Autumn 2015
15 Square, the working name of NORM-UK
15 Squared
The magazine of 15 Square
Editorial
Special points of
interest:
David Smith
 Brian Sewell
Following yet another school shooting in the USA I was
interested to hear an interview with Justin Webb who in 2001
moved to the United States, as the BBC's chief Washington
correspondent and has since returned to the UK.
 The year ahead
 Keele Medical School
 PACE debate
Webb said that in his eight years in America he came to love
many aspects of American life. But the link between freedom
and guns he could never grasp. He would ask his American
friends to look around the world and ask themselves if Yemen
(which has one of the highest rates of gun ownership per
person) really a nation they admire and seek to emulate?”
INSIDE THIS ISSUE:
Editorial
1
Brian Sewell
2
The year ahead
3
Keele Medical School
6
PACE debate
8
News
11
Trustees
12
He never really got an answer. But he says that getting an
answer — or at least holding a sensible discussion — is the big
challenge for America now. It is a question of addressing
culture. It is a multi-generational project where urban and
suburban Americans try to persuade the rest of the nation that
freedom can still be protected, without a gun in the closet. And
it has to be persuasion.
You have to accept that this link between freedom and guns is
a genuine and honest view. Any real effort to take guns away
from people would result in something approaching a new civil
war. It would not be politically possible.
It struck me how similar this was to the attitude to circumcision
in the USA. Circumcision is an entrenched cultural practice
that is going to take years to change.
In the past the UK has imported many things from the US but I
am glad that gun culture in not one of them. We must do all we
can to ensure that routine circumcision is also not one of them.
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15 SQUARED
Brian Sewell
It was with great sadness that we learned of the death of our patron, Brian Sewell, who
died of cancer on 19 September 2015, aged 84. He was Britain’s most famous and
controversial art critic, renowned for his forthright opinions.
Some years ago he wrote an article about female circumcision and was amazed by the
number of men who wrote to him saying ‘What about us?’ After he had written a critical
article about circumcision, we wrote to him inviting him to become our patron, and were
delighted when he accepted ‘with alacrity’, as he put it.
In a television documentary about circumcision he said:
The real argument about circumcision is, for me, why in our enlightened times when we
get very upset about the circumcision of women, why do we go on circumcising boys?
At school going through the rigmarole of mutual masturbation it always seemed to be
so easy, straightforward, immediate, unfussy, untroubled—-just if you had a foreskin,
it’s the perfect aid. It does everything an artificial lubricant does without the mess.
PAGE 3
The year ahead.
David Smith
Now that our rebrand is nearing completion we are planning our strategy for the next few
months. One of the aspects of our work we want to concentrate on in the coming year is
the psychological damage. It is an area we have struggled with since our formation.
Originally we ran support group meetings that gave men a voice to talk in a safe
environment. These were initially popular but with the advent of internet forums
attendances fell. But we also have to recognise that the psychological damage affects
men in different ways some more severely than others. Last year I gave a talk to The
Porterbrook Clinic in Sheffield. One of their team suggested more research was needed
on the psychological damage that he thought should be described as Post Circumcision
syndrome.
We have twenty years of evidence in our archive and hope over the next few months that
we will be able to use this as the basis of a research project.
One of the major new features of our new website is that it gives users the chance to tell
their own story about how circumcision has affected them and I hope that is going to
provide information for a project on how to deal with the psychological issues. Please put
your story on the site.
This is an area we have struggled with for some considerable time without success
particularly trying to get professional input. Last year our sister charity Genital Autonomy
ran a one day workshop at Keele University designed to teach professionals the specific
damage caused by circumcision. GA spent ages circulating the details to every counsellor
within a fifty mile radius and apart from Justine Eardley-Dunn, not one person responded.
However, our colleagues from Sexpo in Finland did attend and we have been working
together on various initiatives.
One of the stories that have been posted on our new site graphically illustrates the
problems we are facing and the attitude of the profession.
