https://en.intactiwiki.org/w/api.php?action=feedcontributions&feedformat=atom&user=WikiModEn4IntactiWiki - User contributions [en]2026-06-13T07:03:28ZUser contributionsMediaWiki 1.45.1https://en.intactiwiki.org/w/index.php?title=Supercanister&diff=16257Supercanister2020-09-28T03:02:30Z<p>WikiModEn4: </p>
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<div>{| class="infobox vcard" style="175px; font-size:90%" border="0" cellspacing="4" align="right" <br />
|- <br />
| align="right" | [[Image:supercanister.jpg|175px]]<br />
|- style="background: #DCDCDC"<br />
| align="center" | Novice Supercanister Combo Kit<br />
|}<br />
<br />
The Supercanister is a [[tugger]] which can also work as a [[weights|weight]]. It is produced by [https://foreskinrestoration.men/ Advanced Devices Inc.]. It is constructed from medical grade Delrin polymer and stainless steel hardware. The Supercanister is a design that was based off the 35mm film canister method of tugging. The Supercanister also has a unique magnetic safety release. The safety release is designed to release tension in the event tension exceeds a safe predetermined maximum. This is done to protect the wearer's penis from excess tension. The Supercanister also allows the wearer to cleanly urinate without having to remove the device. There is a provision to insert a cotton plug to prevent drips from soiling clothing. <br />
<br />
Advanced Devices produces two models of Supercanister, Novice and Advanced. The Novice model is designed for men with little to no slack skin.The ADI Supercanister Novice model comes in 3 sizes (Med/Large, XL, and 2XL). The Advanced model is a "one size fits all" tapered cone design which offers some amount of bi-directional tension for the inner and outer skin. <br />
<br />
{{SEEALSO}}<br />
<br />
* [[Basics of foreskin restoration]]<br />
* [[Foreskin restoration]]<br />
* [[Surgical foreskin restoration]]<br />
* [[Category:Films about foreskin restoration]]<br />
* [[Literature about foreskin restoration]]<br />
<br />
<br />
{{LINKS}}<br />
* [https://foreskinrestoration.men/ Foreskin Restoration Site]<br />
* [http://www.youtube.com/user/foreskinrestore1 YouTube channel]<br />
<br />
<!-- {{REF}} --><br />
<br />
[[Category:Foreskin restoration devices]]<br />
[[Category:Foreskin restoration]]<br />
[[Category:From IntactWiki]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Foreskin_restoration&diff=16256Foreskin restoration2020-09-28T02:56:03Z<p>WikiModEn4: </p>
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<div>{{GraphicWarning}}<br />
[[Image:Restoration before after.JPG |thumbnail|right|300px| A human penis circumcised at birth, before and after 42 months of non-surgical restoration.]]<br />
<br />
'''Foreskin restoration''' refers to the process of expanding the residual skin on the circumcised [[penis]] by non-surgical means in order to recreate the [[foreskin]] which was removed in [[circumcision]].<ref name="wisdom">{{REFjournal<br />
|last=Wisdom<br />
|first=Travis<br />
|author-link=<br />
|etal=no<br />
|title=Constructing phallic beauty: Foreskin restoration, genital cutting and circumcisionism<br />
|trans-title=<br />
|language=<br />
|journal=Brill<br />
|location=<br />
|date=2014<br />
|volume=<br />
|issue=<br />
|pages=93-134<br />
|url=https://www.academia.edu/7648223/Constructing_Phallic_Beauty_Foreskin_Restoration_Genital_Cutting_and_Circumcisionism?email_work_card=view-paper<br />
|archived=<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.1163/9781848881259_007<br />
|accessdate=2020-08-16<br />
}}</ref> It can also refer to the process of [[Tissue expansion| expanding existing skin]] in a penis whose foreskin is abnormally short or non-existent (see [[aposthia]]).<ref name="collier2011">{{REFjournal<br />
|last=Collier<br />
|first=Roger<br />
|author-link=<br />
|title=Whole again: the practice of foreskin restoration<br />
|trans-title=<br />
|language=<br />
|journal=CMAJ<br />
|date=2011<br />
|volume=183<br />
|issue=18<br />
|pages=2092-3<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3255154/<br />
|quote=<br />
|pubmedID=3255154<br />
|pubmedCID=22083672<br />
|DOI=10.1503/cmaj.109-4009<br />
|accessdate=<br />
}}</ref><br />
<br />
Foreskin restoration can be achieved via surgical and/or non-surgical means. Men take up foreskin restoration to restore [[sensation]] to the [[glans penis]] and to restore the [[gliding action]] of the natural penis. Another reason for restoring is a desire to create the natural appearance of an intact penis with the [[foreskin]] covering the [[glans penis]]. Foreskin restoration techniques are most commonly undertaken by men who resent having been [[circumcision|circumcised]] as children, or who have sustained an injury. They are also used by intact men who simply desire a longer foreskin.<br />
<br />
== History ==<br />
<br />
Foreskin stretching (called "uncircumcision," or ''[[epispasm]]'') appears to have been a common practice among Hellenized Jewish men in Hellenistic and Roman societies,<ref name="Rubin">{{REFjournal<br />
|last=Rubin<br />
|first=Jody P.<br />
|title=Celsus's Decircumcision Operation<br />
|journal=Urology<br />
|volume=16<br />
|issue=1<br />
|pages=121-124<br />
|url=http://www.cirp.org/library/restoration/rubin/<br />
|quote=<br />
|pubmedID=6994325<br />
|pubmedCID=<br />
|DOI=10.1016/0090-4295(80)90354-4<br />
|date=1980-07<br />
|accessdate=<br />
}}</ref> from at least as early as the 2nd century {{#tip-text:BCE|Before Common Era, an alternative to BC}}.<ref>{{REFbook<br />
|last=Glick<br />
|first=Leonard<br />
|author-link=Leonard B. Glick<br />
|year=2005<br />
|title=Marked in Your Flesh<br />
|url=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter="This Is My Covenant", Circumcision in the World of Temple Judaism<br />
|page=31<br />
|location=New York, New York<br />
|publisher=Oxford University Press<br />
|isbn=0-19-517674-X<br />
|quote=Foreskin stretching (called "uncircumcision," or epispasm) appears to have been a common practice among Hellenized Jewish men...<br />
|accessdate=2011-09-23<br />
|note=<br />
}}</ref><br />
<br />
Key features of Hellenistic culture were athletic exercises in gymnasia and athletic performances in public arenas, where men appeared in the nude. While the penis sheathed in an intact foreskin was normal and acceptable, ancient Greeks and their Hellenistic successors considered the circumcised penis to be offensive, as it was perceived as a vulgar imitation of erection, unfit for public display. The ancient Greeks and their Hellenistic successors considered the "ideal prepuce" to be long, tapered, and "well-proportioned." Removing it was considered mutilation. Men with short foreskins, a condition known as ''lypodermos'', would wear a leather cord called a ''kynodesme'' to prevent its accidental exposure.<ref>{{REFjournal<br />
|last=Hodges<br />
|first=Frederick M.<br />
|author-link=Frederick M. Hodges<br />
|title=The Ideal Prepuce in Ancient Greece and Rome: Male Genital Aesthetics and Their Relation to Lipodermos, Circumcision, Foreskin Restoration, and the Kynodesme<br />
|journal=Bulletin of the History of Medicine<br />
|date=2001-09<br />
|note=Fall 2001<br />
|volume=75<br />
|issue=3<br />
|pages=375-405<br />
|url=http://www.cirp.org/library/history/hodges2/<br />
|quote=<br />
|pubmedID=11568485<br />
|pubmedCID=<br />
|DOI=<br />
|accessdate=2019-09-30<br />
}}</ref><br />
<br />
The sight of circumcised genitals at public baths or gymnasia would inspire laughter and ridicule. Jewish men who wished to gain acceptance in the larger social world gave themselves a presentable appearance by pulling the remaining foreskin forward as far as possible, and keeping it under enough tension to encourage permanent stretching toward its original length. Using a fibular pin or a cord, they pierced the front of the remaining foreskin, drew it forward, and fixed it in place; sometimes they would attach a weight to maintain tension. Over time the foreskin stretched and restored at least some of the appearance of an intact organ.<ref>{{REFbook<br />
|last=Glick<br />
|first=Leonard<br />
|author-link=Leonard B. Glick<br />
|year=2005<br />
|title=Marked in Your Flesh<br />
|url=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter="This Is My Covenant", Circumcision in the World of Temple Judaism<br />
|page=31<br />
|location=New York, New York<br />
|publisher=Oxford University Press<br />
|isbn=0-19-517674-X<br />
|quote=...some, eager for acceptance in the larger social world, gave themselves a presentable appearance by pulling the remaining foreskin forward...<br />
|accessdate=2011-09-23<br />
|note=<br />
}}</ref> Up until the 2th century, [[Jewish circumcision]] involved only partial foreskin removal. Rabbis of the 2th century mandated peri’ah, or the complete ablation of the foreskin in order to prevent Jewish men from engaging in foreskin restoration.<ref>{{REFbook<br />
|last=Glick<br />
|first=Leonard<br />
|author-link=Leonard B. Glick<br />
|year=2005<br />
|title=Marked in Your Flesh<br />
|url=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter="This Is My Covenant", Circumcision in the World of Temple Judaism<br />
|page=31<br />
|location=New York, New York<br />
|publisher=Oxford University Press<br />
|isbn=0-19-517674-X<br />
|quote=For obvious reasons this was anathema to the rabbis: tantamount to rejection of Judaism and defiance of rabbinic authority.<br />
|accessdate=2011-09-23<br />
|note=<br />
}}</ref><br />
<br />
During World War II, some European Jews sought out underground foreskin restoration operations as a way to escape Nazi persecution.<ref name="Tushmet">{{REFjournal<br />
|last=Tushmet<br />
|first=Leonard<br />
|title=Uncircumcision<br />
|journal=Medical Times<br />
|volume=93<br />
|issue=6<br />
|pages=588-593<br />
|url=http://www.cirp.org/library/restoration/tushmet1/<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=1965<br />
|accessdate=<br />
}}</ref><br />
<br />
The practice of foreskin restoration was revived in the late twentieth century using modern materials and techniques. In 1982 a group called Brothers United for Future Foreskins ([[BUFF]]) was formed, which publicized the use of tape in non-surgical restoration methods. Later in 1991, another group called UNCircumcising Information and Resources Centers ([[UNCIRC]]) was formed.<ref name="Bigelow - uncirc">{{REFjournal<br />
|last=Bigelow<br />
|first=Jim<br />
|author-link=Jim Bigelow<br />
|title=Uncircumcising: undoing the effects of an ancient practice in a modern world<br />
|journal=Mothering<br />
|volume=Summer<br />
|issue=<br />
|pages=121-124<br />
|url=http://www.cirp.org/library/restoration/bigelow1/<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=1994<br />
|accessdate=<br />
}}</ref><br />
<br />
The National Organization of Restoring Men ([[NORM]]) was founded in 1989 in San Francisco, as a non-profit support group for men restoring the appearance of a foreskin. It was originally known as RECAP, an acronym for the phrase Recover A Penis. In 1994 UNCIRC was incorporated into this group.<ref name="NORM history">{{REFweb<br />
| quote=<br />
| url=http://www.norm.org/history.html<br />
| title=NORM - History<br />
| last=Griffiths<br />
| first=R. Wayne<br />
| publisher=<br />
| work=<br />
| date=2006<br />
| accessdate=2019-09-30<br />
}}</ref> Since its founding, several NORM chapters have been founded throughout the United States, as well as internationally in Canada, the United Kingdom, Australia, New Zealand, and Germany.<br />
<br />
== Nonsurgical techniques ==<br />
<br />
[[Image:Foreskin restoration diagram.jpg |thumbnail|right|550px| A series of steps for non-surgical foreskin restoration. ]]<br />
<br />
Nonsurgical foreskin restoration is the most commonly used method of foreskin restoration. It is accomplished through [[tissue expansion]] and involves pulling on the remnants of the foreskin. Both the skin of the penile shaft and the mucosal inner lining of the foreskin, if any remains after circumcision, may be expanded. The skin is pulled forward over the glans, and tension is applied manually, by using weights or elastic straps. In the latter two cases a device must be attached to the skin; surgical tape is often used.<br />
<br />
[[Image:Tlctugger applied.jpg|thumbnail|left|150px| TLCTugger device applied to a circumcised penis for non-surgical foreskin restoration.]]<br />
<br />
An example of a device using elastic straps is the T-Tape method, which was developed in the 1990s with the idea of enabling restoration to take place more rapidly. Many specialized [http://intactwiki.org/wiki/Category:Foreskin_restoration_devices restoration devices] (like the [[TLC-X|TLC Tugger]] shown in the picture) that grip the skin with or without tape are also commercially available. Tension from these devices may be applied by weights or elastic straps, by pushing the skin forward on the penis, or by a combination of these methods.<br />
<br />
The amount of tension produced by any method must be adjusted to avoid injury, pain or discomfort, and provides a limit on the rate at which new tissue can be grown. There is a risk of damaging tissues if excessive tension is used, or if tension is applied for too long. Websites about foreskin restoration vary in their recommendations, from suggesting a regimen of moderate amounts of tension applied for several hours a day,<ref name="NORM regimen">{{REFweb<br />
| quote=<br />
| url=http://www.norm.org/regimen.html<br />
| title=NORM - Recommended Restoration Regimen<br />
| last=Griffiths<br />
| first=R. Wayne<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2006-08-27<br />
}}</ref> to recommending periods of higher tension applied for only a few minutes per day.<ref name="FRC manual">{{REFweb<br />
| quote=<br />
| url=http://foreskinrestorationchat.info/manualtugging.html<br />
| title=Foreskin Restoration Chat Manual Restoration Method and Guide<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2006-08-27<br />
}}</ref><ref name="Doug's site">{{REFweb<br />
| quote=<br />
| url=http://pages.suddenlink.net/manual_methods/<br />
| title=Manual Methods of Foreskin Restoration<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2007-07-19<br />
}}</ref><br />
<br />
Applying tension to tissue has long been known to stimulate [[mitosis]], and research shows that expanded human tissues have the attributes of the original tissue.<ref name="Cordes">{{REFjournal<br />
|last=Cordes<br />
|first=Stephanie<br />
|last2=Calhoun<br />
|first2=Karen H.<br />
|last3=Quinn<br />
|first3=Francis B.<br />
|title=Tissue Expanders<br />
|journal=University of Texas Medical Branch Department of Otolaryngology Grand Rounds<br />
|volume=<br />
|issue=<br />
|pages=<br />
|url=http://www.utmb.edu/otoref/Grnds/tissue-expand.html<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=1997-10-15<br />
|accessdate=<br />
}}</ref> Unlike conventional skin expansion techniques, however, the process of nonsurgical foreskin restoration may take several years to complete. The time required depends on the amount of skin available to expand, the amount of skin desired in the end, and the regimen of stretching methods used. Patience and dedication are needed; support groups exist to help with these (see External links section). The act of stretching the skin is often described informally as "tugging" in these groups, especially those on the Internet.<br />
<br />
Intact men who would like to have a longer foreskin may use these same techniques of [[tissue expansion]] to lengthen a short [[foreskin]]. Benefits include improved protection of the [[glans penis]], improved [[gliding action]], and improved physical appearance.<br />
<br />
See [[Basics of foreskin restoration]]<br />
<br />
== Surgical techniques ==<br />
<br />
Surgical techniques of foreskin restoration are historical. They are seldom, if ever, used today because they have not given good results.<br />
<br />
Surgical methods of foreskin restoration, sometimes known as foreskin reconstruction, usually involve a method of grafting skin onto the distal portion of the penile shaft. The grafted skin is typically taken from the scrotum, which contains the same smooth muscle (known as [[dartos|dartos fascia]]) as does the skin of the penis. One method involves a four stage procedure in which the shaft is buried in the scrotum for a period of time.<ref name="Greer">{{REFjournal<br />
|last=Greer<br />
|first=Donald M.<br />
|last2=Mohl<br />
|first2=Paul C.<br />
|last3=Sheley<br />
|first3=Kathy A.<br />
|title=A technique for foreskin reconstruction and some preliminary results<br />
|journal=The Journal of Sex Research<br />
|volume=18<br />
|issue=4<br />
|pages=324-330<br />
|url=http://www.cirp.org/library/restoration/greer1/<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.1080/00224498209551158<br />
|date=1982<br />
|accessdate=<br />
}}</ref> Such techniques are costly, and have the potential to produce unsatisfactory results or serious complications related to the skin graft.<br />
<br />
British Columbia resident Paul Tinari was held down and circumcised at eight years old, in what he stated was "a routine form of punishment" for [[masturbation]] at residential schools. Following a lawsuit, Tinari's surgical foreskin restoration was covered by the British Columbia Ministry of Health. The plastic surgeon who performed the restoration was the first in Canada to have done such an operation, and used a technique similar to that described above.<ref name="Tyee article">{{REFjournal<br />
|last=Euringer<br />
|first=Amanda<br />
|title=BC Health Pays to Restore Man's Foreskin<br />
|journal=The Tyee<br />
|volume=<br />
|issue=<br />
|pages=<br />
|url=http://thetyee.ca/News/2006/07/25/Circumcision/<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=2006-07-25<br />
|accessdate=<br />
}}</ref><ref name="NRM article">{{REFjournal<br />
|last=Laliberté<br />
|first=Jennifer<br />
|title=BC man's foreskin op a success<br />
|journal=National Review of Medicine<br />
|volume=3<br />
|issue=12<br />
|pages=<br />
|url=http://www.nationalreviewofmedicine.com/issue/2006/06_30/3_patients_practice01_12.html<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=2006-06-30<br />
|accessdate=<br />
}}</ref><br />
<br />
See [[Surgical foreskin restoration]]<br />
<br />
== Results ==<br />
<br />
Results of surgical foreskin restoration are much faster, but are often described as unsatisfactory, and most restoration groups advise against them.<br />
<br />
Results of non-surgical methods vary widely, and depend on such factors as the amount of skin present at the start of the restoration, degree of commitment, technique, and the individual's body. Foreskin restoration successfully restores sensitivity to [[glans penis]] and restores the [[gliding action]]. Certain parts of the natural foreskin cannot be reformed. In particular, the [[ridged band]], a nerve-bearing tissue structure extending around the penis just inside the tip of the foreskin,<ref name="Taylor interview">{{REFweb<br />
| quote=<br />
| url=http://www.intact.ca/taylor.html<br />
| title=Interview with John Taylor<br />
| last=Taylor<br />
| first=John R.<br />
| publisher=<br />
| work=<br />
| date=1997-02-04<br />
| accessdate=2007-08-26<br />
}}</ref><ref name=Joy-frenar>{{REFbook<br />
|last=Bigelow<br />
|first=Jim<br />
|author-link=Jim Bigelow<br />
|year=<br />
|title=The Joy of Uncircumcising!<br />
|url=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=<br />
|page=13<br />
|location=<br />
|publisher=<br />
|isbn=096304821X<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref> which helps to contract the tip of the foreskin so that it remains positioned over the glans, cannot be recreated. Restored foreskins can appear much looser at the tip and some men report difficulty in keeping the glans covered. Surgical "touch-up" procedures exist to reduce the orifice of the restored foreskin, recreating the tightening function of the band of muscle fibers near the tip of the foreskin, though they have not proven successful in every case.<ref name=Joy-touchup>{{REFbook<br />
|last=Bigelow<br />
|first=Jim<br />
|author-link=Jim Bigelow<br />
|year=<br />
|title=The Joy of Uncircumcising!<br />
|url=<br />
|editor=<br />
|edition=1998<br />
|volume=<br />
|chapter=<br />
|pages=188-192<br />
|location=<br />
|publisher=<br />
|isbn=096304821X<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref> A loose effect can also be alleviated by creating increased length, but requires a longer commitment to the restoration program. In addition, several websites claim that the use of O-rings during the restoration program can train the skin to maintain a puckered shape.<br />
<br />
As the shaft skin expands and gets longer the circumcision scar will travel down toward the tip and eventually turn under and be concealed inside the foreskin.<br />
<br />
== Physical aspects ==<br />
<br />
The natural foreskin has three principal components, in addition to blood vessels, nerves and connective tissue: [[skin]], which is exposed exteriorely; [[mucous membrane]], which is the inside surface in contact with the [[glans penis]] when the [[penis]] is flaccid; and a layer of [[Dartos| muscle]] fibers under the foreskin. The [[ridged band]] is just inside the tip of the [[foreskin]].<br />
<br />
Generally, the skin grows more readily in response to stretching than does the mucous membrane. The ring of muscle which normally holds the foreskin closed is completely removed in the majority of circumcisions and cannot be regrown, so the covering resulting from stretching techniques is usually looser than that of a natural foreskin. According to some observers it is difficult to distinguish a restored foreskin from a natural foreskin because restoration produces a "nearly normal-appearing prepuce."<ref name="Goodwin">{{REFjournal<br />
|last=Goodwin<br />
|first=Willard E.<br />
|title=Uncircumcision: A Technique For Plastic Reconstruction of a Prepuce After Circumcision<br />
|journal=J Urol<br />
