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Viagra from Online Sources Mostly Fake>

CHICAGO -- Most of the sildenafil (Viagra) sold online is fake and contains far less of the active ingredient than the real thing, researchers said here.

In an analysis of pills from 22 different websites claiming to sell the drug, 77% of samples were counterfeit and contained only between 30% and 50% of the levels of active ingredient advertised on its label, Irwin Goldstein, MD, of San Diego Sexual Medicine in California, and colleagues reported during a poster session at the World Meeting on Sexual Medicine.

"The fastest growing drug class in the world is counterfeit drugs," Goldstein said. "It's not just the phosphodiesterase 5 (PDE5) inhibitors [like sildenafil], but they are the vast bulk. It's a huge problem."

Irwin said fake drugs have been a burgeoning problem largely because of their increased online availability. In 2010, worldwide sales of counterfeit drugs was estimated to be $75 billion, and in that year in the U.S., $5.6 million in illegal pharmaceutical products were seized, up from $2.1 million in 2005.

He noted that one in six Americans purchased prescriptions online last year, translating to some 36 million consumers who may have been exposed to fake drugs. That includes all fake drugs, not just the PDE5 inhibitors, but he noted erectile dysfunction [ED] drugs are a target of counterfeiters because of the stigma some patients feel about the disorder and have to purchase drugs in-person.

To assess the black market for sildenafil, Goldstein and colleagues at Pfizer Global Security ordered drugs from the top 22 websites that came up in searches for "buy Viagra" in March 2011.

None of the websites required a prescription, and 91% claimed to sell "generic Viagra," which is not yet authorized by the FDA.

The cost per tablet ranged from $3.28 to $33, and the postal origins of the purchases were most commonly Hong Kong, the U.S., and the U.K., with only a few shipments from Canada, India, and other parts of China.

Irwin noted that the four Internet pharmacies claiming to be Canadian didn't ship medication from Canada; most came from Hong Kong instead.

They found that of the 22 sample tablets examined, 77% were counterfeit, 18% were authentic, and one was an illegal generic.

The authentic medications shipped from the U.S. and the U.K. and were apparently diverted from their original market, he said. The illegal generic, on the other hand, which closely resembled real sildenafil, shipped from India.

The counterfeit tablets only contained between 30% and 50% of the labeled amount of the active ingredient, sildenafil citrate. Goldstein said the drugs are largely made by "illicit narcotic labs."

There were also clear visual clues that the counterfeit tablets weren't real, Goldstein said. The packaging was different, and the pills were darker blue, heavier, and thicker than normal.

They were also found to contain undeclared ingredients such as gypsum -- the main ingredient in drywall -- as well as commercial paint and printer ink, he said.

Fakes could also contain other harmful active ingredients, such as other antihypertensive medications: "That's when it gets dangerous," Goldstein said.

Hartmut Porst, MD, a private practitioner in Hamburg, Germany, who moderated the discussion during which the poster was presented, said the problem is rampant in his country and it's nearly impossible to prevent patients from ordering their ED drugs online.

"They say, 'I'm getting a good erection and I don't get any side effects, and I pay only 20% of the normal cost,'" Porst said. "How can you convince them otherwise?"

Goldstein responded that doctors should ask patients how they are obtaining their medications, and that emergency departments "seeing patients getting sick from these medications must ask where they are getting them from."

Jim Wook Kim, MD, of Korea University Medical Center, said his country's sexual medicine society has been running an anti-fake drug campaign for years and its research has shown that four of 10 patients who go to the doctor's office for ED treatment had tried a fake ED drug at one point in their lives.

Edgardo Becher, MD, PhD, president of the International Society of Sexual Medicine, said in an email that his organization has published a position statement against fake PDE5 inhibitors in the Journal of Sexual Medicine.

"It is a widespread problem, totally uncontrolled, and nobody knows what those pills contain," he said in an email to MedPage Today.

