Medicalized (non-religious) circumcision, an invention of English-speaking physicians, is in steep decline everywhere in the world — except for the United States. Join Marilyn Milos, RN; John Geisheker, Esq.,; Ronald Goldman, Ph.D.; Gillian Longley, RN, BSN; and Miriam Pollack in a critical examination of the practice of infant male circumcision in North America.

Photo courtesy Jessica Wallach, www.PortraitPlaytime.com

Part One:
The Foreskin

The United States has been a predominantly circumcising culture since the mid 20th century, a time when childbirth and infancy began to be heavily medicalized through childbirth interventions and the aggressive marketing of infant formulas.   Along with the loss of knowledge of normal childbirth and breastfeeding, Americans have also lost their knowledge of the normal intact (non-circumcised) penis.

This lack of knowledge of the foreskin on the part of North American parents and health professionals underlies, in part, the perpetuation of the practice of circumcision, and has frequently led to false or harmful advice on the care of intact boys.  Part I of this series will demystify the foreskin, while at the same time laying a foundation for understanding the harmful impact of its loss to circumcision.

Warning: These workshops are liberally illustrated with photographs and diagrams of adult and infant penises, as well as graphic images of the circumcision procedure. These images are intended for educational purposes only, but some viewers may find them offensive or disturbing. Viewer discretion is advised.

The foundation of understanding the value of not circumcising infant boys is having a solid knowledge of what the foreskin is, and what it is there for.  In this course, Gillian Longley RN, BSN, explains the anatomy of the intact penis, and shows how its unique structure and specialized tissue support a wide array of protective and sexual functions. The development of the foreskin in the fetus and child will also be discussed, particularly the gradual natural separation of the foreskin from the head (glans) of the penis.  This information will provide the rationale for a discussion of correct care of the penis in the intact boy, and the normal variations that may occur during penile development in childhood.

John Geisheker, J.D., LL.M., Executive Director of Doctors Opposing Circumcision, will conclude this course with a discussion of the problem of forcible, premature retraction of the foreskin by incorrectly informed health care professionals. Although the American Academy of Pediatrics specifically recommends against forcible retraction, as circumcision rates drop in North America more and more boys are subjected to this inappropriate, unnecessary, and harmful practice that is obsolete in most of the world.

Dates:
Sunday, October 5, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern
Tuesday, October 21, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

Circumcision: Surgical Methods and Complications (90 minutes)
Presenter:  Gillian Longley RN, BSN

Parents are largely unfamiliar with the realities of how a foreskin is actually cut away. The common myths that circumcision is “quick and safe,” ”just a little snip” or that the baby doesn’t experience any pain are false representations of the procedure. In fact, circumcision involves multiple tissue-damaging steps to remove the foreskin. Moreover, the circumcision devices used on the small penis of a newborn are relatively imprecise - which may lead to specific complications beyond the usual surgical risks of bleeding and infection. This course, led by Gillian Longley RN, BSN, will provide participants with an in depth understanding of what is really involved with a circumcision and what the baby undergoing a circumcision may experience, during and after the procedure.

The course begins with an exploration of infant pain, and circumcision pain relief measures, including the facts that not all doctors use anesthesia for circumcision, that no method of local anesthesia has been shown to completely eliminate the pain of circumcision, and that babies do remember the pain of circumcision. The three main techniques of infant circumcision will be explained step by step with still photo illustrations.  The range of complications which may result are illustrated and explained, including the often-ignored longer term harms that may occur due to loss of the foreskin’s protective and sexual functions, which may not manifest until years later.

The course will close with a brief look at the potentially harmful effects of circumcision on breastfeeding and mother-child bonding, which will be covered in greater depth in a later class in this series.

Dates:
Sunday, October 12, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern
Tuesday, October 28, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

How Circumcision Affects Sexuality (90 minutes)
Presenter: Marilyn Milos, RN

Circumcision is a primal wound that causes pain and trauma to an infant’s penis–his organ of pleasure and procreation. Initially, circumcision interferes with the maternal infant bond, disrupts breastfeeding and normal sleep patterns, and undermines the successful completion of the baby’s first developmental task of establishing trust. Even when analgesia is used, circumcision causes pain to the penis, and every experience of that organ, from then on, is overlaid on a neuronal background of pain.