|volume=144<br />
|issue=5<br />
|pages=1203-1205<br />
|url=http://www.cirp.org/library/restoration/goodwin1/<br />
|quote=<br />
|pubmedID=2231896<br />
|pubmedCID=<br />
|DOI=<br />
|date=1990<br />
|accessdate=<br />
}}</ref><br />
<br />
Nonsurgical foreskin restoration does not restore portions of the [[Frenulum| frenulum]] or the [[ridged band]] removed during circumcision. Although not commonly performed, there are surgical [http://intactwiki.org/wiki/Category:Foreskin_restoration_touch-up_surgeries "touch-up" techniques] that can re-create some of the functionality of the frenulum and dartos muscle.<ref>{{REFbook<br />
|last=Bigelow<br />
|first=Jim<br />
|author-link=Jim Bigelow<br />
|year=<br />
|title=The Joy of Uncircumcising!<br />
|url=<br />
|work=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=<br />
|pages=188-191<br />
|location=<br />
|publisher=<br />
|isbn=<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref><br />
<br />
The process of foreskin restoration seeks to regenerate some of the tissue removed by circumcision by expansion of residual tissue, as well as providing coverage of the glans. According to research, the [[foreskin]] comprises over one-half of the skin and mucosa of the human penis.<ref>{{REFjournal<br />
|last=Taylor<br />
|first=J.R.<br />
|author-link=John R. Taylor<br />
|first2=A.P.<br />
|last2=Lockwood<br />
|first3=A.J.<br />
|last3=Taylor<br />
|title=The prepuce: Specialized mucosa of the penis and its loss to circumcision<br />
|journal=Brit J Urol<br />
|date=1996-02-01<br />
|volume=77<br />
|issue=<br />
|pages=291-295<br />
|url=http://www.cirp.org/library/anatomy/taylor/<br />
|quote=<br />
|pubmedID=8800902 <br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410x.1996.85023.x<br />
|accessdate=<br />
}}</ref><br />
<br />
By growing more penile skin, foreskin restorers recover the skin mobility that was eliminated by their circumcision. The ability to [[gliding action|glide the skin of the penis over the glans]] constitutes a mechanical component of the stimulation mechanism of the penis.<br />
<br />
In some men, foreskin restoration may alleviate certain problems they attribute to their circumcisions. Such problems, as reported to an anti-circumcision group by men circumcised in infancy or childhood, include prominent [[Circumcision scar|scarring]] (33%), insufficient penile skin for comfortable erection (27%), erectile curvature from uneven skin loss (16%), and pain and bleeding upon erection/manipulation (17%). The poll also asked about awareness of or involvement in foreskin restoration, and included an open comment section. Many respondents and their wives "reported that restoration resolved the unnatural dryness of the circumcised penis, which caused abrasion, pain or bleeding during intercourse, and that restoration offered unique pleasures, which enhanced sexual intimacy."<ref name="Hammond">{{REFjournal<br />
|last=Hammond<br />
|first=T.<br />
|author-link=Tim Hammond<br />
|title=A Preliminary Poll of Men Circumcised in Infancy or Childhood<br />
|journal=BJU Int<br />
|volume=83<br />
|issue=Suppl. 1<br />
|pages=85-92<br />
|url=http://www3.interscience.wiley.com/cgi-bin/fulltext/119091408/PDFSTART<br />
|quote=<br />
|pubmedID=10349419<br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410x.1999.0830s1085.x<br />
|date=1999<br />
|accessdate=<br />
}}</ref><br />
<br />
Some men who have undertaken foreskin restoration report a visibly smoother glans, which some of these men attribute to decreased levels of [[keratinization]] following restoration. <br />
<br />
<!--Several studies have suggested that the glans is equally sensitive in circumcised and uncircumcised males,<ref name="masters">{{REFbook<br />
|last=Masters<br />
|first=William H.<br />
|last2=Johnson<br />
|first2=Virginia E.<br />
|year=1966<br />
|title=Human Sexual Response<br />
|url=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=<br />
|pages=189-191<br />
|location=Boston<br />
|publisher=Little, Brown & Co<br />
|isbn=0-316-54987-8<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}} (excerpt accessible [http://www.circs.org/library/masters/ here])</ref><ref name="bleustein">{{REFjournal<br />
|last=Bleustein<br />
|first=Clifford B.<br />
|first2=James D.<br />
|last2=Fogarty<br />
|first3=Haftan<br />
|last3=Eckholdt<br />
|first4=Joseph C.<br />
|last4=Arezzo<br />
|first5=Arnold<br />
|last5=Melman<br />
|title=Effect of neonatal circumcision on penile neurologic sensation<br />
|journal=Urology<br />
|volume=65<br />
|issue=4<br />
|pages=773-777<br />
|url=<br />
|quote=<br />
|pubmedID=15833526<br />
|pubmedCID=<br />
|DOI=10.1016/j.urology.2004.11.007<br />
|date=2005-04<br />
|accessdate=<br />
}}</ref><ref name = "bleustein2003">{{REFconference<br />
|place=Chicago, Illinois<br />
|title=American Urological Association 98th Annual Meeting<br />
|url=<br />
|last=Bleustein<br />
|first=Clifford B.<br />
|coauthors=Haftan Eckholdt, Joseph C. Arezzo and Arnold Melman<br />
|source=Effects of Circumcision on Male Penile Sensitivity<br />
|datefrom=2003-04-26<br />
|dateto=2003-05-01<br />
|accessdate=2019-09-29<br />
}}</ref><ref name="payne2007">{{REFjournal<br />
|last=Payne<br />
|first=Kimberley<br />
|last2=Thaler<br />
|first2=Lea<br />
|last3=Kukkonen<br />
|first3=Tuuli<br />
|last4=Carrier<br />
|first4=Serge<br />
|last5=Binik<br />
|first5=Yitzchak<br />
|author5-link=Irving M. Binik<br />
|title=Sensation and Sexual Arousal in Circumcised and Uncircumcised Men<br />
|journal=J Sex Med<br />
|volume=4<br />
|issue=3<br />
|pages=667-674<br />
|url=http://www.blackwell-synergy.com/doi/abs/10.1111/j.1743-6109.2007.00471.x<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.1111/j.1743-6109.2007.00471.x<br />
|date=2007-05<br />
|accessdate=2019-09-30<br />
}}</ref> <br />
<br />
The work of Masters & Johnson (1966) has been shown to have severe methodological flaws that render their conclusions inaccurate and essentially useless. The work of Bleustein (2003) and Payne (2007) is similarly flawed by methodological faults.<br />
<br />
Although Kirby (1994) suggested that the perceived sensitivity gains of the glans reported by some men are psychological, with glans sensitivity itself being unaffected.<ref>{{REFjournal<br />
|last=Kirby<br />
|first=R.S.<br />
|title=The Joy of Uncircumcising! Restore your birthright and maximize sexual pleasure<br />
|journal=BMJ<br />
|date=1994-09-10<br />
|volume=309<br />
|issue=<br />
|page=679<br />
|url=http://bmj.bmjjournals.com/cgi/content/full/309/6955/679/a<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.1136/bmj.309.6955.679a<br />
|accessdate=2019-9-29<br />
}}</ref>--> <br />
Sorrells (2007) ''et al'' and Yang ''et al'' (2008) have reported empirical data that proves there is more sensation in intact males.<ref name="sorrels">{{REFjournal<br />
|last=Sorrells<br />
|first=<br />
|title=Fine-touch pressure thresholds in the adult penis<br />
|journal=BJU Int<br />
|volume=99<br />
|issue=4<br />
|pages=864-869<br />
|url=http://www3.interscience.wiley.com/cgi-bin/fulltext/118508429/PDFSTART<br />
|quote=<br />
|pubmedID=1737884<br />
|pubmedCID=<br />
|DOI=<br />
|date=2007-04<br />
|accessdate=<br />
}}</ref><ref name="yang">{{REFjournal<br />
|last=Yang<br />
|first=D.M.<br />
|last2=Lin<br />
|first2=H.<br />
|last3=Zhang<br />
|first3=B.<br />
|last4=Guo<br />
|first4=W.<br />
|title=Circumcision affects glans penis vibration perception threshold<br />
|journal=Zhonghua Nan Ke Xue<br />
|volume=14<br />
|issue=4<br />
|pages=328-330<br />
|url=https://www.researchgate.net/publication/5370953_Circumcision_affects_glans_penis_vibration_perception_threshold<br />
|quote=<br />
|pubmedID=18481425<br />
|pubmedCID=<br />
|DOI=<br />
|date=2008-09-14<br />
|accessdate=2019-09-30<br />
}}</ref><br />
<br />
==Generally recognized benefits of foreskin restoration==<br />
<br />
1. ''An end to tight and painful erections''. Increasing the quantity of skin results in longer skin and less tension when the penis is erect.<br />
<br />
2. ''Gliding mechanism'': the [[gliding action]] is beneficial because it facilitates [[masturbation]] and sex by reducing friction and providing a stimulating sheath that pleasurably slips back and forth over the [[glans]], thereby decreasing the need for artificial lubrication. The motion of the penile skin by the gliding action stimulates the nerves in the skin which are sensitive to motion and stretching.<br />
<br />
3. ''Feeling whole'': The presence of the restored foreskin causes one to look and feel whole, complete, and normal.<br />
<br />
4. ''Coverage of the glans'': this is beneficial because (a) it protects the glans from uncomfortably rubbing up against things, and (b) by keeping the glans moist and protected, it leads to dekeratinization, which subsequently increases sensation.<br />
<br />
5. ''More sensation'': It is true that non-surgical foreskin restoration cannot restore the [[ridged band]] or the [[frenulum]], but a restored foreskin does have some nerves in it. Those nerves are stimulated by the gliding of the foreskin, so it is quite pleasurable to have a restored foreskin. Some men who were circumcised as adults and subsequently restored have estimated that they got back about 80 percent of what they had lost in sensation.<br />
<br />
6. ''Increased comfort'': The head of one's [[penis]] is protected by [[foreskin]] as nature intended.<br />
<br />
7. ''Decreased'' [[keratinization]] of the [[glans penis]].<br />
<br />
8. ''Esthetics'': One's penis approaches the Greek ideal of male beauty.<ref>{{REFweb<br />
|url=http://acroposthion.com/ancient-greeks-and-the-foreskin/<br />
|title=Ancient Greeks & the Foreskin<br />
|trans-title=<br />
|language=<br />
|last=<br />
|first=<br />
|publisher=<br />
|website=Acroposthion<br />
|date=2017<br />
|accessdate=2010-10-02<br />
|format=<br />
|quote=The ancient Greeks were against the practice of circumcising their males and possessing a generous foreskin was a significantly important part of their culture.<br />
}}</ref> The [[circumcision scar]] is now completely concealed by the longer skin which relocates the scar to the inside. As the restored foreskin gets longer and extends beyond the glans penis, the [[acroposthion]] is reformed.<br />
<br />
== Emotional, psychological, and psychiatric benefits ==<br />
<br />
Foreskin restoration has been reported as having beneficial emotional results in some men,<ref name="Greer"/><ref name="Goodwin"/><ref name="Penn">{{REFjournal<br />
|last=Penn<br />
|first=Jack<br />
|title=Penile Reform<br />
|journal=British Journal of Plastic Surgery<br />
|volume=16<br />
|issue=287-8<br />
|pages=<br />
|url=http://www.cirp.org/library/restoration/penn1/<br />
|quote=<br />
|pubmedID=14042759<br />
|pubmedCID=<br />
|DOI=10.1016/S0007-1226(63)80123-X<br />
|date=1963<br />
|accessdate=2019-09-29<br />
}}</ref><ref name="Boyle">{{REFjournal<br />
|last=Boyle<br />
|first=G.J.<br />
|last2=Goldman<br />
|first2=R.<br />
|author2-link=Ronald Goldman<br />
|last3=Svoboda<br />
|first3=J.S.<br />
|last4=Fernandez<br />
|first4=E.<br />
|title=Male Circumcision: Pain, Trauma and Psychosexual Sequelae<br />
|journal=Journal of Health Psychology<br />
|volume=7<br />
|issue=3<br />
|pages=329-343<br />
|url=http://www.cirp.org/library/psych/boyle6/<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.1177/1359105302007003225<br />
|date=2002<br />
|accessdate=2019-09-29<br />
}}</ref> and has been proposed as a treatment for negative feelings in some adult men about their involuntary infant circumcisions.<ref name="watson2017">{{REFjournal<br />
|last=Watson<br />
|first=Lindsay<br />
|author-link=<br />
|last2=Golden<br />
|first2=Tom<br />
|author2-link=<br />
|etal=no<br />
|title=Male circumcision grief: effective and ineffective therapeutic approaches<br />
|trans-title=<br />
|language=<br />
|journal=New Male Studies: An International Journal<br />
|location=<br />
|date=2017<br />
|volume=6<br />
|issue=2<br />
|pages=109-25<br />
|url=http://newmalestudies.com/OJS/index.php/nms/article/view/261/317<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|accessdate=2019-12-12<br />
}}</ref><br />
<br />
== Foreskin Coverage Index ==<br />
<br />
In an effort to provide men partaking in foreskin restoration a reference to the extent of their circumcision skin loss, various foreskin coverage indexes have been created. The latest and most complete example is the [https://foreskinrestoration.men/foreskin-restoration-coverage-index/ ADI Coverage Index.] The index depicts a range of penises in both the flaccid and erect state from 0 to 10, with 0 being the tightest circumcision and 10 the longest foreskin. Men undergoing foreskin restoration can chart their progress using the coverage index (CI).<br />
<br />
== Literature ==<br />
<br />
Books, websites and numerous articles have been published about foreskin restoration. See our compiled list of [[literature about foreskin restoration]].<br />
<br />
== Regeneration of the foreskin ==<br />
<br />
Recently there has been growing interest in regenerative medicine as a means to regenerate the human male foreskin. This option, unlike non-surgical foreskin restoration, would result in a true human male foreskin being regrown. <br />
<br />
In early 2010, [[Foregen]], a non-profit organization dedicated to funding a clinical trial for the purposes of regrowing the human male foreskin, had been founded. A clinical trial had been scheduled for late 2010, but there were insufficient donations to follow through.<ref>{{REFjournal<br />
|last=<br />
|first=<br />
|title=Foregen<br />
|journal=<br />
|volume=<br />
|issue=<br />
|pages=<br />
|url=http://www.foregen.org/blog/?p=84<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=2010-09-21<br />
|accessdate=2010-11-28<br />
}}</ref><br />
<br />
The proposed method would involve placing the patient under general anesthesia. The penile skin would be opened at the circumcision scar, while the scar tissue is surgically debrided. A biomedical solution would then be applied to both ends of the wound, causing the foreskin to regenerate with the DNA in the patient's own cells. A biodegradable scaffold would be used to offer support for the regenerating foreskin.<ref>{{REFjournal<br />
|last=<br />
|first=<br />
|title=Clinical Regen Trial<br />
|journal=<br />
|volume=<br />
|issue=<br />
|pages=<br />
|url=http://www.foregen.org/projects/<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=2010-06-23<br />
|accessdate=2010-06-23<br />
}}</ref><br />
<br />
In 2018, Foregen announced the creation of a "decellularized extracellular matrix–based biomaterial scaffold" for the purpose of regenerating human foreskin.<ref>{{REFjournal<br />
|last=Purpura<br />
|first=V.<br />
|last2=Bondioli<br />
|first2=E.<br />
|last3=Cunningham<br />
|first3=E.J.<br />
|etal=yes<br />
|title=The development of a decellularized extracellular matrix–based biomaterial scaffold derived from human foreskin for the purpose of foreskin reconstruction in circumcised males<br />
|journal=Journal of Tissue Engineering<br />
|date=2018<br />
|volume=9<br />
|issue=<br />
|pages=1-11<br />
|url=https://journals.sagepub.com/doi/full/10.1177/2041731418812613<br />
|quote=<br />
|pubmedID=30622692<br />
|pubmedCID=PMC6304708<br />
|DOI=10.1177/2041731418812613<br />
|accessdate=2019-09-25<br />
}}</ref><br />
<br />
Foreskin regeneration is only theoretical as of 2020. No foreskin has ever been regenerated. There is no assurance that foreskin regeneration would actually be successful if attempted.<br />
<br />
{{SEEALSO}}<br />
* [[Circumcision]]<br />
* [[Epispasm]]<br />
* [[Foreskin]]<br />
* [[Gliding action]]<br />
* [[Penis]]<br />
* [[Restoration]]<br />
* [[Ridged band]]<br />
* [[Psychological issues of male circumcision]]<br />
* [[Basics of foreskin restoration]]<br />
* [[Surgical foreskin restoration]]<br />
* [[Literature about foreskin restoration]]<br />
* [[:Category:Foreskin restoration devices]]<br />
* [[:Category:Films about foreskin restoration]]<br />
<br />
{{LINKS}}<br />
* [http://www.norm.org NORM - National Organization of Restoring Men (U.S.)]<br />
* [http://www.cirp.org/pages/restore.html CIRP Foreskin restoration for circumcised males]<br />
* [https://foreskinrestoration.men/ Foreskin restoration information website]<br />
* {{REFweb<br />
|url=https://www.doctorsopposingcircumcision.org/for-professionals/foreskin-restoration/<br />
|title=Non-surgical foreskin restoration<br />
|last=<br />
|first=<br />
|publisher=<br />
|website=Doctors Opposing Circumcision<br />
|date=2019-02<br />
|accessdate=2019-09-28<br />
|format=<br />
|quote=<br />
}}<br />
* [http://www.norm-uk.org NORM-UK - National Organization of Restoring Men (UK)]<br />
* {{REFjournal<br />
|last=Anonymous<br />
|first=<br />
|author-link=<br />
|etal=no<br />
|title=The joy of uncircumcising<br />
|trans-title=<br />
|language=<br />
|journal=BMJ<br />
|location=<br />
|date=1994-09-10<br />
|volume=309<br />
|issue=<br />
|pages=676-7<br />
|url=http://www.cirp.org/library/restoration/anonymous1/<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.1136/bmj.309.6955.676a <br />
|accessdate=2019-11-26<br />
}}<br />
<br />
* {{REFnews<br />
|title=Many men bitterly regret being circumcised. A new method allows them to repair the damage.<br />
|url=https://www.independent.co.uk/life-style/health-and-families/health-news/how-to-reverse-the-irreversible-1338650.html<br />
|last=Carter<br />
|first=Rica<br />
|last2=Rockhall<br />
|first2=Anna<br />
|publisher=The Independent<br />
|website=www.independent.co.uk<br />
|date=1996-06-25<br />
|accessdate=2020-06-23<br />
|quote=Foreskin restoration is a slow process of stretching the penile skin over the naked glans, and can take several years. Many men, however, report an improvement in comfort and sensitivity after only a couple of weeks.<br />
}}<br />
<br />
* {{REFweb<br />
|url=https://www.yourwholebaby.org/restoration<br />
|archived=<br />
|title=Restoration<br />
|trans-title=<br />
|language=<br />
|last=<br />
|first=<br />
|author-link=<br />
|publisher=Your Whole Baby<br />
|website=www.yourwholebaby.org<br />
|date=<br />
|accessdate=2020-05-20<br />
|format=<br />
|quote=<br />
}}<br />
* [http://www.iomfats.org/resources/restoring/media/restoring_faq.pdf My responses to a few Frequently Asked Questions about Non-Surgical Foreskin Restoration], Roy M. Payne; Fryer, Leo (2001-03)<br />
* {{REFjournal<br />
|last=Brandes<br />
|first=S.B.<br />
|last2=McAninch<br />
|first2=J.W.<br />
|title=Surgical methods of restoring the prepuce: a critical review<br />
|journal=BJU Int<br />
|volume=83<br />
|issue=Suppl. 1<br />
|pages=109-113<br />
|url=https://onlinelibrary.wiley.com/doi/epdf/10.1046/j.1464-410x.1999.0830s1109.x<br />
|quote=<br />
|pubmedID=10349422<br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410x.1999.0830s1109.x<br />
|date=1999<br />
|accessdate=2019-09-30<br />
}}<br />
* {{REFweb<br />
|url=https://www.reddit.com/r/foreskin_restoration/<br />
|title=REDDIT foreskin restoration sub-reddit<br />
|last=<br />
|first=<br />
|accessdate=2019-11-16<br />
}}<br />
<br />
* {{REFweb<br />
|url=http://wasnotmychoice.com/foreskin-restoration/<br />
|archived=<br />
|title=Foreskin Restoration<br />
|trans-title=<br />
|language=English<br />
|last=<br />
|first=<br />
|author-link=<br />
|publisher=<br />
|website=http://wasnotmychoice.com<br />
|date=<br />
|accessdate=2020-08-28<br />
|format=<br />
|quote=<br />
}}<br />
<br />
{{REF}}<br />
<br />
[[Category:Foreskin restoration]]<br />
[[Category:Judaism]]<br />
[[Category:From Intactipedia]]<br />
[[Category:From IntactWiki]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Foreskin_restoration&diff=16255Foreskin restoration2020-09-28T02:50:22Z<p>WikiModEn4: Add coverage index</p>
<hr />
<div>{{GraphicWarning}}<br />
[[Image:Restoration before after.JPG |thumbnail|right|300px| A human penis circumcised at birth, before and after 42 months of non-surgical restoration.]]<br />
<br />
'''Foreskin restoration''' refers to the process of expanding the residual skin on the circumcised [[penis]] by non-surgical means in order to recreate the [[foreskin]] which was removed in [[circumcision]].<ref name="wisdom">{{REFjournal<br />
|last=Wisdom<br />
|first=Travis<br />
|author-link=<br />
|etal=no<br />
|title=Constructing phallic beauty: Foreskin restoration, genital cutting and circumcisionism<br />
|trans-title=<br />
|language=<br />
|journal=Brill<br />
|location=<br />
|date=2014<br />
|volume=<br />
|issue=<br />
|pages=93-134<br />
|url=https://www.academia.edu/7648223/Constructing_Phallic_Beauty_Foreskin_Restoration_Genital_Cutting_and_Circumcisionism?email_work_card=view-paper<br />
|archived=<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.1163/9781848881259_007<br />
|accessdate=2020-08-16<br />
}}</ref> It can also refer to the process of [[Tissue expansion| expanding existing skin]] in a penis whose foreskin is abnormally short or non-existent (see [[aposthia]]).<ref name="collier2011">{{REFjournal<br />
|last=Collier<br />
|first=Roger<br />
|author-link=<br />
|title=Whole again: the practice of foreskin restoration<br />
|trans-title=<br />
|language=<br />
|journal=CMAJ<br />
|date=2011<br />
|volume=183<br />
|issue=18<br />
|pages=2092-3<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3255154/<br />
|quote=<br />
|pubmedID=3255154<br />
|pubmedCID=22083672<br />
|DOI=10.1503/cmaj.109-4009<br />
|accessdate=<br />
}}</ref><br />
<br />
Foreskin restoration can be achieved via surgical and/or non-surgical means. Men take up foreskin restoration to restore [[sensation]] to the [[glans penis]] and to restore the [[gliding action]] of the natural penis. Another reason for restoring is a desire to create the natural appearance of an intact penis with the [[foreskin]] covering the [[glans penis]]. Foreskin restoration techniques are most commonly undertaken by men who resent having been [[circumcision|circumcised]] as children, or who have sustained an injury. They are also used by intact men who simply desire a longer foreskin.<br />