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Japan's Shame

TIME

Tokyo, Police superintendent Keiji Goto logs onto his Toshiba laptop, opens his Netscape Internet browser and moves his mouse to the Yahoo! Japan search engine. He types in adult. Down the screen scrolls a list of site categories, many of them with the telltale suffix jp, denoting that they originate in Japan. He clicks on one that promises images of lolitas. The home page appears with a picture of a pig-tailed Japanese girl in a sailor-style school uniform. He clicks again. On the screen appears another teenager, this one naked. Click. A girl is bound and gagged. Click. Another is being fondled. Child pornography, Goto says, is our national shame. It's also the latest export market to be dominated by Japan. The country lags far behind the U.S. in the hottest industry of the 1990s, electronic commerce. Japan has just two of the world's top 100 information-technology companies, according to a Business Week survey, compared with 57 from the U.S. In one area of dubious distinction, however, jp.com competes with the best: child pornography. According to estimates from Interpol, as much as 80% of the child porn available on commercial sites worldwide originates in Japan. A police study found more than 3,000 Websites based in Japan distributing pornography, 40% of them featuring children. Policing porn on the Internet is difficult anywhere, says Ralf Mutschke, assistant director of Interpol's criminal division. But most of the world at least has laws that prohibit child pornography. Japan doesn't.

This lack of legislation frustrates global attempts to crack down. We're asked by international police to help arrest child pornographers, but there's nothing we can do, says Goto, deputy director of the National Police Agency's community safety bureau. Japan's criminal law prohibits sex with minors, but a minor is defined as someone age 12 or younger, and the only act specifically outlawed is sexual intercourse. Taking lewd pictures of children is permissible. Some pornography--both with adults and children--is banned under an obscenity code, but only if it explicitly shows genitalia.

To show how difficult it is to prosecute, Goto zooms in on an onscreen photo of a naked girl. Bright pink Japanese characters spelling secret cover the girl's crotch. Employing special software that can be downloaded for free from other websites, Goto electronically removes the computer-generated fig leaf. Yet even this full frontal nudity can't be legally called obscene. The photo is a little fuzzy there, Goto points out. It's not really clear enough. Some especially sensational cases have been prosecuted. In March, a real-estate company owner was arrested for selling CD-ROMs containing hundreds of child porn videos apiece, all downloaded from the Internet. In January, a schoolteacher was accused of dressing up in wig and skirt to take videos of women bathing at a hot spring resort in Fukui. In March, a mother was arrested for letting men have sex with her 15-year-old daughter for $85 a session. Another mother was sentenced to four years probation in December for taking $850 from an Osaka hospital employee to photograph her 10-year-old daughter in the nude. Last year, a 35-year-old high school teacher in Gifu was accused of taking videos underneath girls' skirts by standing under a staircase.

It's an embarrassment, says Mayumi Moriyama, a member of the lower house of parliament and a former education minister. Anyone who wants to buy, sell or produce child pornography comes to Japan. We make it easy for them. Moriyama, a member of the dominant Liberal Democratic Party, joined several opposition lawmakers last week in introducing legislation to crack down on the scourge. A watered-down version of a bill that failed to pass last year, the law is far from perfect. It wouldn't make possession of child porn illegal. And the definition of what kind of pornography is punishable, while broader than the current obscenity code, would remain vague, making prosecution difficult. But the law would impose prison terms of up to three years for people who distribute, sell or display child pornography.

New regulations crafted to control child porn on the Net went into effect last week, but these are weakly worded as well. It requires distributors to register with the police (but threatens no penalties if they do not) and asks Internet service providers to remove objectionable material voluntarily. The ojii-san (old men) don't understand cyberspace, so they don't understand how easy it is for pornographic photos of Japanese children to get sent all over the world, says Yutaka Iimori, a coordinator with the CyberAngels, a group whose 33 volunteers scan the Internet on their home computers and collect pornographic addresses, which are then turned over to the police.

The standard opposition to any attempt at curbing porn is that it infringes upon free speech, a concept handed to Japan by the U.S. after World War II and, as in America, defended fiercely by activists. I quite agree that we have to fight against the sexual abuse of children, says parliament member Yukio Edano. But we have to weigh that against protecting the rights to free speech.

Preventing people from getting their hands on pornography doesn't seem to be much of a threat right now. The country is awash in child porn, and there's little attempt at hiding it. Subway riders peruse pornographic comics that are explicit, graphic and sometimes violent in their depiction of young girls. Porn outlets dot the landscape of Japanese cities, and even mainstream book shops, newsstands and convenience stores sell explicit material. General interest magazines and newspapers also feature erotic photography, as well as advertisements for sex shops and escorts.

