# Circumcision down to 56% in USA



## carriebft (Mar 10, 2007)

http://www.medicalnewstoday.com/articles/94200.php










i find it odd that the summary claims factors for lower rates are immigration and insurance coverage when the report itself specifically says:

Quote:

Changes in public sentiment, differences in insurance coverage, or fluctuations in immigrant populations can impact the prevalence of the procedure.
I suppose they just *accidentally* overlooked the first reason.


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## moonmama7 (Jan 9, 2006)

I thought it's been down to 50/50 for years now.


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## SammyJr (Aug 21, 2006)

The immigrants thing is pure Schoen. He has always tried to paint circumcision as the patriotic, all-American thing to do and that only ignorant, dirty, first generation aren't circumcised. Like with many things in this country, when you run out of evidence and the lies stop working, wave the flag and question the patriotism of the nonbelievers.


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## phatchristy (Jul 6, 2005)

Well, the statistics they took are for hospital births, it wouldn't cover those who are born outside of a hospital setting would it? And, would it cover those who circ at a ped's office?


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## paquerette (Oct 16, 2004)

I think 99% of births are in a hospital environment, so out of hospital births are statistically irrelevant.


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## carriebft (Mar 10, 2007)

Quote:


Originally Posted by *moonmama7* 
I thought it's been down to 50/50 for years now.

Hovering around...it was 57 for two years in a row I believe, so this is a lowering from there.


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## mamabain (Sep 19, 2002)

i believe the immigrant population bit. not stereotypically but just because i don't see my hispanic clients cutting their boys as often as i hear the anglo and african american clients in my office doing so. i live in indiana which is probably closer to 80 or 90% circ rate.


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## Benji'sMom (Sep 14, 2004)

"The national rate has remained relatively stable for a decade. It peaked at 65 percent in 1980. "

Wha? Only 65%? I thought it peaked at closer to 90%?


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## Ophelia (Feb 16, 2005)

Quote:


Originally Posted by *Benji'sMom* 
"The national rate has remained relatively stable for a decade. It peaked at 65 percent in 1980. "

Wha? Only 65%? I thought it peaked at closer to 90%?

And I thought just about all male babies in the U.S. were circ'd in the 60's and 70's. Actually, I was naive and used to think only Jewish circ'd and was very sorry to find out I was wrong.

Does anyone have stats from decades ago (without graphic pictures)?


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## MCatLvrMom2A&X (Nov 18, 2004)

Statistics: http://www.cirp.org/library/statistics/USA/
This one goes all the way back to 1937 with a rate of 30% that year. With a peak of nearly 100% from 62-71. Lots of other graphs there as well.

Statistics: http://www.circs.org/reviews/rates/usa.html Info from 79 on.

Statistics: http://www.cirp.org/library/statistics/bollinger2003/ This one starts in 1870 with a 0% rate, then showing a peak at around 1980 with a steady decline after that up to 2000. In 2001 according to the graphic there was a circ rate of 51.1%


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## crazy_eights (Nov 22, 2001)

It varies by region also. The Midwest and South still have very high RIC rates. And working in the hospital in L&D where one of the intake questions is "do you desire circ", I have to say that at least here it is almost across the board, only immigrants that decline.


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## carriebft (Mar 10, 2007)

South rates: 56%

They aren't doing too bad.

Midwest: 75%

also getting better


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## Mommiska (Jan 3, 2002)

Quote:


Originally Posted by *mom2seven* 
It varies by region also. The Midwest and South still have very high RIC rates. And working in the hospital in L&D where one of the intake questions is "do you desire circ", I have to say that at least here it is almost across the board, only immigrants that decline.

And your point is?

It seems to more than just hint at racism to suggest that it is 'only' immigrants who are causing the drop in circumcision rates in the States.

In this case - good for the immigrants! They have the self-confidence and knowledge not to be sucked into needlessly harming their infants and damaging their child's future sex life, simply in order to 'fit in'. That's more than can be said for the parents of 56% of American newborn boys.









But rates for parentings cutting their children are down all over the States - 56% overall, which means that 44% of little boys are being left intact.

There are clearly _many_ non-immigrant







parents who are clued up about the horrendous damage caused by circumcision, and they are protecting their sons.

The numbers of baby boys protected will only go up. Knowledge is a powerful thing. Group-think can only go so far in keeping circumcision alive, thankfully.


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## fruitful womb (Nov 20, 2004)

Quote:


Originally Posted by *mom2seven* 
It varies by region also. The Midwest and South still have very high RIC rates. And working in the hospital in L&D where one of the intake questions is *"do you desire circ"*, I have to say that at least here it is almost across the board, only immigrants that decline.


It should be AGAINST hospital policy to *SOLICIT* _unnecessary_ COSMETIC surgery on a healthy sexual organ!

Does a doctor ask a mother if she desires to have her appendix removed during her c/s?


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## carriebft (Mar 10, 2007)

Right! Immigrants are americans too and live here, so









Also, like I said--

-the report itself says personal opinions on the matter are contributing to the decline

and, numbers in the south are second best! Only the west has lower numbers.


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## carriebft (Mar 10, 2007)

Quote:


Originally Posted by *fruitful womb* 
It should be AGAINST hospital policy to *SOLICIT* _unnecessary_ COSMETIC surgery on a healthy sexual organ!

Does a doctor ask a mother if she desires to have her appendix removed during her c/s?

I was asked no less than 5 times if I wanted my son circumcised in the hospital I delivered at. This was also the experience of another MDC mom who used the same hospital group.








:

Probably a contributing factor in why the west/northeast numbers are higher.

for the curious:
-once when getting all my info when I first got there
-once when he was born and they were entering more info
-once when I requested to leave a day early
-another time when a new nurse came on
-when the OB came in for final check


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## DklovesMkandJK (Jun 18, 2007)

Quote:


Originally Posted by *carriebft* 
I was asked no less than 5 times if I wanted my son circumcised in the hospital I delivered at. This was also the experience of another MDC mom who used the same hospital group.








:

Probably a contributing factor in why the west/northeast numbers are higher.

for the curious:
-once when getting all my info when I first got there
-once when he was born and they were entering more info
-once when I requested to leave a day early
-another time when a new nurse came on
-when the OB came in for final check

I was going to add a big "hey me too!" until I saw that is was you, Carrie, and that you may have already been refering to me!









I swear even housekeeping asked if we were circ'ing.







:

Finally another OB asked again and I just about lost it. After reading her the riot act she said that she respected my decision and agreed that it was needless and detrimental.







Why the hell don't they tell all thier patients that from the get go?!?!


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## crazy_eights (Nov 22, 2001)

Quote:


Originally Posted by *carriebft* 
Right! Immigrants are americans too and live here, so









My point was not racist, simply demographics. At least where I am located, changing norms don't seem to have affected the circ rate an iota. We do have a huge influx from Mexico, Central and South America, as well as large population of Bosnians and those from the Far East, all cultures that don't circ. Good for them that they are not feeling pressured into imitating the "American Way". Though I have heard from many Russians that their teenage sons are asking to be circ'ed b/c they are tired of being teased and want to fit in. I know two personally that relented and let their teenage sons get circ'ed. I'm sad that the peer pressure is still such that they felt they needed to get this done.

And for the record, many of them are not Americans but either residents or illegal immigrants. As to "soliciting elective surgery" - when we ask "do you want to breast of bottle feed?" are we soliciting one vs. the other? It's still one of those things they do in the hospital before discharge and if they want it done, it's part of the record. There are a whole list of requests that are asked of the parents with no value judgment either way - it just helps make sure that everyone is on the same page. It's actually very, very important that you make it clear if you DON"T want it done b/c seriously, there have been cases (including one in a hospital I worked for) where the parents didn't and the OB came in and did it, ASSuming the parents would want it. Ironically, the OB in that case was foreign born from a country that doesn't usually circ!.


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## crazy_eights (Nov 22, 2001)

Quote:


Originally Posted by *carriebft* 
and, numbers in the south are second best! Only the west has lower numbers.

I would be interested in seeing the break down b/c I believe it actually supports the "immigrant" theory. Where are the highest rates of immigrants, legal and otherwise, from Mexico, Central and South America? IIRC, I read that native Southerners have the highest circ. rates in the country.