<br />
== History ==<br />
<br />
Foreskin stretching (called "uncircumcision," or ''[[epispasm]]'') appears to have been a common practice among Hellenized Jewish men in Hellenistic and Roman societies,<ref name="Rubin">{{REFjournal<br />
|last=Rubin<br />
|first=Jody P.<br />
|title=Celsus's Decircumcision Operation<br />
|journal=Urology<br />
|volume=16<br />
|issue=1<br />
|pages=121-124<br />
|url=http://www.cirp.org/library/restoration/rubin/<br />
|quote=<br />
|pubmedID=6994325<br />
|pubmedCID=<br />
|DOI=10.1016/0090-4295(80)90354-4<br />
|date=1980-07<br />
|accessdate=<br />
}}</ref> from at least as early as the 2nd century {{#tip-text:BCE|Before Common Era, an alternative to BC}}.<ref>{{REFbook<br />
|last=Glick<br />
|first=Leonard<br />
|author-link=Leonard B. Glick<br />
|year=2005<br />
|title=Marked in Your Flesh<br />
|url=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter="This Is My Covenant", Circumcision in the World of Temple Judaism<br />
|page=31<br />
|location=New York, New York<br />
|publisher=Oxford University Press<br />
|isbn=0-19-517674-X<br />
|quote=Foreskin stretching (called "uncircumcision," or epispasm) appears to have been a common practice among Hellenized Jewish men...<br />
|accessdate=2011-09-23<br />
|note=<br />
}}</ref><br />
<br />
Key features of Hellenistic culture were athletic exercises in gymnasia and athletic performances in public arenas, where men appeared in the nude. While the penis sheathed in an intact foreskin was normal and acceptable, ancient Greeks and their Hellenistic successors considered the circumcised penis to be offensive, as it was perceived as a vulgar imitation of erection, unfit for public display. The ancient Greeks and their Hellenistic successors considered the "ideal prepuce" to be long, tapered, and "well-proportioned." Removing it was considered mutilation. Men with short foreskins, a condition known as ''lypodermos'', would wear a leather cord called a ''kynodesme'' to prevent its accidental exposure.<ref>{{REFjournal<br />
|last=Hodges<br />
|first=Frederick M.<br />
|author-link=Frederick M. Hodges<br />
|title=The Ideal Prepuce in Ancient Greece and Rome: Male Genital Aesthetics and Their Relation to Lipodermos, Circumcision, Foreskin Restoration, and the Kynodesme<br />
|journal=Bulletin of the History of Medicine<br />
|date=2001-09<br />
|note=Fall 2001<br />
|volume=75<br />
|issue=3<br />
|pages=375-405<br />
|url=http://www.cirp.org/library/history/hodges2/<br />
|quote=<br />
|pubmedID=11568485<br />
|pubmedCID=<br />
|DOI=<br />
|accessdate=2019-09-30<br />
}}</ref><br />
<br />
The sight of circumcised genitals at public baths or gymnasia would inspire laughter and ridicule. Jewish men who wished to gain acceptance in the larger social world gave themselves a presentable appearance by pulling the remaining foreskin forward as far as possible, and keeping it under enough tension to encourage permanent stretching toward its original length. Using a fibular pin or a cord, they pierced the front of the remaining foreskin, drew it forward, and fixed it in place; sometimes they would attach a weight to maintain tension. Over time the foreskin stretched and restored at least some of the appearance of an intact organ.<ref>{{REFbook<br />
|last=Glick<br />
|first=Leonard<br />
|author-link=Leonard B. Glick<br />
|year=2005<br />
|title=Marked in Your Flesh<br />
|url=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter="This Is My Covenant", Circumcision in the World of Temple Judaism<br />
|page=31<br />
|location=New York, New York<br />
|publisher=Oxford University Press<br />
|isbn=0-19-517674-X<br />
|quote=...some, eager for acceptance in the larger social world, gave themselves a presentable appearance by pulling the remaining foreskin forward...<br />
|accessdate=2011-09-23<br />
|note=<br />
}}</ref> Up until the 2th century, [[Jewish circumcision]] involved only partial foreskin removal. Rabbis of the 2th century mandated peri’ah, or the complete ablation of the foreskin in order to prevent Jewish men from engaging in foreskin restoration.<ref>{{REFbook<br />
|last=Glick<br />
|first=Leonard<br />
|author-link=Leonard B. Glick<br />
|year=2005<br />
|title=Marked in Your Flesh<br />
|url=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter="This Is My Covenant", Circumcision in the World of Temple Judaism<br />
|page=31<br />
|location=New York, New York<br />
|publisher=Oxford University Press<br />
|isbn=0-19-517674-X<br />
|quote=For obvious reasons this was anathema to the rabbis: tantamount to rejection of Judaism and defiance of rabbinic authority.<br />
|accessdate=2011-09-23<br />
|note=<br />
}}</ref><br />
<br />
During World War II, some European Jews sought out underground foreskin restoration operations as a way to escape Nazi persecution.<ref name="Tushmet">{{REFjournal<br />
|last=Tushmet<br />
|first=Leonard<br />
|title=Uncircumcision<br />
|journal=Medical Times<br />
|volume=93<br />
|issue=6<br />
|pages=588-593<br />
|url=http://www.cirp.org/library/restoration/tushmet1/<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=1965<br />
|accessdate=<br />
}}</ref><br />
<br />
The practice of foreskin restoration was revived in the late twentieth century using modern materials and techniques. In 1982 a group called Brothers United for Future Foreskins ([[BUFF]]) was formed, which publicized the use of tape in non-surgical restoration methods. Later in 1991, another group called UNCircumcising Information and Resources Centers ([[UNCIRC]]) was formed.<ref name="Bigelow - uncirc">{{REFjournal<br />
|last=Bigelow<br />
|first=Jim<br />
|author-link=Jim Bigelow<br />
|title=Uncircumcising: undoing the effects of an ancient practice in a modern world<br />
|journal=Mothering<br />
|volume=Summer<br />
|issue=<br />
|pages=121-124<br />
|url=http://www.cirp.org/library/restoration/bigelow1/<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=1994<br />
|accessdate=<br />
}}</ref><br />
<br />
The National Organization of Restoring Men ([[NORM]]) was founded in 1989 in San Francisco, as a non-profit support group for men restoring the appearance of a foreskin. It was originally known as RECAP, an acronym for the phrase Recover A Penis. In 1994 UNCIRC was incorporated into this group.<ref name="NORM history">{{REFweb<br />
| quote=<br />
| url=http://www.norm.org/history.html<br />
| title=NORM - History<br />
| last=Griffiths<br />
| first=R. Wayne<br />
| publisher=<br />
| work=<br />
| date=2006<br />
| accessdate=2019-09-30<br />
}}</ref> Since its founding, several NORM chapters have been founded throughout the United States, as well as internationally in Canada, the United Kingdom, Australia, New Zealand, and Germany.<br />
<br />
== Nonsurgical techniques ==<br />
<br />
[[Image:Foreskin restoration diagram.jpg |thumbnail|right|550px| A series of steps for non-surgical foreskin restoration. ]]<br />
<br />
Nonsurgical foreskin restoration is the most commonly used method of foreskin restoration. It is accomplished through [[tissue expansion]] and involves pulling on the remnants of the foreskin. Both the skin of the penile shaft and the mucosal inner lining of the foreskin, if any remains after circumcision, may be expanded. The skin is pulled forward over the glans, and tension is applied manually, by using weights or elastic straps. In the latter two cases a device must be attached to the skin; surgical tape is often used.<br />
<br />
[[Image:Tlctugger applied.jpg|thumbnail|left|150px| TLCTugger device applied to a circumcised penis for non-surgical foreskin restoration.]]<br />
<br />
An example of a device using elastic straps is the T-Tape method, which was developed in the 1990s with the idea of enabling restoration to take place more rapidly. Many specialized [http://intactwiki.org/wiki/Category:Foreskin_restoration_devices restoration devices] (like the [[TLC-X|TLC Tugger]] shown in the picture) that grip the skin with or without tape are also commercially available. Tension from these devices may be applied by weights or elastic straps, by pushing the skin forward on the penis, or by a combination of these methods.<br />
<br />
The amount of tension produced by any method must be adjusted to avoid injury, pain or discomfort, and provides a limit on the rate at which new tissue can be grown. There is a risk of damaging tissues if excessive tension is used, or if tension is applied for too long. Websites about foreskin restoration vary in their recommendations, from suggesting a regimen of moderate amounts of tension applied for several hours a day,<ref name="NORM regimen">{{REFweb<br />
| quote=<br />
| url=http://www.norm.org/regimen.html<br />
| title=NORM - Recommended Restoration Regimen<br />
| last=Griffiths<br />
| first=R. Wayne<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2006-08-27<br />
}}</ref> to recommending periods of higher tension applied for only a few minutes per day.<ref name="FRC manual">{{REFweb<br />
| quote=<br />
| url=http://foreskinrestorationchat.info/manualtugging.html<br />
| title=Foreskin Restoration Chat Manual Restoration Method and Guide<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2006-08-27<br />
}}</ref><ref name="Doug's site">{{REFweb<br />
| quote=<br />
| url=http://pages.suddenlink.net/manual_methods/<br />
| title=Manual Methods of Foreskin Restoration<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2007-07-19<br />
}}</ref><br />
<br />
Applying tension to tissue has long been known to stimulate [[mitosis]], and research shows that expanded human tissues have the attributes of the original tissue.<ref name="Cordes">{{REFjournal<br />
|last=Cordes<br />
|first=Stephanie<br />
|last2=Calhoun<br />
|first2=Karen H.<br />
|last3=Quinn<br />
|first3=Francis B.<br />
|title=Tissue Expanders<br />
|journal=University of Texas Medical Branch Department of Otolaryngology Grand Rounds<br />
|volume=<br />
|issue=<br />
|pages=<br />
|url=http://www.utmb.edu/otoref/Grnds/tissue-expand.html<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=1997-10-15<br />
|accessdate=<br />
}}</ref> Unlike conventional skin expansion techniques, however, the process of nonsurgical foreskin restoration may take several years to complete. The time required depends on the amount of skin available to expand, the amount of skin desired in the end, and the regimen of stretching methods used. Patience and dedication are needed; support groups exist to help with these (see External links section). The act of stretching the skin is often described informally as "tugging" in these groups, especially those on the Internet.<br />
<br />
Intact men who would like to have a longer foreskin may use these same techniques of [[tissue expansion]] to lengthen a short [[foreskin]]. Benefits include improved protection of the [[glans penis]], improved [[gliding action]], and improved physical appearance.<br />
<br />
See [[Basics of foreskin restoration]]<br />
<br />
== Surgical techniques ==<br />
<br />
Surgical techniques of foreskin restoration are historical. They are seldom, if ever, used today because they have not given good results.<br />
<br />
Surgical methods of foreskin restoration, sometimes known as foreskin reconstruction, usually involve a method of grafting skin onto the distal portion of the penile shaft. The grafted skin is typically taken from the scrotum, which contains the same smooth muscle (known as [[dartos|dartos fascia]]) as does the skin of the penis. One method involves a four stage procedure in which the shaft is buried in the scrotum for a period of time.<ref name="Greer">{{REFjournal<br />
|last=Greer<br />
|first=Donald M.<br />
|last2=Mohl<br />
|first2=Paul C.<br />
|last3=Sheley<br />
|first3=Kathy A.<br />
|title=A technique for foreskin reconstruction and some preliminary results<br />
|journal=The Journal of Sex Research<br />
|volume=18<br />
|issue=4<br />
|pages=324-330<br />
|url=http://www.cirp.org/library/restoration/greer1/<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.1080/00224498209551158<br />
|date=1982<br />
|accessdate=<br />
}}</ref> Such techniques are costly, and have the potential to produce unsatisfactory results or serious complications related to the skin graft.<br />
<br />
British Columbia resident Paul Tinari was held down and circumcised at eight years old, in what he stated was "a routine form of punishment" for [[masturbation]] at residential schools. Following a lawsuit, Tinari's surgical foreskin restoration was covered by the British Columbia Ministry of Health. The plastic surgeon who performed the restoration was the first in Canada to have done such an operation, and used a technique similar to that described above.<ref name="Tyee article">{{REFjournal<br />
|last=Euringer<br />
|first=Amanda<br />
|title=BC Health Pays to Restore Man's Foreskin<br />
|journal=The Tyee<br />
|volume=<br />
|issue=<br />
|pages=<br />
|url=http://thetyee.ca/News/2006/07/25/Circumcision/<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=2006-07-25<br />
|accessdate=<br />
}}</ref><ref name="NRM article">{{REFjournal<br />
|last=Laliberté<br />
|first=Jennifer<br />
|title=BC man's foreskin op a success<br />
|journal=National Review of Medicine<br />
|volume=3<br />
|issue=12<br />
|pages=<br />
|url=http://www.nationalreviewofmedicine.com/issue/2006/06_30/3_patients_practice01_12.html<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=2006-06-30<br />
|accessdate=<br />
}}</ref><br />
<br />
See [[Surgical foreskin restoration]]<br />
<br />
== Results ==<br />
<br />
Results of surgical foreskin restoration are much faster, but are often described as unsatisfactory, and most restoration groups advise against them.<br />
<br />
Results of non-surgical methods vary widely, and depend on such factors as the amount of skin present at the start of the restoration, degree of commitment, technique, and the individual's body. Foreskin restoration successfully restores sensitivity to [[glans penis]] and restores the [[gliding action]]. Certain parts of the natural foreskin cannot be reformed. In particular, the [[ridged band]], a nerve-bearing tissue structure extending around the penis just inside the tip of the foreskin,<ref name="Taylor interview">{{REFweb<br />
| quote=<br />
| url=http://www.intact.ca/taylor.html<br />
| title=Interview with John Taylor<br />
| last=Taylor<br />
| first=John R.<br />
| publisher=<br />
| work=<br />
| date=1997-02-04<br />
| accessdate=2007-08-26<br />
}}</ref><ref name=Joy-frenar>{{REFbook<br />
|last=Bigelow<br />
|first=Jim<br />
|author-link=Jim Bigelow<br />
|year=<br />
|title=The Joy of Uncircumcising!<br />
|url=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=<br />
|page=13<br />
|location=<br />
|publisher=<br />
|isbn=096304821X<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref> which helps to contract the tip of the foreskin so that it remains positioned over the glans, cannot be recreated. Restored foreskins can appear much looser at the tip and some men report difficulty in keeping the glans covered. Surgical "touch-up" procedures exist to reduce the orifice of the restored foreskin, recreating the tightening function of the band of muscle fibers near the tip of the foreskin, though they have not proven successful in every case.<ref name=Joy-touchup>{{REFbook<br />
|last=Bigelow<br />
|first=Jim<br />
|author-link=Jim Bigelow<br />
|year=<br />
|title=The Joy of Uncircumcising!<br />
|url=<br />
|editor=<br />
|edition=1998<br />
|volume=<br />
|chapter=<br />
|pages=188-192<br />
|location=<br />
|publisher=<br />
|isbn=096304821X<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref> A loose effect can also be alleviated by creating increased length, but requires a longer commitment to the restoration program. In addition, several websites claim that the use of O-rings during the restoration program can train the skin to maintain a puckered shape.<br />
<br />
As the shaft skin expands and gets longer the circumcision scar will travel down toward the tip and eventually turn under and be concealed inside the foreskin.<br />
<br />
== Physical aspects ==<br />
<br />
The natural foreskin has three principal components, in addition to blood vessels, nerves and connective tissue: [[skin]], which is exposed exteriorely; [[mucous membrane]], which is the inside surface in contact with the [[glans penis]] when the [[penis]] is flaccid; and a layer of [[Dartos| muscle]] fibers under the foreskin. The [[ridged band]] is just inside the tip of the [[foreskin]].<br />
<br />
Generally, the skin grows more readily in response to stretching than does the mucous membrane. The ring of muscle which normally holds the foreskin closed is completely removed in the majority of circumcisions and cannot be regrown, so the covering resulting from stretching techniques is usually looser than that of a natural foreskin. According to some observers it is difficult to distinguish a restored foreskin from a natural foreskin because restoration produces a "nearly normal-appearing prepuce."<ref name="Goodwin">{{REFjournal<br />
|last=Goodwin<br />
|first=Willard E.<br />
|title=Uncircumcision: A Technique For Plastic Reconstruction of a Prepuce After Circumcision<br />
|journal=J Urol<br />
|volume=144<br />
|issue=5<br />
|pages=1203-1205<br />
|url=http://www.cirp.org/library/restoration/goodwin1/<br />
|quote=<br />
|pubmedID=2231896<br />
|pubmedCID=<br />
|DOI=<br />
|date=1990<br />
|accessdate=<br />
}}</ref><br />
<br />
Nonsurgical foreskin restoration does not restore portions of the [[Frenulum| frenulum]] or the [[ridged band]] removed during circumcision. Although not commonly performed, there are surgical [http://intactwiki.org/wiki/Category:Foreskin_restoration_touch-up_surgeries "touch-up" techniques] that can re-create some of the functionality of the frenulum and dartos muscle.<ref>{{REFbook<br />
|last=Bigelow<br />
|first=Jim<br />
|author-link=Jim Bigelow<br />
|year=<br />
|title=The Joy of Uncircumcising!<br />
|url=<br />
|work=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=<br />
|pages=188-191<br />
|location=<br />
|publisher=<br />
|isbn=<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref><br />
<br />
The process of foreskin restoration seeks to regenerate some of the tissue removed by circumcision by expansion of residual tissue, as well as providing coverage of the glans. According to research, the [[foreskin]] comprises over one-half of the skin and mucosa of the human penis.<ref>{{REFjournal<br />
|last=Taylor<br />
|first=J.R.<br />
|author-link=John R. Taylor<br />
|first2=A.P.<br />
|last2=Lockwood<br />
|first3=A.J.<br />
|last3=Taylor<br />
|title=The prepuce: Specialized mucosa of the penis and its loss to circumcision<br />
|journal=Brit J Urol<br />
|date=1996-02-01<br />
|volume=77<br />
|issue=<br />
|pages=291-295<br />
|url=http://www.cirp.org/library/anatomy/taylor/<br />
|quote=<br />
|pubmedID=8800902 <br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410x.1996.85023.x<br />
|accessdate=<br />
}}</ref><br />
<br />
By growing more penile skin, foreskin restorers recover the skin mobility that was eliminated by their circumcision. The ability to [[gliding action|glide the skin of the penis over the glans]] constitutes a mechanical component of the stimulation mechanism of the penis.<br />
<br />
In some men, foreskin restoration may alleviate certain problems they attribute to their circumcisions. Such problems, as reported to an anti-circumcision group by men circumcised in infancy or childhood, include prominent [[Circumcision scar|scarring]] (33%), insufficient penile skin for comfortable erection (27%), erectile curvature from uneven skin loss (16%), and pain and bleeding upon erection/manipulation (17%). The poll also asked about awareness of or involvement in foreskin restoration, and included an open comment section. Many respondents and their wives "reported that restoration resolved the unnatural dryness of the circumcised penis, which caused abrasion, pain or bleeding during intercourse, and that restoration offered unique pleasures, which enhanced sexual intimacy."<ref name="Hammond">{{REFjournal<br />
|last=Hammond<br />
|first=T.<br />
|author-link=Tim Hammond<br />
|title=A Preliminary Poll of Men Circumcised in Infancy or Childhood<br />
|journal=BJU Int<br />
|volume=83<br />
|issue=Suppl. 1<br />
|pages=85-92<br />
|url=http://www3.interscience.wiley.com/cgi-bin/fulltext/119091408/PDFSTART<br />
|quote=<br />
|pubmedID=10349419<br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410x.1999.0830s1085.x<br />
|date=1999<br />
|accessdate=<br />
}}</ref><br />
<br />
Some men who have undertaken foreskin restoration report a visibly smoother glans, which some of these men attribute to decreased levels of [[keratinization]] following restoration. <br />
<br />
<!--Several studies have suggested that the glans is equally sensitive in circumcised and uncircumcised males,<ref name="masters">{{REFbook<br />
|last=Masters<br />
|first=William H.<br />
|last2=Johnson<br />
|first2=Virginia E.<br />
|year=1966<br />
|title=Human Sexual Response<br />
|url=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=<br />
|pages=189-191<br />
|location=Boston<br />
|publisher=Little, Brown & Co<br />
|isbn=0-316-54987-8<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}} (excerpt accessible [http://www.circs.org/library/masters/ here])</ref><ref name="bleustein">{{REFjournal<br />
|last=Bleustein<br />
|first=Clifford B.<br />
|first2=James D.<br />
|last2=Fogarty<br />
|first3=Haftan<br />
|last3=Eckholdt<br />
|first4=Joseph C.<br />
|last4=Arezzo<br />
|first5=Arnold<br />
|last5=Melman<br />
|title=Effect of neonatal circumcision on penile neurologic sensation<br />
|journal=Urology<br />
|volume=65<br />
|issue=4<br />
|pages=773-777<br />
|url=<br />
|quote=<br />
|pubmedID=15833526<br />
|pubmedCID=<br />
|DOI=10.1016/j.urology.2004.11.007<br />
|date=2005-04<br />