I suffered a breakdown in my early twenties and was referred to a psychiatrist. The psychiatrist
refused to believe that anyone could have negative feelings about circumcision and that I was
using this as a cover for some other major problem. The interview was a total disaster. I left
feeling as though I had been sexually abused by a dirty old man.
I have had a shock recently which has brought into focus the problems we are dealing with
without professional help. People contact us for many reasons, either to help with their
problem or to support us. Some members stay with us for years, others for a short while.
Sometimes members leave because we have helped them to move on, sometimes they
die and the next of kin informs us. Most times we are unaware of the reason.
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Thanks to Jonathon Conte from the USA I have recently learned of the fate of one of
our previous members called Paul who originally joined NORM-UK in 1996 stayed for a
few years and then lapsed.
In 2005 he contacted us again telling us that he had heard of a place in the USA
performing surgical foreskin restoration and asked me if I knew of this and if we could
supply contact details. I advised him that surgical restoration was a difficult process
and was not a quick fix and tried to persuade him to undertake non surgical restoration.
This was probably not what he wanted to hear and it is difficult to convince people that
surgery might not heal the psychological damage even if a magic wand could be waved
and his foreskin could be replaced as it would have been before he was circumcised.
Like many men who contact us he was clinging to that hope and I had effectively taken
his lifeline from him without being able to offer him any form of professional
psychological support apart from the occasional phone call.
He phoned me again in 2008 and apologised for not renewing his sub. He explained
that he was struggling with depression and was not coping well.
Some weeks later we received a letter from his mother who said that after learning what
her son had experienced she wanted to join to lend her support. They did not renew
their sub after the first year and I never heard from them again.
At the end of August Jonathon Conte posted an item on Facebook. He found a report
in a newspaper dating back to 2008 which explains why Paul and his mother did not
renew their sub. Until then I had no knowledge of their fate. The report is chilling as it
highlights the way the medical profession and the press treat the subject.
Sutton postal worker depressed by circumcision joined mother in
suicide pact
Julia Kennard / Saturday 25 October 2008 / News (Sutton Guardian)
A depressed former postal worker and his mother killed themselves in a suicide pact,
an inquest has been told.
The inquest heard that Mr Burrows, a single man, had become depressed since the
age of 16 when he had a circumcision arranged by his mother.
He developed depression and dysmorphobia – a condition marked by excessive
preoccupation with an imaginary or minor defect in part of the body. Later in the year
he began to reject help given by doctors.
PAGE 5
At the inquest Dr Roy Palmer read a letter by Dr Indira Naganathar, who once treated Mr
Burrows. He said: “He had problems with a circumcision his mother arranged for him as a
child which he believed had disfigured his penis and prevented him from having sexual
relationships.
“From the age of 16 he started to have depression and concerns about his appearance.
“He would look at himself several times in the mirror and check his teeth. “He became
worried about scarring on his neck caused by two moles.’’ Toxicology tests revealed the
pair had been killed by a cocktail of drugs.
The Guardian report says several things we should be taking notice of. The report says
that he had become depressed since the age of sixteen when he had a circumcision
arranged by his mother. It should have said that he was circumcised in childhood but his
depression intensified when he was sixteen.
He developed depression and dysmorphobia – a condition marked by excessive
preoccupation with an imaginary or minor defect in part of the body. Again we see
evidence that is the reverse of what is actually true. He did not have an imaginary defect
in his body. He had an actual defect in his body that was caused by the circumcision. Just
to rub salt into the wounds and to try to reinforce the fact that he was suffering from
dysmorphobia and to trivialise the damage cause by the circumcision the doctor added
“From the age of 16 he started to have depression and concerns about his appearance.
“He would look at himself several times in the mirror and check his teeth. “He became
worried about scarring on his neck caused by two moles.
Later in the year he began to reject help given by doctors. Is that a surprise when the
doctors were responsible for his condition and were probably making his situation worse?
Remember the story I read earlier that had been posted on our website.
