Andrew Gross
Published July 15, 2019 Revised June 30, 2022
A group called Doctors Opposing Circumcision portrays itself as a medical organization. The website describes the organization as "an international network of physicians dedicated to protecting the genital integrity and eventual autonomy of all children, serving both health professionals and the public through education, support, and advocacy."
In fact it's just a façade. You don’t need to be a physician in order to join; you don't even need a medical background. All you would need is to send money to the group’s president. Nearly half of the organization’s Board of Directors - 6 out of 14 - aren't even physicians. [1]
THE PRESIDENT
Founder and president George Denniston is a retired Seattle physician and professor emeritus at the University of Washington. Denniston is an Intact America board member and the author of several anti-circumcision books - in collaboration with NOCIRC founder Marilyn Milos.
According to the website, Denniston founded DOC in 1995 "to eradicate the unethical and unnecessary practice of partial penile amputation of children (circumcision), not only because of the harm that it has done to millions of American boys and men, but also because it has damaged the reputation of the medical profession." [1]
Denniston told a Canadian reporter, “I have never seen anything in medical literature as bad as circumcision literature. A lot of it stands out to me as bullshit. Advocates for circumcision use medical literature to promote their cause and don’t give a damn if it’s true or not." [2] The irony of that statement is breathtaking.
He made several false and misleading statements in a rambling 9-minute video for YouTube. For example, he falsely claimed that most circumcised boys develop meatal stenosis, and that every circumcision has complications and causes permanent damage. [3] The American Academy of Pediatrics described two studies in which less than one percent of circumcised boys developed meatal stenosis. The AAP reported that overall, "significant acute complications are rare, occurring in approximately 1 in 500 newborn male circumcisions." [4] "In medical terms a complication is a unexpected or unplanned bad result. Because the purpose of circumcision is to remove the foreskin, the loss of the foreskin is not unexpected or unplanned, so the loss of the foreskin is not a complication." [5]
Denniston wrote in a medical journal that the rate of adult circumcision in Finland is 1 in 16,667 - a statistic that has no basis in fact. [6][7] He has made the absurd argument that circumcision may be the cause of up to one million abortions in the United States each year. [8]
He opened a 3 1/2 minute video for parents with the outrageous statement that, "Most American obstetricians should not be allowed anywhere near a woman giving birth." While correctly stating that surgical procedures like episiotomies and C-section births are typically done unnecesarily, he ignored the fact that these procedures are often crucial to save mothers and babies. He implied that healthy mothers should not give birth in hospitals, citing the British NHS. [9] That is dangerous advice in an era in which mothers increasingly are older, are obese, or have other health issues. A planned home birth in the United States can triple the likelihood of a perinatal death versus a comparable birth at a hospital. [10]
THE WEBSITE
It's telling that DOC didn't include any evidence to support these statements, which appear prominently on the homepage of the organization's website. The statements are manifestly false.
South Korea routinely circumcises boys. Here DOC is being not just mendacious - but disingenuous. DOC opposes circumcision for all boys at any age and for any reason.
The “perfectly normal” foreskin provides a moist environment - at the entrance to the urinary tract - ideal for harmful bacteria to thrive. Science-based studies show that circumcision has no significant effect on sexual performance or pleasure.
Benefits of circumcision include: prevention of phimosis; lower risk of balanitis, urinary tract infection, and penile cancer; and better hygiene. Pain can be managed with anesthesia. The risk of a significant foreskin complication [13] is 25 times greater than the risk of a significant circumcision complication. [4] Scientific evidence does not show that circumcision affects maternal-child bonding.
The American Academy of Pediatrics, American Medical Association, American Urological Association, American College of Obstetricians and Gynecologists, American College of Nurse-Midwives, U.S. Centers for Disease Control, Canadian Paediatric Society, Royal Australasian College of Physicians, and World Health Organization all agree that parents have a right to choose circumcision for their newborn sons.
Here are several additional examples from the DOC website that are false, misleading, hysterical, and potentially harmful.