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## carriebft (Mar 10, 2007)

I wasn't sayin gyou were racist, my point (and i have said this a lot in threads so I didn't bring out my whole explaination once more) is that they are here and not circumcising and many of them are legal. But, legal, illlegal or otherwise, their children are citizens who are not being circumcised and it's a great thing.


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## thixle (Sep 26, 2007)

Quote:

It should be AGAINST hospital policy to SOLICIT unnecessary COSMETIC surgery on a healthy sexual organ!
I live in KY, had a GIRL, and still had a circ consent form given to me in with the photo orders and birth certificate registrtation.







I believe the latest circ rate in KY is about 85%


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## carriebft (Mar 10, 2007)

Quote:


Originally Posted by *mom2seven* 
I would be interested in seeing the break down b/c I believe it actually supports the "immigrant" theory. Where are the highest rates of immigrants, legal and otherwise, from Mexico, Central and South America? IIRC, I read that native Southerners have the highest circ. rates in the country.

No one is saying that immigrants aren't playing a part of the turn away from genital cutting. They definitely are! (and i think its a great thing!) But there are other factors (including personal sentiments changing and lack of funding)

Look at Canada, for example, and how lack of funding has changed the circumcision picture. So that plays a lot into it, too.

Then sentiment can take hold

etcetc

to see th break down, just read the article, go to the lnk provided for the PDF of the full report.


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## mamabadger (Apr 21, 2006)

Quote:


Originally Posted by *carriebft* 
I was asked no less than 5 times if I wanted my son circumcised in the hospital I delivered at.
...
-once when getting all my info when I first got there
-once when he was born and they were entering more info
-once when I requested to leave a day early
-another time when a new nurse came on
-when the OB came in for final check









That is unbelievable! Even twenty years ago, I was asked only once, just before discharge, "You didn't want him circumcised, did you?" by a nurse who wrinkled up her nose as she asked and expressed relief when I said no. Why are things proceeding so slowly in US hospitals?


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## carriebft (Mar 10, 2007)

Also, I think people are also saying:

WHO CARES if it is immigrants causing the number to fall? If it was blacks causing the numbers to fall, what would we think?

Also, sometimes you get people who think they can write off the decline by using this "its the immigrants" argument. which makes no sense...unless you look at it from a racism angle (NOT saying you are doing this, just explaining why people often scoff when the 'its the immigrants' rationale is brought up)


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## graceomalley (Dec 8, 2006)

Wow, 56% is still WAY too high









It should be 0.56%.


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## carriebft (Mar 10, 2007)

Quote:


Originally Posted by *mamabadger* 







That is unbelievable! Even twenty years ago, I was asked only once, just before discharge, "You didn't want him circumcised, did you?" by a nurse who wrinkled up her nose as she asked and expressed relief when I said no. Why are things proceeding so slowly in US hospitals?


tell me bout it! and DK had the same experience (yeah i was referring to you







)

It's money...it's false information...it's lack of education...it's look like daddy....so many reasons I think...


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## graceomalley (Dec 8, 2006)

And the 0.56% should only be in medically necessary cases (which wouldn't be found in newborns anyway - even hypospadius surgery is done when they're older).


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## fruitful womb (Nov 20, 2004)

> Quote:
> 
> 
> Originally Posted by *mom2seven*
> ...


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## Quirky (Jun 18, 2002)

Quote:


Originally Posted by *mom2seven*
As to "soliciting elective surgery" - when we ask "do you want to breast of bottle feed?" are we soliciting one vs. the other? It's still one of those things they do in the hospital before discharge and if they want it done, it's part of the record. There are a whole list of requests that are asked of the parents with no value judgment either way - it just helps make sure that everyone is on the same page.

Baby's gotta eat -- so breast or bottle is a necessary question, because baby's gotta have one or the other.

However, circumcision is entirely optional. But the mere fact that the hospital offers the procedure, and asks whether parents want it done, leads parents to infer that it is necessary, or at worst not harmful. Just as formula gift bags demonstrably lead to lower rates of breastfeeding success, if anyone were to study whether circ rates are higher at hospitals that ask the "circ or no circ" at admission rather than not, I bet dollars to doughnuts the answer would be a clear affirmative.


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## Fellow Traveler (Jan 8, 2008)

Quote:


Originally Posted by *mom2seven* 
And for the record, many of them are not Americans but either residents or illegal immigrants. As to "soliciting elective surgery" - when we ask "do you want to breast of bottle feed?" are we soliciting one vs. the other? It's still one of those things they do in the hospital before discharge and if they want it done, it's part of the record.

Quote:


Originally Posted by *Quirky* 
Baby's gotta eat -- so breast or bottle is a necessary question, because baby's gotta have one or the other.

However, circumcision is entirely optional. But the mere fact that the hospital offers the procedure, and asks whether parents want it done, leads parents to infer that it is necessary, or at worst not harmful. Just as formula gift bags demonstrably lead to lower rates of breastfeeding success, if anyone were to study whether circ rates are higher at hospitals that ask the "circ or no circ" at admission rather than not, I bet dollars to doughnuts the answer would be a clear affirmative.



I agree with Quirky. I don't think the question needs to change but rather why are we even asking the question to begin with? How does an OB or anyone else in L&D reconcile this procedure with standard medical ethics? Why not just remove it from the list and actively dissuade anyone who continues to ask for it?

Quote:


Originally Posted by *mom2seven* 
There are a whole list of requests that are asked of the parents with no value judgment either way - it just helps make sure that everyone is on the same page. It's actually very, very important that you make it clear if you DON"T want it done b/c seriously, there have been cases (including one in a hospital I worked for) where the parents didn't and the OB came in and did it, ASSuming the parents would want it. Ironically, the OB in that case was foreign born from a country that doesn't usually circ!.

See this is the problem in this country although I am sure peoples experience varies, at least from the posts in this thread it seems that even when someone marks the "choice" (and I use that term loosely) to not perform the circumcision and informs the staff they are still besieged like it was some sort of mistake. But if OBs and Peds would simply follow their oaths and proper medical ethics there would be no need for this and no room for that kind of "mistake".


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## Astoria (May 27, 2004)

When I delivered in the midwest, I was attacked by a nurse for not choosing circumcision. First she was coercive, saying, oh come on, the doc's doing circumcisions now, let me just put him on the line. "on the line????!!!" She was wheeling his isolette away as she was saying this (I had a very bad general anesthesia emergency c-section I was recovering from, hence, not holding him at the moment.) It was scary. Then when I had made myself overwhelmingly and completely clear, she got near hysterical and was yelling at me, "that is filthy, its disgusting, he'll never forgive you for doing this to him, he'll have to do it when he can feel it!!!!" The birth experience and aftercare were already traumatic. This definitely did NOT help. (Um, and yes, of course, both my sons are intact.)


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## fruitful womb (Nov 20, 2004)

Quote:


Originally Posted by *Astoria* 
When I delivered in the midwest, I was attacked by a nurse for not choosing circumcision. First she was coercive, saying, oh come on, the doc's doing circumcisions now, let me just put him on the line. "on the line????!!!" She was wheeling his isolette away as she was saying this (I had a very bad general anesthesia emergency c-section I was recovering from, hence, not holding him at the moment.) It was scary. Then when I had made myself overwhelmingly and completely clear, she got near hysterical and was yelling at me, "that is filthy, its disgusting, he'll never forgive you for doing this to him, he'll have to do it when he can feel it!!!!" The birth experience and aftercare were already traumatic. This definitely did NOT help. (Um, and yes, of course, both my sons are intact.)










Wow!
You should report her! That nurse should be fired!







:


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## crazy_eights (Nov 22, 2001)

Sigh. My only point about immigrant population is that the American population is not getting the message, at least in certain areas of the country.


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## RestoredIntactivst (Jun 10, 2005)

Quote:


Originally Posted by *thixle* 
I believe the latest circ rate in KY is about 85%









I wouldn't be surprised... Out of all the guys that I know for sure (have told me in convo), only 2 are intact. Most proudly announce at the begining of our conversations that they are happy to have been cut. Then by the end of talking, they usually agree that maybe being circ'ed isn't as good as they first thought!