Countless magazines and videos offer images of girls dressed in school uniforms, a favorite fantasy. Girls in physical education classes and at swimming pools sometimes become unknowing subjects of clandestine photographers. Their handiwork ends up filling pages of specialized magazines that show girls in shorts or underwear or undressing in public changing rooms. Much of it ends up on the Internet, as well. We get asked all the time by men to go with them to hotels to take naked pictures, says a 14-year-old girl loitering outside a bar in one of Tokyo's neon-lit entertainment meccas, Ikebukuro. On a rainy Saturday night, the streets are jammed with young girls and male recruiters, called scouts, who try to coax the girls into clubs that feature advertising placards depicting cartoon schoolgirls and come-ons like Let's enjoy play with sexy girls. Usually I say no, she insists. But if they give me 80,000 yen [$675], I'll do it.

Japan has a polite term for the teen-sex peddlers: enjo kosai, which translates as supportive relationship. According to Junko Miyamoto, coordinator of a private group campaigning to stop sexual exploitation of children, the term was invented to make prostitution sound O.K. Of the dozens of girls Time recently interviewed, each said she had been offered money to have sex or be photographed nude. There are myriad ways for male customers to hook up with enjo kosai: karaoke lounges, love hotels, strip clubs, magazine ads and telephone clubs where men sit in a booth and take calls from girls dialing in on their cell phones. The problem is people don't regard this as sexual exploitation, says Miyamoto. They regard it as misbehaving kids.

The common explanation for Japan's tolerance of child porn is that the country is run by a clique of old men with little sensitivity toward women and children. But it's not just old men who are involved. Most of our customers are in their 30s, says Seiji Wasaki, 27, a clerk in a porn shop in Tokyo's Shinjuku entertainment district. Parliament member Edano, at 34 one of Japan's youngest politicians, views it as a matter of choice. You can't neglect the fact that some high school girls quite willingly do this, he says. If the girl and the man agree to exchange money for sex, and if it's really her will, then it is completely the act of individuals and shouldn't be regulated. The problem, Edano says, is that the girls haven't been properly educated to make an informed decision. A man who frequents teen prostitutes (and who prefers not to be identified) claims that two years ago, the going rate for sex with a 16-year-old girl was $250. Today, men want younger partners. A tryst with a 12-year-old costs more than $400.

There's another theory for the obsession with pedophilia: that Japanese men feel threatened by adult women. Many men are incapable of relating to adult women on an equal stance, says Yukihiro Murase, a professor of human sexuality at Tokyo's Hitotsubashi University. Whatever the explanation, it won't be easy getting a tough law against child porn through the male-dominated parliament. In fact, a similar effort failed last year. But the exposure of Japan's child porn on the Internet may serve a useful purpose for cracking down on this shameful trade, for it has brought the smut out of the insular world of Japan for all the world to see. We feel embarrassed, says parliament member Moriyama. So now we want to hurry up and do something.

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The best investment a rich man can do, is one into destruction. Destruction of the surrounding world, near and far, makes his wealth more valuable.

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Meet the Guys Obsessed With the Smell of Vagina

While getting eaten out is hailed as the pinnacle of female pleasure, if you’re a woman who’s insecure about smells, it can be hard to enjoy and relax without bathing first. While there’s nothing wrong with hot showers and good hygiene, the vagina, a self-cleansing organ, really doesn’t need to be filled with suds to function healthily. The common fear that your vagina smells "bad" is rooted in sexist, old-fashioned culture rather than fact. “Any body part can have a bad odor if there is an infection or if the individual practices poor hygiene,” says Dr. Michael Aaron, an NYC-based sex therapist and author of the upcoming book Modern Sexuality. “But nothing about vagina makes it intrinsically smelly except for ignorant assumptions of sex negative people.”

Rest assured, any man worth your time won’t mock your scent. Beyond understanding that the smell of vagina is normal, many guys are incredibly turned on by the scent.

“Lots of men enjoy the smell of a vagina, particularly when the woman is aroused and lubricated,” explains Dr. Aaron. “People release pheromones, a unique scent that may often be sexually stimulating.”