PHIMOSIS
DOC says that "pathological phimosis is rare; one large study found the cumulative risk to be 0.6% by age 15 years. Most cases are likely caused by forced retraction of the foreskin in childhood ... that causes tears, resulting in scarring and adhesion of the foreskin to the glans as the tissue heals." [11]
The researchers in the British study that DOC cited actually misstated their study result. To arrive at the figure of 0.6%, the researchers found that 62 boys out of 1,000 were circumcised to treat pathological phimosis. They stated that the incidence of pathological phimosis was 0.4% of boys per year, or cumulatively 0.6% by their 15th birthday. In other words, the researchers assumed that all boys diagnosed with pathological phimosis were prescribed circumcision as treatment. [12] Apparently they didn't consider the possibility that some patients diagnosed with phimosis might receive any treatment other than circumcision.
Indeed, a 2016 study in Denmark found that circumcision was the treatment for just 24% of patients diagnosed with phimosis. The Danish study reported that 5% of boys under 18 suffered a foreskin complication serious enough to require treatment at a medical center; 95% of the patients were diagnosed with phimosis. The incidence of circumcision was 0.4% - the same as the British study [13] But the cumulative incidence of a foreskin operation was 1.7%. About 55% of the patients had initially been treated with topical sterioids. If British doctors treat phimosis in a similar manner as their Danish peers, the British researchers - and DOC by extension - may have undervalued the actual incidence of phimosis by nearly 90%.
Urinary Tract Infections
DOC advises that infections can be treated with "good topical ointments and antibiotics", and circumcision should be considered only as a last resort, and should "rarely, if ever, be necessary." [14] DOC claims that "the risk of a urinary tract infection (UTI) in a boy that has not been circumcised is no different than in one who has been circumcised, except possibly in the first six months of life. Even then, the risk is still quite small at less than 1 in 100 ... Treatment with antibiotics, given by mouth, is usually all that is needed for a UTI in an intact boy, the same as it would be for girls (who have a 5 times greater chance of getting a UTI)." [15]
There are a few reasons why girls may have a higher UTI rate. First, the male urinary tract (7.5 in/20 cm) is 5 times longer than the female urinary tract (1.5 in/4 cm.) Second, the distance from the anus to the urethra is much shorter in girls. Finally, the "increased moist tissue and folds of females’ genitals might allow bacteria to colonize the area more easily." [16] Unlike circumcision, surgical cutting wouldn't reduce the risk of infection for girls; in fact it might increase the risk.
A 2000 study reported that the risk of a UTI in the first year of life was ten times greater for uncircumcised boys than for circumcised boys. [17] A 2005 meta-analysis also found a 90% decrease in UTI risk for circumcised boys. [18] A 2018 study found that circumcision decreased the risk of UTIs by almost 80%. [19]
The World Health Organization and U.S. Centers for Disease Control have advised that antibiotics should be used sparingly. The WHO is concerned that UTIs have become more resistant to antibiotics, [20] [21] which the CDC warned can have harmful side effects. [22] By significantly reducing the incidence of UTIs, newborn circumcision reduces the need for antibiotics in the first place. DOC's advice that parents can simply rely on antibiotics to treat a persistent infection is naive and potentially harmful.
SUDDEN INFANT DEATH SYNDROME
Attempting to frighten parents, DOC reported that circumcision is linked to Sudden Infant Death Syndrome (SIDS), [23] citing a study from the United Kingdom. [24] A prominent Dutch physician rejected the study as “flawed, biased and unreliable," [25] and this website contains a point-by-point refutation. [26] The researcher falsely assumed that all Muslim boys are circumcised at birth. He ignored the inconvenient fact that some countries with low circumcision rates report high rates of SIDS. He failed to account for the increasingly common use of pain relief. He even cherry-picked a religious myth. I am unaware of any medical association that advises that circumcision increases the risk of SIDS.