I'd like to see if this new survey did a state-by-state breakdown to see how that looks. Wouldn't it be cool if we could access the raw data (down to the exact city) and create a colorcoded gradient map of percentages similar to those gas price maps?

Seriously, why don't they do that? With today's nearly limitless computer processing power and storage space, surely it is possible to plug in the raw data and get something like that. I mean who ever decided to break the whole country into only 4 regions for this type of data anyway? I am in Northern Kentucky, close enough to Cincinnati to be considered Ohio - only 20 minutes to downtown Cincy from my house. People here are of a different mindset and have different habits than people just 30 miles further into Kentucky... and even more different compared to people living in Texas or North Dakota. Yet we are are often lumped into the same "region" (depending upon which map you use). How does that make sense?







:

And while I am on that soapbox.... Those of you that think KY is a "southern" state, guess again. I know there are states that get alot colder than us through the winter, but I wouldn't consider 5 degrees F (our forecast low temp for Sunday morning) as a "southern" temperature! We usually hit single digits at least a couple times per year. Although.... I guess I wouldn't mind being a southern state with these new circ numbers! Way to go South!


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## Night_Nurse (Nov 23, 2007)

Quote:


Originally Posted by *Mommiska* 
It seems to more than just hint at racism to suggest that it is 'only' immigrants who are causing the drop in circumcision rates in the States.


Yes.
I am a southern, caucasian, 7th generation from my home state who chose to keep my baby boy intact.
I can say many mainstream white families circ in my southern hospital but most of the doctors and nurses who deliver at my hospital keep their sons intact, regardless of race/nationality (I'd guess it was somewhere around 75%).
On the other hand, unfortunately we've started seeing a trend with some Hispanic patients coming to our facility from Mexico and adopting the more "American" looking penis style for their sons.







:
So not all immigrants leave their sons intact and not all American citizens circ. I just have to think that many more boys are intact now because their parents are researching and finding it's not medically necessary or required.
For any writer to make a blanket statement that lower circ rates are due to only immigration is just plain ignorant and it irks me everytime I read that in an article.


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## Dabble (Jun 14, 2007)

What difference does it make exactly what is bringing the circ rates down? As long as they're going down







.

I pray for the trend to continue, no matter what the cause. Fewer baby boys being traumatized and mutilated sounds good to me!


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## fruitful womb (Nov 20, 2004)

Quote:


Originally Posted by *mom2seven* 
Sigh. My only point about immigrant population is that the American population is not getting the message, at least in certain areas of the country.









Point well noted.


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## afishwithabike (Jun 8, 2005)

I am honestly glad that a LOT of insurances won't cover it. Sad that it's an unvoluntary act BUT it's better than NOTHING.


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## Night_Nurse (Nov 23, 2007)

Quote:


Originally Posted by *jwhispers* 
How does an OB or anyone else in L&D reconcile this procedure with standard medical ethics? Why not just remove it from the list and actively dissuade anyone who continues to ask for it?


Well of course, the doc doesn't want to dissuade anyone because that would cut into their profit margin.








However, every hospital I know of has an ethics advisory board. Why not everyone write to their local hospital's ethics panel and ask about this? Ask why it's performed and how it agrees with medical ethics or even how offering RIC advocates for the rights and safety of the child (especially when performed without any real anesthetic). I wonder what a hosptial's response might be?
At the very least, if it was not offered in the hospital, fewer boys might get cut (and I think some ins. will not cover RIC outside the hospital).

You know, I have heard of hosptials that do NOT offer RIC at all, but I've never read any names/locations. Does anyone know of non-circing hosp. in the US?
If so, please list.


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## Night_Nurse (Nov 23, 2007)

Quote:


Originally Posted by *Astoria* 
When I delivered in the midwest, I was attacked by a nurse for not choosing circumcision. First she was coercive, saying, oh come on, the doc's doing circumcisions now, let me just put him on the line. "on the line????!!!" She was wheeling his isolette away as she was saying this (I had a very bad general anesthesia emergency c-section I was recovering from, hence, not holding him at the moment.) It was scary. Then when I had made myself overwhelmingly and completely clear, she got near hysterical and was yelling at me, "that is filthy, its disgusting, he'll never forgive you for doing this to him, he'll have to do it when he can feel it!!!!" The birth experience and aftercare were already traumatic. This definitely did NOT help. (Um, and yes, of course, both my sons are intact.)

I really, really hope you reported her to the department head and the nurse manager. That's so inappropriate


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## crazy_eights (Nov 22, 2001)

Quote:


Originally Posted by *Night_Nurse* 
On the other hand, unfortunately we've started seeing a trend with some Hispanic patients coming to our facility from Mexico and adopting the more "American" looking penis style for their sons.







:

And we are seeing it with the Russian and Bosnian population here. Back to my point about the word not getting out nearly as well as some would think based on numbers alone....


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## fruitful womb (Nov 20, 2004)

Quote:


Originally Posted by *Night_Nurse* 
Well of course, the doc doesn't want to dissuade anyone because that would cut into their profit margin.








However, every hospital I know of has an ethics advisory board. Why not everyone write to their local hospital's ethics panel and ask about this? Ask why it's performed and how it agrees with medical ethics or even how offering RIC advocates for the rights and safety of the child (especially when performed without any real anesthetic). I wonder what a hosptial's response might be?
At the very least, if it was not offered in the hospital, fewer boys might get cut (and I think some ins. will not cover RIC outside the hospital).

*You know, I have heard of hosptials that do NOT offer RIC at all, but I've never read any names/locations. Does anyone know of non-circing hosp. in the US?
If so, please list*.

I know that Parker Hospital in Dallas don't offer it. I don't think they even do it anymore there. I could be wrong about this. If my memory serves me correctly then it was my MIL who is a nurse told me this.

I truly honestly believe that if this procedure wasn't offered, meaning no one actually asked the parents if "Do you desire to circ?" Rates would drop dramatically!


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## Fellow Traveler (Jan 8, 2008)

Quote:


Originally Posted by *fruitful womb* 
I know that Parker Hospital in Dallas don't offer it. I don't think they even do it anymore there. I could be wrong about this. If my memory serves me correctly then it was my MIL who is a nurse told me this.

I truly honestly believe that if this procedure wasn't offered, meaning no one actually asked the parents if "Do you desire to circ?" Rates would drop dramatically!

This is true; I don't think this can truly end until the docs grow a spine and apply the same ethics to RIC that they would to all other procedures. It shouldn't even be something they suggest. I think this is how the rates in Canada and Australia got driven down; the docs (and other hospital staff) just eventually came clean. When you hear stories like Astoria's and hear that medical professionals still think that, you realize there is still a lot of work left to do.


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## +stella+ (Apr 17, 2005)

"You know, I have heard of hosptials that do NOT offer RIC at all, but I've never read any names/locations. Does anyone know of non-circing hosp. in the US?
If so, please list."

Banner Good Sam in phx does not, or did not in 04. I believe the other Banner hospitals in the area dont either but I am not certain. Banner is non profit (if that makes any difference)
My cousin had babies at Paradise Valley Hospital in PV and she had her boys circed at the peds office.







: So I think there are some that arent doing it in the hospital after birth but arent discouraging people to go to their peds when they ask for it to be done.


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## MCatLvrMom2A&X (Nov 18, 2004)

Statistics: http://www.circs.org/reviews/rates/usa.html
This is from back in 99
National 65.3%
NorthEast 65.4%
MidWest 81.4%
South 64.1%
West 36.7%

Statistics: http://www.cirp.org/library/statistics/USA/
As of 2004 this site lists the circ rates as follows:
Northeast Region: 66.4%
North Central Region: 79.5%
Southern Region: 58.5%
Western Region: 31.7%

Statistics: http://www.cirp.org/library/statisti...taterates2004/
This one has states listed (not all of the unfortunatly)
Arkansas 67%
Arizona 25%
California 21%








Colorado 63%
Florida 39%
Hawaii 82%
Iowa 82%
Kentucky 85%
Maine 72%
Massachusetts 67%
Michigan 85%
Minnesota 77%
Missouri 78%
Nebraska 81%
Nevada 14%








New Hampshire 76%
New Jersey 67%
New York 59%
North Carolina 58%
Oregon 30%








Rhode Island 74%
South Carolina 83%
Utah 53%
Vermont 68%
Washington 26%








West Virginia 83%
Wisconsin 83%

2005 Stats: http://www.prweb.com/releases/2005/3/prweb217505.htm

Quote:

March 14, 2005 -- The U.S. circumcision rate declined 11.4% over two years, according to figures just released by the National Center for Health Statistics, from 63.1% in 2001 to 55.9% in 2003, following a steady, twenty-five year decline. At this rate, in just 12 years, the US will join other English-speaking countries in abandoning circumcision.
This is the only statistics by state that I have been able to find. Unfortunatly only a small percentage is listed. I would love to know the circ rates for all the states especially my own.