|accessdate=<br />
}}</ref><ref name = "bleustein2003">{{REFconference<br />
|place=Chicago, Illinois<br />
|title=American Urological Association 98th Annual Meeting<br />
|url=<br />
|last=Bleustein<br />
|first=Clifford B.<br />
|coauthors=Haftan Eckholdt, Joseph C. Arezzo and Arnold Melman<br />
|source=Effects of Circumcision on Male Penile Sensitivity<br />
|datefrom=2003-04-26<br />
|dateto=2003-05-01<br />
|accessdate=2019-09-29<br />
}}</ref><ref name="payne2007">{{REFjournal<br />
|last=Payne<br />
|first=Kimberley<br />
|last2=Thaler<br />
|first2=Lea<br />
|last3=Kukkonen<br />
|first3=Tuuli<br />
|last4=Carrier<br />
|first4=Serge<br />
|last5=Binik<br />
|first5=Yitzchak<br />
|author5-link=Irving M. Binik<br />
|title=Sensation and Sexual Arousal in Circumcised and Uncircumcised Men<br />
|journal=J Sex Med<br />
|volume=4<br />
|issue=3<br />
|pages=667-674<br />
|url=http://www.blackwell-synergy.com/doi/abs/10.1111/j.1743-6109.2007.00471.x<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.1111/j.1743-6109.2007.00471.x<br />
|date=2007-05<br />
|accessdate=2019-09-30<br />
}}</ref> <br />
<br />
The work of Masters & Johnson (1966) has been shown to have severe methodological flaws that render their conclusions inaccurate and essentially useless. The work of Bleustein (2003) and Payne (2007) is similarly flawed by methodological faults.<br />
<br />
Although Kirby (1994) suggested that the perceived sensitivity gains of the glans reported by some men are psychological, with glans sensitivity itself being unaffected.<ref>{{REFjournal<br />
|last=Kirby<br />
|first=R.S.<br />
|title=The Joy of Uncircumcising! Restore your birthright and maximize sexual pleasure<br />
|journal=BMJ<br />
|date=1994-09-10<br />
|volume=309<br />
|issue=<br />
|page=679<br />
|url=http://bmj.bmjjournals.com/cgi/content/full/309/6955/679/a<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.1136/bmj.309.6955.679a<br />
|accessdate=2019-9-29<br />
}}</ref>--> <br />
Sorrells (2007) ''et al'' and Yang ''et al'' (2008) have reported empirical data that proves there is more sensation in intact males.<ref name="sorrels">{{REFjournal<br />
|last=Sorrells<br />
|first=<br />
|title=Fine-touch pressure thresholds in the adult penis<br />
|journal=BJU Int<br />
|volume=99<br />
|issue=4<br />
|pages=864-869<br />
|url=http://www3.interscience.wiley.com/cgi-bin/fulltext/118508429/PDFSTART<br />
|quote=<br />
|pubmedID=1737884<br />
|pubmedCID=<br />
|DOI=<br />
|date=2007-04<br />
|accessdate=<br />
}}</ref><ref name="yang">{{REFjournal<br />
|last=Yang<br />
|first=D.M.<br />
|last2=Lin<br />
|first2=H.<br />
|last3=Zhang<br />
|first3=B.<br />
|last4=Guo<br />
|first4=W.<br />
|title=Circumcision affects glans penis vibration perception threshold<br />
|journal=Zhonghua Nan Ke Xue<br />
|volume=14<br />
|issue=4<br />
|pages=328-330<br />
|url=https://www.researchgate.net/publication/5370953_Circumcision_affects_glans_penis_vibration_perception_threshold<br />
|quote=<br />
|pubmedID=18481425<br />
|pubmedCID=<br />
|DOI=<br />
|date=2008-09-14<br />
|accessdate=2019-09-30<br />
}}</ref><br />
<br />
==Generally recognized benefits of foreskin restoration==<br />
<br />
1. ''An end to tight and painful erections''. Increasing the quantity of skin results in longer skin and less tension when the penis is erect.<br />
<br />
2. ''Gliding mechanism'': the [[gliding action]] is beneficial because it facilitates [[masturbation]] and sex by reducing friction and providing a stimulating sheath that pleasurably slips back and forth over the [[glans]], thereby decreasing the need for artificial lubrication. The motion of the penile skin by the gliding action stimulates the nerves in the skin which are sensitive to motion and stretching.<br />
<br />
3. ''Feeling whole'': The presence of the restored foreskin causes one to look and feel whole, complete, and normal.<br />
<br />
4. ''Coverage of the glans'': this is beneficial because (a) it protects the glans from uncomfortably rubbing up against things, and (b) by keeping the glans moist and protected, it leads to dekeratinization, which subsequently increases sensation.<br />
<br />
5. ''More sensation'': It is true that non-surgical foreskin restoration cannot restore the [[ridged band]] or the [[frenulum]], but a restored foreskin does have some nerves in it. Those nerves are stimulated by the gliding of the foreskin, so it is quite pleasurable to have a restored foreskin. Some men who were circumcised as adults and subsequently restored have estimated that they got back about 80 percent of what they had lost in sensation.<br />
<br />
6. ''Increased comfort'': The head of one's [[penis]] is protected by [[foreskin]] as nature intended.<br />
<br />
7. ''Decreased'' [[keratinization]] of the [[glans penis]].<br />
<br />
8. ''Esthetics'': One's penis approaches the Greek ideal of male beauty.<ref>{{REFweb<br />
|url=http://acroposthion.com/ancient-greeks-and-the-foreskin/<br />
|title=Ancient Greeks & the Foreskin<br />
|trans-title=<br />
|language=<br />
|last=<br />
|first=<br />
|publisher=<br />
|website=Acroposthion<br />
|date=2017<br />
|accessdate=2010-10-02<br />
|format=<br />
|quote=The ancient Greeks were against the practice of circumcising their males and possessing a generous foreskin was a significantly important part of their culture.<br />
}}</ref> The [[circumcision scar]] is now completely concealed by the longer skin which relocates the scar to the inside. As the restored foreskin gets longer and extends beyond the glans penis, the [[acroposthion]] is reformed.<br />
<br />
== Emotional, psychological, and psychiatric benefits ==<br />
<br />
Foreskin restoration has been reported as having beneficial emotional results in some men,<ref name="Greer"/><ref name="Goodwin"/><ref name="Penn">{{REFjournal<br />
|last=Penn<br />
|first=Jack<br />
|title=Penile Reform<br />
|journal=British Journal of Plastic Surgery<br />
|volume=16<br />
|issue=287-8<br />
|pages=<br />
|url=http://www.cirp.org/library/restoration/penn1/<br />
|quote=<br />
|pubmedID=14042759<br />
|pubmedCID=<br />
|DOI=10.1016/S0007-1226(63)80123-X<br />
|date=1963<br />
|accessdate=2019-09-29<br />
}}</ref><ref name="Boyle">{{REFjournal<br />
|last=Boyle<br />
|first=G.J.<br />
|last2=Goldman<br />
|first2=R.<br />
|author2-link=Ronald Goldman<br />
|last3=Svoboda<br />
|first3=J.S.<br />
|last4=Fernandez<br />
|first4=E.<br />
|title=Male Circumcision: Pain, Trauma and Psychosexual Sequelae<br />
|journal=Journal of Health Psychology<br />
|volume=7<br />
|issue=3<br />
|pages=329-343<br />
|url=http://www.cirp.org/library/psych/boyle6/<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.1177/1359105302007003225<br />
|date=2002<br />
|accessdate=2019-09-29<br />
}}</ref> and has been proposed as a treatment for negative feelings in some adult men about their involuntary infant circumcisions.<ref name="watson2017">{{REFjournal<br />
|last=Watson<br />
|first=Lindsay<br />
|author-link=<br />
|last2=Golden<br />
|first2=Tom<br />
|author2-link=<br />
|etal=no<br />
|title=Male circumcision grief: effective and ineffective therapeutic approaches<br />
|trans-title=<br />
|language=<br />
|journal=New Male Studies: An International Journal<br />
|location=<br />
|date=2017<br />
|volume=6<br />
|issue=2<br />
|pages=109-25<br />
|url=http://newmalestudies.com/OJS/index.php/nms/article/view/261/317<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|accessdate=2019-12-12<br />
}}</ref><br />
<br />
== Foreskin Coverage Index ==<br />
<br />
In an effort to provide men partaking in foreskin restoration a reference to the extent of their circumcision skin loss, various foreskin coverage indexes have been created. The latest and most complete example is the [https://foreskinrestoration.men/foreskin-restoration-coverage-index/ ADI Coverage Index.] The index depicts a range of penises in both the flaccid and erect state from 0 to 10, with 0 being the tightest circumcision and 10 the longest foreskin. Men undergoing foreskin restoration can chart their progress using the coverage index (CI).<br />
<br />
== Literature ==<br />
<br />
Books, websites and numerous articles have been published about foreskin restoration. See our compiled list of [[literature about foreskin restoration]].<br />
<br />
== Regeneration of the foreskin ==<br />
<br />
Recently there has been growing interest in regenerative medicine as a means to regenerate the human male foreskin. This option, unlike non-surgical foreskin restoration, would result in a true human male foreskin being regrown. <br />
<br />
In early 2010, [[Foregen]], a non-profit organization dedicated to funding a clinical trial for the purposes of regrowing the human male foreskin, had been founded. A clinical trial had been scheduled for late 2010, but there were insufficient donations to follow through.<ref>{{REFjournal<br />
|last=<br />
|first=<br />
|title=Foregen<br />
|journal=<br />
|volume=<br />
|issue=<br />
|pages=<br />
|url=http://www.foregen.org/blog/?p=84<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=2010-09-21<br />
|accessdate=2010-11-28<br />
}}</ref><br />
<br />
The proposed method would involve placing the patient under general anaesthesia. The penile skin would be opened at the circumcision scar, while the scar tissue is surgically debrided. A biomedical solution would then be applied to both ends of the wound, causing the foreskin to regenerate with the DNA in the patient's own cells. A biodegradable scaffold would be used to offer support for the regenerating foreskin.<ref>{{REFjournal<br />
|last=<br />
|first=<br />
|title=Clinical Regen Trial<br />
|journal=<br />
|volume=<br />
|issue=<br />
|pages=<br />
|url=http://www.foregen.org/projects/<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=2010-06-23<br />
|accessdate=2010-06-23<br />
}}</ref><br />
<br />
In 2018, Foregen announced the creation of a "decellularized extracellular matrix–based biomaterial scaffold" for the purpose of regenerating human foreskin.<ref>{{REFjournal<br />
|last=Purpura<br />
|first=V.<br />
|last2=Bondioli<br />
|first2=E.<br />
|last3=Cunningham<br />
|first3=E.J.<br />
|etal=yes<br />
|title=The development of a decellularized extracellular matrix–based biomaterial scaffold derived from human foreskin for the purpose of foreskin reconstruction in circumcised males<br />
|journal=Journal of Tissue Engineering<br />
|date=2018<br />
|volume=9<br />
|issue=<br />
|pages=1-11<br />
|url=https://journals.sagepub.com/doi/full/10.1177/2041731418812613<br />
|quote=<br />
|pubmedID=30622692<br />
|pubmedCID=PMC6304708<br />
|DOI=10.1177/2041731418812613<br />
|accessdate=2019-09-25<br />
}}</ref><br />
<br />
Foreskin regeneration is only theoretical as of 2020. No foreskin has ever been regenerated. There is no assurance that foreskin regeneration would actually be successful if attempted.<br />
<br />
{{SEEALSO}}<br />
* [[Circumcision]]<br />
* [[Epispasm]]<br />
* [[Foreskin]]<br />
* [[Gliding action]]<br />
* [[Penis]]<br />
* [[Restoration]]<br />
* [[Ridged band]]<br />
* [[Psychological issues of male circumcision]]<br />
* [[Basics of foreskin restoration]]<br />
* [[Surgical foreskin restoration]]<br />
* [[Literature about foreskin restoration]]<br />
* [[:Category:Foreskin restoration devices]]<br />
* [[:Category:Films about foreskin restoration]]<br />
<br />
{{LINKS}}<br />
* [http://www.norm.org NORM - National Organization of Restoring Men (U.S.)]<br />
* [http://www.cirp.org/pages/restore.html CIRP Foreskin restoration for circumcised males]<br />
* {{REFweb<br />
|url=https://www.doctorsopposingcircumcision.org/for-professionals/foreskin-restoration/<br />
|title=Non-surgical foreskin restoration<br />
|last=<br />
|first=<br />
|publisher=<br />
|website=Doctors Opposing Circumcision<br />
|date=2019-02<br />
|accessdate=2019-09-28<br />
|format=<br />
|quote=<br />
}}<br />
* [http://www.norm-uk.org NORM-UK - National Organization of Restoring Men (UK)]<br />
* {{REFjournal<br />
|last=Anonymous<br />
|first=<br />
|author-link=<br />
|etal=no<br />
|title=The joy of uncircumcising<br />
|trans-title=<br />
|language=<br />
|journal=BMJ<br />
|location=<br />
|date=1994-09-10<br />
|volume=309<br />
|issue=<br />
|pages=676-7<br />
|url=http://www.cirp.org/library/restoration/anonymous1/<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.1136/bmj.309.6955.676a <br />
|accessdate=2019-11-26<br />
}}<br />
<br />
* {{REFnews<br />
|title=Many men bitterly regret being circumcised. A new method allows them to repair the damage.<br />
|url=https://www.independent.co.uk/life-style/health-and-families/health-news/how-to-reverse-the-irreversible-1338650.html<br />
|last=Carter<br />
|first=Rica<br />
|last2=Rockhall<br />
|first2=Anna<br />
|publisher=The Independent<br />
|website=www.independent.co.uk<br />
|date=1996-06-25<br />
|accessdate=2020-06-23<br />
|quote=Foreskin restoration is a slow process of stretching the penile skin over the naked glans, and can take several years. Many men, however, report an improvement in comfort and sensitivity after only a couple of weeks.<br />
}}<br />
<br />
* {{REFweb<br />
|url=https://www.yourwholebaby.org/restoration<br />
|archived=<br />
|title=Restoration<br />
|trans-title=<br />
|language=<br />
|last=<br />
|first=<br />
|author-link=<br />
|publisher=Your Whole Baby<br />
|website=www.yourwholebaby.org<br />
|date=<br />
|accessdate=2020-05-20<br />
|format=<br />
|quote=<br />
}}<br />
* [http://www.iomfats.org/resources/restoring/media/restoring_faq.pdf My responses to a few Frequently Asked Questions about Non-Surgical Foreskin Restoration], Roy M. Payne; Fryer, Leo (2001-03)<br />
* {{REFjournal<br />
|last=Brandes<br />
|first=S.B.<br />
|last2=McAninch<br />
|first2=J.W.<br />
|title=Surgical methods of restoring the prepuce: a critical review<br />
|journal=BJU Int<br />
|volume=83<br />
|issue=Suppl. 1<br />
|pages=109-113<br />
|url=https://onlinelibrary.wiley.com/doi/epdf/10.1046/j.1464-410x.1999.0830s1109.x<br />
|quote=<br />
|pubmedID=10349422<br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410x.1999.0830s1109.x<br />
|date=1999<br />
|accessdate=2019-09-30<br />
}}<br />
* {{REFweb<br />
|url=https://www.reddit.com/r/foreskin_restoration/<br />
|title=REDDIT foreskin restoration sub-reddit<br />
|last=<br />
|first=<br />
|accessdate=2019-11-16<br />
}}<br />
<br />
* {{REFweb<br />
|url=http://wasnotmychoice.com/foreskin-restoration/<br />
|archived=<br />
|title=Foreskin Restoration<br />
|trans-title=<br />
|language=English<br />
|last=<br />
|first=<br />
|author-link=<br />
|publisher=<br />
|website=http://wasnotmychoice.com<br />
|date=<br />
|accessdate=2020-08-28<br />
|format=<br />
|quote=<br />
}}<br />
<br />
{{REF}}<br />
<br />
[[Category:Foreskin restoration]]<br />
[[Category:Judaism]]<br />
[[Category:From Intactipedia]]<br />
[[Category:From IntactWiki]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intaction&diff=15505Intaction2020-07-24T03:31:33Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intaction<br />
|titlestyle = color:black;<br />
|image = [[File:Intaction logonewcropped.png|175px]]<br />
|imagestyle = <br />
|caption = Intaction logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2010<br />
|header3 = Founder:<br />
|data4 = [[Anthony Losquadro]]<br />
|header5 = Founding location:<br />
|data6 = New York City<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Brooklyn, New York City<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|http://intaction.org}}<br />
}}<br />
'''Intaction Inc.''' is a anti-[[circumcision]] advocacy organization based in Brooklyn, N.Y., USA. Intaction is a 501 (c)(3) organization and a registered corporation under the Not-For-Profit Laws of New York State, and formed in 2010. Intaction Inc. supports the [[WWDOGA]].<br />
The founder and Director is [[Anthony Losquadro]].<br />
Intaction's name is derived from the words "Intact" and "Action." Members of the organization refer to themselves as "Intactivists," and the anti-circumcision movement as "Intactivism."<br />
<br />
==Advocacy==<br />
Intaction also has a large full-time mobile education truck, which they use to display photo campaigns such as "Circumcision - I Did Not Consent" and "Foreskin - A Girl Can Hope.<ref>{{REFweb<br />
|url=https://www.vice.com/en_us/article/wd4ggx/intaction-is-fighting-for-your-babys-foreskin<br />
|title=The Fight for Baby Foreskin Hits the Streets<br />
|last=Euse<br />
|first=Erica<br />
|date=2014-05-12<br />
|publisher=Vice<br />
|accessdate=2020-04-11<br />
}}</ref> In addition to public education events held mostly in New York City, the group marches in parades advocating for the intact body and foreskin.<ref>{{REFweb<br />
|url=https://www.sheknows.com/parenting/articles/1140294/anti-circumcision-intactivist-movement-parents-2/<br />
|title=Inside the Anti-Circumcision Movement: These Blood-Soaked Activists Want You to Cut Them Some Slack<br />
|last=O'Connor<br />
|first=A.M.<br />
|date=2018-07-12<br />
|publisher=She Knows<br />
|accessdate=2020-04-11<br />
}}</ref><br />
<br />
The group is also frequently present at New York City's Union Square Park.<ref>{{REFweb<br />
|url=https://www.independent.co.uk/life-style/new-york-city-circumcision-america-protest-infant-sons-foreskin-a8500026.html<br />
|title=An advocacy group in New York City wants people to stop circumcising their infant sons<br />
|last=Ritschel<br />
|first=Chelsea<br />
|date=2018-08-20<br />
|publisher=The Independent<br />
|accessdate=2020-04-11<br />
}}</ref><ref>{{REFweb<br />
|url=https://melmagazine.com/en-us/story/why-foreskin-activists-are-taking-to-the-streets<br />
|title=Why Foreskin Activists Are Taking to the Streets<br />
|last=Myers<br />
|first=Quinn<br />
|date=<br />
|publisher=Mel Magazine<br />
|accessdate=2020-04-11<br />
}}</ref><br />
<br />
[[File:20180412 170459croppedWeb.jpg|thumb | Intaction's Mobile Unit with "Foreskin A Girl Can Hope" campaign (2018-Present)]]<br />
[[File:Intaction 1323correctedsmall.jpg|thumb | Mobile Unit with "Circumcision I Did Not Consent campaign (2014-2017)]]<br />
They are "fighting against [https://intaction.org circumcision] https://intaction.org through education, advocacy, and activism".<ref>https://intaction.org/about-us/</ref>.<br />
<br />
== Board of Directors ==<br />
* [[Craig Adams]]<br />
* [[Aura Bobadilla]], Latino coordinator<br />
* [[Jonathan Friedman]]<br />
* [[David Grant]]<br />
* [[William Kaye]]<br />
* [[Everett Leiter]]<br />
* [[Anthony Losquadro]]<br />
* [[Michael Winnel]], (Sydney, AU) Australian Liaison<br />
* [[Adam Zeldis]]<br />
<br />
== Address ==<br />
Intaction Inc.<br><br />
PO Box 370599<br><br />
Brooklyn, NY, 11237, USA<br><br />
1-866-6-FORESKIN (1-866-636-7375)<br />
<br />
{{SEEALSO}}<br />
* {{REFweb<br />
|url=https://splinternews.com/inside-the-anti-circumcision-movement-these-blood-soak-1793861318<br />
|title=Inside the Anti-Circumcision Movement: These Blood-Soaked Activists Want You to Cut Them Some Slack<br />
|first=Charlotte<br />
|last=Shane<br />
|publisher=Splinter<br />
|date=2016-08-22<br />
|accessdate=2020-01-25<br />
}}<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|https://intaction.org/|2019-09-15}}<br />
* [https://www.youtube.com/intaction1/ YouTube Channel]<br />
* [https://circumcisionchronicles.libsyn.com/ Circumcision Chronicles UNCUT Podcast]<br />
<br />
{{REF}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intaction]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Foreskin_Revolution&diff=14402Foreskin Revolution2020-05-08T13:33:38Z<p>WikiModEn4: fixed url errors</p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Foreskin Revolution<br />
|titlestyle = color:black;<br />
|image = [[File:Foreskin revolution logo.png|175px]]<br />
|imagestyle = <br />
|caption = Foreskin Revolution logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2018<br />
|header3 = Founder:<br />
|data4 = [[Michael Winnel]]<br />
|header5 = Founding location:<br />
|data6 = Sydney<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Sydney Australia<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|http://foreskinrevolution.com}}<br />
}}<br />
'''Foreskin Revolution''' is a anti-[[circumcision]] advocacy organization based in Australia. Foreskin Revolution supports the [[WWDOGA]].<br />
The founder and Director is [[Michael Winnel]].<br />
<br />
Foreskin Revolution is a [[human rights]] movement that uses art, politics and popular culture to spread the core messages - that the normal, whole body is awesome with the [[foreskin]] being the most enjoyable part of the body, and that [http://foreskinrevolution.com circumcision] of a healthy child is an assault on that body that needs to end. We wrap all of this in a revolutionary spirit that holds a place for everyone - cut men and their partners who resent it, intact men who are sick of the body shaming or anyone who understands that our society needs to move beyond this harmful practice. <ref>https://www.sbs.com.au/news/the-feed/the-movement-to-save-men-s-foreskins-has-come-to-australia</ref><br />
<br />
{{SEEALSO}}<br />
<br />
* [[Australia]]<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://foreskinrevolution.com/|2020-05-03}}<br />
* [https://www.youtube.com/channel/UCL55XSqdCcZJW5vtx6eEW0g/ YouTube Channel]<br />
* [https://www.sbs.com.au/news/the-feed/the-movement-to-save-men-s-foreskins-has-come-to-australia The movement to save men's foreskins has come to Australia]<br />
<br />
{{REF}}<br />
<br />
[[Category: Intactivism organization]]<br />
[[Category: Australia]]<br />
<br />
[[de: Foreskin Revolution]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14366Intact America2020-05-05T13:13:04Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America logo.jpg|175px]]<br />
|imagestyle = <br />
|caption = <br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2008<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|https://intactamerica.org}}<br />
}}<br />
