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Intact America Part 2: They're unreliable because they lie

Intact America brazenly lies and distorts circumcision studies and statements from medical authorities. Today we present four such examples. Intact America and its leaders falsely claim

  • that circumcision causes more than 100 deaths in the U.S. each year

  • that a study shows that circumcision contributes to erectile dysfunction

  • that the AAP admits that circumcision complications were not systematically studied

  • that a member of the AAP task force backtracked from the Policy Statement

CIRCUMCISION DEATHS

Intact America warns that more than 100 boys die from circumcision in the United States each year. This claim is based on a 2010 study by Intact America's strategy adviser Dan Bollinger. [1]

Bollinger admitted that 117 deaths was a "rough estimate." His figure was quickly refuted by software engineer Jake Waskett. [2] Waskett observed that Bollinger's estimate was not based on any actual deaths attributed to circumcision, but rather was based on two faulty assumptions.

First, Bollinger found that the fatality rate for male neonates during 1991-2000 was 40% higher than the fatality rate for female neonates. He assumed that the higher rate was based entirely on circumcision. But Waskett noted that males have a significantly higher neonatal fatality rate than females all over the world, including in countries with low circumcision rates.

Second, Bollinger multiplied his total by 7.72 in order to account for circumcision deaths that occur after hospital release. But he offered no evidence that all or most male neonatal deaths after discharge were caused by circumcision.

According to The Circumcision Decision, “Other experts on infant mortality put the rate of mortality from circumcision at between 0 and 3 per hundreds of thousands of circumcisions. This is based on a study that showed zero deaths in 100,000 U.S. infant circumcisions, and another study that found a mortality rate of 1 death in 500,000 circumcisions. Given that there are 1.3 million male infant circumcisions in the U.S., that would put the mortality rate at 0 to 2.5; not 100 to 117.” [3]

The 117 figure is so off base that even in their 2012 response, the European critics of the AAP didn't mention Bollinger's figure when discussing circumcision deaths. [4] Yet Intact America continues to use this discredited number to mislead its followers and the general public. [5]

ERECTILE DYSFUNCTION

Intact America has cautioned that circumcision contributes to erectile dysfunction, citing a 2011 study which found that circumcised men were 4 1/2 times more like to have erectile dysfunction than the uncircumcised men. [6]

Making general conclusions based on this preliminary study is premature and careless. The results were skewed by self-selection bias, and should not be used to make broad generalizations.

How do we know that it's irresponsible to apply the results to the general population? Because Intact America's Dan Bollinger said so! As co-author of the study, Bollinger cautioned, "We hope readers will heed our advice in not extrapolating these results to the general population from this preliminary investigation, but instead use it as a springboard to further investigation, perhaps in a sufficiently large random-sample study." [6] Intact America cannot claim ignorance when it publishes broad statements that the "study shows that circumcised men have a 4.5 time greater chance" of ED and that "circumcision [is] a significant contributor to ED."

Bollinger's study conflicts with a 2008 study by John Krieger that found no correlation between circumcision and erectile dysfunction. Krieger reported, "Adult male circumcision was not associated with sexual dysfunction.” [7] [8]

CIRCUMCISION COMPLICATIONS

Executive Director Georganne Chapin has repeatedly claimed that the AAP Task Force "admits that the risks and complications have never been systematically studied.’” [9] [10] This is a significant distortion of the AAP Policy Statement.

The AAP did not say, as Chapin falsely asserted, that circumcision complications have never been systematically studied. (The word "systematically doesn't appear anywhere in the AAP Policy Statement.) Rather, the AAP explained that definitions of complication, early complication, and late complication vary from study to study, making it difficult to merge the data in order to arrive at a precise total complication rate. Additionally, complication rates for procedures that are performed by trained hospital personnel may be different from those in developing countries and by untrained ritual practitioners.

And the very next sentence in the Policy Statement reported that “significant acute complications are rare, occurring in approximately 1 in 500 newborn male circumcisions.” The AAP added that circumcisions performed by trained professionals in modern medical facilities have fewer complications. [11]

THE FREEDMAN ARTICLE

Following the reaction to the AAP's 2012 Policy Statement, Task Force member Dr. Andrew Freedman wrote an article for the AAP journal to clarify common misconceptions and offer a solution that different sides of the debate might consider. [12]

Within a month the executive director of Intact America pounced on the article. Georganne Chapin explained to a radio audience that Freedman had admitted that circumcision doesn't have any medical benefits. [emphasis by the speaker] “In this commentary he says, "We didn't mean that it was medically beneficial. We meant that it was important culturally in America.’ … In other words, he basically threw under the bus all of the previous medical rationales.” [13]

Intact America has continued to assert that Freedman walked back the AAP Policy Statement. [14] '

But Intact America has distorted Freedman's point. In an email to a Circumcision Choice admin, Freedman complained that circumcision opponents...