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## MCatLvrMom2A&X (Nov 18, 2004)

A question in I may Nevada the lowest rate listed at 14%. I was wondering why that might be, does anyone know? Is there are larger population of Native Americans there? (I may be totally off on that thought if so please correct me) Since from what I have read it is rare that they circ.


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## Quirky (Jun 18, 2002)

Quote:


Originally Posted by *mom2seven*
Sigh. My only point about immigrant population is that the American population is not getting the message, at least in certain areas of the country.

Well, and who exactly is supposed to be communicating the message to them? How about doctors, nurses, and hospitals step up to the plate and take on their ethical obligations to ensure full informed consent rather than presenting the hugely important circumcision issue as a personal parental choice akin to "do you want fries with that?" on an admission form?


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## Kylix (May 3, 2002)

Quote:


Originally Posted by *Astoria* 
When I delivered in the midwest, I was attacked by a nurse for not choosing circumcision. First she was coercive, saying, oh come on, the doc's doing circumcisions now, let me just put him on the line. "on the line????!!!" She was wheeling his isolette away as she was saying this (I had a very bad general anesthesia emergency c-section I was recovering from, hence, not holding him at the moment.) It was scary. Then when I had made myself overwhelmingly and completely clear, she got near hysterical and was yelling at me, "that is filthy, its disgusting, he'll never forgive you for doing this to him, he'll have to do it when he can feel it!!!!" The birth experience and aftercare were already traumatic. This definitely did NOT help. (Um, and yes, of course, both my sons are intact.)

That is SCARY! Imagine how this nurse may have affected moms not as strong in their resolve as you??

I hope she is currently out of a job.

Kylix


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## LavenderMae (Sep 20, 2002)

I think nurses and doctors soliciting cosmetic genital surgery for newborns (oops I mean newborn boys) is more than unethical.

My state was way higher in 2004 than I would have thought.









I think it's awesome that many immigrants aren't starting to torture their newborn sons too, good for them!!!!!! But I do not think that is the whole picture of why the rates are falling.


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## fruitful womb (Nov 20, 2004)

I don't see TX on the list. In fact, I have never seen TX participate in the rates data.

Since there are so many immigrants in TX (Want to learn Spanish? Come to TX! Its spoken just as much as the English language.) the circ rate should be low.

If TX turned in their numbers the national decline would even be lower.


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## crazy_eights (Nov 22, 2001)

Quote:


Originally Posted by *Quirky* 
Well, and who exactly is supposed to be communicating the message to them? How about doctors, nurses, and hospitals step up to the plate and take on their ethical obligations to ensure full informed consent rather than presenting the hugely important circumcision issue as a personal parental choice akin to "do you want fries with that?" on an admission form?

Gee, I'll be stepping out now. Despite the RN after my name, I do NOT set hospital policy. And as I mentioned, if you don't want your baby circ'ed it is REALLY IMPORTANT you communicate that. At least where I work it gets bold lettered and highlighted so no one makes a mistake. You do seem really, really uninformed about how hospitals work. The informed consent part happens long before they get to me in OB triage and yes, some OB's are better than others. I've heard some say "there is no reason to do it" and others that try to present a "more fair and balanced" picture (can we insert eyeroll here?). My job is only to make sure that their wishes are communicated. FTR, if anyone asks, if they aren't sure or are asking, I present the "really no medical reason for it" side of things.

Thanks for all your hostility when I was just trying to make an valid point.







:


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## Fyrestorm (Feb 14, 2006)

Quote:


Originally Posted by *mom2seven* 
As to "soliciting elective surgery" - when we ask "do you want to breast of bottle feed?" here are a whole list of requests that are asare we soliciting one vs. the other?

Apples and oranges...

Yes asking if you want to cut up your baby at admittance is soliciting cosmetic surgery...you might as well be asking is you want to give the babe a nose job...that would be an equal comparison and noticeably ridiculous!!


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## Fyrestorm (Feb 14, 2006)

Personally, I think that not only should circumcision have to be requested...not offered in hospitals, I think if it is requested, a counselor should be called in to find out what psychological reasons are behind parents wanting to mutilate their sons.

I wonder what the hospital procedure would be for a parent requesting that their daughter be cut would be?


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## hollytheteacher (Mar 10, 2007)

Quote:


Originally Posted by *mamabadger* 







That is unbelievable! Even twenty years ago, I was asked only once, just before discharge, "You didn't want him circumcised, did you?" by a nurse who wrinkled up her nose as she asked and expressed relief when I said no. Why are things proceeding so slowly in US hospitals?

It's so weird because i was asked at least 5 times as well and when i would say NO they would say something like "thank god! Your lucky little boy!" i almost wonder if like they are forced to ask it like that without giving any info and then if you decline then they are allowed to say that they agree with you or something? i just dont' get it!! I had the nicest nurse who when i said no, she looked at my sweet boy and said "You are a lucky boy with a very smart mommy" but it's like why did you even offer it? or at least why don't you tell people that there is an unnnecessary cosmetic surgery offered to little boys if they would be interested. (if they must offer it)


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## Quaniliaz (Oct 11, 2002)

Quote:


Originally Posted by *fruitful womb* 
It should be AGAINST hospital policy to *SOLICIT* _unnecessary_ COSMETIC surgery on a healthy sexual organ!

There is actually a local hospital that has a grant to pay for RIC for those on medical assistance, since MA no longer covers it.









Creepy - I want to know who the heck funds such a stupid grant.


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## Microsoap (Dec 29, 2005)

Hey, fruitful_womb, it's interesting you mention HOW you ask the question and how it CAN be suggestive. I've never forgotten this factoid, though I forget *where* I learned it:

They asked children a question w/ one of two answers ("Do you want to eat type-A, or type-B?"). Kids instinctively picked the 2nd thing offered to them than the first.

If only it were so easy to say "Do you want your son circumcised or left intact?" in that sense.

*P.S. I'm rooting for Newfoundland's circumcision rate of virtually ZERO (0)% for the U.S.!!!*


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## Fellow Traveler (Jan 8, 2008)

Quote:


Originally Posted by *mom2seven* 
Gee, I'll be stepping out now. Despite the RN after my name, I do NOT set hospital policy.

I understand that for people in your position, and I think there may be a few here, that it is beyond the scope of your authority to directly change hospital policy. I would like to take this thread in a different direction and ask what kind of approaches would better reach the hospital staff. Ultimately it will be the doctors that protect the boys; I believe this is how it happened in Canada and Australia.

Quote:


Originally Posted by *mom2seven* 
And as I mentioned, if you don't want your baby circ'ed it is REALLY IMPORTANT you communicate that. At least where I work it gets bold lettered and highlighted so no one makes a mistake. You do seem really, really uninformed about how hospitals work. The informed consent part happens long before they get to me in OB triage and yes, some OB's are better than others. I've heard some say "there is no reason to do it" and others that try to present a "more fair and balanced" picture (can we insert eyeroll here?).

So here is where I am confused. There is some subset of OBs who tell parents that it is not medically necessary. However, I presume, they go ahead and accede to the wishes of parents who opt to circumcise. This, to me , is incongruous and presents a courious ethical problem. They know there is no reason yet they will perform unnecessary surgery. Why would they not say it is not medically necessary AND because of that I will not perform it. At the very least that would give pause to those who try and present a more "fair and balanced" picture









Quote:


Originally Posted by *mom2seven* 
My job is only to make sure that their wishes are communicated. FTR, if anyone asks, if they aren't sure or are asking, I present the "really no medical reason for it" side of things.

Thanks for all your hostility when I was just trying to make an valid point.







