For nearly three months, no one could find 4-year-old Chase Ryan Nebus-Hironimus.
In late February, his mother, Heather Hironimus, took him and fled their home just before his father was due to pick him up in accordance with their child custody agreement. She then checked into an undisclosed domestic violence crisis shelter, out of reach of the boy’s father and law enforcement, which had labeled Hironimus a fugitive and ordered her arrest.
While the real life Chase was hidden, his name was everywhere — on court documents and Facebook pages, news headlines and protest posters. The Florida toddler has become the focus of a controversial and emotionally charged health debate. Or rather, his foreskin has.
Hironimus opposed circumcision for her son, saying it would be physically and psychological traumatic. His father, Dennis Nebus, wanted him to undergo the procedure, which he said had health benefits and was “the normal thing to do.” But what would normally be a debate between parents has instead played out in a strange and fiercely public manner online, thanks to ongoing legal disputes and a very vocal “Intactivist” campaign to stop the surgery.
Intactivists, who say that circumcision is a medically unnecessary “barbaric violation,” have made Hironimus a martyr and her son a cause celebre. A group called Chase’s Guardians has raised more than $50,000 to pay Hironimus’s legal fees. Intact America, a New York-based nonprofit, is urging Florida doctors not to perform the surgery if Chase is brought to them. Protesters gathered outside the Palm Beach County Courthouse after Hironimus was jailed last week holding signs that read “Free Heather” and “Keep Foreskin and State Separate,” according to the Associated Press.
Hironimus was released from jail Sunday after tearfully signing a consent form agreeing to Chase’s circumcision. With a stroke of her pen, she ended years of litigation over the issue. Although Hironimus had initially agreed to circumcision in a 2012 “parenting plan” she formed with Nebus around the time of their separation a year after Chase was born (the two were never married), she later fought the surgery in state courts and filed a federal lawsuit alleging that a court-ordered circumcision violates her son’s civil rights. Though she is no longer being held in contempt of court, she now faces up to five years in prison for interference with custody, a third-degree felony.
But her signature will not end the debate about circumcision, for Chase or anyone else.
Mary Hironimus, Heather’s mother, told the Orlando Sun-Sentinel that she and other Intactivists plan on reaching out to doctors around the county and asking them not to perform the surgery. And Georganne Chapin, executive director of Intact America, argued to the paper that Hironimus’s agreement was coerced.
“If anyone finds out the circumstances under which she signed, a doctor would be insane to carry out that surgery,” she said.
Meanwhile, the dramatic legal dispute has given new fire to Intactivists and other circumcision opponents. They argue that there is no medical need for the procedure and compare it to female genital mutilation, a painful and dangerous procedure that the World Health Organization says violates the rights of girls. Intactivists say that the removal of foreskin is likewise a “mutilation,” one that decreases sexual pleasure and carries risk of complications.
The argument isn’t a new one. Though circumcision has long been practiced as a religious rite by Jews, Muslims and several ethnic groups in Sub-Saharan Africa, other groups were neutral or opposed to the procedure. A 15th-century papal bull warned Christians against the practice, on pain of “loss of eternal salvation.”
But circumcision gained favor during the 19th century — the notoriously prudish Victorians believed it would prevent men from masturbating. By the mid-20th century, more than half of American boys underwent the procedure, boosted by safer medical practices, accumulating research about the health benefits and the belief that, as Chase’s father put it, it was “the normal thing to do.” The proportion of male babies circumcised in hospitals peaked at about 65 percent in 1981, then fell to 58 percent by 2010, according to the Centers for Disease Control and Prevention. The total number of circumcisions is probably higher, because that statistic doesn’t include procedures conducted outside the hospital, like the Jewish bris.
Even at that lower number, the United States is still an anomaly in terms of circumcision rates. According to the WHO, only about 30 percent of men worldwide are circumcised. But the organization believes that number should be higher, citing “compelling research” that the procedure reduces the risk of acquiring HIV. Other studies have found that circumcision prevents the spread of herpes, HPV and syphilis. Meanwhile, the majority of research refutes the Intactivist argument that the surgery affects sexual function or pleasure, according to a 2013 review published in the Journal of Sex Medicine. And after years of flip-flopping on the issue, the American Academy of Pediatrics declared in 2012 that the benefits of circumcision outweigh the risks, though final say should be left up to parents.
But when it comes to a subject that, as Slate’s Mark Joseph Stern wrote in a 2013 condemnation of Intactivism, taps into “humanity’s most persistent weaknesses: sexual insecurity and resentment of one’s parents,” scientific studies are rarely as influential as impassioned appeals to tradition or human rights, depending on the argument. In 2012, after a German court ruled that circumcision causes “bodily harm,” some Jews called it an attack on their religion. (An anti-circumcision comic called “Foreskin Man” features a blonde superhero who rescues babies from a “Monster Mohel,” the Jewish expert who performs ritual circumcision). The ruling was later overturned by the German parliament.
On the other side, opponents of circumcision have protested the procedure wearing white pants with a red crotch — a graphic depiction of how violent and painful they believe circumcision to be. And while proponents of circumcision often paint Intactivists as ignorant fearmongers, the procedure has plenty of highly respected critics, particularly among activists against female genital mutilation, including Somalia’s Soraya Mire and author Alice Walker.
Opinions, even medical ones, are based largely in cultural, not clinical, arguments. In a lengthy feature on the issue, Ars Technica reported that about 70 percent of circumcised male doctors support the procedure, while an almost identical fraction of uncircumcised doctors opposed it, according to a 2010 survey in the Journal of Men’s Health.
Morten Frisch, a Danish epidemiologist who has written studies questioning the practice, acknowledged as much to the Web site: “We never deny that we are from a non-circumcising culture,” he said. “While we claim that the U.S. view is culturally biased, the opposing view from the [American Academy of Pediatrics] was that it’s us who are culturally biased, and to an extent they are right.”
In the case of Chase, the toddler from Florida, the ethical and medical questions are even more fraught. Physicians generally agree that infancy is the best time to perform a circumcision, because babies do not need to undergo general anesthesia and are unlikely to feel much pain or experience any complications. And in court documents, Hironimus has said that her son is terrified of the procedure.
Whether it’s more frightening than hiding from his father, having his mother imprisoned and his name turned into a rallying cry for activists on both sides, only Chase, perhaps, will some day be able to say.