News Sexual Health

Rules Under Consideration in Two States Regarding STD Transmission to Children

Martha Kempner

An Indiana grandmother is asking lawmakers to criminalize the transmission of STDs from a child molester to his or her victim, while New York's mayor has declined to comment on whether he’ll support the continued enforcement of regulations to discourage a circumcision ritual that's been known to spread herpes to infants.

Two recent stories highlight efforts to limit the possible transmission of sexually transmitted infections from adults to children, albeit in very different ways. A grandmother in Indiana is asking lawmakers to criminalize the transmission of sexually transmitted diseases from a child molester to his or her victim, while in New York City, Mayor Bill de Blasio has declined to comment on whether he’ll support the continued enforcement regulations designed to discourage a specific circumcision ritual that has been known to spread herpes to infants.

The grandmother, who is being identified only as Shelly, told her local news station that her grandson has suffered almost monthly herpes outbreaks since he was molested by a family friend in 2010 and 2011. The boy was 5 years old at the time of the abuse. His abuser was tried, convicted, and sent to prison for six years, but Shelly thinks that is not enough given the additional suffering that herpes has caused her grandson.

Herpes is a sexually transmitted infection that causes open sores on the mouth or genitals which can be painful. Caused by the viruses herpes simplex 1 and 2, the sores can be transmitted from genitals to genitals, mouth to mouth, or mouth to genitals (or vice versa). The first time a person has an outbreak, they may also have flu-like symptoms such as fever, body aches, or swollen glands. Once a person is infected with herpes, the sores can reappear at any time. Some people only ever have one outbreak, while others have the frequent appearance of sores, often in the same place on their body. The Centers for Disease Control and Prevention estimates that one in six people in the United States between the ages of 14 and 49 has genital herpes.

Anti-viral medication can decrease the frequency and duration of outbreaks, but Shelly points out that these medications were made for adults. “He has suffered greatly with it,” she said. “They’re blisters, like chicken pox, and they itch like chicken pox.”

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Shelly believes that her grandson’s molester should have received extra punishment as a result. “It must be recognized as a separate crime, because it’s a life-altering incident and it should be recognized as that, not just pushing it together with the whole group of molestation. That’s not right,” she said.

At least one lawmaker agrees. State Sen. John Broden (D-South Bend) told the local television station, “I’m certainly going to introduce some kind of legislation next session to see if this might be a penalty that warrants and enhancement. When you have this sort of resulting effect on the victim it sort of makes the crime one that frankly is worse.”

Meanwhile, New York Mayor Bill de Blasio was asked by Jewish leaders whether he would enforce the rules put in place by his predecessor to regulate the practice of “metzitzah b’peh.” Ritual circumcision is common in the Jewish community—known as a bris, this rite of passage occurs when an infant boy is 8 days old and is often performed by a religious figure known as a mohel. Though not common, some ultra-Orthodox communities use “metzitzah b’peh,” which is also known as “snip and suck”—after removing the foreskin, the mohel puts his mouth on the infant’s penis and sucks the blood.

The city’s health department became concerned about the ritual a few years ago after a string of infants were infected with herpes. In fact, since 2000, 13 infants have been infected with herpes as a result of this ritual—two of these babies died from the disease and two others suffered brain damage. In 2012, the department passed controversial regulations in an effort to prevent this type of transmission. Though it did not attempt to forbid the ritual—which would violate the community’s religious freedom—the department passed rules requiring that mohels receive written consent from the parents before undergoing the practice. The consent form explains that the health department advises parents that “direct oral suction should not be performed” because of the herpes risk. At the time the regulations were passed, the health department said it would not actively monitor mohels but would instead only investigate if parents complained. At least two infants have contracted herpes since the regulations were passed.

Despite this, some religious leaders and politicians were outraged by the new rules. In August 2012, about 200 Orthodox rabbis issued a decree that said the rules were based on “lies and misinformation.” According to a translation published by Yeshiva World News, their decree said, “We are decreeing that according to our opinion, it is forbidden according to the Torah to participate in the evil plans of the NYC Health Dept. in any form.” According to the Jewish Times, a state assemblyman called the regulations “a deliberate insult to the intelligence and dignity” of New York’s Orthodox Jews.

Last week, de Blasio, who took office in January of this year, spoke at the annual gala of Agudath Israel of America, an ultra-Orthodox umbrella group. The mayor talked about how important the Orthodox community is to New York City and trumpeted his plan to provide pre-K to all communities. However, he dodged questions on whether his administration would support enforcing the regulations regarding ritual circumcision.

