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June 21, 2011

The great California foreskin fight of 2011

http://www.jewishjournal.com/cover_story/article/the_great_california_foreskin_fight_of_2011_20110621

Jena Troutman, right, was the proponent of a short-lived Santa Monica ballot initiative seeking to ban circumcision in that city. She and other “intactivists” — including, from left, 10-time candidate for Santa Monica City Council Jon Mann, child and adolescent psychiatrist Arthur Pogosyan and medical anthropologist Astrik Vardanyan — say circumcision is a cruel and harmful practice with no medical justification. Intactivists are divided over whether a blanket ban  without a religious exemption is a good idea, though.

Jena Troutman, right, was the proponent of a short-lived Santa Monica ballot initiative seeking to ban circumcision in that city. She and other “intactivists” — including, from left, 10-time candidate for Santa Monica City Council Jon Mann, child and adolescent psychiatrist Arthur Pogosyan and medical anthropologist Astrik Vardanyan — say circumcision is a cruel and harmful practice with no medical justification. Intactivists are divided over whether a blanket ban without a religious exemption is a good idea, though.

As luck would have it, the day local Jewish leaders gathered in Santa Monica to discuss the community’s response to a proposed ballot measure aimed at banning circumcision in that city was the very same day the proposition was rescinded by its proponent.

Twenty-five people came to the meeting at the Milken Family Foundation offices on Fourth Street on June 6, including high-ranking Jewish professionals, local rabbis of all stripes and other Jewish community leaders.

Catherine Schneider, senior vice president for community engagement at The Jewish Federation of Greater Los Angeles, who orchestrated the two-week-long effort to fight the proposed ballot initiative, said the prevailing atmosphere in the room that morning was of deep concern.

“People had very strong opinions of what this would mean for their communities,” Schneider said.

“One of the concerns that I had was that people not look at this and say, ‘Look what those nuts in Santa Monica are doing,’ ” said Richard Bloom, the city’s mayor, who attended the June 6 meeting. Bloom, who is Jewish, spoke first. He pledged his full support to fight against the measure.

Bloom’s other concern — one expressed by many others at the meeting — was that people might not take the situation seriously. An entire genre of Jewish humor focuses on ritual circumcisers, or mohelim. (Have you heard the one about the wallet? How about the one about the storefront with the clock in the window?)

But aside from writers of pun-filled newspaper headlines, nobody involved in this fight is joking.

A measure identical to the one submitted and quickly rescinded in Santa Monica is set to appear on the ballot in San Francisco in November 2011. If passed, the new law would make circumcision of a minor — for any reason other than a medical emergency — a misdemeanor, punishable by a $1,000 fine and one year in county jail. The Bay Area Jewish Community Relations Council (JCRC) is currently leading a broad-based campaign against that proposition, which could cost as much as $500,000 — none of it tax-deductible. Last week, lawmakers in Sacramento and Washington, D.C., independently announced that they would try to derail the ballot initiative by legislative means.

And, if you listen closely to the individuals on both sides of the Great Foreskin Fight of 2011, it becomes clear how committed they all are to their respective causes. Also apparent is just how complicated the debate around circumcision is — religiously, legally and, yes, medically.

Lawyers on both sides of the debate argue vociferously about what rights a parent should have vis-à-vis a child and whether cities should have any authority in matters of medical care. The foremost American medical authorities neither recommend routine infant circumcision nor explicitly discourage parents from circumcising their infant sons, leaving doctors and researchers to argue vehemently in favor and against the procedure and accuse one another of practicing junk science.

Meanwhile, mothers and grandmothers, fathers and grandfathers have been staking out opposing positions with equal passion. And while the overwhelming majority of religious leaders — particularly Jewish ones, but others as well — have spoken out against the proposed ban, a small band of Jews are working to make the decision not to circumcise one’s son into a legitimate Jewish choice.

Who are the intactivists?

Of the three anti-circumcision activists — intactivists, as many call themselves — who became the faces of the campaign to ban the practice in California cities, two are relative newcomers to the movement. But the fight over circumcision has been going on for decades, and the histories of all three can all quickly be traced back to the roots of the anti-circumcision movement, a small but vocal group that has never enjoyed as much attention as it is getting today.

Jena Troutman is the mother of two young sons who was behind the short-lived attempt to ban circumcision in Santa Monica. As an active member of the “natural birth community,” Troutman, who works as a midwife’s assistant and is a certified lactation educator and birth doula, is emblematic of a certain subgroup of the   intactivist movement.

