Advocating Genital Autonomy: Methods of Intactivism in the United States

This project investigates the methods employed by activists in the genital autonomy movement in the United States. “Intactivists” advocate the inalienable right of humans (and children in particular) to have intact genitals, free from any unnecessary or damaging modifications without their fully informed consent. For this project, I conducted structured interviews with sixteen self-identified intactivists to identify the primary methods they use to advocate for genital autonomy. Participants advocate the principle of autonomy by disseminating information about (a) the intact body and functions of the genitals; (b) the damages of genital surgeries that worsen with age; and (c) the ethical dilemmas associated with all medically unnecessary genital modifications.

Introduction

The genital autonomy, or “intactivist,” movement advocates for the legal protection of children from medically unnecessary genital surgeries without patient consent. This movement aims to bring consciousness and awareness of genital mutilations and to educate communities about both the benefits of the intact sex organs and the problems of amputating genital tissue in healthy children. The genital autonomy movement challenges the international practice of genital mutilation, which affects children of all gender classifications. Circumcision affects 15.3 million male and female children and young adults, amputating part or all of their external sexual organs every year (Denniston, et al., 2010). Genital autonomy is an international collective social movement whose foundational principle is the right to body ownership; that all human beings – females, males, and the intersexed – have an inalienable right to intact genitals, free from any genital modifications, such as clitoridectomy, infibulation, circumcision, and sex reassignment, that are unnecessary and damaging to the body. The “declaration of genital integrity,” as set forth and adopted by the General Assembly of the first International Symposium on Circumcision, recognizes “the inherent right of all human beings to an intact body… Without religious or racial prejudice,” this “basic human right” is affirmed (Denniston, et. al., 1999, p. 505). Without sound medical exigency and without consent, genital modifications performed on children violate this principle.

US intactivism became a collective effort in 1986 with the founding of the National Organization of Circumcision Information Resource Centers (NOCIRC). This organization later shaped the direction of the movement. Activists and scholars of a variety of professions examined many of the foundational principles of the genital autonomy movement when NOCIRC organized and adopted the symposium, March 3, 1989, in Anaheim, California (About NOCIRC, 2010). These principles included but were not limited to (a) genital autonomy as an inalienable right, (b) accurate information about the human body, (c) the right to informed consent, (d) the advocacy for medical research on the functions of the sex organs, and (e) physician accountability for violating the code of ethics when performing genital surgeries (Bollinger, 2006).

NOCIRC was the first legally unified organization in the US to specifically address male circumcision; and although this is the primary focus, the organization does offer resources and a list of affiliates that research female circumcision and sex reassignment surgeries (NOCIRC Centers and Other Organizations, 2010). The founding of NOCIRC occurred against the backdrop of three large social movements in US history: the civil, Women’s, and gay rights social movements directed activism to strengthen the liberties and freedoms of their communities. The crux of these movements has been social, legal, and political equity and to broaden an understanding of, and respect for, human rights. Intactivism is related because the movement exists to bring awareness about an issue that affects everyone, transcending all social locations (race, class, gender, etc.). Genital autonomy is a basic human right, and the primary goal of intactivism is to secure this right for everyone. As with these social movements, intactivism questions and challenges deeply embedded ideologies about social normalcies. Intactivism advocates better sex education and knowledge of the human body, including the functions of the foreskin and the physical, psychological, and sexual effects of circumcision.

After the founding of NOCIRC, several intactivist organizations followed, and over time, the movement has grown substantially. A variety of reference and non-profit Internet web pages exist that disseminate resources to communities about issues related to circumcision.

The Circumcision Information Resource Pages (CIRP) provides copies of medical and academic journal articles about circumcision. The aims of the non-profit organizations and advocacy groups also vary: NOCIRC is largely a grassroots organization, and now has over 120 chapters worldwide (NOCIRC Centers, 2010). Genital Autonomy is a UK-based charity that advocates human rights, whereas Jews against Circumcision, Jewish Circumcision Resource Center, and Quranic Path examine circumcision and religious ideology. Intact America was founded in 2009, and largely exists to combat male circumcision in the US from governmental venues such as lobbying. The Whole Network is a grassroots organization that operates primarily through social media. Doctors Opposing Circumcision exists as an international collective effort of physicians opposed to non-therapeutic circumcision. Attorneys for the Rights of the Child offers legal support as related to involuntary genital surgeries, and NORM-UK offers alternatives to circumcision for intact men who have foreskin problems. The National Organization for Restoring Men (NORM) offers support and information for men interested in undergoing non-surgical foreskin restoration to undo some of the damage from circumcision. Organizations that primarily advocate for women’s bodily integrity and against female circumcision, such as (I)NTACT, Inter-Africa Committee, RainbO, Equality Now, and Light-foot Associates, are registered affiliates with NOCIRC (Affiliate Organizations, 2010).

