Hironimus Circumcision Case: Doctor Threatens to File Complaint Against Hospital

A protester opposes circumcision.EXPAND
A protester opposes circumcision.
photo by Bloodstained Men via Flickr Creative Commons

John Trainer, M.D., is a family doctor in Jacksonville. He has circumcised children and taught other doctors how to perform circumcisions. His own son is circumcised. 

But during the past few months, as he's followed the case of 4-year-old Chase Hironimus — whose father won a highly publicized legal battle against his mother regarding whether the boy should be circumcised — Trainer reexamined his own position on the surgery and has come to believe that routine infant circumcision is a violation of medical ethics and that Chase's case is particularly egregious because the mother's consent was forced under duress.

Now, he is threatening Joe DiMaggio Children's Hospital, where a doctor is rumored to be circumcising Chase this week, saying that if the surgery proceeds, he will file a complaint with the state Department of Health, which would then have to consider the matter. So far, the matter has been treated in state court as a contract dispute, but this could force a different set of authorities — medical administrators — to look at it in a new light.  

Hironimus, in a contract signed years ago, agreed to the circumcision but changed her mind as the boy aged and she learned more about the procedure. A judge ruled that the circumcision could proceed, and she fled with the child and was caught months later and jailed. She was forced to sign a consent form for the procedure or else remain in jail indefinitely. She signed it, crying hysterically in a courtroom.

From a physician's point of view, Trainer told New Times, "it's absolutely mind-boggling this would be considered as real consent." Of the doctor rumored to be scheduled to perform a circumcision on Chase —  Gary Birken — Trainer said, "it is incumbent on him" to be "aware that this is a dramatic case, an unusual case.

"Where this this galls me the most," Trainer says, "is that if we are physicians and ethical and called on to police our profession," and the doctor here "either knew or should have known" — that's the phrasing commonly used in ethical standards — "that consent was tainted," and if he proceeds in this particular case, "at the very least his ethics need to be challenged." 

Furthermore, he said, pediatric surgery ethics require that a doctor make the child aware of what is happening and consider the child's opinion in elective surgeries. Court documents asserted that Chase was scared of and does not want the procedure. 

Trainer says he has no personal connection to the case, but as he followed it and engaged with anticircumcision activists, it was like the "allegorical scales falling off my eyes." 

Circumcision in America was popularized by John Harvey Kellogg in the 1800s to prevent masturbation. Trainer says it's absurd that "the cereal magnate could still have impact on human anatomy 100 years later — I think it's barbaric and cruel." In a circumcision, he says, irrespective of the pain to the child, "you have an open wound in a soiled diaper with urine and feces. If we were asking any other surgeon to do this under these circumstances, it would be 'reductio ad absurdum.'"  

It's also, he says, "the only procedure an obstetrician will do on a man — and with absolutely no follow-up. They'll never see that penis again — no follow-up. This is unheard-of with any other procedure."  

Asked if he faced any career risks by preemptively speaking out against a doctor or hospital, Trainer said, "I am on the Board of Directors of Baptist Primary Care, a leader in a consortium of 150 providers — the largest and most trusted health-care system in Northeast Florida. If I suffer backlash for speaking out, I am OK with that. Actually, my Facebook page is blowing up with people commending me for being courageous. I don't really feel that brave."

Activists have launched a letter-writing and social media campaign to warn doctors not to circumcise Chase. Joe DiMaggio Children's Hospital has acknowledged on Facebook that it is aware of the objections, writing: 

We have heard your concerns loud and clear. We recognize this is an emotionally charged topic and case, evident by the number of posts to this page from people in and outside our community. Joe DiMaggio Children's Hospital has been a pillar in the South Florida community and an advocate for many causes, always working for the benefit of its patients while providing quality service and care. We ask that you respect the confidentiality of all our patients as cases evolve. Please understand that we can't and will not discuss specifics in this forum due to HIPAA guidelines.

A protest at the hospital was scheduled for today at 11 a.m.

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