RETURNING GUEST AUTHOR: COVID-19 Opportunity - A Call to Action

A month ago, in March, I posted about how one possibly good thing to be happening during this whole coronavirus pandemic is the fact that elective surgeries in the United States are being postponed if not canceled in order to preserve equipment such as masks, avoid patient infection, and ensure adequate medical personnel for responding to COVID-19 patients. I posted about how some new parents have been surprised to find that their providers currently aren’t performing circumcisions.

Well, just today, a fellow intactivist, Jason F., posted on his Facebook wall the window of opportunity that this pandemic presents to intactivists; the pandemic has resulted in massive budget shortfalls, and now states are looking to cut expenses.

I've posted content by this fellow intactivist before, regarding meatal stenosis. (That blog post can be accessed here.) I don't have time to sit down and write long, detailed blog posts anymore, so I'll merely copy and paste what he wrote here:

The following was copied and pasted from a status on the Facebook wall of Jason F. with his permission.

Forget the brief period when states said elective procedures should be put on hold.

The BIG news is the massive budget shortfalls facing almost every state due to CoViD-19 and related closures. Tax revenues are dramatically down and states are frantically looking in every corner of their budgets for where they can slash expenses.

Circumcision should be the first to go (from Medicaid) in the 35 states that still pay for it automatically at birth. It is outrageous that states would prioritize genital mutilation over other critical services; it’s outrageous we were ever paying for this with our tax dollars in the first place. Even in the 15 states that have dropped routine infant circumcision from Medicaid, doctors and nurses and administrators often find ways to do the surgery, code it fraudulently and get paid. Think about it: infant circumcision is such an essential business in the USA that medical professionals are willing to risk their careers, risk massive fines and possibly jail to ensure that every parent who asks for circumcision is served. Circumcision as identity.

If ever there was a year to strike, it’s 2020. Contact your state representatives and senators (especially those on the budget committee), contact your state Medicaid office or Department of Health, and make the case that penis chopping should be on the chopping block. New York, Illinois, Texas, Pennsylvania, Michigan and Ohio stand to save millions of dollars from doing like the rest of the civilized world + 15 American states in eliminating circumcision of healthy boys from public healthcare programs.

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From NBC News today:

COVID-19 has led to dramatic decreases in revenue for state governments across the country — regardless of which party has its hand on the wheel. Many states are still crunching their numbers ahead of the next fiscal year, which begins in the summer for most. [Hint hint: budgeting season starts NOW.]

The lastest came on Tuesday afternoon when Ohio Gov. Mike DeWine, a Republican, announced that the past two months have led his state to miss its budget estimates by $776.9 million and that he is cutting $775 million in spending as a response. Those cuts, which include $210 million to Medicaid and $465 million in education spending, must be made within the next two months, he said. (Ohio is already $777 million short — if they keep paying for circumcision in the face of this, the should burn in hell. Mike DeWine should put a stop to it tomorrow.)

With the COVID-19 outbreak shutting down large swathes of the economy, all sorts of revenue sources for the states have dwindled significantly, including sales, income and other taxes.

In Maryland, state budget officials outlined a nearly $3 billion shortfall they're projecting in the final quarter of this fiscal year. Some other states in serious trouble: Oklahoma, Alaska, Arkansas, Wyoming and West Virginia.
(Original article can be accessed here.)

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West Virginia and Ohio (along with Michigan, Kentucky and Indiana) have the highest infant circumcision rates in the country. Why are they still paying for it in the face of the biggest budget crises in a lifetime???

You heard the man. Get right to it!

Related Post:

GUEST AUTHOR: Meatal Stenosis

CORONAVIRUS: Elective Surgery Including Infant Circumcision Being Delayed

External Link:

NBC NEWS: Trump says only blue states have budget woes. He couldn't be more wrong.

GUEST AUTHOR: Meatal Stenosis

OK.

So I've been following the ramblings of a knowledgeable intactivist on Facebook, and I've recently run across something in my news feed that I think merits a guest author post on my blog. I am trying to convince him to start his own blog, but until he does, I think his best should at least be posted SOMEWHERE.

I've seen elsewhere in medical literature that meatal stenosis is a problem most common in circumcised males, and I've understood that it is a narrowing of the meatus, or hole at the end of the penis, but I had no idea how much impact this may have on the well-being of men.