With that in mind, intactivism examines the intersections of circumcision with discourses of medicine, culture, and religion. No organization polls its members or keeps statistical information on intactivist activism. Without contacting each organization and center, it is difficult to ascertain how large the movement is or sense the global scale and population. However, there is at least one NOCIRC center in every living continent and there are several genital autonomy organizations in Canada, Europe, South Korea, and Australia (Affiliate Organizations, 2010).

The methods that intactivists employ are vital in order to successfully advocate for genital autonomy. This paper examines the various strategies used by intactivists to raise awareness about the issues surrounding genital surgeries and advocating for genital autonomy in the United States. Which strategies are employed? Are the methods community-based, such as online networking sites, or academic-based, such as formal internship programs, organizational chapters, and conferences, or both? How do intactivists reach those who do not have this capability? How do opponents of circumcision and participants in the genital autonomy movement distribute this knowledge to the general public who likely is unaware of this research? By employing a variety of methods and approaches to activism, intactivists in the United States better succeed in promoting the goals of the movement as they dissect the issues in question and advocate genital autonomy from several different ways. Personal testimony to activism is common, and several social movements draw heavily on the technique of examining experience in order to execute change. This research is also interested in examining the relevancy of personal experiences of intactivists and the methods to promote the goals of the movement.

Literature Review

Many genital autonomy advocacy organizations address genital surgeries, as they relate to females, males, and the intersexed. Much of the intactivist movement in the United States primarily focuses on male circumcision, the most common form of genital mutilation in the US, which is the focus of this paper.

Activists spend time educating people about the medicalization of circumcision in the West, and explain how proponents framed circumcision as a medical necessity to cure a variety of diseases and disorders. The normalcy of circumcision in the West has resulted in a cultural malevolence to the natural male body.

Historical Backdrop and Medicalization of Male Circumcision

The history of circumcision is convoluted. Currently, only a small percentage of the world’s male infants have been circumcised – less than seventeen percent. It is generally estimated that the rate of circumcision in the United States is between 30 and 60 percent (Zoler, 2010; DeLaet, 2009; Hodges, 1996). This wide range of estimations is likely due in part to inconsistent reporting of medical statistics. The commonality of the practice of circumcision in the US has left the public largely unaware of the origins or motives of the practice. These are generally overlooked in discussions of circumcision (Dunsmuir & Gordon, 1999; Wallerstein, 1980).

Circumcision has been performed ritually, culturally and for erroneous medical purposes, for more than four thousand years. It is only in the last two centuries that it has become formally medicalized (Dunsmuir & Gordon, 1999; Bigelow, 1994; Lewis, 1949; Milos & Macris, 1992). Beginning in the mid eighteenth century, the foreskin underwent a transformation of perception. What once had been a functional and pleasurable part of the penis became pathologized and casually treated as “a useless bit of flesh” (Darby, 2005, p. 4). Those ascribing to new Victorian norms became determined to convince parents that their boys would be "better off without a feature their fathers had enjoyed" (Darby, 2005, p. 4). Consequently, the intact penis, once viewed as “pure, healthy, natural, beautiful, masculine, and good,” came to be regarded as something “polluted, unnatural, harmful, alien, effeminized, and disfigured” (Darby, 2005, p. 4; Miller, 2002, p. 501).

In the nineteenth century circumcision developed into a routine medical procedure professing to cure many illnesses, at a time when the causation of those diseases was not known (Dunsmuir & Gordon, 1999; Milos & Macris, 1992). Circumcision in the West also became marketable as a method to stop masturbation of each sex, which was thought to bring disease and mental illness (Gollaher, 1994; Wallerstein, 1980, 1985; Grimes, 1978; Lewis, 1949; Atkinson, 1941). In a concerted effort to generate support for circumcision, physicians claimed circumcision as cure or prevention of various diseases, including but not limited to: nocturnal emissions, syphilis, epilepsy, spinal paralysis, nocturnal, sexual, urinary, and rectal incontinences, curvature of the spine, paralysis of the bladder, clubfoot, crossed eyes, blindness, deafness, dumbness, alcoholism, gout, asthma, rheumatism, headaches, and hernia (Lallemand, 1836, 39, 42; Hutchinson, 1855; Heckford, 1865; Sayre, Detmold, & Hutchinson, 1870; Sayre, 1870, 1875; Bell, 1873; Kane, 1879; Eggleston, 1886; Gentry, 1890; Rosenberry, 1894; Remondino, 1891).

The characterization of the foreskin as “a source of moral and physical decay” (Darby, 2005, p. 4) was a critical factor in the emergence and acceptance of circumcision as a valid medical procedure. The rising “medical objections to masturbation, the conceptualization of ‘congenital phimosis’ [the normal state in the infant in which the foreskin does not naturally retract from the glans] and spermatorrhea [excessive and accidental ejaculation] as pathological conditions,” in addition to “confused and erroneous theories of infectious diseases” served as the backdrop of the medicalization of circumcision (Darby, 2001, p. 4). This created an “atmosphere of sexual Puritanism in which non-procreative sex was regarded as immoral and sexual pleasure feared, and the emergence of a new professional elite keen to assert its social authority by providing such pleasures were dangerous as well” (Darby, 2005, p. 4). This Puritanical sexual attitude developed, within the medical community, to control men's sexuality by constructing the natural male body as debauched and therefore in need of medicalized correction through circumcision.