'''Intact America''' (IA) is a New York based 501(c)(3) nonprofit organization founded in 2008, as part of the Hudson Center for Health Equity & Quality Inc. It was founded by [[Georganne Chapin]], a healthcare leader, CEO and intactivist. IA's founding was facilitated by Texas businessman Dean Pisani who pledged $1 million to Intact America because, he said, he and his wife were pressured in 1999 by a physician at Northwestern Memorial Hospital to circumcise their first child, a boy. The Pisani's rebuffed the doctor's pressure tactics, and in turn funded the creation of IA.<ref>https://www.inquirer.com/philly/health/Medical_groups_may_recommend_procedure_on_boys_but_opponents_say_benefits_exaggerated.html</ref><br />
<br />
== Mission ==<br />
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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
== Vision ==<br />
Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
Intact America (IA) was registered to exhibit at the 2012 [[American Academy of Pediatrics]] (AAP) convention "trade show" in New Orleans, Louisiana. However the AAP revoked Intact America's registration over concerns that IA's presence would exacerbate the controversy over the AAP's recently released 2012 circumcision policy statement. IA in turn organized a protest of the AAP which attracted [[intactivists]] from across America to demonstrate at the New Orleans Ernest N. Morial Convention Center.<ref>https://www.washingtonpost.com/national/on-faith/anti-circumcision-activists-confront-pediatricians/2012/10/22/f6b7c468-1c88-11e2-8817-41b9a7aaabc7_story.html</ref> This seminal event was the place were the intactivist protest group [[Bloodstained Men]] was conceived. <br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website designed for non-intactivists. It is meant to be a source of information on issues about male circumcision.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
{{REF}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14359Intact America2020-05-05T05:03:02Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America Logo|175px]]<br />
|imagestyle = <br />
|caption = Intact America Logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2008<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|https://intactamerica.org}}<br />
}}<br />
'''Intact America''' (IA) is a New York 501(c)(3) nonprofit organization founded in 2008, as part of the Hudson Center for Health Equity & Quality Inc. It was founded by [[Georganne Chapin]], a healthcare leader, CEO and intactivist. IA's founding was facilitated by Texas businessman Dean Pisani who pledged $1 million to Intact America because, he said, he and his wife were pressured in 1999 by a physician at Northwestern Memorial Hospital to circumcise their first child, a boy. The Pisani's rebuffed the doctor's pressure tactics, and in turn funded the creation of IA.<ref>https://www.inquirer.com/philly/health/Medical_groups_may_recommend_procedure_on_boys_but_opponents_say_benefits_exaggerated.html</ref><br />
<br />
'''Mission:''' 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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
'''Vision:''' Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
Intact America (IA) was registered to exhibit at the 2012 [[American Academy of Pediatrics]] (AAP) convention "trade show" in New Orleans, Louisiana. However the AAP revoked Intact America's registration over concerns that IA's presence would exacerbate the controversy over the AAP's recently released 2012 circumcision policy statement. IA in turn organized a protest of the AAP which attracted [[intactivists]] from across America to demonstrate at the New Orleans Ernest N. Morial Convention Center.<ref>https://www.washingtonpost.com/national/on-faith/anti-circumcision-activists-confront-pediatricians/2012/10/22/f6b7c468-1c88-11e2-8817-41b9a7aaabc7_story.html</ref> This seminal event was the place were the intactivist protest group [[Bloodstained Men]] was conceived. <br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website designed for non-intactivists. It is meant to be a source of information on issues about male circumcision.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
{{REF}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14358Intact America2020-05-05T05:00:49Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America Logo|175px]]<br />
|imagestyle = <br />
|caption = Intact America Logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2008<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|https://intactamerica.org}}<br />
}}<br />
'''Intact America''' (IA) is a New York 501(c)(3) nonprofit organization founded in 2008, as part of the Hudson Center for Health Equity & Quality Inc. It was founded by [[Georganne Chapin]], a healthcare leader, CEO and intactivist. IA's founding was facilitated by Texas businessman Dean Pisani who pledged $1 million to Intact America because, he said, he and his wife were pressured in 1999 by a physician at Northwestern Memorial Hospital to circumcise their first child, a boy. The Pisani's rebuffed the doctor's pressure tactics, and in turn funded the creation of IA.<ref>https://www.inquirer.com/philly/health/Medical_groups_may_recommend_procedure_on_boys_but_opponents_say_benefits_exaggerated.html</ref><br />
<br />
'''Mission:''' 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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
'''Vision:''' Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
Intact America (IA) was registered to exhibit at the 2012 [[American Academy of Pediatrics]] (AAP) convention "trade show" in New Orleans, Louisiana. However the AAP revoked Intact America's registration over concerns that IA's presence would exacerbate the controversy over the AAP's recently released 2012 circumcision policy statement. IA in turn organized a protest of the AAP which attracted [[intactivists]] from across America to demonstrate at the New Orleans Ernest N. Morial Convention Center.<ref>https://www.washingtonpost.com/national/on-faith/anti-circumcision-activists-confront-pediatricians/2012/10/22/f6b7c468-1c88-11e2-8817-41b9a7aaabc7_story.html</ref> The protest was the place were the intactivist protest group [[Bloodstained Men]] was conceived. <br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website designed for non-intactivists. It is meant to be a source of information on issues about male circumcision.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
{{REF}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Child_circumcision&diff=14356Child circumcision2020-05-04T20:37:10Z<p>WikiModEn4: /* Search for prophylactic reasons */</p>
<hr />
<div>{{GraphicWarning}}<br />
"Male '''circumcision''' (from Latin ''circumcidere'', meaning "to cut around") is the surgical removal of the [[foreskin]] (prepuce) part of the human [[penis]]. The foreskin comprises ''more than fifty percent'' of the epithelium of the penis.<ref name="taylor1996">{{REFjournal<br />
|last=Taylor<br />
|first=J.R.<br />
|author-link=John R. Taylor<br />
|last2=Lockwood<br />
|first2=A.P.<br />
|author2-link=<br />
|last3=Taylor<br />
|first3=A.J.<br />
|title=The prepuce: specialized mucosa of the penis and its loss to circumcision<br />
|journal=Brit J Urol<br />
|date=1996<br />
|volume=77<br />
|issue=<br />
|pages=291-5<br />
|url=http://onlinelibrary.wiley.com/doi/10.1046/j.1464-410X.1996.85023.x/full<br />
|quote=<br />
|pubmedID=8800902<br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410X.1996.85023.x<br />
|accessdate=2019-10-14<br />
}}</ref> [...] The procedure is most often an elective non-therapeutic surgery performed on neonates and children for religious and cultural reasons, but in other cases may be indicated for both therapeutic and prophylactic reasons. It is a radical treatment option for pathological [[phimosis]], refractory [[Balanitis| balanoposthitis]] and chronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health. <br />
<br />
'''Posthectomy''' is a more accurate medical term that more accurately reflects the injury and loss of functional body tissue, but the Biblical euphemism, ''circumcision'', is more commonly used. <br />
<br />
With reference to involuntary, non-therapeutic circumcision of children, [[Child Genital Cutting (CGC)]] is a new term that has been introduced to avoid issues associated with more traditional terms.<br />
<br />
== Historical background ==<br />
<br />
The amputation of the [[foreskin]] is a very old ritual, whose exact origin cannot be verified beyond doubt. Medical historians assume that circumcision already served in ancient history as a way to control the sexuality of slaves and members of the lower classes without compromising their ability to reproduce. In religious history circumcision may be seen as a substitute for human sacrifice. In prehistoric times it was not uncommon to placate the gods with human sacrifice. Castration of slaves or conquered enemies was common as well. Following religious changes this sacrifice was altered, and only a part of the very organ responsible for the creation of new life was sacrificed.<br />
<br />
[[Image:Circumcision Sakkara 3.jpg|200px|right]] For the Aborigines, the Australian natives, the tradition of circumcision is said to go back to 10,000 BC. On the African continent, the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of circumcision date back to the time around 3000-2000 BC. The oldest known depiction<ref>{{REFweb<br />
|url=https://commons.wikimedia.org/wiki/File:Circumcision_Sakkara_3.jpg<br />
|title=File:Circumcision Sakkara 3.jpg<br />
|accessdate=2019-10-12<br />
}}</ref> is an Egyptian tomb relief from the 6th dynasty, approximately 2300-2000 BC. It is not known precisely who was circumcised and why in those times.<br />
<br />
In many cultures circumcision during puberty serves as a rite of passage, bringing adolescents into the community. As with other painful or humiliating initiation rites, proof of courage and mastering of critical situations are the key motivations. From some African tribes it is also known that the amputation of the [[foreskin]] is seen as the removal of an inborn piece of femininity from the boys, thus making them men.<br />
<br />
===Judaism===<br />
<br />
In the Jewish religion, the tradition of circumcision goes back to a passage in the Book of Genesis (17, 10-14). It is seen as a [[Abrahamic covenant| covenant between God and man]], dating back to the patriarch Abraham.<br />
<br />
{{Citation<br />
|Text=10 This is my covenant with you and your descendants after you, the covenant you are to keep: Every male among you shall be circumcised. 11 You are to undergo circumcision, and it will be the sign of the covenant between me and you. 12 For the generations to come every male among you who is eight days old must be circumcised, including those born in your household or bought with money from a foreigner—those who are not your offspring. 13 Whether born in your household or bought with your money, they must be circumcised. My covenant in your flesh is to be an everlasting covenant. 14 Any uncircumcised male, who has not been circumcised in the flesh, will be cut off from his people; he has broken my covenant.” <br />
|Author=Bible<br />
|Source=Gen 17, 10-14, NIV<br />
}}<br />
<br />
According to the anthropologist and sociologist Nissan Rubin, the Jewish form of circumcision, called ''[[Brit Milah| brit mila]]'', during the first two millennia did not include the later customary ''periah'', namely the complete scraping of the inner [[foreskin]] from the [[Glans penis|glans]]. This was only added around 135 AD, to make it impossible to restore the [[foreskin]] by stretching, which became popular in the wake of Hellenic influence. While originally only the tip of the [[foreskin]] was cut off, periah removes the entire [[foreskin]]. In the Greek society of the day, a denuded [[Glans penis|glans]] was considered obscene and risible. In ultra-orthodox communities, circumcision is followed by the ''[[mohel]]'', the ritual circumciser, sucking blood from the wound with his mouth. This practice is highly controversial, as it can result in an infection with [[herpes]] simplex type 1. In New York City, between 2000 and 2011 eleven children were infected with [[herpes]], 10 of whom had to be treated in hospital. Two of them suffered permanent brain damage, two others died. In the 12th century, the Jewish philosopher and doctor [[Moses Maimonides| Maimonides]] pointed out that circumcision was necessary, as it diminished sexual desires and reduced the pleasure to a degree just sufficient for mere reproduction.<br />
<br />
===Christianity===<br />
Jesus was born into a Jewish family in Israel, where Judaism was the prevailing religion, so he was circumcised on the eighth day.<ref name="luke2:21>{{REFweb<br />
|url=https://www.biblegateway.com/passage/?search=Luke+2%3A21&version=NASB<br />
|title=Gospel of Luke<br />
|trans-title=<br />
|language=<br />
|last=Luke<br />
|first=<br />
|author-link=<br />
|publisher=NASB<br />
|website=Bible Gateway<br />
|date=<br />
|accessdate=2019-11-10<br />
|format=<br />
|quote=And when eight days had passed, before His circumcision, His name was then called Jesus, the name given by the angel before He was conceived in the womb.<br />
}}</ref><br />
<br />
The first Christians had been born Jewish, so a question arose whether one must be circumcised to be a Christian. When Christian leaders met at the [[Council at Jerusalem]] in the First Century to decide what was required to be a Christian, a letter was written to explain the requirements, but circumcision was omitted from the requirements.<ref>{{REFweb<br />
|url=https://www.biblegateway.com/passage/?search=Acts+15%3A1-30&version=NASB<br />
|title=Acts 15:1-30<br />
|last=Luke<br />
|first=<br />
|accessdate=2019-11-10<br />
}}</ref><br />
<br />
In Christianity, circumcision is practiced only in a few Coptic churches. There is no general belief that circumcision is a requirement of Christianity.<ref name="hill2004">{{REFweb<br />
|url=http://www.cirp.org/pages/cultural/christian.html<br />
|title=The Holy Bible, Circumcision, False Prophets, and Christian Parents<br />
|trans-title=<br />
|language=<br />
|last=Hill<br />
|first=George<br />
|author-link=George Hill<br />
|publisher=Circumcision Reference Library<br />
|website=<br />
|date=2004-08-29<br />
|accessdate=2019-11-10<br />
|format=HTML<br />
|quote=The falseness of those who advocate circumcision is a recurrent theme in the New Testament. <br />
}}</ref><br />
<br />
Nevertheless, Christian moral notions had decisive influence on the spread of this practice. In the puritan influenced USA, circumcision of children was popular in the 19th century as a means to prevent [[masturbation]]. In those days, this so-called ‘self-abuse‘ was not only considered immoral, but was supposedly responsible for a variety of diseases. Masturbation, however, is not mentioned anywhere in the Holy Bible, so there is no support for the belief that it is somehow immoral or sinful. <br />
<br />
Even the mere existence of a [[foreskin]] was linked to many illnesses. Among them one could find syphilis, epilepsy, paralysis of the spine, bed wetting, scoliosis (spinal deformity), paralysis of the bladder, club foot, nerve pain in the lower abdomen, tuberculosis and lazy eye. One of the best known advocates of child circumcision was [[John Harvey Kellogg]], co-inventor of the corn flakes bearing his name. In 1888, he wrote:<br />
<br />
{{Citation<br />
|Text=A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of [[phimosis]]. The operation should be performed by a surgeon without administering an anaesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. In females, the author has found the application of pure carbolic acid to the clitoris an excellent means of allaying the abnormal excitement, and preventing the recurrence of the practice in those whose will-power has become so weakened that the patient is unable to exercise entire self-control. <br />
|Author=[[John Harvey Kellogg]]<br />
|Source=<br />
|ref=<ref>{{REFbook<br />
|url=https://archive.org/details/plainfaorold00kell/page/290<br />
|chapter=Treatment for Self-abuse and Its Effects<br />
|title=Plain Facts for Old and Young<br />
|location=Burlington, Iowa<br />
|publisher=F. Segner & Co.<br />
|year=1888<br />
|pages=107<br />
}}</ref><br />
}}<br />
<br />
===Islam===<br />
In Islam, circumcision is also religiously founded, even though there is no mention of it in the Koran itself. According to tradition, the Prophet Mohammed was born without a [[foreskin]]. It is seen as a sign of prophets that they are born without a [[foreskin]] already. It is considered an honour to "resemble the example of the Prophet", meaning to be circumcised. In Islam, unlike Judaism, there is no specific age at which the circumcision should be performed. Most circumcisions take place at ages between 6 and 10 years, but the range goes from birth to adulthood.<br />
<br />
== Rationale ==<br />
<br />
Reasons for performing circumcision range widely by culture, religion, location, and age.<br />
<br />
===Cultural===<br />
<br />
Many cultures perform circumcision as a rite of passage into manhood. This is common in the Middle East and amongst some indigenous African and Southeast Asian peoples.<br />
<br />
The United States and Israel are the only industrialized countries in the world to have a high incidence of non-therapeutic infant male circumcision. The vast majority of infant circumcisions performed in the United States are for non-religious, non-medical reasons. See [[History of circumcision]].<br />
<br />
===Religious===<br />
The circumcision of newborn boys is seen as a divine commandment in the Jewish faith. Though absent in the Koran, male circumcision is considered a religious requirement in Islam, and it is performed on male children of varying ages. Converts to these faiths may also choose to undergo circumcision, but it is not always required.<br />
<br />
===Medical indication===<br />
In some cases, circumcision is legitimately indicated; a patient may be suffering recurring infections, and other methods of treatment have failed. In other cases, a patient may be suffering from a severe case of [[phimosis]]. Overall, the actual medical necessity for circumcision is extremely rare. All circumcisions injure the patient by amputating the [[foreskin]] its with many protective, immunological, sensory, and sexual [[Foreskin#Physiological_functions| functions]]. <br />
<br />
# '''Deformed or malformed foreskin'''. A foreskin so deformed or malformed that it does not function properly may be removed by circumcision.<br />
<br />
# '''Traumatically injured foreskin'''. A foreskin so traumatically injured foreskin that cannot be surgically repaird is a valid medical reason for circumcision.<br />
<br />
# '''Diseased foreskin.''' A foreskin that is diseased is a valid indication for cirumcision. Some diseases that qualify are malignancy, lichen sclerosis, yeast infection in men with diabetes, and recurrent posthitis.<br />
<br />
In such cases, the benefit of removing the problem foreskin may exceed the maleficial results of tissue and function destruction.<br />
<br />
====Arguments of prophylaxia====<br />
Though the practice of ritual circumcision of males, both consenting and non-consenting, has existed for millenia, the search for "potential medical benefits" began relatively recently. The discussion of circumcision in the Ninth Edition of the ''Encyclopǽdia Britannica'' (1876) made no mention of any prophylactic, medical, or therapeutic value or function.<ref>{{REFweb<br />
|url=http://www.cirp.org/library/history/encyclopaediabritannica1876/<br />
|title=Circumcision<br />
|trans-title=<br />
|language=<br />
|last=Cheyne<br />
|first=T. K.<br />
|author-link=<br />
|publisher=Encyclopǽdia Brittanica<br />
|website=Circumcision Reference Library<br />
|date=1876<br />
|accessdate=2019-11-10<br />
|format=<br />
|quote=<br />
}}</ref><br />
<br />
Initially, circumcision was adopted as a way to stop boys and men from masturbating, where masturbation was seen as the cause for many diseases. As the myth that circumcision prevented [[masturbation]] became debunked, advocates of circumcision began the great search to find the "medical benefits" of circumcision. <br />
<br />
Male and female circumcision involves the removal and disruption of normal anatomical structures that are primary areas of sexual sensation.<ref name="taylor1996" /> In the past, some advocates of mass circumcision have considered the prepuce to be a "mistake of nature,"<ref><br />
<nowiki>{{Cold and Wiswell (1995)}} | [[Template:Cold and Wiswell (1995)|see more]]</nowiki></p><br />
</ref> but this notion has no validity because the prepuce is ubiquitous in primates and because it provides functional advantages.<ref name="cold-mcgrath1995">{{REFbook<br />
|last=Cold<br />
|first=Christopher<br />
|last2=McGrath<br />
|first2=Kenneth<br />
|author2-link=Ken McGrath<br />
|year=1999<br />
|title=Male and female circumcision: medical, legal, and ethical considerations in pediatric practice<br />
|url=http://www.cirp.org/library/anatomy/cold-mcgrath/<br />
|work=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=Anatomy and histology of the penile and clitoral prepuce in primates<br />
|pages=<br />
|location=New York<br />
|publisher=<br />
|isbn=0306461315<br />
|quote=<br />
|accessdate=2019-10-12<br />
|note=<br />
}}</ref><br />
<br />
===Search for prophylactic reasons===<br />
<br />
The practice of finding prophylactic reasons for infant circumcision started in Germany in the nineteenth century, when non-Jewish Germans criticized the Jewish practice of infant circumcision as being barbaric, Jewish doctors sprang to the defense of the religious practice by claiming health benefits.<ref name="ephron2001">{{REFbook<br />
|last=Ephron<br />
|first=John M.<br />
|author-link=<br />
|year=2001<br />
|title=Medicine and the German Jews<br />
|url=http://www.cirp.org/library/history/ephron1/<br />
