penis in a circumcision performed on January 5th by a doctor in Liberia. Phillip Zinnah, Sr. 25, father of the boy explained that he took his son to the TB Annex to one Dr. Nimley for circumcision, but it all went wrong when the doctor completely cut off the boy’s penis, leaving him in severe pain. The doctor is not responding for the damages, and the institution, TB Annex, says they don't perform circumcisions and this would have been done in secret by the doctor.

Meanwhile, a child's life has been irreversibly damaged in a way to seems to echo the baby hurt by a rabbi from Pittsburgh and a Memphis baby hurt at Christ Community Health Centers last year. A Saudi baby also had his penis partially cut off last November.




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What Brian Morris, in conjunction with Richard Wamai (research on HIV), Aaron Tobian (Johns Hopkins University), Ronald Gray (Johns Hopkins University and director of one of the 3 African trials on HIV and circumcision), Robert Bailey (responsible for another one of the 3 African trials), Daniel Halperin (author of several papers on HIV and circumcision),  Thomas Wiswell (author of the often cited study on circumcision and UTIs) and others, wrote on their propaganda paper from 2012, "A 'snip' in time":

"Infant circumcision is safe, simple, convenient and cost-effective. The available evidence strongly supports infancy as the optimal time for circumcision.

Of course, for those illustrious individuals, this child's horrible experience is simply an "adverse event". According to a 2012 paper by Robert Bailey cited by the World Health Organization:

"In developed countries, adverse events following neonatal circumcision are well documented and their incidence is very low, from 0.2 to 0.6%.5 Before the RCTs, outcomes in Africa for male circumcision among adults were poorly documented. In a review,6 adverse event rates following African male circumcisions ranged from 0 to 24%. The RCTs, which provided services in a clinical trial setting, reported the following adverse event rates: 3.8% in Orange Farm, South Africa; 1.5% in Kisumu, Kenya; and 3.6% in Rakai, Uganda.1,7,8 Most recently, at the former Orange Farm RCT site, 1.8% of medical male circumcisions offered in one high-volume facility resulted in an adverse event"
Let's stop treating children as statistics. Let's respect children. Children of all genders deserve to grow with intact genitals.

Friday, February 28, 2014

Are American doctors still performing clitoridectomies (FGM) on girls?

The website "Atlas of Pelvic Surgery" has an article on "excision of the hypertrophied clitoris". I first thought it was a historic note about how clitoridectomies used to be performed 60 years ago, but no, what I found was that the"Atlas of Pelvic Surgery was originally developed as a practical guide to the performance of gynecologic procedures which reflected Dr. Wheeless' broad experience in surgery and his skill as a teacher."

The "Atlas of Pelvic Surgery" started as a book published by Dr. Wheeless, with its third edition printed in 1997 (coincidentally the year that the federal law against FGM was enacted in the United States). The website itself constitutes the 4th edition of the Atlas. In fact the index of recent updates includes the article on excision of the hypertrophied clitoris, so this article must be relatively recent (but no date is given)

Graphic taken from the Atlas of Pelvic Surgery website

I was in shock. Yes I know that the treatment for intersex girls with enlarged clitoris used to be the removal of the clitoris... long time ago! Today, they use "nerve sparing surgeries" to reduce but not to remove the clitoris (clitoroplasty), and yet this procedure when performed on a minor constitutes a violation of a child's physical integrity (according to the PACE), may damage orgasmic function, and is rejected by the intersex community as a violation of human rights.

But... clitoridectomy (excision of the clitoris)... TODAY?

Excised hypertrophied clitoris... from a 1925 book


The website is the work of Clifford R. Wheeless, Jr., MD, and Marcella L. Roenneburg, MD. both of them servicing Baltimore, Maryland, Dr. Wheeless here, and Dr. Roenneburg here.



I verified the ownership of the website. The domain is registered to Dr. Roenneburg.