Later, in the twentieth century, new medical rationalizations were made and adopted in order to justify routine foreskin amputations (Milos & Macris 1992). Although many of the diseases previously thought to be curable by circumcision still were advocated throughout the twentieth century, others were proposed, including: superfluous sensitivity, tuberculosis, penile cancer, prostate cancer, venereal disease, cancer of the tongue, female cervical cancer, nervousness, bladder and rectal cancers, and urinary tract infection (Hutchinson, 1900; Mark, 1901; Wolbarst, 1914, 1926, 1932; Ravich, 1942, 1951, 1971; Hand, 1949; Wynder, et al., 1954, Fishbein, 1969; Wiswell, et al., 1985).

During the nineteenth and twentieth centuries, male genital surgeries spread to all English-speaking countries including England, Canada, Australia, New Zealand, and the United States. Presently, none of these countries routinely performs circumcision and the practice has virtually ceased. The exception, however, is the United States. Many Americans remain ignorant to the importance of the foreskin, and have erroneous beliefs and tenuous fears about hygiene, disease, appearance, sexuality, and the denial of the pain of infant circumcision (Milos & Macris, 1992).

Preputial Functions and Benefits

The foreskin plays a crucial role in human sexuality and male sexual function, which becomes dysfunctional, and in many ways defective, after its amputation. The foreskin offers various protective, mechanical, sensory, and sexual functions. The foreskin protects the glans (the head of the penis) from foreign stimuli, urine and feces, and contains lysozyme to kill invading pathogens (Hill, 2007). It protects from dryness and abrasion, shielding the glans from the process of keratinization, which is the body’s natural attempt to suffice for missing protection (Morgan, 1967; Cold & Taylor, 1999; Bigelow, 1994). As skin cells overlap on each other, the glans becomes dried out, leathery, and an abundance of sensitivity is buried and lost beneath the thickened layers of skin (Foley, 1966; Fink, 1988; Milos & Macris, 1992). The foreskin comprises over half of the mobile skin in the penis and allows for the unique gliding action that facilitates penetration and intromission (the motions of sex) (Whiddon, 1953; Morgan, 1965, 1967; Foley, 1966; Hill, 2007; Lander, 1997; Davenport, 1996). The foreskin is also a specific erogenous zone containing nerve endings that are most sensitive to temperature and fine touch including thousands of coiled fine touch receptors called Meissner’s Corpuscles (Winkelmann, 1956, 1959; Moldwin & Valderrama, 1989; Taylor, et al., 1996; Hill, 2007).

Without the foreskin, these protective capabilities, operating mechanics, sexuality, sensitivity, and erogeneity, become adversely affected and greatly diminished (Winkelmann, 1959; Morgan, 1965; Foley, 1966; Morgan, 1967; Falliers, 1970; Bigelow, 1994; Van Howe & Cold, 1997; Hill, 2003, 2007; Boyle, 2004; Thorvaldsen & Meyhoff, 2005; Masood, et al., 2005).

This body of research suggests benefits to leaving the penis intact and electing not to circumcise, which challenges the circumcising norm of American culture. This knowledge also suggests that there are specific damaging effects to circumcising an infant. Intactivists largely advocate accurate medical information about the purpose of the foreskin and its various functions, and without sound medical exigency, circumcision should not be considered as a method of treatment.

Misconceptions of Circumcision

The genital autonomy movement attempts to address the myths and misconceptions surrounding the foreskin and circumcision. Many intactivists, who focus on the medical disciplines to raise awareness on the male body, argue that the foreskin is a significant part of male genitals and that it allows for optimum sexual health and function (Hill, 2007; Prakash, et al., 1982; Foley, 1966; Fink, 1988; Milos & Macris, 1992; Lander, 1997; Davenport, 1996; Winkelmann, 1956, 1959; Moldwin & Valderrama, 1989; Taylor, et al., 1996; Talarico & Jasaitis, 1973).

In addition to resisting the medicalization of circumcision and providing information about the male body, genital autonomy activists also shed awareness on various myths related to the foreskin and the circumcision procedure, including: medical power, health, infection, hygiene, and pain. By challenging these misconceptions, genital autonomy activists resist social and medical conformity, both of which are instrumental in propagating circumcision as perfunctory.

Many parents rely on their physicians for information about circumcision. Yet, physicians often recommend circumcision without disseminating information about the functions of the foreskin, or the risks and harms of the surgery. Some healthcare professionals may unknowingly cause harm to intact children by forcibly retracting the foreskin that is attached to the glans, and then urge circumcision as a remedy for the damage (Geisheker & Travis, 2008; Fleiss, 2000). “…The question is not foreskin problems but the attitude of the American medical profession in pushing what most physicians throughout the world consider unnecessary surgery. Worldwide, foreskin problems are treated medically, rarely surgically” (Wallerstein, 1986). As Paul M. Fleiss, MD, said, “Probably, the only problem you will encounter with the foreskin of your intact boy is that someone will think that he has a problem” (Fleiss, 2000).