SEXUALLY TRANSMITTED DISEASES
To dismiss the medical benefit of STD protection, DOC employs the Peter Pan fallacy - repeating the mantra that infants and children are not sexually active and therefore not at risk for STDs. [27] [28] Yet DOC posted an article on its website titled, "The Sexual Impact of Circumcision." By DOC’s reasoning infants and children are not sexually active; therefore any sexual impact is irrelevant. [29] DOC cannot have it both ways.
On a separate page DOC attempts to refute the evidence that circumcision protects against HIV and AIDS. [30] British researcher Stephen Moreton issued a point-by-point rebuttal. Moreton stated that DOC "merely repeats tired old arguments that were debunked years previously in the scientific literature - debunkings that DOC, in typical fashion, simply ignores." [31] I encourage readers to click through and read both the DOC post and Moreton's response.
SEXUAL IMPACT
Citing O'Hara's 1999 survey of women, DOC said that women with circumcised partners reported a decreased enjoyment of intercourse, decreased sense of intimacy, and a decreased ability to experience orgasm from vaginal intercourse. [29]
The O'Hara study [32] violated standard survey methodology. Respondents were recruited via an ad placed in an anti-circumcision newsletter, and the survey was conducted over a period of several years. Survey questions featured prejudicial terms and were structured to elicit responses favoring uncircumcised sex. Some questions were added or reworded during the survey period. The study is worthless. [33] According to a 2015 Canadian study women reported no significant differences in their "experiences of sexual arousal, vaginal lubrication, orgasm, or pain with penetrative intercourse." [34]
DOC cited two studies to show that "the loss of the gliding action of the foreskin can lead to difficulties with intromission, with an increased amount of force required for penetration." The 2004 Chinese study of men who were circumcised as adults to treat erectile dysfunction [35] cannot reveal anything about the possible effects of elective infant circumcision on sexual performance. [36]
In the 2002 study, [38] a University of Washington psychiatrist cut a hole in the bottom of a Styrofoam cup, mounted the cup on a diet scale, and penetrated the hole with his erect penis - alternately with his glans exposed and with his foreskin covering the glans. In other words, the 76 year-old researcher had sex with a Styrofoam cup. This experiment did not involve even one vagina or circumcised penis. [39] The use of these studies shows that DOC does not follow scientific principles. Or perhaps they don't understand how science works in the first place.
PSYCHOLOGICAL IMPACT
DOC cited several studies to show that circumcision causes PTSD, "anger, shame, shyness, fear, low self-esteem, and decreased ability for emotional intimacy." [39] My analyses of circumcision grief [40] and other psychological effects [41] addressed these studies and debunked various claims regarding longterm trauma. The Centers for Disease Control also addressed many of these assertions. [42]
Of particular concern is DOC's promotion of a study by longtime anti-circumcision activist Morten Frisch. DOC claims that the study shows that "circumcised boys may have a greater risk of developing autism spectrum disorder before age ten and a higher risk for infantile autism before age five."
This alarming statement ignores the study's several deficiencies. Frisch cited a study that examined a link between autism and Tylenol usage, not circumcision. Frisch equated displaying a painful reaction with experiencing a pain reaction. He admitted that there were significant cultural differences between the circumcised Muslims boys and the uncircumcised Danish boys. Finally, DOC ignored the author's caveat that "no firm conclusions should be drawn at this point." [43] [44] The CDC noted that the many methodological and analytic concerns makes "the findings suspect." [42]
CONCLUSION
Doctor is the second most trusted profession in the United States - second only to nursing. [45] Parents trust medical professionals to provide accurate, unbiased, sober, and scientifically valid information and advice. We trust them with our lives and the lives of our children.
Doctors Opposing Circumcision is a sham organization that betrays and exploits our faith and trust in the medical establishment. George Denniston should change the name to "Doctors Opposing Medicine". The problem is not that DOC advocates against circumcision. The problem is that DOC promotes the same false, misleading, and hysterical "intactofacts" as other anti-circumcision groups.