According to Jewish Woman International, Dr. Roenneburg is a Jewish woman providing service to African women.

These are the indications and purpose of the excision of the hypertrophied clitoris described in the Atlas of Pelvic Surgery (I underlined key words):

Clitoral hypertrophy, regardless of etiology, is a source of psychological stress, especially in young females. Most pediatric gynecologists stress the importance of normal external genitalia in young children. It is important to weigh the role of the clitoris in sexual climax against the psychological stress incurred when the genitalia of a young child are different from her peers.
The purpose of the operation is to excise the hypertrophied clitoris and create normal-appearing external genitalia.


Female patient before and after clitoroplasty (not full excision - but nevertheless removal of a large portion of the clitoris). While the authors of this 2006 article considered the "cosmetic results" good, some loss of sensation and sexual damage is inevitable when altering the clitoris.

I decided to review the U.S. federal law against FGM:

(a) Except as provided in subsection (b), whoever knowingly circumcises, excises, or infibulates the whole or any part of the labia majora or labia minora or clitoris of another person who has not attained the age of 18 years shall be fined under this title or imprisoned not more than 5 years, or both. 
(b) A surgical operation is not a violation of this section if the operation is— 
(1) necessary to the health of the person on whom it is performed, and is performed by a person licensed in the place of its performance as a medical practitioner; or 
(2) performed on a person in labor or who has just given birth and is performed for medical purposes connected with that labor or birth by a person licensed in the place it is performed as a medical practitioner, midwife, or person in training to become such a practitioner or midwife.
Notice that the FGM law provides an exception when it is "necessary to the health of the person". However the excision of hypertrophic clitoris is not medically necessary. It is only done to "normalize" the aspect of the genitalia, adducing "psychological stress" of the child - but in reality this refers to the "psychological stress" of parents who perceive their daughter as abnormal.

I also checked if Maryland has a law against FGM, and found that the punishment for FGM includes "imprisonment for up to five years and/or a fine of up to $5,000".

According to the World Health Organization, there are four types of female genital mutilation, the first one being:

  • Clitoridectomy: partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals) and, in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).
 The recent resolution of the Parliamentary Assembly of the Council of Europe names several procedures that violate the physical integrity of children, among them Female Genital Mutilation and early childhood interventions of intersex children. The procedure described by the Atlas of Pelvic surgery is both, a childhood intervention of intersex children and female genital mutilation.

Given that the Atlas of Pelvic Surgery "reflect[s] Dr. Wheeless' broad experience in surgery", we have to ask: has Dr. Wheeles performed the excision of hypertrophied clitoris? Has he performed this surgery after 1997?

Since the site also reflects "his skill as a teacher", does he teach how to perform this procedure? (the existence of this article on the website would be evidence for this).

Given that Dr. Roenneburg provides service to African women, has she performed this procedure on daughters of African women? On those from countries and cultures where FGM is prevalent?

According to Jewish Women International, Dr. Roenneburg has operated "on scores of women with these devastating childbearing-related wounds, called vesicovaginal fistulas—holes between the bladder and the vagina" in Niger. It should be safe to assume that she is aware that these vesicovaginal fistulas are sometimes consequence of female genital mutilation, and that FGM is prevalent in Niger (one of the forms of FGM prevalent in Niger is clitoridectomy). So why does a website registered under her name and which includes her bio, and which is meant to be used as a learning resource, explains how to perform clitoridectomies? 

Is FGM at the hands of American surgeons any less of a crime?


Are there American girls and women of any ethnia living their lives without their clitoris, having had it removed at the hands of Dr. Wheeles, Dr. Roenneburg, or the students of Dr. Wheeles or readers of his book or their website?


Related: How parents 'consenting' to intersex genital mutilations (IGM) do so because of biased information given by doctors

Related: Clitoris Amputations & Intersex Genital Mutilation (see PDF files)

Testimonials of American women subjected to clitoridectomy as a way to prevent masturbation, by American doctors, at parents request, during the 20th century.