Natural moms are, Troutman explained, the kind of moms who insist on delaying the cutting of a baby’s umbilical cord, to ensure that babies get as much of the placental blood as possible. These moms wear their babies and co-sleep with them. They oppose unnecessary Caesarean sections, prefer home births and are fierce advocates of breastfeeding. Some, Troutman said, question the need for and safety of vaccinations, and it’s no surprise, then, that they’d also be against circumcision.

“We call ourselves ‘lactavist intactivists,’ ” Troutman said. Troutman, who looks young for her 30-odd years and still has the voice of a much younger woman, is an unlikely candidate to spearhead a political campaign that was bound to be controversial.

“I was popular in high school,” Troutman said in an interview last week. “I’ve been popular my whole life. I don’t like it when people don’t like me.”

Troutman’s first exposure to intactivist ideas came in college. A women’s studies professor asked Troutman to explain why she thought circumcision shouldn’t be considered mutilation. “I said, it just isn’t; it’s just what’s done, and it’s not that bad,” Troutman recalled.

Troutman has come a long way since then, boasting a near-100 percent success rate in convincing her clients to keep their babies whole. In the last two years, Troutman has become much more active. In 2010, she founded wholebabyrevolution.com, a Web site for “parents still seeking answers to their circumcision questions.” She drew 30 people to a Genital Integrity Rally at Venice Beach in April as part of a nationwide campaign, and said she staged a few other protests outside local Santa Monica hospitals.

“I just can’t stand that I look over and see St. John’s and know that little babies are being cut in there,” Troutman said.

And so, in May, after hearing news of a toddler’s death following his circumcision in a New York City hospital, Troutman contacted Matthew Hess, the president of MGMBill.org.

Matthew Hess, an “intactivist” campaigning against circumcision, holds his foreskin restoration device. Photo by Will Parson

Hess, 42, lives in San Diego and has been a devoted intactivist for more than a decade. Hess, who isn’t Jewish, was circumcised as a baby in a hospital setting. Sometime in his late 20s, he began to notice a “slow, significant decline in sexual sensitivity.” He found his way to the Web sites of a few prominent intactivist groups, and was shocked by what he found.

“It showed what a normal foreskin looked like and the nerve endings that it contained,” Hess said. He found the photographs of particular interest. “It showed all kinds of circumcision damage. It showed what’s lost when you’re circumcised.”

Hess, who is married and has no children, used a “nonsurgical foreskin restoration” technique that entails pulling the remaining skin over the head of the penis and keeping it there, which, Hess said, can reverse the keratinization, or toughening, of the skin on the head of the penis. Hess said his sexual experience improved dramatically as a result. “It was night and day,” he said.

Radicalized by his own experience and frustrated by the rate at which routine circumcisions were still taking place in the United States, Hess became politically active.

In 2002, Hess went to a biennial symposium organized by the preeminent education organization in the intactivist movement, the National Organization of Circumcision Information Resource Centers (NOCIRC). The four-day event, which took place in April and was NOCIRC’s seventh such conference, featured speakers from all over the United States and Canada, as well as from Europe, Australia and Israel. In all, about 100 people attended, and Hess left feeling energized.

“What can I contribute?” Hess remembered thinking. “What’s not being done?”

The answer was the MGM Bill. The acronym stands for Male Genital Mutilation, and Hess, who is not a lawyer (he wouldn’t disclose his profession, saying only that he does not work in a field related to medicine, circumcision or religion), took the language of the Federal Prohibition of Female Genital Mutilation Act of 1995 and altered it to apply it to men. “It wasn’t like no one had ever thought of it before,” Hess said. “I was just the first one to do it.”

Indeed, when Congress was considering outlawing female genital mutilation, or FGM, some lawmakers had anticipated exactly this consequence. In an article dated Oct. 12, 1996, about the passage of the law prohibiting FGM, New York Times reporter Celia W. Dugger noted that the proponents of the law had some difficulty getting it through Congress, for two reasons. “Some members simply could not believe that the practice actually goes on,” Dugger wrote. “And some were worried that it would lead to proposals to abolish male circumcision.”

Hess purchased the domain name mgmbill.org on Nov. 21, 2003, and began soliciting comments on his modified version of the FGM law a few weeks later. Starting in 2004, and every year since, Hess and his network of volunteers have submitted copies of the MGM Bill to the president of the United States and to every member of the House and Senate. Hess and his partners across the country have also annually submitted state-specific bills to every lawmaker in their states.