News Sexual Health

Voters in Two California Cities Asked to Ban Male Circumcision Based on Scientifically Inaccurate Claims

Martha Kempner

Activists opposed to male circumcision hope that someday cutting a boy's foreskin will be a federal crime. In the meantime, they're working to ban the procedure in two California cities.

In my parents’ living room, there is a special section on the bookshelf that, were one to label it, might be called, “books by our family” or “books we wrote.”  It’s a small section; just three deep. It contains the children’s book my mother wrote in 1969 (Nicholas, a now-inappropriate tale of a young boy riding the subway alone and getting lost), Predictable Pairings (a psychological profile of marriages by my grandfather), and Preventing V.D. and Cancer by Circumcision, which was written by my great-grandfather, Abraham Ravich. Now I admit that while I felt some sort of family pride (and have always hoped to add my own tome to the shelf), I haven’t read them all. I can quote Nicholas, but I only got as far the dedication in my grandfather’s book (it is, in part, dedicated to my sister and me), and haven’t even cracked open the book on circumcision, so what I know about it is second or third hand.

My great-grandfather was a urologist in Brooklyn in the 30s, 40s, and 50s. To hear my family tell it, many of his patients were Jewish immigrants and he observed that they had a lower rate of what was then called V.D. (now I suppose STDs or STIs) and prostate cancer.  He theorized that circumcision played a role in these reduced rates.  I have to admit, it never struck me as particularly interesting and it never occurred to me that it would be quite controversial but as my mother says, you learn something new every day. Today, in writing this story, I learned that in some circles Poppy Abe (whose formal portrait now hangs in my downstairs bathroom) is considered a “zealot” who “invented” the claims of a cancer connection to advance the practice of male circumcision.

In fact, there is a growing movement against male circumcision which activists (who like to use the term “intactivists”) call “male genital mutilation.” Activists in California collected over 7,100 signatures in order to get a new initiative on the November ballot in San Francisco that would ban the practice of male circumcision within the city limits.  They argue that the procedure is medically unnecessary and say that they hope this initiative is the start of a wave of laws on this issue.  Matthew Hess, the author of the San Francisco measure and a similar measure slated for Santa Monica’s November 2012 ballot, explained: “The end goal for us is making cutting boys’ foreskin a federal crime.”

Jena Troutman is also advocating for the ballot initiative. Ms. Troutman, who is the mother of two boys, runs a website called She explains that through her activism she is just trying to “save little babies” from a procedure that “can do serious damage.”  Ms. Troutman apparently approaches pregnant women on the beach to warn them of the dangers of circumcision. 

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In truth, there are few dangers in circumcision. A study conducted by SDI Health for the Centers for Disease Control and Prevention (CDC) in 2010 found that there was very low rate of complications associated with newborn circumcisions, that most complications were considered mild, and that no babies died. The claims that male circumcision is akin to female genital mutilation are also refuted by many.  Dr. David Baron, a family physician, certified mohel (someone who performs Jewish ritual circumcision), and former chief of staff at Santa Monica-U.C.L.A., told the New York Times that that he viewed the effort to ban the procedure as “ridiculous and dishonest.” He added: “to say it is mutilation is wrong from the get-go.”

There is also new research that suggests my great-grandfather may not have been all that far off when he said that circumcision could prevent V.D. and cancer. Based on scientific evidence, male circumcision is now being promoted in Africa as one of the most important ways to prevent HIV. And, a couple of weeks ago, I wrote an article on a new research study that suggested the male foreskin could be a reservoir for HPV, the virus that causes genital warts and is responsible for most cases of cervical cancer. 

That said, there is not enough evidence for medical experts to suggest routine circumcisions of male infants in this country. As the American Pediatric Association explains:

“Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child’s current well-being, parents should determine what is in the best interest of the child.”  

If voters in San Francisco and elsewhere pass measures like this, however, parents will not have a choice. Moreover, these measures do not contain any religious exemptions despite the fact that to many—Jews and Muslims in particular—circumcision is a religious ritual of the utmost importance.  As Brad Greenberg of the explains 

“This custom is as old as Judaism itself. Commanded by God to a 99-year-old Abraham, circumcision was to signify fidelity to the Lord. It has been a central part of Jewish tradition ever since, so much so that even Yom Kippur—the holiest of holidays—doesn’t delay the circumcision of an infant.” 

In fact, some have gone as far as to call the ballot measures themselves anti-Semitic and likened them to bans on circumcision that existed in Soviet-era Russia and Eastern Europe and in ancient Roman and Greek times.

Even without such bans, however, the “intactivists,” may be making more progress than we realize as rates of circumcision are dropping all over the United States.  While over 90 percent of infant males in the United States were circumcised in the 1970s this was down to 64 percent in 1995 and just 33 percent in 2009. 

I wonder what Poppy Abe would think?