|work=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=6<br />
|pages=222-233<br />
|location=New Haven<br />
|publisher=Yale University Press<br />
|isbn=0-300-08377-7<br />
|quote=<br />
|accessdate=2019-11-20<br />
|note=<br />
}}</ref> And so started the long tradition of Jewish doctors inventing reasons for circumcision (and deceving gentile doctors).<br />
<br />
Following the discovery of bacteria as a cause of many diseases – such as tuberculosis – the search began for other illnesses that could be prevented by circumcision.<br />
<br />
In 1870 the renowned Dr. Lewis A. Sayre of NYC’s famed Bellevue Hospital<ref>https://nypost.com/2016/12/03/bellevues-doctors-invented-the-procedures-you-take-for-granted/</ref> claimed to cure a boy’s paralyzed legs with circumcision. Sayre's wild advocacy of circumcision exemplified how some [https://intaction.org/circumcision-facts-and-myths/ circumcision facts and myths] originated. He also claimed to cure epilepsy, mental disorders, hip-joint pain, & hernias with circumcision. “Genital irritations” & masturbation were deemed to be the cause of these issues. Sayre was later elected as the President of the American Medical Association. <ref>American Medical Association. Transactions of the American Medical Association. 1870;21:205–11</ref> <br />
<br />
In the 1920s it was penile cancer. Abraham L. Wolbarst (1926) claims that circumcision can prevent penile cancer.<ref name="wolbarst1926">{{REFjournal<br />
|last=Wolbarst<br />
|first=Abraham L.<br />
|author-link=Abraham L. Wolbarst<br />
|title=Is circumcision a prophylactic against penis cancer?<br />
|journal=Cancer<br />
|date=Jul 1926<br />
|volume=3<br />
|issue=4<br />
|pages=301-10<br />
}}</ref>. <br />
<br />
In the 1940s, prostate and tongue cancer as well as STDs. Eugene H. Hand (1949) falsely explains that circumcision somehow protects against venereal diseases and tongue cancer.<ref name="hand1949">{{REFjournal<br />
|title=Circumcision and venereal disease.<br />
|last=Hand<br />
|first=Eugene H.<br />
|journal=Archives of Dermatology and Syphilology<br />
|date=Sep 1949<br />
|volume=60<br />
|issue=3<br />
|pages=341-346<br />
}}</ref>. <br />
<br />
In the 1950s it was cervical cancer. Abraham Ravich (1951) invents the myth that circumcision reduces the risk of women getting cervical cancer.<ref name="ravich1951">{{REFjournal<br />
|url=https://www.ncbi.nlm.nih.gov/pubmed/14853120<br />
|title=Prophylaxis of cancer of the prostate, penis, and cervix by circumcision<br />
|last=Ravich<br />
|first=Abraham<br />
|last2=Ravich<br />
|first2=R.A.<br />
|journal=New York State Journal of Medicine<br />
|date=Jun 1951<br />
|volume=51<br />
|issue=12<br />
|pages=1519-1520<br />
|pubmedID=14853120<br />
|accessdate=2019-10-12<br />
}}</ref> <br />
<br />
In the late 1960s it was neuroses. Morris Fishbein (1969) calls for circumcision to prevent nervousness and, of course, [[masturbation]].<ref>{{REFbook<br />
|last=Fishbein<br />
|first=Morris<br />
|chapter=Sex hygiene<br />
|title=Modern Home Medical Adviser<br />
|location=Garden City, New York<br />
|publisher=Doubleday & Co<br />
|year=1969<br />
|pages=90, 119<br />
|url=https://openlibrary.org/works/OL95362W/Modern_home_medical_adviser<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
In the 1970s bladder- and rectal cancer. Abraham Ravich (1971) claims that circumcision would prevent bladder cancer and rectal cancer.<ref>{{REFjournal<br />
|last=Ravich<br />
|first=Abraham<br />
|url=https://www.deepdyve.com/lp/wiley/viral-carcinogenesis-in-venereally-susceptible-organs-HCeWmTLmKl<br />
|title=Viral carcinogenesis in venereally susceptible organs<br />
|journal=Cancer<br />
|date=Jun 1971<br />
|volume=27<br />
|issue=6<br />
|pages=1493-1496<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
In the 1980s, UTIs. Thomas E. Wiswell (1985) claims that circumcision, using a methodologically flawed report, reduces the risk of urinary tract infections.<ref name="wiswell1985">{{REFjournal <br />
|last=Wiswell<br />
|first=Thomas E.<br />
|author-link=Thomas E. Wiswell<br />
|url=https://pediatrics.aappublications.org/content/75/5/901<br />
|title=Decreased incidence of urinary tract infections in circumcised male infants<br />
|journal=Pediatrics<br />
|date=May 1985<br />
|volume=75<br />
|issue=5<br />
|pages=901-903<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
Aaron J. Fink (1986), with no evidence whatsoever, claims that circumcision protects against AIDS followed.<ref name="fink1986">{{REFjournal<br />
|last=Fink<br />
|first=Aaron J.<br />
|author-link=Aaron J. Fink<br />
|title=A possible explanation for heterosexual male infection with AIDS<br />
|journal=New England Journal of Medicine<br />
|date=1986-10-30<br />
|volume=31<br />
|issue=18<br />
|pages=1167<br />
|url=https://www.nejm.org/doi/full/10.1056/NEJM198610303151818<br />
|DOI=10.1056/NEJM198610303151818<br />
|accessdate=2019-11-20<br />
}}</ref> <br />
<br />
Retrospectively, circumcision was always advertised as a cure for whatever disease was in the public spotlight at the time. [[Doctors Opposing Circumcision]] (2016) states:<br />
<blockquote><br />
These claims date originally from before the advent of evidence-based medicine, when doctors relied on the opinions of other clinicians to inform their practice, rather than on scientifically collected evidence.<ref name="doc2016">{{REFweb<br />
|url=https://www.doctorsopposingcircumcision.org/for-professionals/alleged-medical-benefits/<br />
|title=Alleged Medical Benefits<br />
|trans-title=<br />
|language=<br />
|last=<br />
|first=<br />
|author-link=<br />
|publisher=Doctors Opposing Circumcision<br />
|website=<br />
|date=2016-05<br />
|accessdate=2019-11-20<br />
|format=<br />
|quote=<br />
}}</ref><br />
</blockquote><br />
<br />
The sheer mass of studies and publications that were released during those almost 180 years on this topic are the reason that even arguments that have been disproved multiple times, especially regarding infant and child circumcision, tenaciously persist up until today.<br />
<br />
An ever-recurring element of initiation rites found in many different cultures is the fixation upon the genitalia.<br />
<br />
It reflects the fascination that emerges from the ability to create new life. In most cultures, fertility is seen as the most precious good, and the body parts involved frequently find themselves in the focus of ritual acts. In many parts of the world, those rites take place when the boy reaches puberty, and are meant to symbolize his transition from boy to man. The removal of the male [[foreskin]] is just one of many phenomena that developed in this context. They range from the removal of the frenulum in boys and men through partial or complete removal of the [[foreskin]] up to radical operations. Australian Aborigines, as mentioned above, have their [[foreskin]]s removed. It is also usual that, a few weeks later, young men have their [[penis]]es sliced open, resulting in a partly or completely divided urethra.<br />
<br />
Another known, particularly massive, intervention is the stripping of the entire skin off the [[penis]]. In Indonesia, boys have metal or bamboo balls inserted into their [[penis]] shaft or [[Glans penis|glans]] at the beginning of puberty, which form little "humps".<br />
<br />
For many cultures it is also common to perform similar rituals on girls. This can range from relatively small interventions such as piercing or cutting the clitoral hood, to its complete removal and up to radical removal of clitoral hood, clitoris, inner and outer labia followed by sewing up the vagina.<br />
<br />
''The following text is taken from the [[Circumpendium]].''<br />
<br />
=== Prophylactic reasons ===<br />
<br />
Some people claim that circumcision has prophylactic benefits. Especially in the USA those arguments have persisted for more then a 100 years, with ever changing diseases circumcision is said to protect against. At first, these were diseases where [[masturbation]] was believed to be the cause. After bacteria and viruses had been discovered, arguments changed, and one after another miscellaneous diseases were cited.<br />
<br />
* [[Phimosis]]: as mentioned earlier, true [[phimosis]] is rare and can be treated effectively without surgery. According to a study by Blalock ''et al.'' (2003)<ref>{{REFjournal<br />
|last=Blalock<br />
|first=H.J.<br />
|last2=Vemulakonda<br />
|first2=V.<br />
|last3=Ritchey<br />
|first3=M.L.<br />
|last4=Ribbeck<br />
|first4=M.<br />
|title=Outpatient management of [[phimosis]] Following newborn circumcision<br />
|journal=J Urol<br />
|date=2003<br />
|volume=169<br />
|issue=6<br />
|pages=2332-2334<br />
|url=http://www.cirp.org/library/complications/blalock1/<br />
|accessdate=2019-11-07<br />
}}</ref>, 2.9% of those circumcised develop a post-operative [[phimosis]], in which the circumcision scar constricts. In intact patients, the rate of [[phimosis]] is only 1% (see also the study by [[Jakob Øster]]). Therefore, circumcision is not a preventive measure for [[phimosis]].<br />
* Sexually Transmitted Diseases (STDs): a vast number of studies has been conducted on the subject of transmission of STDs.<br />
* First, it has to be noted that any form of protection against these diseases only affects people who are sexually active. Circumcision in childhood cannot be justified on these grounds, since any assumed protective effect will not occur before the boy is already old enough to decide about circumcision for himself.<br />
* As mentioned above, the [[foreskin]] keeps the [[Glans penis|glans]] moist. This subpreputial moisture contains, among other substances, the enzyme lysozyme, which breaks up the cell wall of bacteria, thereby providing a natural antibacterial screen. This explains the results of several studies, such as Laumann ''et al.''<ref>{{REFjournal<br />
|last=Laumann<br />
|first=E.O.<br />
|last2=Masi<br />
|first2=C.M.<br />
|last3=Zuckerman<br />
|first3=E.W.<br />
|title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice<br />
|journal=JAMA<br />
|date=1997<br />
|volume=277<br />
|issue=<br />
|pages=1052-1057<br />
|url=http://www.cirp.org/library/general/laumann/<br />
|accessdate=2019-11-06<br />
}}</ref>, which found a higher rate of infection with bacterial venereal diseases in circumcised than in intact men.<br />
* The studies by Fleiss ''et al.'' (1998) support this.<ref name="fleiss-hodges-vanhowe1998">{{REFjournal<br />
|last=Fleiss<br />
|first=P.M.<br />
|last2=Hodges<br />
|first2=F.M.<br />
|last3=Van Howe<br />
|first3=R.S.<br />
|title=Immunological functions of the human prepuce<br />
|journal=Sex Transm Inf<br />
|date=1998<br />
|volume=74<br />
|issue=<br />
|pages=364-367<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1758142/pdf/v074p00364.pdf<br />
|accessdate=2019-11-06<br />
}}</ref> According to the [[AAP]], the general sexual behaviour of the male - such as frequent change in partners and the use of condoms - has a much higher impact on sexually transmitted diseases then the circumcision status.<ref>{{REFjournal<br />
|last=Task Force on Circumcision<br />
|first=<br />
|title=Circumcision policy statement<br />
|journal=Pediatrics<br />
|date=1999<br />
|volume=103<br />
|issue=3<br />
|pages=686-93<br />
|url=http://www.cirp.org/library/statements/aap1999/<br />
|accessdate=2019-11-15<br />
}}</ref><br />
* HIV / AIDS: in the recent past, the argument that circumcision could help to contain the spread of HIV has been stated numerous times.<br />
*:First, two notes: for one, the use of condoms is still by far the most effective protection against an infection. During intercourse with that preventive measure, circumcision status does not make a difference.<br />
*:Secondly, the assumed protection would only affect healthy men who have intercourse with an infected woman. An infected man can infect a women by transmission of his bodily fluids, so that his circumcision status is irrelevant. Therefore, the use of condoms remains vital in containing the spread of HIV, which in return renders circumcision unnecessary<br />
* Due to the inevitable loss of sensitivity as a result of circumcision, there is also the temptation to go without condoms, in order not to lose even more sensitivity.<ref>{{REFjournal<br />
|last=Hooykaas<br />
|first=C.<br />
|last2=van der Velde<br />
|first2=F.W.<br />
|last3=van der Linden<br />
|first3=M.M.<br />
|etal=yes<br />
|title=The importance of ethnicity as a risk factor for STDs and sexual behaviour among heterosexuals<br />
|journal=Genitourin Med<br />
|date=1991<br />
|volume=67<br />
|issue=5<br />
|pages=378-383<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1194736/pdf/genitmed00041-0022.pdf<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Michael<br />
|first=R.T.<br />
|last2=Wadsworth<br />
|first2=J.<br />
|last3=Feinleib<br />
|first3=J.<br />
|etal=yes<br />
|title=Private sexual behavior, public opinion, and public health policy related to sexually transmitted diseases: a US-British comparison<br />
|journal=Am J Public Health<br />
|date=1998<br />
|volume=88<br />
|issue=5<br />
|pages=749-754<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1508929/pdf/amjph00017-0039.pdf<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Laumann<br />
|first=E.O.<br />
|last2=Masi<br />
|first2=C.M.<br />
|last3=Zuckerman<br />
|first3=E.W.<br />
|title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice<br />
|journal=JAMA<br />
|date=1997<br />
|volume=277<br />
|issue=<br />
|pages=1052-1057<br />
|url=http://www.cirp.org/library/general/laumann/<br />
|accessdate=2019-11-06<br />
}}</ref><br />
* Two studies that have been published in early 2007<ref>{{REFjournal<br />
|last=Gray, R.H. and colleagues<br />
|first=<br />
|title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial<br />
|journal=Lancet<br />
|date=2007<br />
|volume=369<br />
|issue=<br />
|pages=657-666<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=[[Robert C. Bailey|Bailey, R.C.]] and colleagues<br />
|first=<br />
|title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial<br />
|journal=Lancet<br />
|date=2007<br />
|volume=369<br />
|issue=<br />
|pages=643-656<br />
|url=<br />
|accessdate=<br />
}}</ref>, which investigated the effectiveness of circumcision as a means of reducing the spread of HIV from infected women to heterosexual men in African high risk areas, have been repeatedly subjected to strong criticism. Both studies were ended prematurely, which distorted the results. The men who had been circumcised for the study had to stay sexually inactive during the wound healing, which gave the intact control group more relative opportunity to become infected. These African randomized clinical trials have been demonstrated to have very serious methodological and statistical errors that distort the results in favor of circumcision.<ref name="boyle-hill2011">{{REFjournal<br />
|last=Boyle<br />
|first=Gregory J.<br />
|author-link=Gregory Boyle<br />
|last2=Hill<br />
|first2=George<br />
|author2-link=George Hill<br />
|title=Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns<br />
|journal=J Law Med<br />
|date=2011-12<br />
|volume=19<br />
|issue=2<br />
|pages=316-34<br />
|url=http://www.salem-news.com/fms/pdf/2011-12_JLM-Boyle-Hill.pdf<br />
|quote=<br />
|pubmedID=22320006<br />
|pubmedCID=<br />
|DOI=<br />
|accessdate=2019-11-09<br />
}}</ref><br />
<br />
The fact that the USA has both the highest rate of circumcised males in the western world, as well as the highest HIV infection rate, makes the studies look dubious. Besides that, several other studies concluded that circumcision does not have a significant impact on the risk of infection with HIV.<ref>{{REFjournal<br />
|last=Grosskurth<br />
|first=H.<br />
|last2=Mosha<br />
|first2=F.<br />
|last3=Todd<br />
|first3=J.<br />
|etal=yes<br />
|title=A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results<br />
|journal=AIDS<br />
|date=1995<br />
|volume=9<br />
|issue=8<br />
|pages=927-934<br />
|url=https://insights.ovid.com/aids/aids/1995/08/000/community-trial-impact-improved-sexually/15/00002030<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Barongo<br />
|first=L.R.<br />
|last2=Borgdorff<br />
|first2=M..W.<br />
|last3=Mosha<br />
|first3=F.F.<br />
|etal=yes<br />
|title=The epidemiology of HIV-1 infection in urban areas, roadside settlements and rural villages in Mwanza Region, Tanzania<br />
|journal=AIDS<br />
|date=1992<br />
|volume=6<br />
|issue=12<br />
|pages=1521-1528<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Changedia SM, Gilada IS<br />
|first=<br />
|title=Role of male circumcision in HIV transmission insignificant in conjugal relationship (abstract no. ThPeC7420)<br />
|url=<br />
|place=Barcelona, Spain<br />
|source=Presented at the Fourteenth International AIDS Conference<br />
|datefrom=2002-07-07<br />
|dateto=2002-07-12<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Connolly CA, Shishana O, Simbayi L, Colvin M<br />
|first=<br />
|title=HIV and circumcision in South Africa (Abstract No. MoPeC3491)<br />
|url=<br />
|place=Bangkok, Thailand<br />
|source=Presented at the 15th International AIDS Conference<br />
|datefrom=2004-07-11<br />
|dateto=2004-07-16<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Thomas AG, Bakhireva LN, Brodine SK, Shaffer RA<br />
|first=<br />
|title=Prevalence of male circumcision and its association with HIV and sexually transmitted infections in a U.S. navy population (Abstract no. TuPeC4861)<br />
|url=https://apps.dtic.mil/dtic/tr/fulltext/u2/a458066.pdf<br />
|place=Bangkok, Thailand<br />
|source=Presented at the 15th International AIDS Conference<br />
|datefrom=2004-07-11<br />
|dateto=2004-07-16<br />
|accessdate=2019-11-15<br />
}}</ref><br />
* Urinary tract infections (UTI): a UTI can be effectively treated with antibiotics, this was also proven by studies<ref>{{REFjournal<br />
|last=McCracken<br />
|first=G.<br />
|title=Options in antimicrobial management of urinary tract infections in infants and children<br />
|journal=Pediatr Infect Dis J<br />
|date=1989<br />
|volume=8<br />
|issue=8<br />
|pages=552-555<br />
|url=http://www.cirp.org/library/disease/UTI/mccracken/<br />
|accessdate=2019-11-19<br />
}}</ref><ref>{{REFjournal<br />
|last=Larcombe<br />
|first=J.<br />
|title=Urinary tract infection in children<br />
|journal=BMJ<br />
|date=1999<br />
|volume=319<br />
|issue=<br />
|pages=1173-1175<br />
|url=<br />
|accessdate=<br />
}}</ref>. A Swedish study <ref>{{REFjournal<br />
|last=Mårild<br />
|first=S.<br />
|last2=Jodal<br />
|first2=U.<br />
|title=Incidence rate of first–time symptomatic urinary tract infection in children under 6 years of age<br />
|journal=Acta Paediatr<br />
|date=1998<br />
|volume=87<br />
|issue=5<br />
|pages=549-552<br />
|url=<br />
|accessdate=<br />
}}</ref> found that, during the first 6 years of life, the incidence of UTIs in boys was 1.8%, but in girls was 6.6%. UTIs are less common in boys after the first year of life. Mueller ''et al.'' <ref>{{REFjournal<br />
|last=Mueller<br />
|first=E.R.<br />
|last2=Steinhardt<br />
|first2=G.<br />
|last3=Naseer<br />
|first3=S.<br />
|title=The incidence of genitourinary abnormalities in circumcised and uncircumcised boys presenting with an initial urinary tract infection by 6 months of age<br />
|journal=Pediatrics<br />
|date=1997<br />
|volume=100 (Supplement)<br />
|issue=<br />
|pages=580<br />
|url=<br />
|accessdate=<br />
}}</ref> did not find a significant difference in UTI rates between circumcised and intact boys with normal urinary tract anatomy.<br />
* Other studies suggest that circumcision is more likely to raise than to lower the generally low risk of acquiring UTI: multiple studies from Israel showed a strong correlation between ritual circumcision on the 8th day of life and postoperative UTI.<ref>{{REFjournal<br />
|last=Menahem<br />
|first=S.<br />
|title=Complications arising from ritual circumcision: pathogenesis and possible prevention<br />
|journal=Isr J Med Sci<br />
|date=1981<br />
|volume=17<br />
|issue=1<br />
|pages=45-48<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Cohen<br />
|first=H.A.<br />
|last2=Drucker<br />
|first2=M.M.<br />
|last3=Vainer<br />
|first3=S.<br />
|etal=yes<br />
|title=Postcircumcision urinary tract infection<br />
|journal=Clin Pediatr<br />
|date=1992<br />
|volume=31<br />
|issue=6<br />
|pages=322-324<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Goldman<br />
|first=M.<br />
|last2=Barr<br />
|first2=J.<br />
|last3=Bistritzer<br />
|first3=T.<br />
|last4=Aladjem<br />
|first4=M.<br />
|title=Urinary tract infection following ritual Jewish circumcision<br />
|journal=Isr J Med Sci<br />
|date=1996<br />
|volume=32<br />
|issue=<br />
|pages=1098-1102<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
* It can be concluded that circumcision is ineffective as a preventive measure against UTIs.<br />
* Penile and cervical cancer / HPV: first studies on those diseases and their assumed prevention by circumcision date back to 1932, a time when the cause for those illnesses was not yet fully understood<br />
<ref>{{REFjournal<br />
|last=Wolbarst<br />
|first=A.<br />
|title=Circumcision and penile cancer<br />
|journal=Lancet<br />
|date=1932<br />
|volume=1<br />
|issue=5655<br />
|pages=150-153<br />
|url=<br />
|accessdate=<br />
}}</ref>. Today, it is known that sexually transmitted human papillomavirus (HPV) is a major risk factor<ref>{{REFjournal<br />
|last=McCance<br />
|first=D.J.<br />
|last2=Kalache<br />
|first2=A.<br />
|last3=Ashdown<br />
|first3=K.<br />
|etal=yes<br />
|title=Human papillomavirus types 16 and 18 in carcinomas of the penis from Brazil<br />
|journal=Int J Cancer<br />
|date=1986<br />
|volume=37<br />
|issue=1<br />
|pages=55-59<br />
|url=<br />
|accessdate=<br />
}}</ref>, as well as smoking<ref>{{REFjournal<br />
|last=Harish<br />
|first=K.<br />
|last2=Ravi<br />
|first2=R.<br />
|title=The role of tobacco in penile carcinoma<br />
|journal=Brit J Urol<br />
|date=1995<br />
