Sunday, August 25, 2013

WHO: Codifying Medical Fraud

How do you justify the forced genital mutilation of minors?

  1. Invent pathological conditions that make it indispensable.
  2. Link anatomically correct male organs to the proliferation of disease.

It used to be that forced genital mutilation, particularly the forced genital mutilation of males at any age, was sanctioned under the immunity of "religious freedom." Additionally, parental privilege and cultural relativism could be invoked in order to justify the forcible amputation of a male child's foreskin.

Given other practices that fall under this category, however, the alibis of "religious freedom, "parental choice" and "cultural immunity," have lost validity.

Perhaps the best example of this is none other than female circumcision; a federal law makes the forced cutting of girls of any kind, and at any age, a punishable offense, and there are no exemptions for "religious" female genital cutting, or cultures where female genital cutting is practiced.

For this reason, advocates of circumcision, particularly male circumcision, have sought to, not only justify the forced circumcision of healthy, non-consenting minors, but to make the practice indispensable.

For over a century, circumcision "researchers" can be seen trying to link circumcision with the prevention of feared diseases; there is no shortage of "studies" that say that circumcision prevents this or that, all written by "researchers" who promote its universal adaption. They can also be seen trying to pathologize the presence of anatomically correct male genitalia, and the many stages of its development, setting arbitrary ages by which the foreskin should be "retractable for cleaning."

While there will never be enough "research" to justify the forced circumcision of girls, it seems circumcision advocates have made the covert contract with themselves, that the forced circumcision of boys will one day be justified, even made compulsory, if only they could come up with the right amount of "studies" that say circumcision prevents disease. We see them trying very hard today, promoting "mass circumcision" in Africa, in the so-called name of AIDS prevention.

Despite their hard work and efforts, however, not a single respected medical organization has found the latest HIV/circumcision propaganda to be convincing enough to recommend the circumcision of minors. In their latest statement, the AAP tries to sell the one-line "benefits outweigh the risks" slogan, but still concluding that the same "benefits" are "insufficient to recommend the practice."

Not quite having achieved the recommendation they wanted, it appears circumcision advocates are returning to the older tactic of trying to pathologize anatomically correct genitals.

WHO Codifies False Conditions Into Existence
The World Health Organization (WHO) has just released their new 2013 ICD-10 codes, which are scheduled to go into effect in October 2014. ICD, which stands for "International Classification of Diseases", is the global system for reporting morbidity and mortality statistics, for billing, and for health care automated decision support.

The new codes for conditions of the foreskin include a prominent (first on the list) billable code, for a condition whoever wrote these codes want to call "adherent prepuce in the newborn." If these codes go into effect, it means that doctors and hospitals will be able to claim "adherent prepuce" as a valid medical diagnosis in neonates (valid in the sense that a billable code exists in the WHO ICD system, not that it is an actual medical condition necessitating surgical correction), and be able to legally charge to "correct" it, thereby possibly justifying routine infant circumcision.

The new proposed codes under classification N47, "Disorders of the Prepuce," can be seen here. (To view, click on the hyperlink for "9 codes" in the second bullet point to read the full list of nine, beginning with N47.0 - Adherent Prepuce, Newborn.)

Without medical or clinical indication, doctors have no business performing surgery on healthy, non-consenting newborns, let alone asking parents to make any kind of "decision." However, if these codes, which the US Centers for Medicaid and Medicare use, go into effect, doctors will have a code available to justify routine infant circumcision, starting next year unless the new code is rescinded. A whole new ICD-11 code system is slated to be introduced for 2015.

Who Did It?
Research documents the normal development of anatomically correct male organs,(1-5) and there is no such thing as a pathological condition known as "adherent prepuce in the newborn"; all boys are born with the prepuce fused to the glans at birth, and if we are to believe the WHO, then all boys are born with a pathological condition which doctors can charge for "correcting." In essence, the WHO's board of physicians has declared the newborn foreskin, which is normally fused to the glans at birth, to be a disorder.

"How many legs does a dog have if you call the tail a leg? Four. Calling a tail a leg doesn't make it a leg." - Abraham Lincoln

The fact that the WHO's board of physicians have decided to call a normal stage of development in the male infant penis a medical disorder, and have even made an ICD code for it does not make it a medical disorder. The foreskin is not a congenital birth defect. 

What I want to know is, who was responsible for writing these codes?

I suspect it was Americans who are in cahoots with fellows at the American Academy of Pediatrics; judging from their last statement, the AAP would like nothing more than to force the 18 state Medicaid programs who dropped coverage for male infant circumcision to start covering it again.

It is despicable to know that interested individuals at the WHO can use their ICD system to codify anatomically correct organs as pathological disorders, in order to warrant medical reimbursement for their "correction."

Who wrote these codes?

Who is responsible for this deplorable travesty? 

Why would a Geneva-based international organization do such a thing as pathologize all males at birth? I would expect that coming from a country where circumcision is rare, that the people of Switzerland would have a better understanding of anatomically correct male genitalia.

