~Joseph4GI
Advocates of genital integrity can now breathe a sigh of relief; it appears as though America's foremost advocate of male circumcision has finally kicked the bucket.
Interestingly enough, his obituary mentions nothing of male circumcision, although it could be said that the defense, advocacy and active promotion of male infant circumcision in America was his legacy.
I'll take care of that.
Edgar Schoen's Legacy: America's Male Infant Circumcision Champion
There was a time when the routine circumcision of newborn baby boys was a near-universal practice in the British Commonwealth. The practice has nearly vanished, however, but it remains popular in the United States, where 80% of all US males are circumcised from birth.*
But how could this be?
How is it that in other Commonwealth nations such as the UK, Australia and New Zealand, male infant circumcision has all but disappeared, but in America it's doing so well?
This man alone may be solely responsible for male infant circumcision's survival in the United States.
Read on to see why this may be the case.
Let's go back in time to before there was ever such a thing as the "American Academy of Pediatrics Circumcision Task Force."
*Actually, the rate of male infant circumcision has been declining recently, as low as 56% according to the CDC, and Schoen and friends had been busy trying to change that.
The Very First AAP Task Force on Circumcision
The year is 1970.
Recognizing the need for an authoritative statement on routine neonatal circumcision, the American Academy of Pediatrics' Committee on Fetus and Newborn issued a statement saying that there were "no valid medical indications" for performing circumcisions on newborns.
This bold statement, released in 1971, was met with objections from some physicians, leading the AAP to create their very first Task Force on Circumcision in 1975 to reconsider the previous position.
A First in American Medicine; The Parents Will Decide
The AAP Task Force published their report in Pediatrics in October 1975, saying they had found "no basis" for changing their statement. There was "No absolute medical indication for routine circumcision of the newborn."
However they added the following qualification:
Nevertheless, traditional, cultural and religious factors play a role in the decision made by parents, pediatrician, obstetrician, or family practitioner on behalf of a son. It is the responsibility of the physician to provide parents with factual and informative medical options regarding circumcision. The final decision is theirs, and should be based on true informed consent. It is advantageous or discussion to take place well in advance of deliver, when the capacity for clear response is more likely.
This statement is an extraordinarily unique instance in the history of American medicine.
The pediatricians declared that their colleagues should be willing to perform surgery lacking adequate medical rationale, provided only that parents request, or agree to it.
In short, a group of credentialed, well-qualified, learned pediatricians gave parents exclusive right to authorize physicians to perform surgery for explicitly non-medical reasons.
In collaboration with the American College of Obstetricians and Gynecologists (ACOG), the AAP's Committee on Fetus and Newborn issued Guidelines for Prenatal Care in 1983, which repeated the 1975 recommendations.
Enter Edgar J. Schoen
The ACOG/AAP publication attracted Schoen's attention, and in 1989, Schoen was made chair of another Task Force on Circumcision who released yet another statement, this one highly biased in favor of male infant circumcision.
Due attention was paid to "contraindications" and "complications," but the report discussed the prevention of phimosis, paraphimosis, cancer of the penis and cervix, infections as "potential medical benefits."
It characterized circumcision as "a rapid and generally safe procedure when performed by an experienced operator." Infants were said to respond with "transient behavioral and physiologic changes."
The conclusion was studiously ambiguous:
"Newborn circumcision has potential medical benefits and advantages as well as disadvantages and risks. When circumcision is being considered, the benefits and risks should be explained to the parents and informed consent obtained."
Notably absent was the 1975 statement about "no valid medical indications."
Where did it go?
It is clear that, while not exactly a brief for circumcision, the AAP 1975 Circumcision Policy Statement was much more biased in favor of circumcision than the previous statements.
1999 - Schoen Is Dissatisfied
The Schoen-chaired statement drew objections from circumcision opponents, leading to the creation of yet another task force in 1999, and the issuance of a new "circumcision policy statement," this one evaluating all claims in greater detail, and introducing the new and noteworthy topic of medical ethics.
