Billboard puts circumcision issue in public view
Tuesday, January 18, 2005
By Virginia Linn, Pittsburgh Post-GazetteThe topic of circumcision is not something you'd expect to see on a billboard.
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| Darrell Sapp/Post Gazette | |
| The Oakland billboard sponsored by the National Organization of Circumcision Information Resource Centers. |
But that's the latest way a national anti-circumcision group is trying to get its message across.
A prominent sign has been posted since early December on the Boulevard of the Allies that can be seen by thousands of eastbound motorists traveling into Oakland and past Magee-Womens Hospital, the busiest maternity hospital in the region.
Its message: "Babies are Born Perfect. Today's parents say NO to circumcision.''
An identical sign has been posted in Florida and another is heading to Virginia.
It's part of a local and national effort by the National Organization of Circumcision Information Resource Centers to urge parents, barring religious reasons, to not have the surgical procedure done routinely on newborn males. It involves the surgical removal of the penis' foreskin.
In the United States, 1.2 million newborn males, or 59 percent, are circumcised annually, according to a national survey published this month by the International Coalition for Genital Integrity.
Bolstered by recent statements by the American Academy of Pediatrics, The American Medical Association and American Association of Family Physicians that say scientific data does not support the need for routine circumcision, NOCIRC and its local chapters have been trying to get state Medicaid programs to stop paying doctors and hospitals to perform the procedure. While about a dozen states have dropped this funding, Pennsylvania's Medicaid program still pays for the routine surgery.
Marilyn Milos, a registered nurse in San Francisco who heads the national group founded in 1986, said the billboard has generated more hits on the organization's Web site, and "no death threats for this one. I've gotten death threats for 20 years."
The billboard is designed to present a positive message and raise consciousness, she said. "It's not putting people down for yesterday's choices. It strives to educate to hopefully protect people in the future.''
She said it took a long time for the group to come up with the design. "How do you get people to look at something that's not easy to look at. It hasn't been easy getting the message out, as you can imagine.''
That has definitely been the case in Pennsylvania, said Greg Hartley, director of NOCIRC of Pennsylvania.
The billboard, which cost $1,200, has generated little reaction so far.
This follows two smaller ones placed in the city last year, each costing about $800. That's a big chunk out of the state organization's $3,000 to $5,000 annual budget.
Neither Magee-Womens Hospital, which delivers more than 8,000 babies a year, nor the state Department of Health keep records on the number of circumcisions performed.
At Magee, whether to circumcise is up to the parents, and according to anecdotal accounts, most of them have it done, said spokeswoman Michele Baum. That's about the same as described by hospital officials five years ago.
"Unfortunately, it's not an easy thing to change," said Hartley of Franklin Park, whose group supplies hospitals and medical centers with childbirth literature.
Circumcision has long been considered an important part of hygiene and there have been recent studies suggesting increased risk of urinary tract infections, as well as HIV infection in uncircumcised males. While the medical societies have acknowledged these issues, they've concluded there's not enough data to recommend routine neonatal circumcision.
Most boys around the world are not circumcised. Despite these medical arguments, Hartley hasn't had much luck persuading lawmakers to change Medicaid funding.
The Pennsylvania Department of Public Welfare spent $1.6 million for 13,000 circumcisions in fiscal year 2002-2003, the most recent year that figures are available.
"Male infant circumcision does meet the department's definition of medical necessity,'' wrote state Public Welfare Secretary Estelle B. Richman in a Sept. 21, 2004 letter to Hartley. "The department believes that the decision for infant male circumcision should be made by the parents and their health-care provider.''
Medicaid programs in Arizona, California, Florida, Maine, Mississippi, Missouri, Montana, Nevada, North Carolina, Oregon, Utah and Washington have policies against funding circumcision, except for demonstrated medical need, according to the genital integrity coalition survey. Among other states looking at the issue are New Mexico, South Carolina, Louisiana and Colorado.
The coalition report showed that during 2003, many states cut funding for other Medicaid programs while leaving circumcision funds intact.
Milos said as government resources continue to tighten across the country, she hopes more states will end public funding.
For now, Hartley plans to take his campaign to the new state legislators. He said a couple of Pennsylvania legislators in the past have expressed interest, "but feared they'd be taking away a service from poor people."
But that's not the issue, he said. "It's fiscal irresponsibility to fund a procedure that is clearly not medically necessary."
(Virginia Linn can be reached at vlinn@post-gazette.com or 412-263-1662.)