In eight years, only one lawmaker, then Massachusetts state Sen. Michael W. Morrissey, has formally introduced the bill into a committee. It took three years, but on March 2, 2010, Hess and 16 other intactivists testified in favor of the bill at a public hearing before the Massachusetts Senate Joint Committee on the Judiciary. Three people testified against it, including one representative from Christians and Jews United for Israel. The committee rejected the bill and it expired at the end of the legislative term.

In 2011, the MGM Bill was again submitted to federal lawmakers as well as legislators in 14 different states. But in 2010, Hess had decided to try a new tactic: city-based ballot initiatives.

Lloyd Schofield, the proponent of the San Francisco ballot measure that could ban circumcision in the city, went to his first NOCIRC symposium in July 2010 in Berkeley. Hess was there, but Schofield doesn’t remember talking to him. “I think I just shook his hand,” Schofield said in a recent interview.

Schofield refuses to talk about himself much and wouldn’t even confirm the information he apparently gave to a San Francisco Chronicle reporter (who also found him somewhat reticent) in November 2010.

“So who is Schofield?” the Chronicle’s Heather Knight wrote. “He won’t say much other than that he’s a 58-year-old who used to work for a ‘major hotel chain.’ He lives with his partner near Buena Vista Park, and they have no children. His Facebook page notes he’s a fan of ‘The WHOLE Network,’ ‘Bring Back Saving Penises’ and ‘Catholics Against Circumcision.’ But don’t bother asking whether he had the procedure done himself.”

Schofield, who was raised Baptist, said he didn’t have to think much about circumcision. “I just knew this was wrong all my life,” he said.

Schofield said he thinks Marilyn Milos, the Bay Area founder of NOCIRC and the godmother of the intactivist movement, recommended him to be the San Francisco proponent for the MGM ballot initiative.

“I don’t think I was the first choice,” Schofield said, but he and Hess talked and e-mailed a few times, and eventually Schofield agreed to serve as proponent. Schofield didn’t do much of the collecting of signatures, and the first time he and Hess ever spoke to one another in person was on the morning of April 26, the day that they — along with Milos and others — delivered the more than 12,000 signatures that had been collected in support of the San Francisco circumcision ban to the office of the city’s department of elections. 

On May 18, 2011, San Francisco city officials announced that the ballot measure that Hess had written and that Schofield had put forward for San Francisco had qualified for inclusion on the November ballot.

The next day, in solidarity with Schofield, and in memory of Jamaal Coleson Jr., the toddler who died after being circumcised in New York, Troutman submitted her ballot initiative to the Santa Monica City Clerk.

“I think I talked to him once,” Troutman said of her contact with Hess. Hess modified the text of the ballot initiative to make it appropriate for the City of Santa Monica. All Troutman had to do was download the file.

“I printed out the papers,” Troutman said, and took them to City Hall. “It took me five minutes to submit.”

Foreskin Man, Monster Mohel ...

The cover of “Foreskin Man,” No. 1, written and edited by Hess, shows the comic book’s hero battling the ogre-like Dr. Mutilator.

No single development in the foreskin fight so far has attracted more attention than the discovery of the second issue of Hess’ 2010 comic book, “Foreskin Man,” which featured the villain Monster Mohel.

A statement released on June 3 by the San Francisco office of the Anti-Defamation League called the comic “grotesque” as well as “disrespectful and deeply offensive.”

In an interview last week, Hess did not back down from the 12-page book, which he estimates cost him a little less than $10,000 to produce. “I would consider ‘Foreskin Man’ No. 2 to be a success. It was intended to provoke,” Hess said.

“Monster Mohel was based on actual photographs, as were Jorah and Yerik,” Hess said, referring to the villain and his henchmen. “He’s got the white eyes, the beard is a little different, but there’s not much different from a real live mohel. I did add the Uzis.

“I think a lot of Jewish people were angry about that because it exposes brit milah for what it is,” Hess added.

Though Troutman initially called Hess’ comic a fair representation of mohels — “If you’re going around hacking off parts of a baby’s genitals, then you might be called a monster,” she said — she later disavowed any connection with the comic.

“He’s basically tarnishing this human rights movement with indefensible imagery,” Troutman said on June 7, the same day she told Bloom that she had decided to rescind the bill. “I would never have signed the papers to do this bill had I known mgmbill.org’s affiliation with this.”

Schofield called the comic “inflammatory,” although he would not throw Hess under the bus.