The concluding statement was basically a compilation of the last few statements, which seemed to try and satisfy everyone:
"Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In the case of circumcision, in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interests of the child... It is legitimate for parents to take into account cultural, religious and ethnic traditions, in addition to the medical factors, when making this decision."
It seems the best solution any group of pediatricians can come to is to shirk their responsibilities and issue temporary PhD's to parents.
It must be asked, what "medical factors" exist when assessing a perfectly healthy, non-consenting newborn?
Since when are physicians expected to facilitate religious and/or cultural incisions/extirpations?
Needless to say, Schoen was not happy with the 1999 statement.
He soon teamed up with Thomas Wiswell and Stephen Moses, both known circumcision advocates, Moses pushing circumcision as HIV prevention.
Schoen's circumcision dream team called the new statement a "cause for concern," and presented arguments in favor of circumcision, from penile cancer to HIV, calling on the AAP leadership to "quickly address the narrow, biased and inadequate data analysis as well as the inappropriate conclusions."
The AAP Task Force at that time replied by reiterating that while they recognized "potential medical benefits" of circumcision, they were "not sufficiently compelling" when weighed against the "evidence of low incidence, high-morbidity problems." They repeated that they favored "leaving it up to the family to decide whether circumcision is in the best interests of the child."
2003 - Schoen Comes Back
In June 2003, Schoen returns to the scene by writing a letter to Pediatrics, arguing that "new data" had accumulated supporting the claims that circumcision protected against penile cancer, HIV infection, UTIs, phimosis and penile skin lesions, as well as arguing that circumcision "improved genital hygiene throughout life."
In his letter, he urged the AAP revise its 1999 statement, and that a new report be issued to provide "a comprehensive picture of disease prevention from birth through old age."
The next AAP statement on circumcision was to be released 13 years later in 2012, when a policy statement on male infant circumcision was long overdue.
It should be noted that while the 2012 AAP statement does dance around "new, updated data," the statement does little more than repeat the compiled conclusions of it's predecessors, citing "potential benefits," but never quite committing to a recommendation because, in their own words "the benefits are not great enough," placing the onus of responsibility on parents.
Incidentally, the AAP 2012 statement was formally rejected by well-respected pediatric organizations and senior pediatricians from around the world.
Thus, much to Schoen's chagrin, it continues to be fact; No respected medical board in the world recommends circumcision for infants, not even the AAP.
Unanswered Questions
The AAP statements raise more questions than they answer.
The questions are these:
- Without medical or clinical indication, can a doctor even be performing elective, non-medical surgery on healthy, non-consenting minors?
- Let alone be offering parents any kind of a "choice?"
- If the answer is "yes," then the next question would be, what other surgery are physicians expected to perform merely because a parent requests it?
The AAP's biggest mistake was deciding to shirk their responsibilities and put them on parents.
How is it possible that lay parents, the majority of whom never went to medical school, could come up with a more reasonable conclusion than the people holding credentials in the medical field?
How is it physicians are suddenly too stupid to do their jobs, and parents suddenly more learned on medical matters than qualified doctors with degrees?
The AAP should have never opened that can of worms.
Edgar Schoen: Rejected Circumcision Evangelist
America is not the only place where Schoen tried to establish his circumcision legacy. Schoen was a circumcision evangelist who tried to (unsuccessfully) spread circumcision to other parts of the world. The following is an excerpt of a letter written against him in the publication Disease in Childhood:
Schoen’s claims have been rejected wherever he goes. When he published in the New England Journal of Medicine in 1990, his views were opposed by Poland. When he published in Acta Paediatrica Scandinavia in 1991, his views were rebutted by Bollgren and Winberg. When Schoen published in this journal in 1997, his views were countered by Hitchcock and also by Nicoll. In the present instance, his views are offset by Malone.
When the Canadian Paediatric Society published their position statement on neonatal circumcision in 1996, they followed the views of Poland, not those of Schoen. Although Schoen was chairman of the American Academy of Pediatrics (AAP) taskforce on circumcision that published in 1989, he did not serve on the AAP taskforce on circumcision that published in 1999. That second taskforce distanced the AAP from the views published by Schoen’s taskforce a decade earlier.