At its core there is no meaningful distinction between DOC and other intactivist groups. As a former Pentagon official put it, "You can put a lot of lipstick on a pig, but it's still a pig." [46]
[1] "About Us"; Doctors Opposing Circumcision. Last accessed January 14, 2020
[2] Roger Collier; "Ugly messy and nasty debate surrounds circumcision"; Canadian Medical Association Journal; January 10, 2012
[3] George C. Denniston; "Doctors Opposing Circumcision - George Denniston"; YouTube; April 20, 2016
[4] Susan Blank, M.D. et al; "Male Circumcision - Task Force on Circumcision Technical Report"; Pediatrics; September 2012
[5] "Intactivist Lie of the Week: All or Most Circumcisions Result in Complications"; Circumcision Facts and Science; July 10, 2017
[6] George C. Denniston; "Circumcision and the Code of Ethics". Humane Health Care International; April, 1996.
[7] "Is it true that just 1 in 16,667 men will require a circumcision?"; Circumcision Choice; November 29, 2018 [8] George C. Denniston, et al; "Genital Cutting: Protecting Children from Medical, Cultural, and Religious Infringements", p 63; Springer; 2013. "In my practice, I have seen how circumcision can be posited as the untoward cause of many abortions. Adult neonatally circumcised males frequently exhibit an irrational terror at the prospect of a vasectomy. They finally go reluctantly, after their wife has had at least two abortions. They knew that they did not want more children, but their fear of a genital operation was so great from the early trauma of circumcision that they refused vasectomy and thus let their wives suffer needlessly. Multiply these experiences by the 500,000 vasectomies that are performed every year in the United States, and there is the potential for one million abortions caused by circumcision each year."
[9] James Loewen; "A Message for Parents-To-Be from Dr. George Denniston; YouTube; February 4, 2018
[10] Amy Tuteur; "Why is American Home Birth So Dangerous?" New York Times; April 30, 2016
[11] "Phimosis & Balanitis"; Doctors Opposing Circumcision
[12] K.R. Shanker and A.M.K. Rickwood; "The incidence of phimosis in boys"; BJU International; 1999 [13] Ida Sneppen and Jørgen Thorup; "Foreskin Morbidity in Uncircumcised Males"; Pediatrics; May 2016
[14] "Does my son really need a circumcision to treat a foreskin infection?"; Doctors Opposing Circumcision
[15] "What if my son gets a urinary tract infection?"; Doctors Opposing Circumcision
[16] "Circumcision and urinary tract infections"; Children's Hospital of Orange County; June 19, 2015 [17] EJ Schoen et al; "Newborn circumcision decreases incidence and costs of urinary tract infections during the first year of life"; Pediatrics; April 2000. "Newborn circumcision results in a 9. 1-fold decrease in incidence of UTI during the first year of life."
[18] D Singh-Grewal et al; "Circumcision for the prevention of urinary tract infection in boys: a systematic review of randomised trials and observational studies"; Acute paediatrics; May 12, 2005. "The odds of UTI in circumcised boys are about 0.1 when compared with uncircumcised boys. This represents a reduction in odds of nearly 90%."
[19] Michael L. Eisenberg et al; "The Relationship between Neonatal Circumcision, Urinary Tract Infection, and Health"; The World Journal of Men's Health; March 2018. "Importantly, no difference in the rate of UTI was identified in the first two weeks of life. However, up to 2 years of age, uncircumcised boys had a higher rate of UTIs compared to circumcised boys (2.68 per 100 person-years vs. 0.59 per 100 person-years)."