:

I think the hostility comes from the difficulty in squaring the ethical practice of medicine with what is going on in hospitals. Considering you have direct interaction with this problem I think it would be great if you could suggest ways at changing things perhaps at first from: default circumcise (better inform everyone otherwise) to default intact (circumcision nearly impossible to obtain). Certainly there might be steps in between. For instance how do we get staff who declare there is no medical necessity to stop doing it altogether?


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## Mommiska (Jan 3, 2002)

Quote:


Originally Posted by *mom2seven* 
Thanks for all your hostility when I was just trying to make an valid point.







:

I think people were questioning the 'only immigrants fail to circumcise' line.

Your post seemed to imply that you agreed with this statement, based on your anecdotal evidence. That is what I myself was taking issue with.

I don't at all think that it is 'only immigrants' who fail to circumcise. It is clear that when clear and complete information about circumcision is given to parents, most of them will chose to protect their sons.

And I'm not talking about OBs who just say 'it's not medically necessary' (duh







). I'm talking about parents actually being informed about how they are damaging their child - the fact that their child will experience significant pain (whether or not anesthetic is used), the significance of post-operative pain, the long term sexual consequences, the fact that they are cutting off the most sensitive part of the penis and forever taking away the natural action of the penis, etc, etc.

Yes, the information doesn't get to a lot of parents - we all know that, and that is one of the reasons we are all here.

But yes - a lot of us do object to someone coming onto the Case Against Circumcision and implying that it really is just immigrants who don't circ (which also seems to implies that 'nice white people' do cut their sons














.

It is unrealistic to come here, make a statement like that, and expect it to go unchallenged.


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## crazy_eights (Nov 22, 2001)

I can tell you, in my region, having worked in 3 large hospitals in an 8 year period of time - annecdotal though that may be - that I can count on one hand the number of people who didn't request circ. that were not immigrants, legal or otherwise. And you also see the impact of not only the "Americanized" ones wanting it done, but the phenomena of teens coming and wanting it done later. My only point is until education gets out there even with numbers going down, it may not last. There was a time when European immigrants in this country didn't circ. either - but with time and "education", that changed too. That is the point that is getting missed here.


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## carriebft (Mar 10, 2007)

Well, luckily it isn't like that everywhere (and I assume you weren't the ONLY nurse at those hospitals asking the question and recording the answer). I know my ped says that he is getting more and more intact boys at the practice...at least 20% now (northeast here). So I think we are definitely doing well.

Lots to do, of course, and we wouldn't want circumcision to become more popular again. So we need to continue to educate and definitely target teens...also get more info in other languages.

I always try and mix up the tri folds I leave around and def get some other language ones in there, especially spanish (NOCIRC pages are great for this!)

(also, sometimes you can't tell if you are dealing with an immigrant, depending on how long they have been here, etcetc. My husband is an immigrant, for example, but unless you take everyone who denotes themself as "hispanic" as being an immigrant, you wouldn't be able to tell he is one)


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## crazy_eights (Nov 22, 2001)

Quote:


Originally Posted by *carriebft* 
Well, luckily it isn't like that everywhere (and I assume you weren't the ONLY nurse at those hospitals asking the question and recording the answer).

Of course not. But over 8 years you get a pretty good idea of the trend. It's kind of silly to suggest otherwise - like all those masses of intactivists were always getting OTHER nurses? (not to mention that staff talks among themselves).


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## carriebft (Mar 10, 2007)

Quote:


Originally Posted by *mom2seven* 
Of course not. But over 8 years you get a pretty good idea of the trend. It's kind of silly to suggest otherwise - like all those masses of intactivists were always getting OTHER nurses?

I'm not sure why you seem to be taking my post as attacking? I'm just saying, if you had a handful and a bunch of other nurses had handfuls, and if those handfuls were even slooooooowly increasing, then we got some momentum to work off of.

I think that's what we are seeing over this decade-- we are holding steady in some areas but gaining momentum in others. Just gotta seize it and use the data to target better.

And your info adds to that-- gotta better target in your area, esp immigrant populations (in order to keep the tradition away from circumcision) and teens (to turn that tide)

Foreign language intactivism def needs a boost, IMO-- I plan on bringing a lot of spanish material to the march in april.


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## carriebft (Mar 10, 2007)

Let's push this thread in a more productive direction:

1) The two areas that need the most work at the midwest and the northeast. Are there specific attributes about these areas that make them susceptible to higher circumcision rates? what ways can we counteract these? Is there a large NOCIRC presence in these areas? Are there states without NOCIRC reps?

2) Medcaid is a big factor- the report says *30%* of all circumcisions are billed to medicaid. Connecting this to point 1-- are there a lot of midwest and northeast states still paying for this? letter writing to be done?

3) How can we aim to make sure that circumcision doesn't become popular in immigrant populations in order to "be more american"


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## perspective (Nov 3, 2007)

Quote:


Originally Posted by *carriebft* 
Let's push this thread in a more productive direction:

1) The two areas that need the most work at the midwest and the northeast. Are there specific attributes about these areas that make them susceptible to higher circumcision rates? what ways can we counteract these? Is there a large NOCIRC presence in these areas? Are there states without NOCIRC reps?

2) Medcaid is a big factor- the report says *30%* of all circumcisions are billed to medicaid. Connecting this to point 1-- are there a lot of midwest and northeast states still paying for this? letter writing to be done?

3) How can we aim to make sure that circumcision doesn't become popular in immigrant populations in order to "be more american"

Well I live in New York City, with a VERY high jewish population. So even though there is a very large non-jewish population, they are very strongly influenced by this. Its funny how where ever circumcision is, there is always this irrational fear that grows around it. Its this fear that something will go wrong if boys are not circumcised, and for some reason this fear seems to almost ALWAYS spread very effectively, making for more circumcisions to take place. Its a very strange effect.


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## fruitful womb (Nov 20, 2004)

Quote:


Originally Posted by *mom2seven* 
Of course not. But over 8 years you get a pretty good idea of the trend. It's kind of silly to suggest otherwise - like all those masses of intactivists were always getting OTHER nurses? (not to mention that staff talks among themselves).

I'd like to know more about what your referring to. What does the staff members say among themselves? Are they cheering when a baby is saved from this brutal unnecessary attack on the newborn's sexual organ?

I'm am NOT understanding when you say:

Quote:

like all those masses of intactivists were always getting OTHER nurses?
Are you dealing with nurses that are clearly intactivist?

Does your hospital give you a script on how you must ask the parents if they "would like to keep their ds *intact*?"

What would happen if a nurse challenged the policy and simply didn't ask and perhaps instead, explain the care of the intact penis? And as long as they're not asking, the staff members can presume to omit their name from the circ board.


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## crazy_eights (Nov 22, 2001)

Quote:


Originally Posted by *fruitful womb* 
I'd like to know more about what your referring to. What does the staff members say among themselves? Are they cheering when a baby is saved from this brutal unnecessary attack on the newborn's sexual organ?

I'm am NOT understanding when you say:

Are you dealing with nurses that are clearly intactivist?

Does your hospital give you a script on how you must ask the parents if they "would like to keep their ds *intact*?"

What would happen if a nurse challenged the policy and simply didn't ask and perhaps instead, explain the care of the intact penis? And as long as they're not asking, the staff members can presume to omit their name from the circ board.

OK, let me lay it out for you. AFAIK, I'm the only nurse, perhaps one other, that didn't think there was something WRONG with leaving a baby intact. That's the starting point. I've worked with lots and lots of OB's - most are no better.

Yes, there is a "script" in the form of the "OB triage admit form" and asking if they DO or DO NOT desire circ is one of those questions. It must be filled out one way or the other, along with myriad other questions about their care, including if they want a flu shot, the new adult DPT and what are their feeding preferences. What you are suggesting doing would get me fired, and no, sorry, not interested. I'd rather be a resource for those that are looking for good info.


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## carriebft (Mar 10, 2007)

let's remember UA and not get this thread closed (maybe take it to PM?) perspective, you may want to edit.

I did some intactivism work in NYC not too long ago (just general tri fold handing out, wore my shirt out a bit in manhatten, had my buttons going etc) and the response I got was generally very positive.

This was also during that short period where the news was that BLoomberg wanted to recommend circumcision to protect against HIV in NYC and that didn't seem to go over well in any of the papers...so people were talking about it.