Please listen to their testimonies. They were traumatized by doctors. Is it fair to perform this procedure on any girl? Even if she has a "hypertrophic" (which simply means "large") clitoris?

To put it in perspective, would you treat a boy with a "large penis" by having the penis removed?


 Screenshots



Related: Hida Viloria, intersex activist, on Montel Williams. Hida Viloria was born with what these doctors would consider a "hypertrophied clitoris", but her dad, a Colombian doctor, had the awareness to decline surgery.



Circleaks is willing to listen to Dr. Wheeless and Dr. Roenneburg. We wish they can provide a sworn statement that they have not performed this procedure, and can justify a reason why this procedure should be even included on a teaching website -or proceed to advise AGAINST this procedure on their website, and if they do so, we will make their voice public.  Otherwise, it is our duty to expose to the American public our suspicion that these doctors may have performed this procedure or taught others (either in person, through Dr. Wheeless book or through the website) how to perform it, thus possibly prolonging  the history of forced clitoridectomy (female genital mutilation) in the United States into the 21st century.

And yes we are aware that the article is about excision of the "hypertrophied" clitoris - in other words, a large clitoris that resembles a small penis. It remains true that the clitoris is an integral part of female sexuality, and whether it is small or large, its removal has devastating lifetime consequences for the individual. No parent - and no doctor- should ever make this decision for any girl.

Related: Upcoming book about female circumcision and clitoridectomy in the United States

Resources on the Victorian Era clitoridectomy in UK and US


Isaac Baker Brown and his "harmless operative procedure"

Isaac Baker Brown and the clitoridectomy operation

According to this article on FGM Network, a 1894 doctor was one of the last doctors to perform clitoridectomies. We know this is not the case, with the two video testimonials having had their operation during the middle of the 20th century, and with intersex clitoridectomies occurring up to the 70s... or until now?

 The sexual politics of female circumcision - mostly about FGM in Africa, it includes a first person account of a victim of African clitoridectomy and also some information about the origin and motivation of clitoridectomies in the US and UK.

An obsolete residual of the Victorian era, much like routine infant circumcision:
In females, the author has found the application of pure carbolic acid (phenol) to the clitoris an excellent means of allaying the abnormal excitement. John Harvey Kellogg, Plain Facts for Old and Young, 1888 
Cool sitz baths; the cool enema; a spare diet; the application of blisters and other irritants to the sensitive parts of the sexual organs, the removal of the clitoris and nymphae... John Harvey Kellogg, Ladies' guide in health and disease, 1893


More on Dr. Wheeless and Dr. Roenneburg's background:

Dr. Wheeless is certified by the American Board of Obstetrics and Gynecology, is a fellow of the American College of Obstetrics and Gynecology, the American College of Surgeons and the Southern Surgical Association. He received his degree from the University of North Carolina and has been a member of The Johns Hopkins Medical Institution. He was a Professor of Gynecology and Obstetrics at Emory University and at Sinai Hospital, and later at the Hopkins School of Medicine.

Dr. Roennesburg received her medical degree from the Medical College of Wisconsin and completed her internship and residency at Union Memorial Hospital in Baltimore, under the direction of Dr. Wheeless. She received a Distinguished Alumni Award for Community Service by the University of Winsconsin.

Additional Exhibits

Types of Female Genital Mutilation per the World Health Organization. Notice that type I is shown removing not only the external portion of the clitoris, but also the clitoral hood (the prepuce, the equivalent of the male foreskin)

Lawson, Wilkins et al, removal of hypertrophic clitoris. Published in 1958 and again in 1971, pretty much the same procedure explained by Dr. Wheeless and Dr. Roenneburg.
Source: stop.genitalmutilation.org

"Nerve sparing" clitoroplasty, still a mutilating surgery which intends to spare the nerve bundle. Adult patients who had this procedure during childhood still report pain and sexual dysfunction. 