|volume=75<br />
|issue=3<br />
|pages=375-377<br />
|url=<br />
|accessdate=<br />
}}</ref>. Studies have shown that there is no significant difference in the risk of getting penile cancer between circumcised and intact men. To prevent a single case of penile cancer, it would statistically take 600 to 900 circumcisions<ref>{{REFdocument<br />
|title=Position Paper on Neonatal Circumcision<br />
|url=<br />
|contribution=<br />
|last=<br />
|first=<br />
|publisher=American Academy of Family Physicians (Leawood, Kansas)<br />
|format=<br />
|date=2002-02-14<br />
|accessdate=<br />
}}</ref>. The influence of circumcision on the infection risk of the female partner with cervical cancer has been refuted several times as well. HPV vaccination is an effective measure against carcinoma of the cervix.<br />
<br />
In conclusion, circumcision does not provide any proven benefits in preventive medicine.<br />
<br />
== Non-medical indications for circumcision ==<br />
<br />
Apart from the medical indication of pathological phimosis, there also are other reasons for circumcision.<br />
<br />
=== Aesthetic reasons ===<br />
<br />
The visual appearance of the [[penis]] is changed radically after circumcision. In this case, personal taste is decisive whether an intact or a cut [[penis]] is more appealing. Since a circumcision cannot be undone, it is essential to be fully informed about the risks and possible later complications before embarking on an aesthetically motivated circumcision, to decide whether the appearance will justify such bodily modification.<br />
<br />
Since this modification and its possible late effects will be the lifelong burden of the person who undertakes an aesthetically motivated circumcision to suit his personal preferences, a valid decision to proceed can only be made by the person to be circumcised himself, once he has reached the necessary age and level of maturity to make that decision. This should normally be the case when adulthood is reached.<br />
<br />
It should be noted that every circumcision operation leaves a life-long [[circumcision scar]] that encircles the shaft of the penis.<br />
<br />
===Financial reasons===<br />
<br />
In the United States, payment for non-therapeutic circumcision is made by most [[third-party payment| third-party payers]] without question. Doctors frequently perform medically-unnecessary, non-therapeutic circumcision of infants and children simply to collect a fee for the surgical operation. The only beneficiary of such surgery is the [[Financial Incentive| bank account of the medical doctor]].<br />
<br />
=== Moral reasons ===<br />
<br />
With the [[foreskin]], circumcision removes approximately 70% of the sensitive tissue of the [[penis]], lowering the potential for sexual stimulation accordingly. Due to the loss of around 50% of the entire penile skin, the [[penis]] loses the reserve skin that provides cutaneous mobility in the erect [[penis]] and the [[gliding action]].<br />
<br />
In the past, this circumstance was used to make it harder for boys to masturbate and [[masturbation]] less fun, as [[masturbation]] was viewed as immoral and was assumed to cause a variety of diseases. More on that can be found in the chapter "[[Circumcision#Historical_background|Historical background]]". Today, it is known that [[masturbation]] has no negative health effects, but can contribute positively to the child's sexual development. Sexuality is no longer a taboo nowadays, while [[masturbation]] is considered to be a natural part of human sexuality and is no longer seen as immoral. Therefore, circumcision for moral reasons - which would only affect boys too young to give informed consent - is no longer justifiable nowadays.<br />
<br />
=== Hygiene reasons ===<br />
<br />
''Hygiene'' refers to health and only secondarily to cleanliness. <br />
<br />
One should note that the human foreskin is endowed by nature with [[Foreskin#Immunological_functions| immunological functions]] that serve to protect the human body from disease.<ref name="fleiss-hodges-vanhowe1998" /> The glans penis receives blood through the frenular artery.<ref>{{REFjournal<br />
|last=Persad<br />
|first=R.<br />
|author-link=<br />
|last2=Sharma<br />
|first2=S.<br />
|author2-link=<br />
|last3=McTavish<br />
|first3=J.<br />
|author3-link=<br />
|etal=yes<br />
|title=Clinical presentation and pathophysiology of meatal stenosis following circumcision<br />
|journal=Brit J Urol<br />
|date=1995<br />
|volume=75<br />
|issue=1<br />
|pages=91-3<br />
|url=https://www.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.1995.tb07242.x<br />
|quote=<br />
|pubmedID=7850308 <br />
|pubmedCID=<br />
|DOI=10.1111/j.1464-410x.1995.tb07242.x<br />
|accessdate=2019-11-26<br />
}}</ref> These facts are generally overlooked in arguments for alleged hygienic benefits of circumcision.<br />
<br />
A common reason stated for circumcision is the assumption of hygienic benefits. This argument has to be viewed in the context of the environment the person in question grows up in. It is commonly known that bad hygienic circumstances, especially insufficient access to clean drinking water, pose a serious problem. The situation in disaster areas or refugee camps in the so-called third world keep reminding us of that.<br />
<br />
In western industrial nations, however, this problem does not exist, in view of the availability of clean water for daily personal hygiene. If the cleaning of the genitals is performed on a daily basis - and that may be assumed - no pathogens can accumulate under the [[foreskin]]. Cleaning of the [[Glans penis|glans]] and the area underneath the [[foreskin]] is easy - they are simply washed along with the rest of the body, just like the areas between the toes.<br />
<br />
In small boys, where the [[foreskin]] cannot be retracted yet, cleaning is not necessary, since the [[Synechia| membrane]] that fuses the [[foreskin]] to the [[Glans penis|glans]] prevents the accumulation of micro-organisms. The so-called "ballooning", where the [[foreskin]] inflates during urination, is not a serious problem.<br />
<br />
The opening of the [[foreskin]] in small boys is often quite narrow and serves as a one-way valve, allowing the urine to flow out, but preventing entry of microbes, for example from a dirty diaper. As long as the child is able to pass water, everything works as nature intended.<br />
<br />
But even in areas where there are poorer hygienic conditions and an insufficient access to medical care, the benefits of easier cleaning of a circumcised [[penis]] are to be viewed with a critical eye. Although even longer periods without personal hygiene will not result in an accumulation of germs under the [[foreskin]], circumcision itself is not without risk of complications. If the operation is carried out without proper sterility, there is a high risk of an infection of the wound. This also applies to the treatment of common complications like post-operative bleeding.<br />
<br />
The benefit of easier cleaning must be balanced against the risk of promoting serious infections - among others HIV - during the operation. In parts of Africa, several dozen of one tribe's boys die each year as a result of their circumcision.<br />
<br />
<br />
== Circumcision methods ==<br />
<br />
The [[Circumcision methods]] are discussed in a separate article.<br />
<br />
== Risks and late effects ==<br />
<br />
Just like tonsil or appendix surgery, circumcision is a surgical intervention and brings the usual risks related to surgical operations, alongside several specific risks of complications and late effects.<br />
<br />
=== Possible operative and postoperative complications ===<br />
<br />
Circumcision is surgery. Surgical complications of circumcision generally may be classified as hemorrhage, infection, or surgical misadventure up to and including loss of the penis and [[death]].<ref name="williams-kapilla1993">{{REFjournal<br />
|last=Williams<br />
|first=N<br />
|author-link=<br />
|last2=Kapilla<br />
|first2=L<br />
|author2-link=<br />
|etal=no<br />
|title=Complications of circumcision<br />
|trans-title=<br />
|language=<br />
|journal=Brit J Surg<br />
|location=<br />
|date=1993-10<br />
|volume=80<br />
|issue=10<br />
|pages=1231-6<br />
|url=http://www.cirp.org/library/complications/williams-kapila/<br />
|quote=<br />
|pubmedID=8242285<br />
|pubmedCID=<br />
|DOI=10.1002/bjs.1800801005<br />
|accessdate=2019-11-27<br />
}}</ref><br />
<br />
* Intolerance or allergic reactions to the narcotics used.<br />
* Especially in newborns, where the bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is often insufficient for the operation. Even in conjunction with regional anaesthesia of the dorsal nerve of the [[penis]], the rate of failure to provide sufficient anaesthetic even for experienced anaesthetists is still 5-10%. The general anaesthesia that would be needed for newborns, however, poses significant risks for the child, and, therefore, is only likely to be used in emergencies. A surgical operation without proper pain control can lead to the development of a specific pain memory<ref>{{REFweb<br />
|url=http://www.spiegel.de/spiegel/vorab/experte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-849534.html<br />
|title=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder<br />
|trans-title=Children's pain expert warns: Ritual circumcision changes the brain of children<br />
|language=German<br />
|last=Prof. Dr. med. Boris Zernikow<br />
|first=<br />
|publisher=Spiegel Online<br />
|website=<br />
|date=2012-08-12<br />
|accessdate=2019-10-11<br />
|format=<br />
|quote=<br />
}}</ref>. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation. Overall, their pain threshold was lower and the risk of chronic pain increased. Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFjournal<br />
|last=Garry<br />
|first=T.<br />
|title=Circumcision: a survey of fees and practices<br />
|journal=OBG Management<br />
|date=1994<br />
|volume=October<br />
|issue=<br />
|pages=34-36<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Howard<br />
|first=C.R.<br />
|last2=Howard<br />
|first2=F.M.<br />
|last3=Garfunkel<br />
|first3=L.C.<br />
|last4=de Blieck<br />
|first4=E.A.<br />
|last5=Weitzman<br />
|first5=M.<br />
|title=Neonatal circumcision and pain relief: current training practices<br />
|journal=Pediatrics<br />
|date=1998<br />
|volume=101<br />
|issue=<br />
|pages=423-428<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Stang<br />
|first=H.J.<br />
|last2=Snellman<br />
|first2=L.W.<br />
|title=Circumcision practice patterns in the United States<br />
|journal=Pediatrics<br />
|date=1998<br />
|volume=101<br />
|issue=e5<br />
|pages=<br />
|url=<br />
|accessdate=<br />
|note=Link to [[AAP]] website<br />
}}</ref>. During procedures which take several minutes, babies tend to fall into a state of stupor, which in the past was falsely interpreted as peaceful sleep, nurturing the belief that babies felt no pain. Measurements taken in those cases revealed a typically 3- to 4-fold increase in cortisol levels, which equals a state of severe shock.<ref>{{REFjournal<br />
|last=Gunnar<br />
|first=M.R.<br />
|last2=Fisch<br />
|first2=R.O.<br />
|last3=Korsvik<br />
|first3=S.<br />
|last4=Donhowe<br />
|first4=J.M.<br />
|title=The effects of circumcision on serum cortisol and behavior<br />
|journal=Psychoneuroendocrinology<br />
|date=1981<br />
|volume=6<br />
|issue=3<br />
|pages=269-275<br />
|url=http://www.cirp.org/library/pain/gunnar/<br />
|accessdate=2019-11-26<br />
}}</ref><br />
* Postoperative wound pain, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions.<br />
* Postoperative pain from the exposure of the sensitive glans penis to clothing. This pain will endure for several weeks or even longer in some cases.<br />
* Postoperative bleeding of the wound. This can have severe consequences especially for very young infants, if they are not treated promptly. Their blood volume is only about 85 ml per kilogram of body weight, and even moderate blood loss can lead to hypovolaemia, hypovolaemic shock and even death.<ref>{{REFbook<br />
|last=<br />
|first=<br />
|year=2000<br />
|title=Paediatric Handbook<br />
|url=<br />
|work=<br />
|editors=Smart J, Nolan T.<br />
|edition=6<br />
|volume=<br />
|chapter=<br />
|pages=82<br />
|location=Victoria, Australia<br />
|publisher=Blackwell Science Asia<br />
|isbn=<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref><ref>{{REFdocument<br />
|title=Autopsy of Demetrius Manker<br />
|url=<br />
|contribution=Case 93-1711<br />
|last=Wetli<br />
|first=CV<br />
|publisher=Miami: Dade County Medical Examiner Department<br />
|format=<br />
|date=1993-06-23<br />
|accessdate=<br />
}}</ref> <ref>{{REFjournal<br />
|last=Hiss<br />
|first=J.<br />
|last2=Horowitz<br />
|first2=A.<br />
|last3=Kahana<br />
|first3=T.<br />
|title=Fatal haemorrhage following male ritual circumcision<br />
|journal=J Clin Forensic Med<br />
|date=2000<br />
|volume=7<br />
|issue=<br />
|pages=32-34<br />
|url=http://www.cirp.org/library/death/hiss1/<br />
|accessdate=2019-11-06<br />
}}</ref><ref>{{REFdocument<br />
|title=Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan<br />
|url=http://www.circumstitions.com/death-exsang.html<br />
|contribution=<br />
|last=Newell<br />
|first=TEC<br />
|publisher=Burnaby, B.C.: B.C. Coroner's Service<br />
|format=<br />
|date=2004-01-19<br />
|accessdate=2019-11-26<br />
}}</ref><br />
* Post operative [[lymphoedema]].<br />
* Postoperative infections. This includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.<ref>{{REFconference<br />
|last=Dr. med. Hartmann<br />
|first=Wolfgang<br />
|url=<br />
|place=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German)<br />
|title=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German)<br />
|date=2012-11-26<br />
|accessdate=<br />
}}</ref><br />
* [http://www.circumstitions.com/Restric/Botched9wd.html Wound dehiscence], meaning the separation of the edges of the wound or the tissue after suturing.<br />
* Adhesion between the surface or rim of the [[Glans penis|glans]] with the neighbouring penile skin, causing skin pockets and bridges, as well as visually unpleasant results like uneven scars, which make a re-circumcision necessary.<br />
* Postoperative [[phimosis]]: a phimotic ring can develop during scarring, which makes a re-circumcision necessary. According to a study by Blalock ''et al.''<ref>{{REFjournal<br />
|last=Blalock<br />
|first=H.J.<br />
|last2=Vemulakonda<br />
|first2=V.<br />
|last3=Ritchey<br />
|first3=M.L.<br />
|last4=Ribbeck<br />
|first4=M.<br />
|title=Outpatient management of [[phimosis]] Following newborn circumcision<br />
|journal=J Urol<br />
|date=2003<br />
|volume=169<br />
|issue=6<br />
|pages=2332-2334<br />
|url=http://www.cirp.org/library/complications/blalock1/<br />
|accessdate=2019-11-26<br />
}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal<br />
|last=Leitch<br />
|first=I.O.W.<br />
|title=Circumcision - a continuing enigma<br />
|journal=Aust Paediatr J<br />
|date=1970<br />
|volume=6<br />
|issue=<br />
|pages=59-65<br />
|url=http://www.cirp.org/library/general/leitch1/<br />
|accessdate=2019-12-15<br />
}}</ref> 5.5%.<br />
*<br />
* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], is cut during circumcision without being clamped and sutured at its origin separately, it starts to develop new branches over time, which can lead to the development of knots.<br />
* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro-penis) and induratio [[penis]] plastica (skewed penis).<br />
* Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis|glans]] or the [[penis]] can occur.<br />
* In rare cases, necrosis, gangrene, ischaemia, keloid formation and circulatory problems may also occur.<br />
* When the circumcision is followed by the ultra-orthodox Jewish ritual of Metzitzah B'Peh (which consists of sucking blood from the wound with the mouth), there is a risk of infection with [[herpes]] simplex type 1, which can lead to brain damage or death.<ref>{{REFweb<br />
|url=http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritual.html?_r=0<br />
|title=Baby’s Death Renews Debate Over a Circumcision Ritual<br />
|last=Robbins<br />
|first=Liz<br />
|date=2012-03-07<br />
|accessdate=2019-10-11<br />
}}</ref><br />
<br />
=== Physical late effects ===<br />
<br />
* An unavoidable late effect of any circumcision is the permanent loss of sexual sensitivity. This is partly due to the removal of sensory tissue. The [[foreskin]] contains very many nerve endings and touch receptors, which account for the major part of male sexual sensation. If the [[foreskin]] is removed, they can no longer provide sexual stimulation. It is also partly due to the fact that the surface of the [[Glans penis|glans]] reacts to the missing protection from friction and drying out by developing a callus layer. This reduces the sensitivity of the remaining nerves in the [[Glans penis|glans]] gradually over the years. The study conducted by Sorrells ''et al.''<ref>{{REFjournal<br />
|last=Sorrells<br />
|first=M.L.<br />
|last2=Snyder<br />
|first2=J..L.<br />
|last3=Reiss<br />
|first3=M.D.<br />
|etal=yes<br />
|title=Fine-touch pressure thresholds in the adult [[penis]]<br />
|journal=BJU Int<br />
|date=2007<br />
|volume=99<br />
|issue=<br />
|pages=864-869<br />
|url=<br />
|accessdate=<br />
}}</ref> found a significant reduction of sensitivity to touch for circumcised compared to intact [[penis]]es in adult males. Other studies revealed that circumcised men use condoms significantly less often than intact men, since they further limit the sexual sensitivity (see above).<br />
<br />
* Painful tension can occur when there is too little reserve skin left to support a full erection<ref>{{REFjournal<br />
|last=Taylor<br />
|first=J.R.<br />
|last2=Lockwood<br />
|first2=A.P.<br />
|last3=Taylor<br />
|first3=A.J.<br />
|title=The prepuce: <q>Specialized mucosa of the [[penis]] and its loss to circumcision</q><br />
|journal=British Journal of Urology<br />
|date=1996<br />
|volume=77<br />
|issue=<br />
|pages=291-295<br />
|url=<br />
|accessdate=<br />
}}</ref>. This risk is partly dependent on the anatomy of the [[penis]]. While some [[penis]]es already have the majority of their full size when flaccid ([[Flesh Penis]], or "[[shower]]"), others are rather short when flaccid and double or more their size during an erection ([[Blood Penis]], or "[[grower]]"). Especially in children's circumcision, where the [[penis]] is not yet fully developed, the amount of reserve skin needed in adulthood cannot be estimated.<br />
<br />
* Erectile dysfunction: Both the damage inflicted to the blood vessels in the [[foreskin]] and the reduced sexual sensitivity can be causes for reduced erectile function with advancing age.<ref>{{REFjournal<br />
|last=Money<br />
|first=J.<br />
|last2=Davison<br />
|first2=J.<br />
|title=Adult penile circumcision: Erotosexual and cosmetic sequelae<br />
|journal=Journal of Sex Research<br />
|date=1983<br />
|volume=19<br />
|issue=<br />
|pages=289-292<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
<br />
* Orgasm problems: In the wake of reduced sexual sensitivity, due to the loss of sensory tissue and gradual keratinization of the surface of the [[Glans penis|glans]], orgasm problems may develop with increasing age. In this case, the sexual arousal created by intercourse or [[masturbation]] is not enough to achieve orgasm. A preliminary stage of this late effect is the prolonged time circumcised men need to reach an orgasm. This is often fielded as the "cut men have more endurance" argument for circumcision.<br />
* Vaginal dryness: Due to the loss of the natural gliding action, which comes from the mobility of the fore- and shaft skin, a much increased friction between [[penis]] and vagina occurs during intercourse. This can make intercourse painful for both partners and lead to abrasions<ref>{{REFjournal<br />
|last=Frisch<br />
|first=Morten<br />
|author-link=Morten Frisch<br />
|first2=Morten<br />
|last2=Lindholm<br />
|first3=Morten<br />
|last3=Grønbæk<br />
|title=Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark<br />
|journal=International Journal of Epidemiology<br />
|date=2011-10<br />
|volume=40<br />
|issue=5<br />
|pages=1367-1381<br />
|url=<br />
|pubmedID=21672947<br />
|DOI=10.1093/ije/dyr104<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Cortés-González<br />
|first=J.<br />
|last2=Arratia-Maqueo<br />
|first2=J.<br />
|last3=Gómez-Guerra<br />
|first3=L.<br />
|title=Does circumcision has an effect on female's perception of sexual satisfaction?<br />
|journal=Rev Invest Clin<br />
|date=2008<br />
|volume=60<br />
|issue=3<br />
|pages=227<br />
|url=<br />
|pubmedID=18807735<br />
|accessdate=<br />
}}</ref> The prolonged time it takes circumcised men to reach orgasm, as well as the often longer and more vigorous thrusting movements - compared to intact men - play a part in this.<ref>{{REFjournal<br />
|last=Cold<br />
|first=C.J.<br />
|last2=Taylor<br />
|first2=J.R.<br />
|title=The prepuce<br />
|journal=BJU Int<br />
|date=1999<br />
|volume=83<br />
|issue=Suppl. 1<br />
|pages=34-44<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
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|first=K.S.<br />
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|first2=C.C.<br />
|last3=DeVellis<br />
|first3=R.F.<br />
|title=Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction<br />
|journal=J Urol<br />
|date=2002<br />
|volume=167<br />
|issue=5<br />
|pages=2113-2116<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
<br />
* [[Lymphoedema]] of the penis is a normal and expected complication of male circumcision.<br />
<br />
* [[Meatal stenosis]], a pathological narrowing of the opening of the urethra, which mostly occurs in infancy and early childhood. It is one of the most common complications of infant circumcision. A study from 2006 found meatal stenosis exclusively in previously circumcised boys. The incidence rate after a circumcision is approximately 10 to 20 percent.<ref name="vanhowe2006">{{REFjournal<br />