To learn more about what’s so stimulating about the scent of pussy, Cosmopolitan.com spoke to five men who can’t get enough.

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Khmer Rouge terror in Cambodia

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Why 'Lolita' Remains Shocking, And A Favorite

Asking a fiction writer to recommend his favorite book is a little like asking a father to pick his favorite child, like asking an adulterer to name his favorite lover. The writer will hem and haw, the father will equivocate, the adulterer will say he loves them all the same, just in different ways. Of course, we're lying. We all have a favorite: She stood "four foot ten in one sock." "She was Lola in slacks. She was Lo, plain Lo in the morning." But in our arms she will always be Lolita.

Lolita, Vladimir Nabokov's immaculate and disturbing masterpiece, is the story of middle-aged Humbert Humbert and his tragic love affair with his 12-year-old, bubble-gum popping stepdaughter Dolores "Lolita" Haze. It's a post-war road novel, the odyssey of a venerable European man and a prepubescent American girl bouncing across the United States, trying to outrun the past and find a future that doesn't exist. The prose is by turns passionate and playful, while the narrative is simultaneously lyrical and unsettling and erotic and violent — did I mention that, in addition to being a child molester, Humbert is also a murderer? It's a kind of inverted detective story: You immediately know someone's been killed, but have to wait to find out who. The book, which can be viewed as an allegory for Europe's relationship with America, offers a depiction of love that is as patently original as it is brutally shocking.

More shocking, though, is the reaction the author somehow manages to elicit from his readers: empathy. Readers always read, I think, out of a tremendous curiosity about other human beings, we're looking for another soul on the page, and that's what Nabokov has so fearlessly, so complexly, so gorgeously given us. In a lesser writer's hands, we could easily dismiss Mr. Humbert as a monster, but Nabokov denies us that all-too comfortable option. Even if we would never condone his vain and deadly infatuation, we understand it. We're complicit in his sins, and our complicity is seductive and terrifying. "Ladies and Gentlemen of the jury... look at this tangle of thorns."

To be sure, this novel isn't for the faint of heart, but neither should prospective readers retreat to any kind of moral high ground. Nabokov, in fact, threads an unexpected and affirming emotional serenity through his portrait of obsession. His enigmatic narrator leaves us in spellbound rapture. Because for all of its linguistic pyrotechnics — as Humbert confesses, "you can always count on a murderer for a fancy prose style" — and for all its controversial subject matter, Lolita is one of the most beautiful love stories you'll ever read. It may be one of the only love stories you'll ever read. This is the most thrilling and beautiful and most deeply disturbing aspect of the novel — and it's what most persuasively recommends the book — that in addition to finding Humbert's soul on the page, we also find, like it or not, a little of our own.

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Fake news is great news. The more, the better. Because it undermines the media's credibility.

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Vaginal Rejuvenation

Vaginal rejuvenation, or vaginoplasty, is a surgical procedure designed to tighten loose or stretched vaginal wall muscles and to narrow the vaginal opening. These delicate soft tissues can be permanently injured and stretched following childbirth, trauma, and/or aging. Such trauma to the vaginal wall muscles and introitus (i.e. vaginal opening) can leave a woman feeling “loose or floppy” and may interfere with sexual enjoyment or a sense of self-esteem. But thanks to new advances in plastic surgery and cosmetic surgery of the female genitalia, almost every woman can be returned to her teenage dimensions and memories.

Dr. Traci M. Temmen, is a board certified plastic surgeon with experience performing vaginal rejuvenation surgery. Her delicate bedside manner, gentle surgical technique, and understanding of a woman’s anatomy and concerns make her a top choice for women in the Tampa Bay area of Florida considering vaginal rejuvenation and vaginoplasty surgery.

Vaginal Rejuvenation Surgery

The goals of vaginal rejuvenation surgery are to improve a woman’s self-confidence and sexual fulfillment by tightening the inner vaginal walls and the vaginal opening. Tightening of the vagina is this manner can allow for a “fuller” feeling during sexual intimacy, less urinary incontinence, and a heightened sense of sexuality and self-esteem.

During a vaginal rejuvenation surgery, the sides, front, and back of the vaginal canal are repaired and tightened and excess vaginal soft tissues are removed. To narrow the vaginal opening, a small strip of mucosa, or superficial soft tissue, is excised and the resultant wound closed tighter and smaller than before surgery.