A common assumption is that circumcision prevents foreskin infection, which is true. An amputated foreskin does not become infected in either males or females. If breast bud removal were routinely performed, there would be no possibility for women to develop breast cancer, or, if routine labiectomies were performed, women would not develop vulvar cancer. The possibility of bodily infection does not justify unnecessary medical procedures in any circumstance (Milos & Macris, 1992). Infections, along with other minor conditions, can usually be corrected without surgical intervention (Yilmaz, et al., 2003; Van Howe, 1998; Choe, 2000; Poynter & Levy, 1967; Pasieczny, 1977; Dunn, 1989; Wright, 1994). In the rare instances in which surgical intervention is necessary, there are more conservative methods of treatment than circumcision, which do not result in the amputation of the entire foreskin (Fleet, et al., 1995; Cuckow, et al.; 1994). Amputation of a body part should be the last treatment after all less invasive interventions have failed. Acidophilus culture for inflammations and antibiotics for infections are effective treatments. Although Americans would never allow invasive surgeries for girls, many allow the unnecessary amputation of the foreskin for boys.

Genital hygiene is widely used to justify circumcision because it is believed the circumcised penis is cleaner (Schoen, 2008; Kalcev, 1964; Oster, 1968; Russell, 1993; Wright, 1970; Oh, et al., 2002). The circumcised penis is actually less hygienic than the intact penis because the foreskin covers and protects the glans and mucosal membrane from invading pathogens (Hill, 2007). Cleaning the intact penis is as simple as cleaning the vulva. Prior to the natural retraction of the foreskin, “clean only what is seen,” using just warm water (Geisheker & Travis, 2008). When retraction becomes possible, the boy can clean his penis, by retracting, rinsing, and replacing the foreskin to its forward position. Just as females should not use soap to clean their vulva or vaginas, males should not use soap to clean the underside of the foreskin or the glans because such chemicals dry the sensitive mucosal membrane (Birley, et al., 1993).

Circumcision is justified as a minor surgery because it is believed that there is minimal to no pain involved (Anders et. al., 1970; Anders & Chalemian, 1974; Cope, 1998; Emde, et. al., 1971; Tennes & Carter, 1973). In truth, circumcision causes excruciating pain for an infant (Lander, et. al, 1997; Sara & Lowry, 1985; Berens & Pontus, 1990; Snellman & Stang, 1995; Taddio, et. al., 1995). Circumcision also causes greater pain intensity in infants than in adults (Anand & Hickey, 1987). Prior to amputation of the foreskin, the synechial membrane, which connects the foreskin and glans, must be torn. This membrane is identical to that which adheres the fingernail to the finger. The foreskin then is cut longitudinally to widen the opening, and the circumcision clamp is inserted under the foreskin in order to protect the glans. The foreskin is crushed against the clamp and then amputated (Milos & Macris, 1992; Taddio, et al., 1997). Tearing the synechial membrane damages the inner lining of the foreskin and the glans, leaving them raw and subject to infection, scarring, and shrinkage (Fleiss, 1997). Although analgesia is available to help alleviate pain, it is not always effective. The penile dorsal nerve block only blocks the dorsal nerve pathways and its administration requires two injections into the base of the penis (Lander, et al., 1997). Eutectic Mixture of Local Anesthetics (EMLA) cream is not effective and it is contraindicated after birth because it can cause a blood disease (Fontaine, et al., 1994; Benini, et al., 1993). Parents may think their baby “slept through it” (Denniston, 2006), but they do not realize that the baby has withdrawn into neurogenic shock and is in a semi-comatose state caused by the sudden massive pain (Milos & Macris, 1992; Anand & Hickey, 1987). The pain of circumcision is inevitable and will intensify each time the infant urinates, defecates, has a diaper change, or is held too tightly for up to two weeks (Anand, et al., 1987; Milos & Macris, 1992).

Examining the Methods of Genital Autonomy Activism

Given this snapshot of literature surrounding genital mutilation, the methods that activists employ are vital in order to successfully advocate social change. Having a body of knowledge that is not reachable, or denied to the public, does not help to bring social progress. Intactivists must negotiate ways to bring consciousness to members of the communities, educate people on these largely overlooked concerns, and then encourage a cultural shift to genital integrity as opposed to the current cultural expression of circumcision. Without having viable methods to engage in praxis, intactivists cannot disrupt and challenge Western culture’s inaccurate and misleading information about male genitals and the supposed need for circumcision.

This project examines the intactivist methods of activism in the genital autonomy movement of the United States. Consequently, this project sheds light on the methods of activists whose primary focus is male circumcision. I encourage other research to investigate the rates of success in each method, and the popularity (which tools are preferred over others), and also the uniqueness of the methods in this movement by juxtaposing it to other social movements.

