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Intact America Proposes Adding Circumcision and Genital Cutting to List of Adverse Childhood Experiences (ACEs); Launches ACEs Website and Electronic App


Intact America announces the launch of, a new website designed to encourage researchers and public health agencies to include child genital cutting in the standard ACEs questionnaire. Together with the simultaneous release of an auto-scoring ACEs quiz mobile app (in Android and iOS), this new tool expands resources available for practitioners who treat victims of childhood trauma.

This initiative was inspired when Dan Bollinger, an independent men’s issues researcher, and Georganne Chapin, Executive Director of Intact America, separately observed that the widely deployed and reputable ACEs 10-item questionnaire included a question about sexual abuse but excluded forcible genital cutting. Subsequently, they collaborated on the website and app, and have published a white paper titled "Child Genital Cutting as an Adverse Childhood Experience" supporting the modification of the standard ACEs questionnaire to include child genital cutting (CGC).

The current ACE questionnaire addresses sexual abuse by asking: “Did an adult or person at least 5 years older than you ever: Touch or fondle you or have you touch their body in a sexual way? Or attempt or actually have oral, anal, or vaginal intercourse with you?” Chapin and Bollinger propose adding “…or surgically alter your genitals or circumcise you at birth or later?

Bollinger states, “Fondling a child’s genitals is considered an ACE, but cutting off genital tissue is not. Childhood genital cutting is painful, traumatic, and alters adult sexual experience.”

More than a million children experience CGC annually in the United States. Most of these are boys who undergo circumcision shortly after birth. As many as half a million girls under the age of 18—most of them from families whose culture of origin practices FGC—are also at risk for this practice, and the 1.6 percent of children born intersex are also at risk for medically unnecessary genital-norming surgery.

“To exclude childhood genital cutting from the evaluation of adverse childhood experiences is to ignore a trauma that—though widespread and culturally tolerated—systematically victimizes children,” says Bollinger. “More than a third of the U.S. adult population have surgically altered genitals, yet to date no study has included CGC on an ACE questionnaire.”

Chapin adds, “While parents and practitioners may believe that such genital surgeries are in the child’s best interest, from the child’s perspective, genital cutting is painful and invasive and has both short-term and life-long consequences. This common but traumatic practice should be universally measured. Our solution is simple and easily implemented.”

Georganne Chapin, an attorney and health care executive who holds a degree in Sociomedical Sciences from Columbia University also serves as chief executive officer of the Hudson Center for Health Equity and Quality, says, “Despite or perhaps because of the routine nature of infant genital surgery in U.S. hospitals, and the fact that this surgery has been carried out for decades with inadequate or even no pain relief, its individual and public health consequences have yet to be explored.”

Dan Bollinger, genital cutting survivor and creator of the app, says, “Adding one ACE to the ACE scores for circumcised men shifts millions of American men into a higher risk level for significant health problems than previously thought. Until we acknowledge and investigate these traumas, we will have no idea who or how to help.”

Adverse Childhood Experiences harm children's developing brains, changing how children respond to stress and damaging their immune systems. In many cases, effects show up decades later, and are associated with high-risk health behaviors in adulthood—such as smoking, alcohol and drug abuse, promiscuity, and obesity—and with ill health, including depression, heart and lung disease, cancer, and decreased lifespan. The new website covers basic information on ACEs, as well as resources on childhood genital cutting for researchers. Neither the website nor the electronic app collects user data or ACE scores.

Intact America is the largest national advocacy group working to end child genital cutting in America and to ensure a healthy sexual future for all people. Intact America fulfills its mission by challenging social and sexual norms and by advocating for the health and wellbeing of all children and the adults they will become.


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Childhood Genital Cutting as an ACE - white paper

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