Who is a Candidate for Vaginal Rejuvenation Surgery?

The ideal candidate for a vaginoplasty or vaginal rejuvenation is a woman who is bothered by a stretched or toneless vaginal wall and/or vaginal opening. Patients undergoing vaginal rejuvenation should not be pregnant or feel pressured by their spouse or partner. Additionally, vaginoplasty patients should not plan on having additional children as childbirth can reverse the effects of vaginal rejuvenation, vaginoplasty, or labiaplasty.

Who is Not a Candidate?

Women with complex medical problems and/or current sexually transmitted diseases or urinary tract infections should not undergo a labiaplasty surgery. Prior to cosmetic surgery in Tampa of the labia or vaginal rejuvenation, all medical problems should be well controlled and any infections should be appropriately treated. Women who have recently had a child should also wait at least 9 to 12 months postpartum before considering vaginal rejuvenation. During this time, the stretched and fatigued vaginal wall muscles will naturally shrink and tighten to varying degrees.

Vaginal Rejuvenation Surgery Scar Location

The scar produced by vaginal rejuvenation surgery is placed lengthwise within the vaginal canal and is not seen on external visualization. Despite the hidden nature of the vaginal rejuvenation scar, Dr. Traci Temmen closes each vaginoplasty incision with meticulous attention to detail, form, and function.

Recovery

Dr. Traci Temmen performs vaginal rejuvenation, labiaplasty, and other cosmetic surgery of the female genitalia in an accredited, private surgical suite, custom-made for plastic surgeons, at the Plastic Surgery Center of Tampa. Dr. Temmen usually performs vaginal rejuvenation surgery under general anesthesia in approximately one hour. Following vaginal rejuvenation, female patients recover in the luxury of a private recovery suite with a recovery room nurse dedicated solely to her comfort.

Most vaginal rejuvenation patients are able to return to work in one to two days, drive when they are no longer taking narcotic pain medications, and return to sexual activity and exercise in two to three weeks.

Vaginal Rejuvenation Surgery Cost

Just like you would never choose your baby-sitter or pediatrician based on cost, price should not be the main consideration when choosing a cosmetic surgeon. Only plastic surgeons certified by the American Board of Plastic Surgery with proper training and experience should be trusted with this delicate area of anatomy. Dr. Traci Temmen is one of only a few female, board certified plastic surgeons offering safe and effective vaginal rejuvenation surgery.

The cost of a vaginal rejuvenation varies by plastic surgeon and by region of the country. In the Tampa Bay area of Florida, the average price of vaginoplasty performed by a board certified plastic surgeon in a well-equipped and clean facility is approximately $4,000 to $5,000. This price includes surgeon fees, anesthesia fees, and facility fees. This cost will increase with complexity, additional surgeries, and increases in planned surgical time.

Dr. Temmen offers convenient payment options for vaginal rejuvenation, labiaplasty, and all other forms of cosmetic surgery of the female genitalia. They accept check, credit, card, and CareCredit, a credit card that offers special financing and low monthly payments for cosmetic surgery procedures.

Risks and Problems

Vaginal rejuvenation is a relatively new procedure to the field of plastic surgery, and thus there are no long-term studies evaluating the effectiveness, risks, benefits, or complications. However, like any surgery, there are known risks and problems associated with vaginal rejuvenation surgery. The most commonly encountered problems following a vaginal rejuvenation are inadequate “tightening,” delayed wound healing, or prolonged bleeding. Wound healing problems usually resolve on their own and do not require additional surgeries.

Additional complications following vaginal rejuvenation surgery include infection, scarring, and changes in sensation. While the risk of these complications with a vaginal rejuvenation are unknown, they can usually be treated as an outpatient or with minor office procedures. Probably the most feared result of a vaginal rejuvenation or labiaplasty surgery is scarring that causes painful sex or changes in sensation leading to painful sex or decreases in enjoyment of sexual intercourse. Because of the known risks and complications following vaginal rejuvenation surgery, only properly trained plastic surgeons operating in accredited facilities should perform these operations.