NY circumcision rate as a state stands around 59-62%.

They have an above average percentage of incidents where it is billed to medicaid (national average: 30% NY average: 45%). African Americans are the most likely to circumcise at 73% followed by whites at 69% and Native Americans at 54%.

Are there different ways of reaching each of these groups? are there factors that account for these differences?


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## Frankly Speaking (May 24, 2002)

Quote:


Originally Posted by *mamabain* 
i believe the immigrant population bit. not stereotypically but just because i don't see my hispanic clients cutting their boys as often as i hear the anglo and african american clients in my office doing so. i live in indiana which is probably closer to 80 or 90% circ rate.

Actually, the "immigrant influence" is not figured into the statistics. When The CDC first began collecting data, they omitted recent immigrants and for continuity, they have continued to collect and report the information in this manner. If they did include the immigrant population, the figures would be about 4% lower.

Blaming it (the lower circumcision rate) on immigrant populations either shows ignorance of this fact or shows a purposeful intent to deceive. I suspect the latter. Before this, it was advanced that only the poor, rural or blacks didn't circumcise with the clear implication of "You don't want to be like them, do you." It is a clear example of racism/classism. Only the targets of discrimination have changed.

.

.


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## Frankly Speaking (May 24, 2002)

Quote:


Originally Posted by *Benji'sMom* 
"The national rate has remained relatively stable for a decade. It peaked at 65 percent in 1980. "

Wha? Only 65%? I thought it peaked at closer to 90%?

Yes, you are correct. This appears to be an attempt to make the reader believe there has been no cultural change and circumcision is as strong as ever except for "those immigrants" and they are solely responsible for the falling circumcision rate. This appears to be a clear cut case of _"I'm from the government and I'm here to help you understand this"_ when it is a clear cut example of deception.

.


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## Frankly Speaking (May 24, 2002)

Quote:


Originally Posted by *mom2seven* 
I would be interested in seeing the break down b/c I believe it actually supports the "immigrant" theory. Where are the highest rates of immigrants, legal and otherwise, from Mexico, Central and South America? IIRC, I read that native Southerners have the highest circ. rates in the country.

Being a native southerner, I can tell you unequivocably that is not true and never has been. Where did you find such information?

.


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## Frankly Speaking (May 24, 2002)

Quote:


Originally Posted by *carriebft* 
Look at Canada, for example, and how lack of funding has changed the circumcision picture. So that plays a lot into it, too.

Actually, funding appears to have had very little influence. Dr. Dennis Kendall, the Registrar of The Saskatchewan College of Physicians and Surgeons (the Saskatchewan equivalent of The AMA) had been releasing public statements for several years warning Canadian physicians about potential liability risks in performing the procedure. The death of Ryleigh McWillis brought all of Dr. Kendall's warnings home and the vast majority of Canadian physicians dropped the procedure from their offerings immediately. It was only then that it was defunded so the defunding actually had little effect.

.


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## Frankly Speaking (May 24, 2002)

fruitful womb said:


> Quote:
> 
> 
> This begs the question, is a practitioner asking, "Do you desire to leave your ds intact or circ'd?" Because sometimes a question can be so suggestive. What message would a parent get if asked, "Do you wish to leave your ds intact?" vs just, "Do you desire to circ?" See what I mean?(
> ...


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## Frankly Speaking (May 24, 2002)

Quote:


Originally Posted by *jwhispers* 
I agree with Quirky. I don't think the question needs to change but rather why are we even asking the question to begin with? How does an OB or anyone else in L&D reconcile this procedure with standard medical ethics? Why not just remove it from the list and actively dissuade anyone who continues to ask for it?

See this is the problem in this country although I am sure peoples experience varies, at least from the posts in this thread it seems that even when someone marks the "choice" (and I use that term loosely) to not perform the circumcision and informs the staff they are still besieged like it was some sort of mistake. But if OBs and Peds would simply follow their oaths and proper medical ethics there would be no need for this and no room for that kind of "mistake".


Yes! Imagine if every medical professional and staffer asked you if you wanted a nose job. After the first few, wouldn't you imagine you'd be looking in the closest mirror to see why they were asking that? Wouldn't you begin thinking you might actually need a nose job?

.


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## Frankly Speaking (May 24, 2002)

Quote:


Originally Posted by *RestoredIntactivst* 
I'd like to see if this new survey did a state-by-state breakdown to see how that looks. Wouldn't it be cool if we could access the raw data (down to the exact city) and create a colorcoded gradient map of percentages similar to those gas price maps?

Seriously, why don't they do that? With today's nearly limitless computer processing power and storage space, surely it is possible to plug in the raw data and get something like that. I mean who ever decided to break the whole country into only 4 regions for this type of data anyway?

Its just a matter that our health care systems are not set up like that. There are numerous insurance companies, Medicare and patient paid procedures and no one has to report to the government. Our statistics are compiled by surveying 500 hospitals across the country and taking their statistics as representative for the region. In countries that have universal government provided health care, the hospitals and physicians have to report to the government to receive payment and that makes compiling statistics efficient and quick. They can follow the population for life for the lifetime circumcision rate and that is just impossible with our system.

Quote:

And while I am on that soapbox.... Those of you that think KY is a "southern" state, guess again. I know there are states that get alot colder than us through the winter, but I wouldn't consider 5 degrees F (our forecast low temp for Sunday morning) as a "southern" temperature! We usually hit single digits at least a couple times per year. Although.... I guess I wouldn't mind being a southern state with these new circ numbers! Way to go South!

Most other southerners (Mississippi, South Carolina or Florida for example) don't consider Kentuckians "true southerners." Lumping Kentuckians into the southern states is simply a convienience to make keeping statistics simple.

.


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## Frankly Speaking (May 24, 2002)

Quote:


Originally Posted by *Night_Nurse* 
On the other hand, unfortunately we've started seeing a trend with some Hispanic patients coming to our facility from Mexico and adopting the more "American" looking penis style for their sons.







:


A study showed that the circumcision rate among recent Hispanic immigrants is up by 300%. It also showed that the circumcision rate among recent immigrants from India is up 800% so that makes the increasing circumcision rate among Hispanics look like small potatoes. I can't help but think this is due to a language barrier and doctors and hospitals "selling" circumcision and these people are not really understanding what they are agreeing to have done or the reasons for it.

.


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## Frankly Speaking (May 24, 2002)

Quote:


Originally Posted by *Night_Nurse* 
You know, I have heard of hosptials that do NOT offer RIC at all, but I've never read any names/locations. Does anyone know of non-circing hosp. in the US?
If so, please list.


The unfortuate thing about many of these hospitals not offering it is because they had an amputation or death at the facility. I know that is the case with Airline Memorial in Texas. A boy died from his circumcision and that was the end of it at that hospital. However, we know that many boys die every year and the number of hospitals no longer hosting the procedure does not match the deaths. Apparently they figure it is within the statistics and will never happen to them again.

For example, Atlanta's Northside Hospital was the site of two boys losing their entire penis in botched circumcisions. They happened on the same day but on two different shifts and by two different doctors. This was widely reported in the local media. Logical thought processes would have you guess that the circumcision rate would fall significantly after that for at least a short while wouldn't it? Actually, the circumcision rate increased in the weeks after the accidents. The rate for white boys did fall but the rate for black boys increased significantly. This indicates that the doctors and nurses were heavily solicting the procedure among black families. The percentage of black mothers giving birth at Northside was very low since the area around Northside is almost exclusively white and well to do or upper middle class. The evidence indicates Northside found a susceptible population in black families and sold the procedure heavily among them. It is apparent that few if any black babies escaped the knife during that time at Northside. Northside had a revenue stream to protect and took out all stops to continue that revenue stream. Statistics from Northside shows that the hospital realizes more than $150,000.00 every year from circumcisions.

.


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## Frankly Speaking (May 24, 2002)

Quote:


Originally Posted by *fruitful womb* 
I truly honestly believe that if this procedure wasn't offered, meaning no one actually asked the parents if "Do you desire to circ?" Rates would drop dramatically!