[20] Debora MacKenzie; "UTIs could soon be life-threatening without new antibiotics"; New Scientist: February 20, 2017
[21] Matt Richtel; "Urinary Tract Infections Affect Millions. The Cures Are Faltering"; New York Times; July 13, 2019
[22] "Antibiotics Aren't Always the Answer"; Centers for Disease Control; August 23, 2018 [23] "Circumcision linked to SIDS"; Doctors Opposing Circumcision; January 11, 2019
[24] Eran Elhaik; "Adversarial childhood events are associated with Sudden Infant Death Syndrome (SIDS): an ecological study"; University of Sheffield; June 7, 2018
[25] "Circumcising babies increases risk of cot death, contested new study suggests"; Jewish Telegraphic Agency; August 17, 2018
[26] Andrew Gross; "No, circumcision doesn't cause SIDS"; Circumcision Choice; April 21, 2022
[27] "Sexually Transmitted Infections (STIs)"; Doctors Opposing Circumcion
[28] In the classic fairy tale Peter Pan was the boy who never grew up. The Peter Pan fallacy assumes that a population - in this case infant boys - will remain static and never grow up. In reality children can be sexually active long before they reach the age that DOC would allow a male to choose circumcision. Masturbation is quite common as early as age 5 or 6. And the U.S. Centers for Disease Control has estimated that 55% of American teens are sexually active before age 18.
[29] "The Sexual Impact of Circumcision"; Doctors Opposing Circumcision [30] "HIV/AIDS"; Doctors Opposing Circumcision
[31] Stephen Moreton; "Doctors Opposing Circumcision lie about HIV"; CircFacts.org; January 31, 2021
[32] Kristen O'Hara and Jeffrey O'Hara; "The effect of male circumcision on the sexual enjoyment of the female partner"; BJU International; January 1999
[33] Andrew Gross; "Sex as the researcher intended it"; Circumcision Choice; April 14, 2018
[34] Jennifer A Bossio et al; “You either have it or you don’t: The impact of male circumcision status on sexual partners”; Canadian Journal of Human Sexuality; 2015
[35] Shen Z, et al; "Erectile function evaluation after adult circumcision; Zhonghua Nan Ke Xue; 2004
[36] Nor can the study of patients who were diagnosed with erectile dysfunction prior to the procedure tell us about possible effects of elective circumcision for healthy adult men. A study of more than 2,700 African men found that “adult male circumcision was not associated with sexual dysfunction. Circumcised men reported increased penile sensitivity and enhanced ease of reaching orgasm." J.N. Krieger, et al; "Adult Male Circumcision: Effects on Sexual Function and Sexual Satisfaction in Kisumu Kenya"; Journal of Sexual Medicine; 2008
[37] Donald R Taves; “The intromission function of the foreskin”; Medical Hypotheses, pp 180-182; August 2002. George Denniston previously cited this study to show that "circumcision has been shown to increase the difficulty of penetration."
[38] Andrew Gross; "The Styrofoam Vagina"; Circumcision Choice; May 30, 2019
[39] "The Psychological Impact of Circumcision"; Doctors Opposing Circumcision
[40] Andrew Gross; "The Circumcision Grief paradox"; Circumcision Choice; June 4, 2022
[41] Andrew Gross; "Does circumcision cause psychological damage?" Circumcision Choice; February 7, 2019
[42] "Summary of Public Comments and CDC Responses to Public Comments for Information for Providers to Share with Male Patients and Parents Regarding Male Circumcision and the Prevention of HIV infection, Sexually Transmitted Infections, and other Health Outcomes"; U.S. Centers for Disease Control and Prevention; August, 2018
[43] Morten Frisch and Jacob Simonsen, “Ritual circumcision and risk of autism spectrum disorder in 0- to 9-year-old boys: national cohort study in Denmark”; Journal of the Royal Society of Medicine; January 8, 2015
[44] Also see Ava Neyer; “The problem with articles on autism risks and how to evaluate studies. Or why circumcision is unlikely to increase rates of autism”; The Chimerical Capuchin; January 10, 2015 [45] Niall McCarthy; "America's Most & Least Trusted Professions"; Forbes; January 11, 2019
[46] Torie Clarke; "Lipstick on a Pig: Winning In the No-Spin Era by Someone Who Knows the Game"; Simon and Schuster; 2006