He believed the circumcision had disfigured his penis. He was right, it had disfigured his
penis.
A few weeks ago two of our charity trustees attended the inquest of another member who
took his own life earlier this year and who attended our AGM two years ago. Again, the
coroner dismissed the fact that his circumcision had played a major part in his depression.
This madness has to stop.
I hope I have given you an insight into the problems and challenges we have to face on a
daily basis. We have some difficult decisions to make with very few resources in terms of
finances and personnel.
PAGE 6
Keele University Medical School.
15 SQUARED
David Smith
Twenty years ago NORM-UK, now being rebranded into 15 Square was founded solely
to help circumcised men who wanted to restore their foreskins but we soon expanded to
help men who still had their foreskin and wanted to keep it despite doctors trying to
persuade them that circumcision was the only cure for phimosis. The amount of
circumcisions are dropping in the UK so saving foreskins has become our main focus.
Peter Ball who has been our resident expert has saved many men from circumcision
over the years. It is shameful that doctors are not taught about alternatives.
As many of you know, I am on the lay interview panel at Keele Medical School. Keele
have recognised that there has been a lot of arrogance in the medical profession and
are trying hard to change this and there is a lot of patient involvement, input and
participation at Keele.
For the last four years, we have had student placements from their Medical School
shared jointly with Savana in Stoke-on-Trent. This has been a challenge and I have had
to make difficult decisions on how to structure the placement in the short time the
students are with us. I consider that the best use of the time is to try to educate them as
much as possible because the time they spend with us is probably the only time in their
training that they will learn anything about the subject, apart from the fact that
circumcision is the only treatment for even the mildest form of phimosis.
We get feedback from the placements through the medical school. One of the areas of
criticism from the students in the past was that there was no engagement with service
users of the charity apart from reading and logging the anonymised queries. I decided
therefore for our last group of students to organise a support group meeting at our office
in Stone that the students were invited to participate. I want to thank the members who
attended that meeting last November, their contribution was invaluable.
This year we had eight students, two of whom attended the support group meeting. I
have recently received the feedback from Keele and it was interesting and somewhat of
a shock to see the different comments from those who attended the SGM and those who
did not. The difference is glaring.
Keele asked the students the following questions and I have cut and pasted some
of the replies.
1 The main thing I have learned from this placement is
The cultural sensitivity & psychological & emotional impact of trauma on the individual.
Meeting affected individuals at NORM-UK
2 The most enjoyable aspect of the placement was
The learning experience- debating, question, being challenged by exposure to new &
complex social material & accommodating/ integrating the material with my own clinical
(+personal) learning experiences
PAGE 7
Attending support group meeting’
3 Comments or issues not already covered This section covered most of the
negative comments.
‘David at NORM was very engaging but I feel he could do better at listening (actively)
to opposing viewpoints and therefore providing a forum for a truly open conversation
on the issue of male circumcision.’
Although the placement provider was a friendly man, he constantly imposed his views
on circumcision on us and was not really open to discussing opinions that differed to
his own and made inappropriate comparisons of circumcision to slavery etc. It was not
a very comfortable environment to openly discuss circumcision as the placement
provider didn't seem open to hearing other views’
I remember my comment about slavery well and it is one I used at the 2008 Keele
symposium. I said that 200+ years ago abolitionists were working to end a traditional
cultural practice that most people found acceptable but is now viewed with horror. Our
members too are trying to end a traditional cultural practice that hopefully in 200 years
with be viewed in the same way slavery is today.
I remember an incident two years ago when on the first day, one of the students
produced a long list of things that circumcision was supposed to prevent and asked me
for my comments and wanted to discuss it in detail. My response was that it did not
matter what it prevented, it was unethical for a doctor to be performing a nontherapeutic operation on a non-consenting child. She did not take this comment kindly
and did not really participate much after that. This is a worry as she was obviously not
interested in exploring the damage circumcision caused and presumably will not take it
into account once she has qualified.