This reminds me of a study that was performed at a military hospital in Hawaii in the early 1980's. It was conducted in a military hospital to get a high rate of compliance. It required the doctors and nurses to provide the parents with truthful information about circumcision. The result was that the circumcision rate dropped from 80% to 20% immediately and after the study ended, it took many months for the rate to climb to its previous level.

This shows us several things: (1) Parents will choose not to circumcise if they are given accurate information. (2) Medical professionals are not giving parents truthful and complete information. (3) Parents will spread this information among each other. (4) Parents are accepting of this information if it comes from a medical provider (5) Much of the continuing cultural acceptance of circumcision is due to the medical profession.

.


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## Frankly Speaking (May 24, 2002)

Quote:


Originally Posted by *Fyrestorm* 
I think if it is requested, a counselor should be called in to find out what psychological reasons are behind parents wanting to mutilate their sons.

Something that really confounds me is that men who are wanting surgical restoration of their amputated foreskins have to agree to and pass a series of psychological evaluations before the doctor will agree to perform the procedure. Why is that? Why do parents not have to go through a similar series of psychological evaluations? That clearly makes no sense.

.


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## Frankly Speaking (May 24, 2002)

Quote:


Originally Posted by *Mommiska* 
I think people were questioning the 'only immigrants *fail* to circumcise' line.

I don't at all think that it is 'only immigrants' who *fail* to circumcise. It is clear that when clear and complete information about circumcision is given to parents, most of them will chose to protect their sons.

Do you yourself realize how loaded the word "*fail*" is? The connotation is a parent who does not circumcise has failed their child or has failed in their responsibility as a parent. In my profession I acted as a negotiator almost daily and the words used are vitally important in perceptions. For instance, sales people are told to never tell a prospect that his product is "cheaper" but that it is "more economical," "more cost efficient" or "more competitive." "Cheaper" implies that the product is of lesser quality. "More" implies that the customer will get something extra.

.


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## ulla (Feb 3, 2007)

Do you have links or citations for any of the studies you are referring to? I'm sure many of us would like to read the source material.


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## Kimono (Aug 29, 2004)

I was actually surprised by my experience in Canada. My doctor was great--he is originally from South Africa, and when I mentioned circumcision, he just said definitely, "it's not recommended." No pros or cons mentioned--just a straight answer. He said if parents wanted circumcision for their son, they had to find a doctor "willing to assume the risk" and then pay for it out of pocket, after we'd been discharged from the hospital. Rates in my province are less than 15% I believe.

So when I was in the hospital, I was surprised that in the "bath and baby care" demonstration, the nurse asked our group if the parents of boys would be circumcising! And then she took a really neutral stance as she said, "It's completely up to you."







: Good grief, why mention it at all? There were no forms, however, When circumcision is done, it has nothing to do with the hospital.

And then two nurses asked me if I'd be circumcising. Again, why? I told the one that we wouldn't be, and she gave me a smile and a thumbs-up.

So even Canada could do better!


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## mntnmom (Sep 21, 2006)

A related thought.....
Do you think parents who grow up around immigrants who don't circ', may be less likely to do it themselves? The entire southwest has a relatively low circ' rate, and I can't believe it's only first generation folks who make the difference. For a long time I thought it was Catholics who didn't circ, not making the connection that all the Catholics I knew were Hispanic!
Though statistically, I suppose they might have started influencing numbers in other parts of the country in the last few years.


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## RestoredIntactivst (Jun 10, 2005)

Quote:


Originally Posted by *mntnmom* 
A related thought.....
Do you think parents who grow up around immigrants who don't circ', may be less likely to do it themselves? The entire southwest has a relatively low circ' rate, and I can't believe it's only first generation folks who make the difference.

It would be interesting if the country was trying to adopt the the immigrant's way of thinking, instead of demanding the immigrants adapt and assimilate completely. That might be a part of it, but I think it is more likely the general slow-to-change mindset of the south - they never adopted circ as readily and completely as the midwest (just based on the figures at CIRP which only go back to 1994 - when south was 64% and midwest was 80%) Does anyone have regional figures that go back further to test this hypothesis?

The recent declines I think is a result of a more connected, more free-to-think, more information saavy generation starting to make these decisions as they have kids. I like the trend and I only wish it happened faster and about 30 years ago!

Quote:


Originally Posted by *mntnmom* 
For a long time I thought it was Catholics who didn't circ

Oh how I wish that was the case... I come from a fairly large 4th generation German Catholic family, and everyone in it (at least in my parents and my generation) is circed. I know for sure that at least 8 of my male cousins are cut because we all grew up together, close in age, and saw each other naked just as a matter of course when going swimming etc. All my uncles must be cut also because they thought I was crazy a couple years ago when I started my anti-circ tirades.


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## Fellow Traveler (Jan 8, 2008)

Quote:


Originally Posted by *mom2seven* 
OK, let me lay it out for you. AFAIK, I'm the only nurse, perhaps one other, that didn't think there was something WRONG with leaving a baby intact. That's the starting point. I've worked with lots and lots of OB's - most are no better.

Yes, there is a "script" in the form of the "OB triage admit form" and asking if they DO or DO NOT desire circ is one of those questions. It must be filled out one way or the other, along with myriad other questions about their care, including if they want a flu shot, the new adult DPT and what are their feeding preferences. What you are suggesting doing would get me fired, and no, sorry, not interested. I'd rather be a resource for those that are looking for good info.

Ok, so lets try and continue pushing this thread in to a positive direction. I would like to know a few things. I suppose you have discussed this with your colleages from time to time and I am wondering what is it that has them so hung up on circumcision being necessary. It is troubling to hear that someone who is supposed to be a medical professional would think there is something inherantly wrong with a normal male penis, especially a physician.

So I am wondering if you have discussed why do they think it is necessary, do they know all of those reasons are a crock? What do they say, if they are told, that the US mostly stands alone among western countries in this practice? I suppose by and large these are smart people, and if the physicians don't know that we are essentially alone what justification are they using to say it is fine to do here even if nobody else is really doing it?

Second, from your prospective, what would be a good tact to take to start changing these beliefs? All though letter writing is always good perhaps that isn't the best path. Are there others you think might be more effective?


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## crazy_eights (Nov 22, 2001)

I think that cultural issues aside, what people forget is that there is research that supports circing. Now, before you attack me, I am NOT saying it is all valid or that it is all of equal quality or all without an agenda. But I do think that is part of how "medical types" justify their already held belief that babies "need" circ or present it as "six of one, half dozen of the other".

Step back for a moment and imagine you are not an intactivist and you are an MD. Studies of all sorts cross your desk in the form of those carried by the medical journals you read. If you don't have an interest in the topic, you are not going to read the studies that critically, but rely on the peer review that accepted the study in the first place. So some of those studies show benefit (a la the "AIDS in Africa" study). My point is that most are going to try to present a "fair and balanced" POV, quoting both sides OR going to say "it's parental choice, not my place to get involved b/c there are studies to support either view". Does that make sense?


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## carriebft (Mar 10, 2007)

Quote:

My point is that most are going to try to present a "fair and balanced" POV, quoting both sides OR going to say "it's parental choice, not my place to get involved b/c there are studies to support either view".

But there are soooo many MDs that don't think that-- MDs in australia calling for the ban, MDs in New Zealand talking openly to papers about the wrongness of it all, MDs in Brazil laughing off the idea that circumcision would be a way to fight AIDS, MDs in Canada and Britain just saying its not necessary, MDs in Finland, Denmarkm etc actually wanting it to be illegal. I don't think your idea that "most" MDs would react that way is in any way supported by world wide evidence.

There has got to be something in particular we can focus on in the regions of the USA where MDs still hold circumcision in the way you see them as holding it-- and it does seem pretty unique here. While other countries' MDs do say that circumcision can be medically beneficially in certain circumstances, they don't hand the decision over to parental choice...they still speak out against it.

And another thing to note is that even our very own AAP specifically states that the benefits do not outweigh the risks; and while they go on to talk about parental choice, I don't often see the former line talked about as much as the latter. But when you see reports from other countries or their medical stances, the wording is far stronger and it is often quotes as such.

Edit: sorry to keep adding but more thoguht just enter my mind....I also seem to see the answer most foreigners give is that circumcision is not even talked about or offered. So I would think this is the case with many doctors...the number probably even surpassing the number of total doctors who mention circumcision at all.