Data and Methods

This study focuses on the diversity of intactivists’ methods, one of which is personal testimony. This research also offers a discussion of the degree to which personal testimony is an activist method, examining the relationship, if any, between “the person” and “the activist².”

Between March-April, 2011, I conducted sixteen structured interviews in order to examine the methods used to promote the goals of the genital autonomy movement. The interviewees identify as intactivists and are active participants in the genital autonomy movement to some degree. Participants were collected from online networking (e.g., Facebook) and online intactivist groups (e.g. Jews against Circumcision [JAC], Wacky World of Circumcision [WWC], and NOCIRC Centers) and interview questions were delivered via electronic correspondences^3.. Facebook was chosen because of the access to a diverse population of intactivists. Both JAC and WWC existed before Facebook and also include a large population of genital autonomy activists. The NOCIRC Centers is a group for branch directors for the NOCIRC centers, which includes over 120 chapters worldwide. I wanted to ensure a diverse sample, however small, of interviewees, and each of these groups offers a large pool of intactivist diversity on the basis of social location and professional background. However, those who responded to the request for interviews were all of Western ethnic backgrounds, and overwhelmingly female: only five of the sixteen interviewees were male. The ages of the participants spawned over fifty years, ranging from eighteen years of age to over seventy.

I have used two methods for analyzing the material obtained in the interviews. First, the activist trajectory and experience of the individual have been examined as an identity narrative. I trace the story presented by the activist of her/his life and work, to attempt to contextualize how s/he came to participate in and contribute to the politics of genital autonomy. This involves a degree of abstraction from the detailed narrative presented, in order to highlight significant factors and events. Secondly, I have extrapolated from the separate narratives some of the key factors that appear to be noteworthy for genital autonomy activists in general. The personal narratives and the discussions of them illustrate how the identity perspective provides a way of understanding how the activists negotiate their lives and beliefs related to genital autonomy. The events and decisions, the activists' actions, and their sequence, play significant roles in mapping out their participation in the larger genital autonomy movement.

Findings and Analysis

Intactivists advocate the principle of autonomy by disseminating information about (a) the intact body and the functions of the genitals; (b) the damages of child genital surgeries that continue throughout adulthood and worsen with age; and (c) the ethical dilemmas associated with all medically unnecessary genital modifications. Activists employ a variety of methods and pedagogical approaches to addressing these components including (a) an anecdotal story of experience, which commences the activist trajectory; (b) “gentle education” pedagogy, which involves consciousness about activist temperament; (c) the ability to individualize the consciousness-raising to meet the specific needs of the person; and (d) advice for future activism based in personal awareness, knowledge, and compassion. Each of these methods combined with the various philosophical approaches to genital autonomy activism provides for a diverse social justice movement.

Of the sixteen people interviewed, each had a unique anecdotal story to tell, which explained the beginning of the participant’s activism in the genital autonomy movement. Personal testimonies were usually given in-depth, during which the interviews revealed several reoccurring themes of how the intactivist “coming out” began.

More than 37 percent discussed an intactivist consciousness after pursuing research on the topics, either for personal interest or by accident. “A light bulb went on in my head – I realized we were designed to fit together in ways we had never imagined, and our ‘improvement’ of the human body through circumcision was a serious detraction of that,” says Michael, after researching the discovery of estrogen receptors in the male foreskin, which he saw reported on the Circumcision Information Research Pages.

More than 18 percent informed me that contact with intactivist friends, colleagues, or seeing intactivism in the community lead them to participating in the movement. Michelle, who runs the blog “Menses Today and Childbirth and…” recalled the beginning of her intactivism: “I was introduced to the phrase by you, Travis, being exposed to it actually made me feel like I could do something positive about the numbers of babies being circumcised.” Jaci, whose friend provided her with information about intactivism and circumcision, later described the practice as “barbaric” and “unnecessary.” In addition to intactivist friends and colleagues, witnessing intactivism in the public can be equally as effective. For William, hearing Dr. Dean Edell, M.D., denounce circumcision on his radio talk show in 1990 changed his viewpoint: “He’s a Jew who has been speaking out against infant male sexual mutilation for a few decades now. So I read much material very quickly and became furious and outraged that this insanity had been forced on me at birth.”

Three participants (more than 18%) spoke of experiencing stress when faced with a culture vastly different than one’s own. This stress included feelings of ridiculousness and concern about the lack of value and appreciation, in addition to the degradation, of the foreskin in the United States. I refer to these sentiments as “culture shock.” Culture shock can come in various forms: the person can experience the differences between one’s native culture and the secondary culture and feel emotional distress, thus a ‘shock.’ The person can also experience cultural shock when faced with cultural values or practices that are diametrically opposed to one’s own. This can occur as intact-friendly people react to America’s circumcision culture.