“It’s not a wide vilification of a religious group, it’s about the person doing the cutting, ” Schofield said in an interview. “The other Jewish characters are shown as normal everyday people. It’s the one act that’s being exaggerated in comic-book style.”

A page from the series’ second issue, in which Foreskin Man battles Monster Mohel. The Anti-Defamation League condemned Hess’ depiction of Jewish ritual circumcisers, calling it “disrespectful and deeply offensive.”

Schofield also argued that he shouldn’t be held responsible for the comic’s content, as it was never linked to the “San Francisco mgmbill” Facebook page.

Abby Michelson Porth, associate director of the JCRC in San Francisco and the leader of the coalition fighting against the circumcision ban ballot measure, heard Schofield make that same argument when they both appeared on a radio show on June 8. She was not convinced.

“Not only did he refuse to distance himself from it, nor would he apologize,” Porth said, “but he told me that I owed him an apology because he’s getting hate mail from Jews.”

... and the united Jewish front

Porth is bound to have her hands full for the next five months, working to ensure that the ballot measure is “overwhelmingly defeated.” But if there’s anything she welcomes about this episode, it’s the way it has brought the Jewish community together to oppose the measure.

A quick glance at the synagogues, Jewish day schools and other Jewish organizations included in the more than 200-member coalition at stopcircban.com shows that Porth, who grew up in San Francisco and met her husband in a pluralistic Jewish youth group, isn’t exaggerating.

Schneider, at L.A.’s Federation, assembled a similarly united front in Santa Monica. Among the Jewish leaders who came to the meeting earlier this month, which took place just 36 hours before the Shavuot holiday, were Orthodox, Conservative, Reform and Reconstructionist rabbis. They were uniformly against the ban — even though they clearly had different feelings about the practice of brit milah itself.

Rabbi Mark S. Diamond, executive vice president of the Board of Rabbis of Southern California, spoke at the meeting earlier this month. An ordained Conservative rabbi from the East Coast, Diamond served a congregation in the Bay Area for nine years where he found — to his surprise — a “vocal member of the opposition” to circumcision. “I told her that I respected her freedom,” Diamond said.

“Nobody’s forcing parents to circumcise their sons,” he added, “but to outlaw it, to criminalize circumcision, is completely outrageous and unacceptable.”

Rabbi Neil Comess-Daniels of Temple Beth Shir Shalom in Santa Monica said that he encourages congregants to do brit milah, but also tells them to talk to their pediatricians about circumcision. He also mentioned that “at this moment there is no indication from all the research that’s been done that it’s a negative thing.”

Still, Comess-Daniels is frank about the limits to which he will push a congregant on this subject. “As a Reform rabbi, I have a different way of counseling than an Orthodox rabbi would,” he said. “And ultimately, in the Reform movement, we allow people to be their own arbiters in many of these cases.”

Rabbi Yitzchok Adlerstein, the director of interfaith affairs for the Simon Wiesenthal Center, said he was lobbying against the proposed ban in the San Francisco mayor’s office last week, and ended up talking about a comment made by Russell Crowe on Twitter.

“Circumcision is barbaric and stupid,” Crowe Tweeted on June 9. “Who are you to correct nature? Is it real that GOD required a donation of foreskin? Babies are perfect.”

The Oscar-winning actor — who later apologized and deleted his comments — was actually making an argument that appears in the Talmud, the Orthodox Adlerstein said. The Roman governor of Judea asked Rabbi Akiva, who lived in the first and second centuries C.E., why God would require circumcision.

“Judaism, and I would say the Judeo-Christian legacy, is that God left the world in a manner to suggest, or demand perfection by human beings,” Adlerstein said, channeling Akiva’s argument.

“Bris is a clarion call to the young child that your place in the world is not assured,” Adlerstein added. “You’ve got to leave your mark upon it because there are things upon it that need improvement.”

Indeed, in the Orthodox world, the practice of brit milah, or bris, is an all-but-foregone conclusion. Rabbi Meyer H. May, an Orthodox rabbi and executive director of the Simon Wiesenthal Center, said that “Foreskin Man” was “a comic book that Goebbels would’ve been happy with,” but he wanted to make clear that the debate was “less about anti-Semitism and more about religious rights.”

The intactivists, May explained, want to limit a parent’s religious practices for the sake of his child.

“If I send my child to synagogue tomorrow,” May asked, “am I violating the child’s rights? I would hate to see an initiative that says I can’t send my children to religious school — which is an extension of this.”