Image source: Article by John M. Hutson at Pediatric Urology Book. Text added by an activist opposing these kinds of surgeries.

Related topic: Dr. Dix Poppas caused strong commotion in 2010 when people learned that he was following up on "nerve sparing clitoroplasties" by testing sensitivity with a q-tip and a vibrating device... on minor patients. This scandal allowed many people to learn about clitoromegaly ("hypertrophied" clitoris) and congenital adrenal hyperplasia. However, as far as we know, nobody has apologized for reducing the clitoris of these girls.

From Hasting Reports, Bad Vibrations

From Secular Parent, The not so good touches of Dr. Dix Poppas

Dr. Dix Poppas, Description of technique

OII Intersex network: A conspiracy of deceit

In "Aesthetic surgery of the Female Genitalia" (2011), Dobbeleir et al indicate that four ethical principles mark the difference with genital cutting practices. The first principle is "Autonomy of the patient" (Patients should be over 18 years old, psychologically stable, and fully informed on the risks and expected results, so that the decision in full knowledge of the issue is theirs only. An informed consent should always be obtained). The text indicates that if any of the preconditions are not fulfilled, aesthetic genital surgery should not take place.

Clitoral surgery on "young girls" does not fulfill this requirement, thus making it Female Genital Mutilation.

The World Health Organization

While far from condemning intersex genital surgeries, the World Health Organization casts such surgeries in negative light (underlined by us):

Many intersex children have undergone medical intervention for health reasons as well as for sociological and ideological reasons. An important consideration with respect to sex assignment is the ethics of surgically altering the genitalia of intersex children to “normalize” them.

Clitoral surgery for intersex conditions was promoted by Hugh Hampton Young in the United States in the late 1930s. Subsequently, a standardized intersex management strategy was developed by psychologists at Johns Hopkins University (USA) based on the idea that infants are gender neutral at birth. (38) Minto et al. note that “the theory of psychosexual neutrality at birth has now been replaced by a model of complex interaction between prenatal and postnatal factors that lead to the development of gender and, later, sexual identity”. (39) However, currently in the United States and many Western European countries, the most likely clinical recommendation to the parents of intersex infants is to raise them as females, often involving surgery to feminize the appearance of the genitalia. (40)

Minto et al. conducted a study aiming to assess the effects of feminizing intersex surgery on adult sexual function in individuals with ambiguous genitalia. As part of this study, they noted a number of ethical issues in relation to this surgery, including that:

  • there is no evidence that feminizing genital surgery leads to improved psychosocial outcomes;
  • feminizing genital surgery cannot guarantee that adult gender identity will develop as female; and that
  • adult sexual function might be altered by removal of clitoral or phallic tissue. (41)

World Health Organization - Gender and Genetics 

The mentioned idea that infants are gender neutral at birth comes from John Money and Johns Hopkins University, who first tested this on David Reimer, when, as a baby (born Bruce, 1965), lost his penis as the result of a botched circumcision. John Money oversaw his raising as a female (Brenda) including follow ups. David's later testimony tells of John Money forcing him and his twin brother Brian to "play sex" with the hope that "Brenda" would accept the passive role. According to David, Money photographed these sessions; David was however unable to obtain copy of the records, which were donated to the Kinsey Institute to remain sealed in perpetuity. During adolescence, the test was deemed a failure, and "Brenda" took a new male identity, David, undergoing breast removal and penile reconstruction. For many years, Money continued presenting the "John/Joan" case (fictitious names) as a success until David went public in 1997. David committed suicide in 2004, at the age of 38.

Many medical institutions still cite the work of John Money when dealing with intersex patients and genital surgeries.

I find it ironic that when dealing with medical excision of clitoral tissue, the WHO says that "adult sexual function might be altered", but when described in the context of female genital mutilation, it "interferes with the natural functions of girls' and women's bodies".