Circumcision removes the foreskin, with its 20,000 - 70,000 specialized, erogenous nerve endings, replacing the penile accelerator that allows a man to ride the wave to orgasm with an on/off switch that offers sensitivity and immediate relief without the ride to orgasm and the full symphony of sensation.  This is why the most common complaint of circumcised men in the USA is premature ejaculation.  At the other end of life, circumcised males complain about sexual dysfunction, including loss of sensitivity and impotence. Many women wonder why sex with a circumcised man is not fulfilling for them. They do not understand the role the foreskin plays in female sexual pleasure, including the gliding mechanism and lubrication.

This workshop, led by Marilyn Milos, RN, Executive Director of NOCIRC, will explore the effects of circumcision on an infant and on the man he becomes. The dynamics of circumcision, sex, and compensation for the trauma and loss will be discussed.

Dates: 
Sunday, October 26, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern
Tuesday, November 4, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

Part Two:  
The Psychology of Circumcision

Circumcision may be the missing piece of the American male psychological puzzle. Some men have discovered a connection between their circumcision and adult feelings related to sexuality, women, self-esteem, and other issues. Part II will focus on the short and long-term effects of circumcision and psychological impacts on individuals and society.  Participants will learn that circumcision not only impacts a man’s sexuality and male/female relationships, but also interferes with breastfeeding and maternal/infant bonding.   These lectures will be of particular interest to those who work with men’s issues, women who want to understand men better, and healthcare professionals who are concerned about preserving the motherbaby relationship.

Infant Response, Long-Term Psychological Effects, and Why Circumcision Continues (90 minutes)
Presenter: Ronald Goldman, Ph.D.

• How does being circumcised feel to the newborn infant? Does the newborn infant feel “discomfort” or extreme pain?
• Does it matter how circumcision feels to the newborn infant? Can newborn infants remember their experience?
• Is an infant too young to experience trauma?
• Are there any examples of events around birth that have a long-term effect on adult
  behavior?
• Can memory of birth be documented?

We will apply the clinical definition of trauma to circumcision and look for symptoms of post-traumatic stress disorder in circumcised men. This new perspective offers clues that could explain certain male feelings, attitudes, and behaviors.  This session will conclude with an exploration of the psychosocial factors that perpetuate circumcision.  In an examination of individual and institutional resistance to change, learn how cultural, emotional, behavioral, and psychological factors affect attitudes and behaviors about circumcision and related matters.  Various anxieties, beliefs, and values impede change - see how we can ignore or deny what is literally in front of our eyes.

Dates:
Sunday, October 19, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern
Tuesday, November 11, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

Circumcision is offered as an option to virtually every mother of a male child born in an American hospital. This parental decision can have unrecognized immediate and long-term consequences on the health of the child and parent.  The lessons of circumcision are many; they remind us of our core values and are applicable to other areas of life. These lessons involve the powerful impact of early infant experience, cultural values, the limitations of science, intellect vs. instinct, and how to make important childcare decisions.

Dates:
Sunday, November 2, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern
Tuesday, November 18, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

Part Three:
Cultural and Economic Underpinnings

Part III will explore the cultural and economic underpinnings of the practice of circumcision.  What are the origins of this cultural practice? Why do non-observant Jews engage in this practice?  Why does infant male circumcision persist in North America, while all other English-speaking nations have either fully abandoned or sharply curtailed it?  What bioethical issues does the practice of circumcision raise? What economic issues sustain this practice, especially in the USA? This part will end with a discussion of growing objections to circumcision within the Jewish population in the United States and in Israel.

Medical Claims, Past and Present (90 minutes)
Presenter:  John Geisheker, JD, LL.M.

There have been many claims made for circumcision through the more than a century of its medicalization.  These claims have generally been a response to the disease most feared at the time.  In the 19^th Century, when the cause of mental disease was unknown, circumcision was claimed to prevent mental illness which supposedly was caused by masturbation.  At the time of the First World War, circumcision was claimed to protect against venereal disease.  From the 1930s to the 1980s, claims were made that circumcision offered protection against cancer.  Although all of these claims have been disproved, some new ones have emerged.  

Does circumcision really protect against AIDS and 100 other diseases and conditions? What are the lingering myths about hygiene needs of boys, and why aren’t physicians re-educating parents and/or advocating for their young patients?   Join John Geisheker, JD, LLM, and Executive Director of Doctors Opposing Circumcision in an exploration of the latest research on the effect of circumcision on a child and his family, and a review of current warnings from world medical societies. 