Indeed, Milos, the 71-year-old founder of NOCIRC, who said she was not taking a position on the circumcision ban, made almost exactly this point in a conversation about circumcision later that day. 

“Anyone born in the United States is protected by the Constitution, which provides the protection of religious freedom,” Milos said. “If you mark a baby as a Muslim or a Jew, you’ve denied his religious freedom, have you not?”

Everything You Think You Know About the Science of Circumcision Is Contested

When talking about circumcision, a procedure in which the foreskin that covers the penis is surgically removed, no fact asserted by one side goes uncontested by the other.

Dr. Edgar Schoen, 85, is a longtime advocate of circumcision and former head of pediatrics at Kaiser Permanente Medical Center in Oakland. Schoen was born in Brooklyn and has lived in the Bay Area for 57 years, and he’s been at the center of the fight over circumcision for most of them.

He was chair of the American Academy of Pediatrics (AAP) Task Force on Circumcision from 1987 to 1989 and handled the task force’s communications from 1989 until 1999. Schoen says he’s on a first-name basis with opponents of circumcision like Milos.

So I asked him about Jamaal, the boy whose death — just a month before his second birthday — had inspired Troutman to try to take the fight against circumcision to the Santa Monica ballot.

“When you hear of a death during circumcision,” Schoen said, “you can bet your bottom dollar that it was an anesthesia death, not a circumcision death.”

Indeed, the initial media reports last month about Jamaal’s death mentioned that the boy had been put under general anesthesia, which, Schoen said, is not uncommon when doing circumcisions on non-newborns. “Not only did the circumcision not cause their death,” Schoen added, “but had they had newborn circumcision, it would have saved their lives.”

This kind of disagreement — total, unambiguous — is characteristic of the medical debate over circumcision. Every study that is conducted — including the recent studies conducted in African countries that circumcision advocates cite as evidence that circumcised men are significantly less likely to be infected by their female partners with HIV — is the subject of intense debate.

Consider:

• Circumcision advocates say that the rate of circumcision is about 75 or 80 percent in the United States today. Many intactivists say that it is 56 percent, and some even claim that the rate of circumcision has dropped to just 32.5 percent.

• Intactivists assert that sexual pleasure and performance is diminished by circumcision. Some circumcision advocates say there is no difference — and others even claim that sex is better and lasts longer for circumcised men (and their partners).

• When talking about the history of circumcision, advocates look to a doctor in the U.S. Army, John Patton, who wrote that circumcision could have prevented a number of debilitating foreskin-related maladies suffered by soldiers during World War II. Intactivists, meanwhile, point to misguided individuals like the surgeon John Harvey Kellogg, who co-invented corn flakes with his brother and is said to have advocated circumcision as a way to curb masturbation.

• There is no medical reason to circumcise a healthy baby, intactivists say. Advocates for circumcision say that the health benefits outweigh the potential risks.

Agreement is effectively nonexistent — even among doctors, which may help explain why the most recent AAP Task Force on Circumcision report, issued in 1999, concluded that “[e]xisting scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision.”

Of particular relevance to Jews is the summary paragraph’s fourth sentence:

“It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in addition to the medical factors, when making this decision.”

Was the blanket ban a bad idea?

When Troutman ultimately decided to drop her ballot measure, she said that if she ever did something like this in the future, she would focus her attention on the circumcisions done in hospitals and would include a religious exemption in the text of the law.

“If I do something like this in the future, I’ll build a coalition, and I’ll probably have Jews on board,” she said.

And even Jews who oppose circumcision say they wouldn’t go so far as to support a ban. Rebecca Wald, a former lawyer and intactivist who lives near Fort Lauderdale, Fla. is the host of Beyond the Bris, a blog she launched in December 2010 as a way to explain why she, as a Jew, was opposed to circumcision — and to reach out to other Jews like herself.

“I have no interest in telling other people what I think they should do or how I think they should live their lives,” Wald said. “I’m also a pragmatist. I don’t think more Jewish people are going to become interested in questioning circumcision if it’s banned. If anything, I think it would go in the other direction.”

But the organized Jewish community has now mobilized to make sure the situation never goes that far. 

“I have never seen another issue unite the Jewish community the way this one has,” said Porth, who has been at San Francisco’s JCRC for more than 10 years. “From the Renewal movement to Chabad, from the secular to the most observant and most traditional quarters of our Jewish community, there is unanimity.”

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