Hugh Young, who runs the online web portal, Circumstitions, experienced cultural shock as an intact male in his native New Zealand: “I was opposed to circumcision ever since I heard about it as a child and found that most of my playmates – that I knew of – were circumcised.” Bronwyn revealed that having intact brothers and a mother as an advocate of the intact penis led her to question circumcision. Some of her sexual experiences with men whose circumcisions caused skin tearing and bleeding, in addition to the “horrible, frenzied sex” with circumcised partners caused her to feel “used and unloved.” Belle Peppa, who runs the blog, The Front Porch Swing, experienced cultural shock after having sexual experiences with intact men in Europe, and then moving to the United States: “I always accepted my lover’s body as an entirety, and I would never consider cutting a part of any person’s sex organ.”

Utilizing personal testimony to discuss this culture shock is a method to bringing awareness to the intact body and to circumcision. By debunking the myths that are sustained in a circumcising culture, those who have experience with the intact body and cultures that believe in bodily integrity, intactivists have the opportunity to discuss the damages caused by circumcision on children. Likewise, several intactivists revealed struggles between two or more social roles that have conflicting requirements and belief systems. These role strains have caused intactivists to bargain between their professional roles (e.g., profession and its requirements) and their beliefs in genital autonomy. Marilyn Milos, RN, Executive Director and Co-founder of NOCIRC, revealed that role strain eventually lead to becoming an intactivist and founding the organization: “I witnessed a circumcision in 1979 and that experience literally changed the course of my life!” During the circumcision she had witnessed, the physician performing the procedure turned to her and said, “there is no medical reason for doing this,” and continued to amputate the boy’s foreskin. “I told my patients what I had learned. After I was fired from Marin General Hospital for telling parents the truth about what would happen to their baby behind closed doors, in 1985, I co-founded [NOCIRC].”

Marilyn’s experience suggests a role strain as a nursing professional torn by the barbarism of circumcision. Gillian Longley, RN, BSN, MSS, also experienced this role strain during the time of her nursing career: “When I was in nursing school in 1980, I witnessed unanaesthetized circumcisions of newborn babies. I knew then and there that circumcision was barbarism.” Gillian, who now serves on the Board of Health Professionals for Intact America, coordinates the NOCIRC chapter in Colorado, and became an advocate for genital autonomy around the same time as Marilyn.

These data suggest that personal experience can be a catalyst for social change. Of the sixteen genital autonomy activists interviewed, each is personally invested in the movement, and activism serves a significant role in their lives beyond simply occupying a space from which to advocate for an arbitrary social cause. The varied experiences through consciousness from research, awareness from intactivism, role strains, and cultural shocks have left intactivists the burden of negotiating deeply held convictions and their professional and personal lives. This negotiation has led this group of people to question genital surgeries, later commencing their personal intactivism.

The majority (over 68%) revealed that personal testimony is an important component to their activism. Mothers, like Marilyn, talk about having circumcised sons and being an intactivist: “I have three circumcised sons. I educated myself too late. And, I’ve dedicated my life to bringing an end to this anachronistic blood ritual. Now, I have five intact grandchildren – four intact grandsons and one intact granddaughter.” However, not all intactivist mothers have circumcised sons. Others, like Gillian, have intact sons and continue to educate people about the harms of circumcision. Lauren Jenks, Executive Director of the grassroots organization, The Whole Network, has one intact son and believes her story is important for everyone: “When I’m talking to other mothers (or pregnant women), I tell them my story. It wasn’t long ago when I was in their shoes – and it really helps that I understand what they are going through.”

Less than 19 percent of interviewees included that only sometimes stories are used and considered important. “I share [my story] sometimes with other intactivists when I want to know their story,” says Caroline, “but it’s pretty personal to me, so I keep it to myself generally.” Other intactivists elect not to utilize personal testimony. In fact, less than 13 percent of the intactivists stated that personal testimony is not used at all.

While discussing personal testimony as an intactivist method, I realized I assumed that every intactivist interviewed would inform me about the instrumental usage of personal testimony as an intrinsic part of conducting activism. In reality, although a majority of intactivists do utilize personal testimony, a significant portion either use it less frequently or elect not to use it at all. This suggests that personal testimony is useful in activism by drawing parallels between life experiences. However, this is not vital to the movement’s survival. Educational outreach, or the ways in which intactivists promote genital autonomy, can be achieved without utilizing personal testimony.

In addition to my preconceived thoughts about personal testimony, I assumed that the majority of the respondents would have declared greater concern with specific activist methods, e.g. organizational chapters, demonstrations, use of social media, etc. On the contrary, a large portion (over 56%) of the responses spoke of pedagogical approaches to activism as the most important intactivist method.

Interviewees were greatly concerned with temperament and felt that it is important that intactivists be non-judgmental, calm, and willing to listen to the stories of those to whom they are speaking. I refer to these pedagogical approaches as “gentle education.” Lauren prefers the gentle education approach: “I prefer to be a compassionate activist. I try to be understanding and patient with those who are trying to find more information. Many times, intactivists can be a bit extreme and abrasive (often unintentionally).” Her awareness and disapproval of more ostentatious approaches leads her to utilize alternate methods: “Sadly [this approach] lands on deaf ears. I have had a much better result when being patient and kind, and people seem to be more open-minded to the information I have to offer.”