“... are misrepresenting my views and taking my words out of context. I have not backtracked from the original policy statement... Unfortunately people, including anti-circumcision activist, [sic] tend to read the policy as a binary equation. Circ good or Circ bad. The policy clearly stated that it was not an endorsement for universal newborn circumcision but a recognition that there is more to that decision than just the medical and that those elements deserved respect and acknowledgement … The point of my editorial was not to tear down or walk back the policy but instead to highlight it’s [sic] nuance, acknowledge what really is going on in the offices and nurseries day to day, and point the way out of this mess.” [15]

A review of Freedman's article shows that his recollection is correct. [emphasis added]

“To understand the recommendations, one has to acknowledge that when parents decide on circumcision, the health issues are only one small piece of the puzzle. In much of the world, newborn circumcision is not primarily a medical decision. Most circumcisions are done due to religious and cultural tradition. In the West, although parents may use the conflicting medical literature to buttress their own beliefs and desires, for the most part parents choose what they want for a wide variety of nonmedical reasons. There can be no doubt that religion, culture, aesthetic preference, familial identity, and personal experience all factor into their decision. Few parents when really questioned are doing it solely to lower the risk of urinary tract infections or ulcerative sexually transmitted infections. Given the role of the phallus in our culture, it is not illegitimate to consider these realms of a person’s life in making this nontherapeutic, only partially medical decision.” [12]

Freedman was explaining that parents often choose circumcision for reasons other than the medical benefits, which are minor. Nothing in the article would lead one to the conclusion that the procedure has no medical benefits.

MORE DISHONESTY

Intact America created "Circumcision Debate" - an Astroturf website that gives a false appearance of neutrality - in order to lure people who are seeking to understand both sides of the debate. The group often ignores pertinent facts and cherry-picks a sentence, deceiving their followers into believing that an article or study supports their anti-circumcision agenda. And yes - the group continues to publish statements that are flat-out FALSE, FALSE, FALSE!

[1] Dan Bollinger, "Lost Boys: An Estimate of U.S. Circumcision-Related Deaths": Journal of Boyhood Studies; Spring 2010

[2] Jake Waskett, "Fatally Flawed: Bollinger's circumcision death calculations": Circumcision News; May 8, 2010

[3] Susan Terkel and Lorna Greenberg; "117 Deaths from Circumcision?"; The Circumcision Decision; 2013

[4] Morten Frisch, et al; "Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision"; Pediatrics; March, 2013.

"Incidental deaths ... have also been reported, but exact figures are not available."

[5] See also our post These Boys, which discusses a list of deaths that intactivists have attributed to circumcision.

[6] Dan Bollinger and Robert S Van Howe; “Alexithymia and Circumcision Trauma: A Preliminary Investigation"; International Journal of Men's Health, pp 84-195; July, 2011

[7] JN Krieger; "Adult Male Circumcision: Effects on Sexual Function and Sexual Satisfaction in Kisumu, Kenya"; J Sex Med; November, 2008

[8] For a detailed critique of the Bollinger-Van Howe study, and the authors' reply, see Brian J Morris and Jake H Waskett; "Claims That Circumcision Increases Alexithymia and Erectile Dysfunction Are Unfounded: A Critique of Bollinger and Van Howe’s “Alexithymia and Circumcision Trauma: A Preliminary Investigation”; International Journal of Men's Health; 2012. In defense of their study, Bollinger and Van Howe cited a 1999 Kristen O'Hara study that a Circumcision Choice admin has thoroughly refuted here.

[9] Georganne Chapin; "We're appalled at genital mutilation of girls. What about boys (and circumcision)?"; Minneapolis Star Tribune; May 11, 2017 [10] Georganne Chapin; NewsTalk Ireland; August 4, 2017. Quote begins at 4:29

[11] Susan Blank, et al; Task Force on Circumcision Technical report; Pediatrics; September, 2012

[12] Andrew L Freedman; "The Circumcision Debate: Beyond Benefits and Risks"; Pediatrics; May, 2016

[13] Georganne Chapin; Thresholds; KPFT Radio, Houston; June 10, 2016 (quote begins at 7:52)

[14] For example, see Georganne Chapin; "Dear Dr. Remley"; Intact America Blog; March 7, 2017. [emphasis in the original] "Freedman’s April 2016 statement sought to 'clarify' the meaning of the 2012 Report’s 'benefits outweigh the risks' position. According to Freedman, the report wasn’t really talking about the medical benefits of [circumcision], but rather the overall benefits..." "Parents Tell the DOC!"; A project of Intact America, Your Whole Baby, Intaction, The Whole Network; May, 2017. "In 2016, Dr. Andrew Freedman, a pediatric urologist who was on the Circumcision Task Force that produced the Report, seemingly backtracked on the policy..."

[15] Andrew L Freedman; email to Andrew Gross; May 10, 2017

October 7: Part 1 - Introduction

October 8: Part 2 - They're unreliable because they lie

October 9: Part 3 - History - the pressure was both inappropriate and indefensible

October 10: Part 4 - We will cannibalize ourselves, rather than focus on the real enemy

October 11: Part 5 - A wild goose chase backfires

October 12: Part 6 - One boy vs five hundred thousand girls

October 13: Part 7 - Conclusion: Where have you gone, Joe DiMaggio?

August 18, 2019: Intact America makes absurd proposal that refutes itself

#IntactAmerica #117Deaths #ErectileDysfunction #SexualProblems #SexualDysfunction #ED #CircumcisionComplications#CircumcisionDeaths #CircumcisionHarms #MedicalBenefits #Astroturfing #CherryPicking #Lies #Falsehoods #Mendacity #Deception

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