Plastic surgeons like Dr. Traci Temmen, certified by the American Board of Plastic Surgery, are not only trained in vaginal rejuvenation surgery, but also in diagnosing and appropriately treating the complications and risks associated with cosmetic surgery of the female genitalia.

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America and Europe are evil. Let them self-destruct by fostering sexual hatred. They will kill each other, and the system will kill itself.

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First federal case under female genital mutilation ban spurs efforts for harsher penalties

Minnesota state Rep. Mary Franson received a note from a friend last year urging her to draft stricter legislation against female genital mutilation. The state had banned the practice in 1994, so the Republican worried that a new law would seem ­“Islamophobic,” given its target audience.

One case changed her mind.

Federal prosecutors last month charged a Michigan doctor and his wife in connection with performing the procedure on two Minnesota girls. The parents of one girl — believed to have been involved in arranging the procedure — lost custody “for a whopping 72 hours,” Franson told lawmakers on the floor of the Minnesota statehouse last week.

Another Michigan doctor, ­Jumana Nagarwala of Detroit, has been charged in a separate case.

Now Franson wants Minnesota to pass a bill that would send perpetrators to prison for up to 20 years, targeting parents as well as doctors.

“We’re saying that if you harm your child in this way, you’re going to be held responsible,” she said.

Female genital mutilation has been a federal crime in the United States for more than two decades, carrying a maximum sentence of five years in prison. But the three doctors are the first to be charged under the law. The case has set off a flurry of new bills across the country, with a growing number of states moving to extend penalties to the parents and hit them with lengthy prison terms.

The issue has been a lightning rod in right-wing political circles for years, with anti-Muslim and anti-immigration activists linking it explicitly to Islam. In fact, there is no mention of female genital mutilation in the Koran, and the procedure is rare in most Muslim countries. But attorneys for the doctors, all three of whom are Muslim, say their trial defense next month is likely to invoke religious freedom, a move that is sure to lend the case even more political ammunition.

Republican-authored bills are pending in Michigan, Minnesota, Texas and Maine, and activists say Massachusetts is also weighing legislative action.

In Minnesota, which is among the 25 states that ban female genital mutilation, state representatives on May 15 voted 124 to 4 in favor of expanding the penalties. The bill will go to the state Senate for consideration, but it will probably be signed into law before the fall.

Female genital mutilation (FGM), sometimes called female genital cutting or circumcision, refers to the ancient, ritual practice of cutting off parts of a girl’s genitalia, and sometimes sewing shut the vaginal opening. It has no health benefits and can result in serious complications, including hemorrhaging and death, the lifelong loss of sexual pleasure, painful intercourse, and chronic infections.

The World Health Organization says more than 200 million women and girls living in 30 countries have experienced FGM. Most of those countries are in Africa.

The practice spans an array of ethnic and religious groups despite nearly universal national bans. Although the rationale for the practice varies, experts say it is often driven by social pressures to control women’s sexuality and ensure girls’ virginity before marriage. Some practitioners also believe that it serves a religious mandate, although the practice has no root in religious doctrine.

Some Muslim clerics have endorsed the practice, but a number of major Muslim leaders have condemned it. The three doctors in Michigan and the girls whom investigators say they cut are from the tiny Dawoodi Bohra sect of Shiite Islam, in which the practice is common and clerics are said to endorse it. The doctors’ trial is set for next month.

There’s no reliable data on how common the practice is in the United States, according to the authors of a 2016 Government Accountability Office report. But the Centers for Disease Control and Prevention estimates that about 513,000 women and girls in the United States either had the procedure or are at risk of experiencing it in the future, based on immigrant populations from countries where the practice is prevalent, including Somalia, Ethi­o­pia and Sudan.

The Maine law would make parents who consent to FGM liable for up to 10 years behind bars. This month, the Texas state Senate unanimously approved a similar bill that would allow the state to prosecute people “who transport or permit the transport of a person for the purpose of FGM,” said the bill’s author, state Sen. Jane Nelson (R).

In Michigan, where the state Senate unanimously approved a package of bills on female genital mutilation May 17, perpetrators and accomplices would face up to 15 years in prison.

“We want to send the message that Michigan is not the place to bring your daughter for this evil, horrific, demonic practice,” state Sen. Rick Jones (R) told his colleagues during a recent hearing on the measure.

