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An open letter to an unenlightened intactivist

Andrew Gross

February 5, 2022

On December 1, 2021 Intact America published an open letter from Executive Director Georganne Chapin to urologist Dr. Michael Mooreville in response to their letters that were published in the same edition of The New Yorker magazine. This post is a letter (slightly edited) that I wrote to Chapin and copied to Dr. Mooreville.

Dear Georganne,

I am writing about your October 11 letter to The New Yorker and your December 1 open letter to Dr. Michael Mooreville. Thank you in advance for taking the time to read my comments below.

Citing a 2019 report published in the Journal of Pediatric Surgery, you stated that "eleven per cent of pediatric-surgery malpractice cases involve circumcision." As Circumcision Choice explained in a December 11 blog post, that statistic has no bearing on the overall safety or risk of the procedure. It would be like saying that motor vehicle accidents cause 20% of all child deaths - more than any other cause - and then conclude that motor vehicles are too dangerous for child passengers. The actual relevant statistic is 0.000887, which is the estimated percentage of pediatric circumcisions that result in a malpractice lawsuit.

You wrote that American doctors and hospitals put babies at risk with a procedure that is not routinely performed on male children in any other Western country. Actually circumcision during infancy is very safe. The AAP has estimated that 1 in 500 newborn circumcisions results in a significant complication, and most complications are easily treated with immediate medical intervention. By comparison a study in Denmark found that 1 in 20 uncircumcised boys under 18 suffered a foreskin complication significant enough to require treatment at a medical center. In other words the risk of a significant foreskin complication is 25 times higher than the risk of a significant circumcision complication.

It’s unclear to me why you compared the United States to other Western countries, since intactivists typically oppose circumcision in every country on earth. At any rate, the procedure is routine for boys in Canada (32%) and Israel (92%.) It’s also provided for most male children in the Philippines, South Korea, Turkey, Africa, and Israel's neighbors in the Middle East.

You asked Dr. Mooreville if other healthy body parts should be removed for preventative medical benefits. Intactivists pose this rhetorical question so often that four years ago, Circumcision Choice published a comprehensive analysis authored by Melanie Lindwall Schaab APRN, FNP-C. She concluded that the foreskin "is the only organ that is safest to remove in newborns" and "simply cannot be logically compared to the prophylactic removal of any other organ."

[The following paragraph did not appear in the mailed letter.]

You told Dr. Mooreville that the rate of penile cancer in the United States is just 1 in 100,000 men. The figure you cited is the annual rate, not the lifetime rate. Over the course a man's life, his risk is between 1 in 600 and 1 in 900. This year about 2,070 men in the U.S. will be diagnosed with penile cancer, and about 470 men will die from the disease. That's nine preventable deaths every week, because circumcision during infancy reduces a male's lifetime risk by more than 99%.

If you are a stickler for accuracy, you'll want to correct the many false statements that you and Intact America have made over the years. For example, you have often falsely stated that (1) the AAP Task Force admitted that the risks and complications have never been systematically studied; and (2) Dr. Andrew Freedman admitted that circumcision doesn't have any medical benefits. Check the Circumcision Choice Facebook page for several other false and misleading statements by Intact America. (Search #IntactAmerica or #FridayForeskinFacts.)

I hope that you will sincerely consider my feedback and dare to think in a more common-sense way about a simple medical procedure that is typically benign, beneficial, and normal. I further hope that you will correct your own mistakes, lest you be declared a hypocrite the next time you decide to deliver a public reprimand.

Very truly yours,

Andrew Gross

Circumcision Choice

cc: Dr. Michael Mooreville


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