During gentle education, intactivists often spend ample time debunking myths surrounding the foreskin, the benefits to the intact penis, and analyzing the ethical concerns around circumcision. Georganne Chapin, J. D., Executive Director of the political and grassroots organization Intact America, urges intactivists to focus on ethics and to not become discouraged: “Don’t be embarrassed to be talking about this, and don’t get intimidated! You are RIGHT. There are NO TWO SIDES to this issue. YOU ARE RIGHT.” Chapin expressed her focus on several key ethical components, and advocates that other intactivists be rightfully concerned with them in their own activism:

“(a) The baby isn’t sick; (b) The foreskin is NORMAL; (c) They don’t circumcise boys or men in most of the world; (d) There is ABSOLUTELY NO evidence that in states where circumcision rates are high, the rates of STD and AIDS and cervical cancer are lower than in states where circumcision rates are low; (e) We don’t cut baby girls; it’s EXACTLY the same from an ethical perspective; (f) It’s not the parent’s choice; (g) There are limits to parental discretion; (h) Freedom of religion gives you the right to believe what you want, but not to harm your child because of such beliefs.”

Another concern is the ability to individualize the consciousness-raising. This approach to activism takes seriously the ideological system and current beliefs of the person and shapes the educational experience around that person's needs. In order to conduct this method, intactivists will apply the gentle education approach in addition to not regurgitating responses to frequently asked questions or common misconceptions surrounding genital autonomy and genital surgeries. “Begin with the person in THEIR square one and go from there,” reminds Marilyn, “…we’ve each had to become educated along [the] way and others need the same education. So, that’s the focus of what we must do.” Whether the person is coming from a religious perspective, medical, or social, it is important to validate the experience and begin the process of individualizing the consciousness-raising using a gentle education approach.

However, not every intactivist interviewed agrees with this approach to activism. John argued that, before consciousness-raising or gentle education can commence, intactivism must be declared and practiced at home: “People should establish and maintain intactivism at home FIRST.” In fact, as opposed to focusing on the public methods of intactivism, the primary concern should be shifted to examine intactivism in the home: “Once an ethical environment is established in one’s own family, one’s own living environment, one can begin to look for additional, convenient opportunities to educate and take legal steps to ban genital corruption. I do not believe evangelism will be effective.”

The variety of responses suggests differing approaches to intactivist activism with emphasis on which methods to employ, what constitutes a method, and which methods should take priority over others. Although the majority (over 56%) of respondents seem to adhere to liberal approaches to social activism and implementing forms of the gentle education approach, over 12 percent of respondents felt that more radical approaches could be useful. These approaches could include elements of shock value: In efforts to reveal gender biases, Jess chooses to ask male circumcision advocates, “would you circumcise your daughter, then?” However, Kyle argues against an assimilationist approach to legal obedience: “I prefer the most extreme, and radical methods of intactivism because I just want circumcision to end now. When I say ‘extreme’ and ‘radical’ that could possibly entail violence against so-called ‘doctors’ who do this to innocent fucking babies.” He later clarified the degree to which the disobedience might be useful: “I’m still not sure about the violence thing. I’m too young for jail or death.” The intactivist movement benefits from this diversity (excluding violent disobedience). Because there are so many ways to advocate genital autonomy, the movement can better flourish with a richness of activists and their unique methods, by creating space for liberal and radical preferences, as well as a mixture of both.

I ended each interview asking what advice could be given for new and upcoming intactivists, specifically asking about what should be done to have the most success as activists for genital autonomy. There were four central themes in response: (a) educate oneself; (b) familiarize yourself with strengths and weaknesses; (c) have patience and do not harbor on personal anger; and (d) be compassionate and listen to others.

Education must begin with the intactivist: “Learn a huge amount about circumcision and intactness,” urges Georganne, “… read all the stuff on intactamerica.org website and the [NOCIRC] website, and [Attorneys for the Rights of the Child], and circumstitions.com, etc.” Equally important to educating oneself about circumcision is not to focus on technicalities and jargon. “Don’t get dragged down in the medical and technical details. That person doesn’t know what s/he’s talking about, you can be sure, especially when trotting out HIV or cervical cancer, or whatever new medical claims might be out there.”

It is also important for intactivists to become familiar with one’s own strengths and weaknesses. This will make activism easier for the activist, more beneficial for the spectator, and more valuable for the movement as a whole. “Face-to-face vs. online, [one-to-one] vs. speaking to crowds, video vs. pictures vs. words, reason vs. emotion, everyone has their own strong and weak points,” says Hugh. “Stay up to date, keep well informed about how circumcision is being promoted (know your enemy), and stay on topic. Circumcision has such crazy ramifications it’s easy to be led down side-tracks.”