4 How would you describe your placement (what you did, learned etc.) and do
you have any advice for students considering picking this placement next year?
The first comments are from students who did not attend the support group meeting.
Interesting and important.
Very informative and challenging
no patient contact, just factual information about the subject
Here is a comment from a student who attended the SGM
‘Both placements offered an invaluable learning experience. David's style might be a
bit difficult to adjust to but it is clear that the issue that the charity deals with is very
real for some men. And it is a pity that their voices are often not heard- though I
suspect that this may be due to the charity's resistance to see/acknowledging the
opposing point-of-view too. This was an issue for both myself and colleagues as we felt
that our view points as part of the medical community were not always being
considered (and there was a sense that clinicians are the 'enemy' in need of
conversion). Perhaps David could provide us with more space to consider the issue
PAGE 8
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for ourselves and to come to our own conclusions and have an equal and open forum
for discussion. Lots of my colleagues missed the opportunity to meet the patients which
really put the issue in context for me and it was a unique privilege to listen in on these
stories from men across ages and across the country- the meeting was held on a
Saturday, but I feel all students should be encouraged to attend it. Sarah (The Keele
placement officer) sent an email to ensure that I had some understanding on the work
that NORM-UK does, I feel this caused me to do a bit more research on NORMs work &
confirmed my interest. I feel the medical school should continue to send these emails
before allocating students to NORM-UK as the placement certainly is not to everyone's
taste. It would help future students to approach the placement from the perspective of
the ethical issues involved and relate the issues to the psychosocial lectures we have
had, otherwise this controversial issue can seem befuddling, intimidating, challenging
(or at worst irrelevant)- as it is outside the remits of anything we have been taught thus
far. The scarcity of objective clinical research on the subject, challenged me to engage,
think for myself and consider deeply how this experience could inform my future
practice.
So, there we have it. A mixture of good and bad and certainly things to consider for next
year. One of the things I struggle with is the comments that we do not listen to the
opposing point of view. So, the comment from one of the students. This was an issue
for both myself and colleagues as we felt that our view points as part of the medical
community were not always being considered (and there was a sense that clinicians are
the 'enemy' in need of conversion.) But how can we? We are a charity dealing with
those damaged by circumcision. The students are with us for twelve hours in total and
they are here to learn about the damage caused by circumcision, not to enter into a
debate about the issue from the opposing side and in most cases clinicians are our
enemy because they are recommending an operation for a condition that in most cases
can be cured with a tube of cream, but perhaps I need to take this into consideration
and perhaps tell them about our encounters with the BMA and GMC. I could write a
similar brief about those encounters.
In the next few weeks we will be having our next intake of students and I am currently
trying to work out a programme. I hope that if I arrange another support group meeting
we might have a few more attendees. It does make a difference as I am sure you will
have seen.
Parliamentary Assembly of the Council of Europe
In conjunction with the film maker Victor Schonfeld, personal emails were sent to every
member of the Parliamentary Assembly of the Council of Europe prior to their
discussion in Strasbourg on 30th September on traditional practices . The emails had a
link to the film It’s a Boy. Here is the text of the email.
TIME-SENSITIVE re Plenary Vote - Parliamentary Assembly, Council of Europe
TO: THE PARLIAMENTARY ASSEMBLY, COUNCIL OF EUROPE
PAGE 9
In 2013, the Parliamentary Assembly made an historic stride for children’s safety and wellbeing. It called on governments to take steps to promote children’s right to physical
integrity, stating clearly that circumcision of young boys amounts to a violation of that
right. Yet now, if an Israel-initiated proposal from the Culture Committee is adopted by the
Assembly next week, children’s rights will be put in second place behind traditional
religious practises. By undermining its own landmark decision the Assembly would
diminish its human rights leadership; and more children will experience pain, distress and
injuries from needless, irreversible alterations of their bodies imposed in the name of
culture and religion.
We urge parliamentarians to consider the evidence with open eyes before the vote.