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## carriebft (Mar 10, 2007)

One more thought, and although this is anecdotal but I figured I'd add it since much of this thread has been the same--

At the March for Genital Integrity last year the big thing I noticed, besides the interest of youth in the movement, was that doctors from other countries, and we met a lot of them, repeated again and again how things are different in their various countries. Many even talked about how it was not even brought up at birth.

So that makes me wonder as well if we can really say that "most" doctors would give a neutral view.

__________________________

not related to above really...

Also this study by the AAP might be helpful to our discussion at large:

Quote:

Conclusion: The most important factors influencing the choice appear to stem from parents perception that increased effort is necessary to care for an uncircumcised penis, concern about UTI, and the fathers circumcision status. For those who decided against circumcision, cultural and traditional factors had sporadic roles, but the majority felt that it was an unnecessary procedure. While most parents view doctors as sources of information, their primary resource appears to be family. For those whose decision was influenced by a physician, obstetricians may carry more weight.

and also this study:

Quote:

Conclusions: Most parents have made a decision on circumcision before physicians discuss it, and physician discussions appear to have little impact on the decision. Ease of cleanliness is still the most common reason parents choose circumcision. (J Am Board Fam Pract 1999;12:16-20)
http://www.cirp.org/library/procedure/tiemstra/

Interesting that the most common reason for NOT circumcising was "it is just not necessary"


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## wednesday (Apr 26, 2004)

Unfortunately where I live it seems all the mainstream parents do circ. I know one non-"hippy" mother whose son is intact, she's a pretty independent thinker though. It came up when a bunch of us moms got together once and the other moms were shocked. One was even like "I thought it was required!"

So I'm very skeptical of those statistics, I'd guess the rate is at least 90+ % here. However it's done more often in the pediatrician's office here than in the hospital so that would account for lower rates reported by hospitals.


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## carriebft (Mar 10, 2007)

I found this to be very interesting; it is a piece from the resource manual for physicians from the College of Physicians and Surgeons of British Columbia:

https://www.cpsbc.ca/cps/physician_r...ual/malecircum

Quote:

Recommendation:
Best medical practice includes the following standards of practice for doctors who are asked to circumcise male infants:

*
Keep up-to-date on the issues surrounding infant male circumcision, including the therapeutic medical indications and legal and ethical issues.
*
Advise parents that the current medical consensus is that routine infant male circumcision is not a recommended procedure; it is non-therapeutic and has no medical prophylactic basis; it is a cosmetic surgical procedure; current evidence indicates that previously-thought prophylactic public health benefits do not out-weigh the potential risks.
*
Provide objective medical information about the risk of complications and potential harm in infant male circumcision.
*
Discuss the new ethical considerations of infant's rights and proxy consent in a non-therapeutic procedure.
*
Listen to parents and consider the basis of their request, which may be based on religious or cultural practices.
Given the above studies I quoted showing parental decision being made before entering the doctor office, do you think something like this would aid the circumcision fight in the USA?


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## carriebft (Mar 10, 2007)

Quote:


Originally Posted by *wednesday* 
Unfortunately where I live it seems all the mainstream parents do circ. I know one non-"hippy" mother whose son is intact, she's a pretty independent thinker though. It came up when a bunch of us moms got together once and the other moms were shocked. One was even like "I thought it was required!"

So I'm very skeptical of those statistics, I'd guess the rate is at least 90+ % here. However it's done more often in the pediatrician's office here than in the hospital so that would account for lower rates reported by hospitals.

North Carolina, I believe, dropped medicaid funding of circumcision, so the numbers are probably much lower than you think for that reason alone. I believe the state numbers stand around 60% in NC.


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## crazy_eights (Nov 22, 2001)

Quote:


Originally Posted by *carriebft* 
But there are soooo many MDs that don't think that-- MDs in australia calling for the ban, MDs in New Zealand talking openly to papers about the wrongness of it all, MDs in Brazil laughing off the idea that circumcision would be a way to fight AIDS, MDs in Canada and Britain just saying its not necessary, MDs in Finland, Denmarkm etc actually wanting it to be illegal. I don't think your idea that "most" MDs would react that way is in any way supported by world wide evidence.

I think you missed my point. It was that MD's (and truly, all of us) tend to see research in the context of how it supports or refutes the ideas they already hold. Old ideas die hard. The fact that MD's in other countries don't view the research the same way actually supports what I am saying.

Personally, I think the best tactic is to get insurance co's to treat RIC as "elective surgery". That would probably make the rates drop faster than anything.


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## Mommiska (Jan 3, 2002)

Quote:


Originally Posted by *wednesday* 
Unfortunately where I live it seems all the mainstream parents do circ. I know one non-"hippy" mother whose son is intact, she's a pretty independent thinker though. It came up when a bunch of us moms got together once and the other moms were shocked. One was even like "I thought it was required!"

So I'm very skeptical of those statistics, I'd guess the rate is at least 90+ % here. However it's done more often in the pediatrician's office here than in the hospital so that would account for lower rates reported by hospitals.

I see you are in NC. My cousin is in NC and she asked me about circumcision when she was pregnant last year (they didn't know the sex of the baby).

She is a very independent thinker, and I immediately told them that my ds was intact and that I'd send her info about circumcision.

She said they were leaning towards circumcision, but she was happy to read anything I sent.

Within 2 hours of me sending info, she wrote back saying she couldn't believe that was legal, and there was no way in h*** that was happening to her child.









Of course, her dh said they needed to talk to friends who had had their sons cut, so that they had 'both sides' of the issue.

All of her friends (I think she had 5 with boys) had cut their sons, but two of them regretted it (and she said that the others didn't realise there was a choice).

Just anecdotal evidence, I realise...but it shows how important it is to get the information out there.


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## wednesday (Apr 26, 2004)

Quote:


Originally Posted by *carriebft* 
North Carolina, I believe, dropped medicaid funding of circumcision, so the numbers are probably much lower than you think for that reason alone. I believe the state numbers stand around 60% in NC.

I guess it IS turning into a class thing then, there was a lot of controversy a few years back that dropping the medicaid coverage was "classist" because poor boys would be intact while middle- and upper-class kids would be circ'ed.

In my son's pre-school classroom (Montessori), he's been attending since 20 months and I have seen most of the little boys being diapered at some point, I was always curious if DS was unusual or not. The fact is out of 10-12 boys the only one I saw to be intact was a child adopted from Guatemala at a year old. This school is kind of price-y, most of the families are well-off and driving like Lexus or Toyota SUVs. I was actually quite surprised that in this demographic the circ rate was so high.

I am also a member of a women's club that is more of a mix of mainly middle-class income, most of the moms work but even if they are struggling they have private insurance. They all have kids under age 8 or so. This was the group that was shocked to learn that my son and the one other woman's son are intact.

I don't think I really know anyone on Medicaid so I couldn't comment on that. Although, my understanding is that Medicaid covers roughly 50% of all births in NC, so if the circ rate is still 60%, and presumably some non-Medicaid folks choose against circ -- that means quite a few Medicaid recipients are coming up with the $$ for the procedure anyway.


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## carriebft (Mar 10, 2007)

The classist argument is one I have heard before, but I just see it as a waste of tax dollars to be doing cosmetic surgery, which is normally the line of reasoning that makes states stop offering it...they kinda realize that there are waiting lists and things that NEED to be covered, and they can save hundred of thousands by not covering genital cutting.

No doubt people find a way around lack of funding, but stopping funding has been a integral part in changing attitude on circumcision in many countries. The best example that most people can understand is Canada....you can go back and look through the news and public opinion pieces on the issue as it was defunded and you slowly see that it leads to public opinion change.


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## MarnieMax (Dec 24, 2004)

Quote:


Originally Posted by *wednesday* 
This school is kind of price-y, most of the families are well-off and driving like Lexus or Toyota SUVs. I was actually quite surprised that in this demographic the circ rate was so high.

I am always curious about this sort of thing as well. Maybe the demographic is different here in northern Cal, but my experience is that intactness is more common in the more educated families, which does not always translate to income, but it is a segment of insured parents who say NO to circ.

Two of my sons have attended Waldorf schools and that set, just from casual observation, has a higher incidence of intact boys (I was a volunteer for day-care and supervision).


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