Dates:
Sunday, November 16, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern
Tuesday, December 2, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

• Beneficence.  The procedure must be directly beneficial to the patient, that is, tailored to address the actual, immediate, and proven needs of the individual patient and no other person.
• Non-Maleficence.  The procedure must cause no avoidable direct or collateral harm, including pain.
• Proportionality. The procedure must be proportional to, no worse than, and curative of the disease or condition diagnosed.  It must begin with the most conservative care and only then move, in measured steps, to more intrusive care.
• Justice.  The procedure must address the actual and immediate needs of the minor or incompetent patient viewed from the patient’s lifetime perspective, rather than the momentary, non-therapeutic or cultural whims of his or her caretakers.

In this program, John Geisheker, J.D., LL.M., Executive Director of Doctors Opposing Circumcision, challenges attendees to consider whether circumcision could possibly meet any one of these bioethical standards - let alone pass the entire test. If circumcision fails as evidence-based medicine, it immediately fails bioethical scrutiny and becomes a mere cultural phenomenon, exposing practitioners to liability. This workshop will conclude with an examination of the role physicians and lawyers can play in ending medically-unnecessary circumcisions. 

Dates:
Sunday, November 23, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern
Tuesday, December 9, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

Part Four: 
Effecting Change
(A Supplemental Program for Intactivists)

Conscious Activism (three, 90-minute workshops)
Presenter:  James S. Turner, Esq.

Over the years, many activist templates have been developed in successful campaigns to influence social policy and public opinion. One of the most successful templates has been developed and utilized by James S. Turner, Esq. , one of the original Nader’s Raiders and author of The Chemical Feast: The Nader Report on Food Protection at the Food and Drug Administration (1970) , an example of the template, and Making Your Own Baby Food (1977), an integrated muckraking and activist self-help book for parents that draws on the template. The many successes that Jim has been involved in include passage of the Organic Food Protection Act of 1990, a four-year campaign on the dangers of artificial sweeteners (Nutrasweet, Saccharin, Aspartame, and Splenda), and the campaign to block Swine Flu vaccination (1976). He also led the legal and scientific team that persuaded the FDA to reclassify acupuncture needles as safe and effective for legal U.S. importation and distribution (1996).

Through these workshops, you will recognize that there are habitual structures in society which limit our ability to be effective, and there are additional structures - often, if not usually overlooked -which will enhance and empower effectiveness if we are congruent with their bedrock reality. Explore the basis of and learn to use this activist template, the backbone of successful campaigns that resulted in intentional, positive social change. 

(JAN/FEB 2009)

REGISTER NOW!

Series of 9 Workshops - $360  ($40 per session - a $90 savings!)

Sundays, October 5, 12, 19, 26, November 2, 9, 16, 23, and December 7, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern

Tuesdays, October 21, 28, November 4, 11, 18, 25, December 2, 9, and 16, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

Series of 3 Workshops - $135 ($45 per session - a $15 savings!)

Part I: The Foreskin (3 presentations)
Sundays, October 5, 12, and 26, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern

Part I: The Foreskin (3 presentations)
Tuesdays, October 21, 28 and November 4, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

Part II: The Psychology of Circumcision (3 presentations)
Sundays, October 19, November 2 and 9, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern

Part II: The Psychology of Circumcision (3 presentations)
Tuesdays, November 11, 18 and 25, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

Part III: Cultural and Economic Underpinnings (3 presentations)
Sundays, November 16, 23 and December 7, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern

Part III: Cultural and Economic Underpinnings (3 presentations)
Tuesdays, December 2, 9, and 16, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

Individual Workshops - $50 each

The Foreskin
Sunday, October 5, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern
Tuesday, October 21, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

Circumcision: Surgical Methods and Complications
Sunday, October 12, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern
Tuesday, October 28, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

How Circumcision Affects Sexuality
Sunday, October 26, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern
Tuesday, November 4, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

Infant Response, Long-Term Psychological Effects, and Why Circumcision Continues
Sunday, October 19, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern
Tuesday, November 11, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

Lessons of Circumcision & Effective Communication
Sunday, November 2, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern
Tuesday, November 18, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

Circumcision as a Woman’s Issue
Sunday, November 9, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern
Tuesday, November 25, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

Medical Claims, Past and Present
Sunday, November 16, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern
Tuesday, December 2, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

Law & Ethics
Sunday, November 23, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern
Tuesday, December 9, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern

Questioning Jewish Circumcision
Sunday, December 7, 2008 at 2:00 p.m. Pacific / 5:00 p.m. Eastern
Tuesday, December 16, 2008 at 5:00 p.m. Pacific / 8:00 p.m. Eastern