Schoen’s present views on circumcision are strikingly similar to those of Wolbarst, which were published nearly a century ago. This suggests that Schoen’s views are founded in a desire to preserve his culture of origin, not in medical science.
Read more here.
Conflict of Interest - Public Health? Or Cultural/Religious Preservation?
But what's so anti-Semitic about pointing out that a person might have religious conviction to put circumcision in a positive light? That a person may be predisposed to welcome evidence that the most particular and problematic religious custom of Judaism might be medically beneficial, and to dismiss arguments to the contrary?
According to a MEDLINE search, Edgar Schoen has been published 20 times in the medical literature on the subject of circumcision.
He also happened to be Jewish, where male infant circumcision is considered to be a divine commandment.
This being the case, he may have had a conviction to defend a cherished tradition that has been under fire since the time of the Maccabees, and which has been falling out of favor in this country, even among Jews themselves.
So it must be asked, did Edgar Schoen's actions stem from a true and genuine interest in public health?
Or did they stem from a religious conviction to protect and promote male infant circumcision under the guise of medical advice?
This is a clip is an excerpt from the Dr. Dean Edell radio program,
which aired live from 1979 until December 10, 2010.
Dean Edell is a Jewish-American physician and broadcaster
who became one of the most outspoken opponents of
circumcision.
It is generally well accepted that
an "authority," especially a medical one, needs to be objective and impartial, and that an
audience can only evaluate information from a source if they know about
conflicts of interest that may affect the objectivity of the source.
Does it not follow that a physician's religious convictions for circumcision ought to be disclosed?
My Thoughts
It is my opinion that Schoen's religious conviction to male infant circumcision is in direct
conflict with a feigned interest in disease prevention and public
health.
Edgar Schoen was a Jewish doctor who protected and promoted forced circumcision for Jewish reasons, while disguising these reasons as medical advice.
Schoen used his credentials and prestigious position of AAP Task Force chair to ensure the survival of a Jewish religious tradition, and thus couldn't care any less about public health and the well-being of children.
Edgar Schoen had ulterior motives for promoting male infant circumcision.
He sought to supplant American culture with his own culture of origin, where being circumcised is a mark of being Jewish, and not being circumcised makes you an outcast.
To a certain degree he has been successful; in America having anatomically correct genitals carries social stigma, as it is seen as "dirty" or "disgusting."
He sought to supplant American culture with his own culture of origin, where being circumcised is a mark of being Jewish, and not being circumcised makes you an outcast.
To a certain degree he has been successful; in America having anatomically correct genitals carries social stigma, as it is seen as "dirty" or "disgusting."
I'd be lying if I said I'm sad that Edgar Schoen died.
He did nothing more than participate in the perpetuation of child abuse and violation of basic human rights in this country.
His legacy will live in infamy as that of America's ultimate circumcision champion.
I feel grief, but not for him...
I feel grief and regret men who are angry at what has happened to them didn't get to see the day when this man were held responsible for his actions; the promotion of male genital mutilation... The mental anguish caused to American men with anatomically correct genitals, by the institutionalized profanity against the natural male body...
I feel an evil man has died without being made to face justice.
I can only imagine this is how holocaust survivors might feel when they learn a Nazi who participated in the execution of Jews has died without having been brought to justice...
The millions of needless surgeries...
The countless infections, partial or full ablations, hemorrhages, deaths, this man is responsible for...
The many lives he ruined...
The many men who have to live their lives with deformed penises... marred bodies...
The many men who have to live with the reality that they must live in a body they did not ask for...
That they must live with an artificial, forced phenomenon...
That they will never know what sex as nature intended it would be...
That they will live with a sense that the body which they were born with was never their own...
That they will never know the feeling of having a whole, intact body...
For the rest of their lives...
It is clear that he left an indelible mark upon American medicine, and upon millions of American males across the country, whether they wanted it or not.
A perpetuator of charlatanism, child abuse and the violation of the most basic and sacred of human rights has died.
Good riddance.
I can't wait for others like him to die off and be relegated to one of the darkest eras in American history.
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