The Department of Homeland Security, which is responsible for criminal investigations under the federal ban, is set to launch a pilot program next month that aims primarily to reduce FGM abroad by warning travelers of its illegality. The practice of taking girls abroad to be cut, sometimes called “vacation cutting,” was banned in 2013.

The program, Operation Limelight USA, will be limited to John F. Kennedy International Airport in New York, although officials said they are still drafting specifics on how it will work.

The fresh wave of attention has been bittersweet for the U.S.-based activists who have spent years campaigning to end a practice that they say is poorly understood and generally ignored by the public, law enforcement and U.S. officials.

“When things like this happen, people just want to focus on getting all states to penalize it. But there’s a bigger picture out here that we’re not focusing on,” said Jaha Dukureh, the founder of the Atlanta-based Safe Hands for Girls, a leading advocacy group against FGM.

Dukureh, who underwent the procedure as an infant in Gambia, said she would rather see education and outreach aimed at preventing the practice than punishment alone.

For instance, many activists, doctors and lawmakers have said they want better training for medical professionals so they can address the issue with pregnant women who have experienced FGM before they give birth to girls. And they want to see efforts to spread awareness of the procedure’s dangers in vulnerable schools and communities, enlisting the support of neighborhood and religious leaders in condemning it.

Somali American activists have been pushing legislators for funds to prevent the practice through education and outreach, said Minnesota state Rep. Susan Allen of the Democratic-Farmer-Labor Party.

“They have not gotten resources,” she said.

The United States banned female genital mutilation in 1997, and in 2003 banned the transport of a minor abroad to have the procedure. But there have been only two other FBI investigations into the practice over the past two decades. In both cases, the FBI was unable to find victims, and only one of the cases, in California, led to charges, according to the GAO report.

Experts say a culture of shame and secrecy — or even ignorance of having undergone a procedure that they might have been too young to remember — keeps many from talking about FGM in the United States.

Deborah Thorp, who is an ­obstetrician-gynecologist in Minneapolis, said she sees at least one patient a day who has undergone FGM. Many are older refugees from Somalia, where the prevalence rate is 98 percent.

But she said she doubts that the practice is common for Somali American children who are born in the United States.

“I’m seeing a lot of moms who are so angry that it got done to them that I have a hard time thinking that they would ever have anything to do with it,” she said.

Some activists and Democratic lawmakers have argued — in lieu of hard data about the prevalence of FGM — that racism, Islamophobia and anti-immigrant sentiments have played a role in fueling enthusiasm for the new policies.

Far-right blogs and news websites have long perpetuated the myth that FGM is a common Islamic practice by immigrants who are fundamentally at odds with American society.

FGM and honor killings “would not exist in the U.S. without mass immigration bringing its practitioners into U.S. communities,” Breitbart reporter ­Katie McHugh wrote in March. Stephen Miller, a top aide to President Trump, has voiced the same sentiment.

In Minnesota last week, some dissenting lawmakers worried that meting out “draconian” punishment for a poorly understood crime might make it worse. The Minnesota law would make it easier and more likely for the state to take custody of a child whose parent is suspected of involvement in FGM. For suspects who are not yet U.S. citizens, the crime would probably mean deportation.

“When you start removing children from their families, increasing penalties for families,” Allen, the state lawmaker, said, “it’s likely that it may deter them from reporting the violence. They may not cooperate with police.”

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It is the secret dream of every Swedish or German woman to marry a black men, or at least have sex with a black man. Every smart young African man should migrate to Europe. Free money, nice house, good sex!

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This surgeon says he can increase your penis size by two inches by injecting it with blood

It’s really not about length. It’s about what you do with it.

But despite this knowledge being spread far and wide, many men are still bothered by the size of their penis – judging by the Google searches for ‘how to make my penis bigger’, anyway.

So of course, surgeons are stepping up to meet the demand, creating procedures that they claim will make men’s dicks larger.

They’re probably more effective than the herbal teas recommended all over the internet, to be fair.

Dr Norman Rowe, a surgeon in New York, has just debuted a new technique for boosting men’s genitals.