The WHO needs to be called on this immedeiately.
  1. Kayaba H, Tamura H, Kitajima S, et al. Analysis of shape and retractability of the prepuce in 603 Japanese boys. J Urol 1996;156(5):1813-5.
  2. Imamura E. Phimosis of infants and young children in Japan. Acta Paediatr Jpn 1997;39(4):403-5.
  3. Ishikawa E, Kawakita M. [Preputial development in Japanese boys]. Hinyokika Kiyo 2004;50(5):305-8.
  4. Øster J. Further fate of the foreskin: incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child 1968;43:200-3.
  5. Thorvaldsen MA, Meyhoff H. Patologisk eller fysiologisk fimose? Ugeskr Læger 2005;167(17):1858-62.
Related Posts:
Politically Correct Research: When Science, Morals and Political Agendas Collide

AAP: Around the Bush and Closer to Nowhere



    According to this study [The prevalence of examiner-diagnosed clitoral hood adhesions in a population of college-aged women], 33% of college-aged women suffer from some degree of clitoral hood adhesions. DOESN'T THAT SOUND DANGEROUS? Shouldn't we AMPUTATE SOMETHING to help them so they're not inconvenienced later? Wait... "no treatment is necessary."

    No one suggests infant girls need immediate revision to ‘help’ them avoid future ‘problems’... nor do they fantasize about forced genital cutting delivering some ‘potential benefits.’ Not anymore, at least… in the 1800s and early 1900s the quacks targeted female genitals as well in order to remove ‘irritations’ which they believed were the root of the evil of ‘self-abuse’ [masturbation].

    Adhesions may be more common than previous published reports imply. Study participants were evaluated for routine health screening and presented with few or no symptoms. These data suggest that adhesions may be a normal variant in otherwise asymptomatic college-aged women and that no treatment is necessary."

  2. I wonder what's next. "Toothless newborn, denture required"?

  3. I don't quite get how these codes work. Is there a specific code for the regular type of routine newborn circumcision that gets performed in American hospitals, or is this a code which refers just to operations where there is a supposed problem with the prepuce?

  4. What can be done to hold this major organisation to account? What are a citizen's options?

  5. The WHO has form on making normal human biological and sexual variation a medical “condition” requiring “treatment”. It wasn’t until 1990 that in response to intense lobbying, changing societal attitudes and public pressure that they finally removed homosexuality from their list of mental disorders, put there in the first place presumably by homophobes.

    Now the circumfetishists have managed to force their own psychological distortions of reality into the codes of the WHO. Does this organisation have any credibility?

  6. This is so unacceptable. Why people keep pushing this mutilation procedure?

  7. I was curious about the expression "adherent prepuce". I did a search on Google, and I found definitions related to female genitalia and late 19th and early 20th century texts, from a time when bacteria and virus were unknown.

    And the W.H.O.'s codes for 2014!

    What is the World Health Organization playing? Are we back in 1870?

    See image:

  8. On the current ICD10: N47 form no mention is made of "infant", just "adherent prepuce". Register to participate in the ICD11 Revision here:

    1. Jhon, if you follow the link I provide in my blog, N47.0 still reads "Adherent prepuce, newborn"

  9. ANY foreskin problem was attributed to being the underlying cause of death in exactly TWO old white men in a nine year period. That the normal fusion of the glans and prepuce is being coded as a "disorder" is despicable.

    Screenshot of the pop-ups connected to the coding:

  10. Yes, I saw that, then went to the WHO website and registered to comment on ICD11 N47 Revision where no mention of "newborn" is made. Following their link to N47 in ICD10, , I found no mention of "newborn" there either. Trying to put a positive face on this apparent incongruency, I speculated that what we have here is internecine warfare in the WHO and... the good guys are winning (for a change!) Do we have a mole in the WHO?

  11. No... But David Tomlinson, inventor of AccuCirc is the "chief advisor on circumcision" at the WHO. Perhaps he, and/or other pro-circ WHO members had a hand in this?

    I'd like to think "we're winning" too. I can't think that as long as there are WHO members gunning for children though. In some African countries, there is already talk of targeting newborns for circumcision to meet their quota.

  12. Re the general topic, is it possible to ask the CDC to provide a break down under the Freedom of Information Act of the race and circumcision status of the most recent year available of HIV infection? I have wondered just what would be shown if MSM, women, intravenous drug users, infants and men who have sex with gays and drug users were removed from the statistics and just men who don't fall under the above categories were examined. How many of these would be caucasion or other and what the circumcision status of these two groups would be. I think the answers would be extremely informative as to the role of circumcision in preventing HIV in this country.

    1. I'm afraid the general topic wasn't "the role of circumcision in preventing HIV," but rather "adherent prepuce" as a valid, "billable" diagnosis.

      It would be interesting to get the CDC to give us a break down of their recent year available on HIV infection. It seems officials at the CDC, and others who are cheerleading for circumcision in this country, are happy to tell us all about what's happening in Africa, but nary a word about what's happening in our own country. Methinks the reason they hesitate is because they know the numbers would be devastating for their circumcision cause.

      Still, I think that before we talk about "the role of circumcision in preventing HIV in this country," or any country, it needs to be established that circumcision plays a role at all. As I have pointed out in an earlier post, circumcision "researchers" have yet to establish a demonstrable causal link. I'm afraid that before this happens, any conclusions we might draw from any country's demographics is purely conjectural correlation hypothesis.