After reading this man's post on the matter, a lot of things suddenly make sense. For example, I myself have actually noticed that there is a different sound when men urinate. And I've often heard of men having problems with urine retention, the "drip" factor, and problems with the urination stream.

A friend of mine, who I know for a fact is circumcised, has confided to me that he has constant UTIs, and that doctors tell him he needs an operation to correct a problem with his urethra. OF COURSE! My friend's meatus and/or urethra are probably narrow, most likely due to his circumcision, causing him urine retention and his constant UTIs!

Learning about my friend, and learning about so many other cases, and reading these thoughts from my online friend gets very frustrating, as UTI reduction is one of the most prominent rationales used by circumcision advocates. According to some, a slight reduction of UTIs within the first few years of life, is quite possibly the only observable benefit of male infant circumcision, if the current body of medical literature is correct. (And many say it is questionable.)

What is the meatus? What is meatal stenosis? How does this impact a man's well-being?

Ladies and Gentlemen, Jason F.!

The following was copied and pasted from a status on the Facebook wall of Jason F. with his permission.

Meatal Stenosis and Its Impact on the Well-being of Males
Jason F.

Hey boys and girls,

Time for my periodic rant about circumcision and meatal stenosis.

Most of us know that meatal stenosis is a routine undesired consequence of infant circumcision. However, even many people who include it in their list of complications don't really know what it is, how it looks, or how it actually affects males.

Stenosis means narrowing. The urinary meatus (in English pronounced mee-AY-tus or mee-AT-us) is the peehole. Many people mistakenly call this the urethra, but the urethra is the tube that carries urine from the bladder to the meatus. The meatus is the terminus of the frenulum, which in turn is the distal end of the male raphe, the seam that runs from the anus, across the perinaeum, across the scrotum, up the ventral side of the penis, and forms the peak of the frenulum and meatus.

First thing to understand about the meatus is that it is supposed to be large. The design of the male urethra is that it becomes linearly larger in diameter from the bladder to the meatus, allowing urine flow to accelerate as it moves through. The widest part of the urethra is just at the meatus, and actually the amazing design of the distal urethra prompts a vortex effect to help pull urine outward. This allows the male to empty his bladder efficiently and completely.

Meatal stenosis occurs when irritation, abrasion, infection or injury allow scar tissue to form and the urinary meatus to narrow. The size of the opening may decrease by half or more. The effect on urination, or ejaculation, is obstruction. What was previously a wide-open highway narrows to a lane or two at the terminus. This disrupts the flow of anything coming down the urethra and creates churn in the fluid dynamics of the urethral chamber toward the end. The effect is a certain amount of reflux, and occasionally backward pressure on the bladder. This can result in retained urine in both the bladder and urethra, as well as damage over time to the bladder muscle. Plain English: cut boys and men drip more.

If there is enough back pressure from meatal stenosis on the central urethra itself, the body may respond with some degree of scar tissue and formation of urethral stricture. This risk is heightened somewhat by urethral infections, which may be more common in circumcised boys because of greater ease of pathogens entering the constantly-exposed meatus and less-efficient flushing of the meatus during micturition.

Friends of mine know that I have been saying for years that I can nearly always tell whether the guy at the urinal next to me is circumcised or intact merely by the sound of his urine stream. Intact males have on average a notably more forceful stream. They generally empty their bladders more rapidly and more thoroughly than circumcised males.

Meatal stenosis risk is much higher in boys circumcised in infancy versus later in childhood, and almost unknown in intact boys and men. The phenomenon is rare where infant circumcision is not routine, so many urologists worldwide have seldom or never encountered it. The medical profession in the United States has begun to grudgingly acknowledge that meatal stenosis is common, but they tend to put the figure low at 5-15% of boys. They decline to admit that it is limited almost exclusively to circumcised boys.

In my personal experience, about ½ to ¾ of all neonatally circumcised males undergo some degree of unnatural meatal narrowing by adulthood. That means about 700,000 new cases every year, a national disgrace. Thousands of American boys undergo surgery to address their advancing meatal stenosis, making it one of the most common surgeries after circumcision. This, along with surgery for readherent prepuce remnant, skin bridges, skin tags and iatrogenic chordee, is just part of the US circumcision industry. It's a booming, if depressing, business for pediatric urologists and a never-ending tragedy for American boys and their families.

The presence and absence of meatal stenosis side-by-side

Photo from the Global Survey of Circumcision Harm.