Essentially, it’s a bit like those vampire facials everyone got excited about when Kim Kardashian shared a bloody-faced selfie. You pop into the surgery, get your own blood injected into your genitals, and, apparently, can expect a growth of 1.5 inches in circumference.*

*Yep. We’re talking girth, not length.

Dr Rowe told Daily Mail Online that the procedure lasts just 10 minutes and there’s no need for a recovery period. You can get the procedure done in your lunch break and go straight back to work. If you fancy.

The only after-effect you need to worry about is accidentally disrupting the symmetry of the injection. Dr Rowe recommends skipping sex for two days post-op.

The procedure is a pretty big deal, as it’s the first time someone’s come up with a way to enlarge the penis without surgery.

Dr Rowe was inspired to create the treatment by the rise of quick fix procedures like Botox and fillers, and wondering if something similar could work for penises.

He then looked into a method often used in sports medicine, which involves injecting blood back into the body to revive the muscle, and the vampire facial.

And voila: he came up with his bulge booster, which he claims can remedy erectile dysfunction alongside increasing girth.

Which all sounds wonderful, if girth is something you’re worried about.

But would you dare to get multiple injections in your dick? Could you actually go through with it? We’re crossing our legs and cringing a little at the thought.

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Tongkat ali standardization is a scam, copied many times over on the Internet. Good for you if it's just a lie (which most probably it is) . Bad for you if indeed they enrich their alleged tongkat ali with eurycomanone. Because it would be reagent grade eurycomanone, not pharmaceutical grade. Better be careful with your health.

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Pedophile's Child Rape Victim Given Suicide Drugs By Doctors

A victim of child sex abuse, who suffered severe anorexia, chronic depression, and hallucinations as a result of her ordeal, was given a lethal injection by doctors who declared that her post-traumatic stress disorder and other conditions were incurable.

The woman, who was in her 20s, suffered sexual abuse at the age of 5 to 15 years old and chose to end her life under Dutch euthanasia laws because she couldn't live with her mental suffering after doctors told her that treatment was hopeless.

She was allowed to undergo euthanasia via lethal injection despite doctors noting a considerable improvement in her condition 2 years ago following "intensive therapy".

Treatment was abandoned last year after independent consultants were called in and said the case was hopeless.

Doctors in the Netherlands also agree that demands for death from a psychiatric patient may be no more than a cry for help.

According to the report, the patient was "totally competent" and there was 'no major depression or other mood disorder which affected her thinking'.

A final GP's report approved the "termination of life" order and the woman was killed by an injection of lethal drugs, the report said.

Nikki Kenward, from disability rights group Distant Voices, said:

"It is both horrifying and worrying that mental health professionals could regard euthanasia in any form as an answer to the complex and deep wounds that result from sexual abuse."

According to the Daily Mail, The woman, who has not been named, began to suffer from mental disorders 15 years ago following sexual abuse, according to the papers released by the Dutch Euthanasia Commission.

The timescale means she was abused between the ages of five and 15.

News of her death angered anti-euthanasia and disability campaigners in everywhere. One Labour MP said it meant sex abuse victims were now being punished with death.

One British politician said it meant sex abuse victims were now being punished with death, saying:

"It almost sends the message that if you are the victim of abuse, and as a result, you get a mental illness, you are punished by being killed, that the punishment for the crime of being a victim is death."

"It serves to reinforce why any move toward legalizing assisted suicide, or assisted dying, is so dangerous."

The papers said that the woman had post-traumatic stress disorder that was resistant to treatment.

Her condition included severe anorexia, chronic depression, and suicidal mood swings, tendencies to self-harm, hallucinations, obsessions, and compulsions.

She also had physical difficulties and was almost entirely bedridden.

Her psychiatrist said, "there was no prospect or hope for her. The patient experienced her suffering as unbearable".

However, the papers also disclosed that two years before her death the woman's doctors called for a second opinion, and on the advice of the new doctors she had an intensive course of trauma therapy.

"This treatment was temporarily partially successful," the documents said.

Treatment was abandoned last year after independent consultants were called in and said the case was hopeless.

The consultants also said that despite her "intolerable" physical and mental suffering, chronic depression and mood swings, she was entirely competent to make the decision to take her own life.

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Universal education for women is not in the interest of men. For some women, a good education is OK. For the majority, it is unneeded.

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