A common initial intactivist reaction to circumcision is intense feeling, usually of anger or resentment, especially if the intactivist has personally experienced the procedure. For example, a man whose body was violated via circumcision, a mother who was given misinformation about circumcising her son, and the sexual partners of circumcised men all have experienced circumcision in different ways, and it is likely that intactivists will endure physical, psychological, and emotional struggles from these experiences. Of the sixteen interviewees, 50 percent spoke of having an intense reaction upon learning about circumcision. However, Caroline warns new intactivists: “Try not to let your anger take over (if you are angry). Realize that you probably will go through an ‘angry phase.’ But do your best to separate this aspect of yourself from the activist ‘you.’ You will be less likely to drive people away.”

Each of these central themes works together as components of successful activism. The final component of successful activism is the ability to demonstrate compassion and the ability to listen to others. “Just remember that most parents are only doing what they think is best and following their doctor’s advice,” says Lauren. It is important to realize that most parents who elect for circumcision do so out of good intentions, although rooted in completely inaccurate and fraudulent information about the male body. “Circumcision is a strong tradition in our culture, and sometimes it is hard for people to see it any other way. However being patient and understanding with people will get you far. Many times, a parent only needs to hear that it is unnecessary (along with some accurate information) to make their decision.”

Conclusion

Intactivism is an international collective social movement, and its foundational principle is the right to genital autonomy for all children, females, males, and the intersexed. The US movement became a collective effort in 1986 with the founding of NOCIRC, clearing the way for other organizations to follow such as Intact America and The Whole Network. The founding of NOCIRC helped to shape the direction of the movement, and many of the foundational principles of the intactivist movement were and are continued to be examined in the international symposium on “Circumcision, Sexual Mutilations, and Genital Integrity,” occurring every two years.

The genital autonomy movement advocates for the legal protection of children from medically unnecessary genital surgeries without consent of the patient. Intactivism strives for an awareness of genital mutilations and educates communities about the benefits of remaining intact and the medical and ethical problems associated with genital cutting.

The methods that intactivists employ are important for the movement’s success. By occupying a variety of methods and approaches to activism, intactivists in the United States better succeed in promoting the goals of the movement as they dissect the issues in question and advocate genital integrity. Intactivists in the US spend ample time educating people about the underpinnings of anti-masturbation ideologies that have historically been used to propagate circumcision in children. From this history a campaign has emerged against the foreskin in efforts to cure and prevent various diseases. Consequently, the functions of the male sex organ and the damages caused by circumcision are typically overlooked and ignored. Intactivists advocate genital autonomy by disseminating this information to bring awareness about circumcision’s damaging effects to the body, the benefits and functions to the foreskin, and the ethical dilemmas associated with any genital surgery on children.

My research shows that personal testimony is important as it suggests a response by active social change. Each intactivist interviewed is personally invested in the genital autonomy movement, and for many, these experiences help shape the framework of their activism. The varied experiences through consciousness from research, awareness from intactivism, role strains, and culture shocks have left intactivists with negotiating their convictions and their professional and personal lives. This negotiation has helped intactivists to start their activism.

In addition, gentle education, which focuses on activist temperament and willingness to listen to others, as a pedagogical approach has been important for many activists. Some intactivists prefer to individualize consciousness raising so that the education is focused on the particular needs and concerns of the individual as opposed to regurgitating common responses for large groups. This individualization utilizes the gentle education pedagogy as an activist method.

Overall, the intactivist movement benefits from this diversity. Because there are so many ways to advocate genital autonomy, the movement best flourishes with a richness of intactivists, their unique methods, by creating a space for liberal and radical preferences, as well as a mixture of both. As a collective effort to end circumcision in the United States by providing communities accurate information about the male body, each method of activism serves uniquely to help advance the overall goal of securing genital autonomy for all children everywhere.

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^1. For a list of foundational definitions of words and theoretical concepts related to this project, refer to “Appendix A.”

^2. Refer to “Appendix B” for a list of research questions.

^3. Refer to “Appendix C” for a list of interview questions.

Advocating Genital Autonomy: Methods of Intactivism in the United States¹

Travis Wisdom
University of Nevada, Las Vegas

Abstract

Introduction

Literature Review

Historical Backdrop and Medicalization of Male Circumcision

Preputial Functions and Benefits

Misconceptions of Circumcision

Examining the Methods of Genital Autonomy Activism

Data and Methods

Findings and Analysis

Conclusion

References

Appendices

Appendix A: Foundational Definitions

Appendix B: Research Questions

Appendix C: Interview Questions

Advocating Genital Autonomy: Methods of Intactivism in the United States1

Travis Wisdom University of Nevada, Las Vegas

Abstract

Introduction

Literature Review

Historical Backdrop and Medicalization of Male Circumcision

Preputial Functions and Benefits

Misconceptions of Circumcision

Examining the Methods of Genital Autonomy Activism

Data and Methods

Findings and Analysis

Conclusion

References

Appendices

Appendix A: Foundational Definitions

Appendix B: Research Questions

Appendix C: Interview Questions

Advocating Genital Autonomy: Methods of Intactivism in the United States¹

Travis Wisdom
University of Nevada, Las Vegas