Please look at the intense suffering and severe injuries caused by circumcisions of young
boys, documented in the groundbreaking Channel 4 film “It’s a Boy!” The documentary is
freely available to all viewers in Europe for the duration of the plenary, in French, English
and German;
Please scrutinise the numerous commonalities between female genital mutilation and
circumcision of boys, detailed in the University of Oxford Medicolegal & Bioethics study:
https://www.academia.edu/10270196/
Female_genital_mutilation_and_male_circumcision_Toward_an_autonomybased_ethical_framework
If the Assembly back-peddles from its historic decision in regard to male circumcision,
might back-peddling from opposition to female genital mutilation come next? It’s
unthinkable, you may say. But having accepted differential treatment for Jewish and
Muslim boys on religious and cultural grounds it is only a small step (and indeed would be
consistent) to accept differential treatment for girls from cultures with traditions of FGM.
In these times when our multicultural societies require robust initiatives to promote
harmony, the way forward cannot be weakening commitments to individual human rights,
particularly for the most vulnerable members of society. Freedom of religion must be
protected, but religious practises must and do have boundaries in societies that choose to
subscribe to human rights conventions. Religious groups can’t be permitted to alter
human rights principles or their interpretation to suit themselves.
And let it be said plainly: A vote to reverse progress in the name of religion is in actuality a
vote to discriminate against children born into minority communities.
We, the undersigned -- international organisations, doctors, lawyers, professors, Jews and
Muslims -- urge the Assembly to remain steadfast in its advocacy of children’s right to
physical integrity, for the sake of all children in Europe.
SIGNED: Droit Au Corps (France); The Secular Medical Forum (UK); MOGiS e.V.
(Germany); Genital Autonomy International; Prof Marie Fox, Centre for Health Law,
Science & Policy, University of Birmingham; Prof Michael Thomson, Centre for Law &
Social Justice, University of Leeds; Liz Davies, Reader in Child Protection, London
Metropolitan University; Victor Schonfeld & Jenifer Millstone, producers "It's a Boy!"; and
others.
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The resolution as amended in Paragraph 9 passed by a very large majority.
Here is the text of paragraph 9:
Paragraph 9
9. As far as circumcision of young boys is concerned, the Assembly refers to its
Resolution 1952 (2013) on children’s right to physical integrity and, out of a concern to
protect children’s rights which the Jewish and Muslim communities surely share,
recommends that member States provide for ritual circumcision of children not to be
allowed unless practised by a person with the requisite training and skill, in appropriate
medical and health conditions. Furthermore, the parents must be duly informed of any
potential medical risk or possible contraindications and take these into account when
deciding what is best for their child, bearing in mind that the child’s interest must be
considered the first priority.
Following the debate Jewish and Muslim groups claimed victory stating that the Council
of Europe 'retreated' over a proposed ban on male circumcision (non-therapeutic
excision of the foreskin) and instead recommended that it only be performed by trained
individuals. Here is a link to some of the press reports:
http://www.jpost.com/International/Council-of-Europe-cancels-anti-circumcisionmeasure-after-joint-Jewish-Muslim-effort-419616
http://www.haaretz.com/jewish-world/jewish-world-news/.premium-1.678461
Milah UK, a leading Jewish advocacy group supporting the practice of circumcision,
said in a statement that the resolution “cancels a previous motion that had cast into
doubt the legality of religious circumcision. However this was challenged by Nathalie
Bargellini, a spokesperson for the council’s Parliamentary Assembly, who stated that
Resolution 2076 “does not cancel nor replace Resolution 1952.” She noted the more
recent resolution references the older one and that The Council of Europe is maintaining
its position that non-medical circumcision of boys is a violation of children’s rights.
Bargellini also said that Resolution 2076 “calls for strict conditions governing the
exercise of this practice.” According to the new resolution, “circumcision should not be
allowed ‘unless practiced by a person with the requisite training and skill, in appropriate
medical and health conditions,’”
We have had endless discussions about this in committee. We agreed that although a
ban would be great and would be a step in the right direction it would be similar to the
FGM legislation and the practice would not stop overnight.
With regard to regulation, If as the PACE document indicated, the procedure had to be
done by licensed persons in sterile conditions it would first cut down the number of
procedures performed on the kitchen table. The problem with carrying out the
procedure in regulated conditions would be that it would give it some sort of
respectability.
However, if the regulations were followed it would also highlight the number of
procedures that result in complications. What we have to ensure is that the children who
end up in intensive care do not go unreported which is happening at the moment.
Hospitals are burying this information. We already know from a Freedom of Information
exercise that eleven boys were admitted to intensive care with life threatening
complications following circumcision in one year in one hospital trust in the West
Midlands. These statistics are not appearing in the press. We need to provide the
evidence that even if done in hygienic conditions the procedure is risky.
PAGE 11
It needs to be part of the evidence given to the parents to enable them to give informed
consent. It will never stop the parent who has to obey their god's command no matter what
the consequences to the child but it is a step in the right direction.
NEWS
Closure of Hyde circumcision clinic
Mancunian Matters has reported the closure by the CQC of a circumcision clinic in Hyde
that has sparked a backlash from the local Muslim community, claiming the closure is an
'attack on the practice of their religious beliefs'.
Here is a link to the report: http://www.mancunianmatters.co.uk/content/091074608-attackreligious-beliefs-closure-hyde-circumcision-clinic-suffers-islamic-backlash
In 2013, the clinic owner, Dr Nadeem Ahmed, was issued a warning for performing a
circumcision on an eight-year-old boy without getting consent from both parents. The CQC
have declined to comment on why the clinic is being shut down, citing legal reasons.
Bloomberg health commissioner: City wrong to repeal
circumcision forms
Politico New York has reported that the city was wrong to repeal circumcision forms.
http://www.capitalnewyork.com/article/city-hall/2015/10/8579265/bloomberg-healthcommissioner-city-wrong-repeal-circumcision-forms
Former city health commissioner Tom Farley thinks it was a mistake for the current board of
health to repeal consent forms that had been required before metzitzah b’peh, the
controversial circumcision ritual that requires a mohel to put his mouth on a baby's wounded
penis.
Farley was health commissioner during Michael Bloomberg’s third term and mayor, and led
the board of health when it implemented the consent forms in 2012 for the ritual, which is
practiced by some Orthodox Jewish sects.
Jewish mom opposes circumcision and suggests Bris is replaced
with a naming ceremony.
In a report in Broward Palm Beach New Times Rebecca Wald talks about her decision not
to circumcise her son and about her work to promote Brit Shalom an alternative naming
ceremy to circumcision. In 2010, Wald launched Beyond the Bris, a go-to website for
Jewish families opting out of circumcision.
http://www.browardpalmbeach.com/news/jewish-mom-opposes-circumcision-suggests-brisbe-replaced-with-naming-ceremony-7317573
15 Square, the working name of NORM-UK
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Stone
Staffordshire
ST15 8AU
Telephone (0044)1785 814044
Email: [email protected]
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NOTE
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NORM NEWS are not necessarily those of the
editor or of any members of the committee. Authors are responsible for all opinions and / or facts
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Trustees of 15 Square
Chair and Founder Dr John Warren, MB BChir DCH FRCP
Vice Chair - Dr Peter Ball MA, MB, BChir
Secretary - Patrick Smyth
Treasurer - Margaret Green
Women’s Group Co-ordinator - Iris Fudge
Committee Members:
Justine Eardley-Dunn, Tony Peters.
Archivist & Researcher - John Dalton BSc, MSc
General Manager David Smith
Honorary Advisor:
Gaye Blake-Roberts
Patrons:
Prof Jack Cohen, Mary Cronk MBE, Alan Cumming,
Published by NORM-UK Registered Charity No: 1072831