|last=Van Howe<br />
|first=R.S.<br />
|title=Incidence of meatal stenosis following neonatal circumcision in a primary care setting<br />
|journal=Clin Pediatr (Phila)<br />
|note=Jan-Feb 2006<br />
|date=2006-01<br />
|volume=45<br />
|issue=1<br />
|pages=49-54<br />
|url=https://www.academia.edu/6992015/Incidence_of_Meatal_Stenosis_following_Neonatal_Circumcision_in_a_Primary_Care_Setting<br />
|accessdate=2019-12-15<br />
}}</ref><ref>{{REFjournal<br />
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|first=A.<br />
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|first2=G.<br />
|last3=Okmian<br />
|first3=L.<br />
|title=Circumcision for [[phimosis]]: a follow-up study<br />
|journal=Scandinavian journal of urology and nephrology<br />
|date=1986<br />
|volume=20<br />
|issue=2<br />
|pages=89<br />
|url=<br />
|pubmedID=3749823<br />
|accessdate=<br />
}} </ref><ref>{{REFweb<br />
|url=http://emedicine.medscape.com/article/1016016-overview<br />
|title=Meatal Stenosis<br />
|publisher=Medscape<br />
|accessdate=2019-10-11<br />
}}</ref><br />
<br />
=== Psychological late effects ===<br />
<br />
[[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effects]] are also possible after a circumcision, especially if the operation was carried out in childhood. On this occasion a variety of trauma may occur, which depend, among others, on age and circumstances of the circumcision. For example, whether the circumcision took place with or without sufficient anaesthesia, if the individual has been informed about the operation beforehand, if he was circumcised against his will or without his consent, and also, in the case of infant circumcision, if he was told about it during childhood or had to find it out coincidentally on his own.<br />
<br />
The psychological late effects of circumcision are not yet fully researched, and many studies took place on rather a small scale. This situation needs to be rectified, because the available studies, as well as the histories of negatively affected men, suggest that these late effects may have more impact than previously assumed.<br />
<br />
* It was observed that infants, following circumcision without pain control, had a disturbed bond with their mother<ref>{{REFjournal<br />
|last=Marshall<br />
|first=R.E.<br />
|last2=Porter<br />
|first2=F.L.<br />
|last3=Rogers<br />
|first3=A.G.<br />
|etal=yes<br />
|title=Circumcision: II effects upon mother-infant interaction<br />
|journal=Early Hum Dev<br />
|date=1982<br />
|volume=7<br />
|issue=4<br />
|pages=367-374<br />
|url=http://www.cirp.org/library/birth/marshall2/<br />
|accessdate=2020-02-01<br />
}}</ref>, as well as problems with nurturing, up to the point of refusal to be fed. The sleeping habits of these babies were also disturbed, with prolonged non-REM sleep and increased waking.<br />
<br />
* In boys circumcised in childhood, post traumatic stress disorder (PTSD) could be diagnosed. In a study on Philippine boys, in whom no PTSD was found prior to the operation, 69% of the boys circumcised in the traditional ritual and 51% of those circumcised by standard medical procedures (including anaesthesia) fulfilled the DSM-IV criteria for PTSD following the operation.<ref>{{REFbook<br />
|last=Ramos<br />
|first=S<br />
|last2=Boyle<br />
|first2=GJ<br />
|year=2001<br />
|title=Understanding circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem<br />
|url=https://link.springer.com/chapter/10.1007/978-1-4757-3351-8_14<br />
|work=<br />
|editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]<br />
|edition=<br />
|volume=<br />
|chapter=Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder<br />
|pages=253-270<br />
|location=New York<br />
|publisher=Kluwer Academic/Plenum Publishers<br />
|isbn=<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref><br />
* Circumcisions, especially those that happen without consent, can spark feelings of helplessness and alienation, which can persist as trauma. These feeling can also be triggered later, when someone circumcised as an infant becomes aware of his circumcision. In an online study, interviewed men stated they felt betrayed - 55% by the mother, 50% by the father, and 58% by the doctor, and 73% felt that their human rights had been violated.<ref name="GSoCH">{{REFweb<br />
|url=http://www.circumcisionharm.org/<br />
|title=Global Survey of Circumcision Harm<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* It can frequently be found that the loss is denied, much as happens with the loss of other body parts. This denial can lead to fathers having their sons circumcised in order not to be reminded of their own loss. In this process, their own body is defined as "normal" and the [[foreskin]] redefined as a foreign object. Their own parents are seen as "good", so that this image is projected onto the circumcision their parents carried out as well, in order to keep the positive emotion intact. The father wants to be a "good" father later in life as well, and so, following an idealised image of his own parents, circumcision, which has been redefined as a "good thing", is passed on to his son by having him circumcised as well.<ref>{{REFjournal<br />
|last=van der Kolk<br />
|first=B.A.<br />
|url=http://www.cirp.org/library/psych/vanderkolk/<br />
|title=The compulsion to repeat the trauma: re-enactment, revictimization, and masochism<br />
|journal=Psychiatr Clin North Am<br />
|date=1989<br />
|volume=12<br />
|issue=2<br />
|pages=389-411<br />
|accessdate=2019-10-12<br />
}}</ref><ref>{{REFjournal<br />
|last=Goldman<br />
|first=R.<br />
|author-link=Ronald Goldman<br />
|url=http://www.cirp.org/library/psych/goldman1/<br />
|title=The psychological impact of circumcision<br />
|journal=BJU Int<br />
|date=1999<br />
|volume=83<br />
|issue=Suppl. 1<br />
|pages=93-103<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* If the circumcised male feels incomplete, or due to the missing [[foreskin]] disadvantaged compared to intact males, an inferiority complex and depression may occur. This can be accompanied by conscious recognition of his own incompleteness, or the deficiency may remain completely subconscious<ref>{{REFjournal<br />
|last=Rhinehart<br />
|first=J.<br />
|url=http://www.cirp.org/library/psych/rhinehart1/<br />
|title=Neonatal circumcision reconsidered<br />
|journal=Transactional Analysis J<br />
|date=1999<br />
|volume=29<br />
|issue=3<br />
|pages=215-221<br />
|accessdate=2019-10-12<br />
}}</ref>. In an online study, 75% of those interviewed stated that they felt incomplete, and 66% said they felt inferior compared with intact males.<ref name="GSoCH"/><br />
* Cases in which children felt ill treated or punished have been documented as well. G. Cansever found in her study on 12 boys aged between 4 and 7 years, who had previously been prepared for their impending circumcision, that the children experienced the operation as an aggressive assault on their bodies.<ref>{{REFjournal<br />
|last=Cansever<br />
|first=G.<br />
|date=1965<br />
|url=http://www.cirp.org/library/psych/cansever/<br />
|title=Psychological effects of circumcision<br />
|journal=Brit. J. Med. Psychol<br />
|volume=38<br />
|pages=321-331<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* Fear of being alone or darkness.<ref name="Levy1945">{{REFjournal<br />
|last=Levy<br />
|first=David M.<br />
|url=http://www.cirp.org/library/psych/levy1/<br />
|title=Psychic trauma of operations in children; and a note on combat neurosis<br />
|journal=American Journal of Diseases of Children<br />
|volume=69<br />
|date=1945<br />
|pages=7-25<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* Fear of doctors, clinics and also closed rooms.<ref name="Levy1945"/><br />
* Relapse into the state of bed-wetting, even if the child was already dry before.<ref name="Levy1945"/><br />
* Circumcised males who become fathers frequently manifest [[adamant father syndrome]].<br />
<br />
== Rights and ethics ==<br />
<br />
The [[Rights situation on circumcision|rights situation]] is discussed in separate article.<br />
<br />
<br />
-----<br />
<br />
<br />
{{FromIntactWiki<br />
|URL=http://intactwiki.org/wiki/Circumcision<br />
|Title=Circumcision<br />
}}<br />
<br />
[[Image:Intact vs circumcised.JPG |thumbnail|right|300px| The intact and circumcised human penis, side by side.]]<br />
<br />
The term "circumcision" without a gender qualifier refers specifically to male circumcision. It means "to cut around," and it refers to the excision of the [[foreskin]] from the penis. Circumcision is most often performed in healthy males for [[Religion and Culture|religious or cultural]] reasons. The procedure may be performed on consenting adults, but it is most often performed on non-consenting minors, particularly newborn children, which is why the ritual is so controversial. Opponents of circumcision consider the circumcision of non-consenting minors to be unethical and a human rights violation, unless there is concrete medical indication. Proponents of circumcision consider the circumcision of non-consenting minors to be a "religious freedom" and a "parental right."<br />
<br />
== Complications ==<br />
=== Pain ===<br />
In the past, advocates of circumcision claimed that a newborn child's nerve system was not yet fully developed, and that as a result, the child felt no pain during the circumcision procedure. Anand & Hickey (1987) have shown that newborn children do in fact feel pain, and more acutely than adults.<ref name="anand-hickey1987">{{REFjournal<br />
|last=Anand<br />
|first=<br />
|author-link=<br />
|last2=Hickey<br />
|first2=<br />
|author2-link=<br />
|etal=no<br />
|title=Pain and its effects in the human neonate and fetus<br />
|trans-title=<br />
|language=<br />
|journal=New Engl J Med<br />
|location=<br />
|date=1987-11-19<br />
|volume=317<br />
|issue=21<br />
|pages=1321-9<br />
|url=http://www.cirp.org/library/pain/anand/<br />
|quote=<br />
|pubmedID=3317037<br />
|pubmedCID=<br />
|DOI=<br />
|accessdate=2019-11-08<br />
}}</ref> This has led American health associations to recommend doctors take measures to reduce the pain of circumcision in infants.<br />
<br />
The [[Position Statements on Infant Circumcision|AAP Circumcision Policy Statement]] states quite clearly that ''"There is considerable evidence that newborns who are circumcised without analgesia experience pain and physiologic stress"''. Furthermore, the pain is quite severe, and requires injections for proper pain management. Sucrose and Acetaminophen ''"cannot be recommended as the sole method of analgesia"''. Topical cream is no longer thought sufficient as ''"the analgesic effect is limited during the phases associated with extensive tissue trauma such as...tightening of the clamp"''.<ref>{{REFjournal<br />
|last=<br />
|first=<br />
|title=American Academy of Pediatrics: Circumcision Policy Statement; Task Force on Circumcision<br />
|journal=Pediatrics<br />
|date=1999-03<br />
|volume=103<br />
|issue=3<br />
|pages=686-693<br />
|url=https://pediatrics.aappublications.org/content/103/3/686#sec-9<br />
|accessdate=2019-11-26<br />
|note=Statement Reaffirmed Sept. 1, 2005<br />
}}</ref><br />
<br />
The [[AAFP]] states quite simply in their [[Position Statements on Infant Circumcision|position paper]], ''"Newborns experience pain during circumcision".''<ref>{{REFweb<br />
|title=Circumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed<br />
|website=Official American Academy of Family Physicians Website<br />
|url=http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html<br />
|accessdate=2011-05-02<br />
}}</ref> This is not a debatable fact, and yet, it is not widely accepted, even by some doctors. It might be hard for some doctors to accept, as they may have been taught that the infant does not feel pain, and may have performed countless circumcisions with this idea. Usage of anesthesia for infant circumcision is still by no means the rule.<br />
<br />
Penile injections of anesthetic are now recommended by all of the major medical institutions. In their [http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml Report 10 of the Council on Scientific Affairs], the AMA states ''"When the decision is made to proceed with circumcision, local anesthesia should be provided for the procedure. Ring block or dorsal penile blocks [injections] are most effective. EMLA cream has limited utility"''. Alarmingly, ''"Despite the clear evidence that newborn males generate brisk pain responses during circumcision, a recent survey of residency training programs found that 26% of programs that taught circumcision provided no instruction on the use of local anesthesia". The AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, and 25% of obstetricians"''.<ref>{{REFweb<br />
|title=Report 10 of the Council on Scientific Affairs (I-99): Neonatal Circumcision<br />
|website=American Medical Association Official Website<br />
|url=http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml<br />
|accessdate=2011-05-04<br />
}}</ref><br />
<br />
The AAP's [http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx Heatlhy Children website] suggests ''"Your pediatrician (or your obstetrician) should discuss the forms of analgesia that are available"''.<ref>{{REFweb<br />
|title=Where We Stand: Circumcision<br />
|publisher=[[AAP]]<br />
|date=2011-03-23<br />
|url=http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx<br />
|accessdate=2019-10-12<br />
}}</ref> Be that as it may, few forms of analgesia are recommended. There are basically two types of injections to choose from, and the website does not go into the difference between a 'dorsal nerve block' and a 'ring block' injection.<br />
<br />
Given what is known from aforementioned official documents, the AAP website may be more informative and effective if it would say ''"Make sure your doctor knows of the ineffectiveness of anything short of local anesthesia, and make sure your baby is given an injection. This is your responsibility, because your doctor may or may not be up to date on the latest understandings of infant sensitivity to pain during circumcision."'' The AAP may be holding back, however, perhaps because this would upset the doctor/parent power relationship, and may cause too much questioning of doctors in general. One may not expect to find this kind of advice on such a website, and yet, anything less than this is a dangerously weak statement.<br />
<br />
To control pain, some physicians that circumcise use Tylenol, sugar,<ref>{{REFweb<br />
| quote=To calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, and soothing music is played in the room.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-guide.html<br />
| title=Parents' Guide to Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2011-04-08<br />
}}</ref><ref>{{REFweb<br />
| quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> a topical cream,<ref>{{REFweb<br />
| quote=Then in our office, he will have topical anesthetic applied to his penis.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb<br />
| quote=We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-guide.html<br />
| title=Parents' Guide to Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2011-04-08<br />
}}</ref> Topical anaesthetic only serves to numb the area to lessen the pain of the injection, but studies have shown that a dorsal penile ring block is not always effective in stopping the pain of circumcision.<ref name='Journal of Perinatology April/May 2002'>{{REFjournal<br />
|last=Taeusch<br />
|first=H. William<br />
|last2=Martinez<br />
|first2=Alma M.<br />
|last3=Partridge<br />
|first3=J. Colin<br />
|last4=Sniderman<br />
|first4=Susan<br />
|last5=Armstrong-Wells<br />
|first5=Jennifer<br />
|last6=Fuentes-Afflick<br />
|first6=Elena<br />
|title=Pain During Mogen or Plastibell Circumcision<br />
|journal=Journal of Perinatology<br />
|volume=22<br />
|issue=3<br />
|pages=214-218<br />
|url=http://www.nature.com/jp/journal/v22/n3/full/7210653a.html<br />
|quote=...more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|note=April/May 2002<br />
|date=2002-04<br />
|accessdate=2011-04-08<br />
}}</ref><ref name='Clinical Pediatrics August 1986'>{{REFjournal<br />
|last=Williamson<br />
|first=Paul S.<br />
|last2=Evans<br />
|first2=Nolan Donovan<br />
|title=Neonatal Cortisol Response to Circumcision with Anesthesia<br />
|journal=Clinical Pediatrics<br />
|volume=25<br />
|issue=8<br />
|pages=412-416<br />
|url=http://cpj.sagepub.com/content/25/8/412.abstract<br />
|quote=The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=1986-08<br />
|accessdate=2011-04-08<br />
}}</ref> During circumcision, somp physicians give children sugar pacifiers to "reduce the perception of pain",<ref>{{REFweb<br />
| quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> but in at least one study, data shows that giving sugar to a child doesn't help to reduce the perception of pain in the child.<ref name='Lancet, The 2010-10-09'>{{REFjournal<br />
|last=Slater<br />
|first=Rebeccah<br />
|first2=Laura<br />
|last2=Cornelissen<br />
|first3=Lorenzo<br />
|last3=Fabrizi<br />
|first4=Debbie<br />
|last4=Patten<br />
|first5=Jan<br />
|last5=Yoxen<br />
|first6=Alan<br />
|last6=Worley<br />
|first7=Stewart<br />
|last7=Boyd<br />
|first8=Judith<br />
|last8=Meek<br />
|first9=Maria<br />
|last9=Prof. Fitzgerald<br />
|title=Oral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial<br />
|journal=The Lancet<br />
|volume=376<br />
|issue=9748<br />
|pages=1225-1232<br />
|url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2961303-7/fulltext<br />
|quote=Our data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuits, and therefore might not be an effective analgesic drug. The ability of sucrose to reduce clinical observational scores after noxious events in newborn infants should not be interpreted as pain relief.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=2010-10-09<br />
|accessdate=2011-04-08<br />
}}</ref> Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals.<br />
<br />
It has been shown that an infant's response to pain can be altered for years as a consequence of circumcision.<ref>{{REFjournal<br />
|last=Taddio<br />
|first=Anna<br />
|first2=Morton<br />
|last2=Goldbach<br />
|first3=Moshe<br />
|last3=Ipp<br />
|first4=Bonnie<br />
|last4=Stevens<br />
|first5=Gideon<br />
|last5=Koren<br />
|title=Effect of neonatal circumcision on pain responses during vaccination in boys<br />
|journal=The Lancet<br />
|volume=345<br />
|issue=8945<br />
|pages=291-2<br />
|url=http://www.cirp.org/library/pain/taddio/<br />
|quote=<br />
|pubmedID=7837863<br />
|pubmedCID=<br />
|DOI=<br />
|date=1995<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Taddio<br />
|first=Anna<br />
|last2=Katz<br />
|first2=J.<br />
|last3=Ilersich<br />
|first3=A.L.<br />
|last4=Koren<br />
|first4=G.<br />
|title=Effects of neonatal circumcision on pain response during subsequent routine vaccination<br />
|journal=The Lancet<br />
|volume=349<br />
|issue=9052<br />
|pages=599-603<br />
|url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)10316-0/fulltext<br />
|quote=<br />
|pubmedID=9057731<br />
|pubmedCID=<br />
|DOI=10.1016/S0140-6736(96)10316-0<br />
|date=1997-03<br />
|accessdate=<br />
}}</ref><br />
<br />
=== Sexual effects ===<br />
<br />
Circumcision and frenectomy remove tissues with heightened erogenous sensitivity. Boyle ''et al.'' (2002) wrote, "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings&mdash;many of which are lost to circumcision."<ref>{{REFjournal<br />
|last=Boyle<br />
|first=Gregory J.<br />
|author-link=Gregory Boyle<br />
|first2=Gillian A.<br />
|last2=Bensley<br />
|title=Adverse Sexual and Psychological Effects of Male Infant Circumcision<br />
|journal=Psychological reports<br />
|volume=88<br />
|issue=3, Part 2<br />
|pages=1105–1106<br />
|url=http://www.cirp.org/library/psych/boyle5/<br />
|quote=<br />
|pubmedID=11597060<br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410x.1999.0830s1085.x<br />
|date=July 2001<br />
|accessdate=<br />
}}</ref> They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well."<br />
<br />
The amputation of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the penis, leaving only the uninhibited protopathic sensibility of the artificially externalized glans penis. The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of the changes in sexual behavior noted in circumcised human males.<ref>{{REFjournal<br />
|last=Van Howe<br />
|first=R.S.<br />
|author-link=Robert Van Howe<br />
|last2=Cold<br />
|first2=C.J.<br />
|title=Advantages and Disadvantages of Neonatal Circumcision<br />
|journal=The Journal of the American Medical Association<br />
|volume=277<br />
|issue=13<br />
|pages=1052-7<br />
|url=http://www.ncbi.nlm.nih.gov/pubmed/9218663<br />
|quote=<br />
|pubmedID=9218663<br />
|pubmedCID=<br />
|DOI=<br />
|date=1997-04-02<br />
|accessdate=<br />
}}</ref><br />
<br />
Histology of the male circumcision scar shows amputation neuromas, Schwann cell proliferation and the bulbous collection of variably sized neurites. Amputation neuromas do not mediate normal sensation and are notorious for generating pain.<ref>{{REFjournal<br />
|last=Cold<br />
|first=C.J.<br />
|first2=J.R.<br />
|last2=Taylor<br />
|title=The prepuce<br />
|journal=British Journal of Urology International<br />
|volume=83<br />
|issue=<br />
|pages=34-44<br />
|url=http://www.cirp.org/library/anatomy/cold-taylor/<br />
|quote=<br />
|pubmedID=10349413<br />
|pubmedCID=<br />
|DOI=<br />
|date=1999-1<br />
|accessdate=<br />
}}</ref><br />
<br />
=== Death ===<br />
A study in 2010 estimated approximately 117 neonatal circumcision-related deaths occur annually in the United States, about one out of every 77 male neonatal deaths, more than suffocation, auto accidents, or even SIDS.<ref name="Bollinger 2010">{{REFjournal<br />
|last=Bollinger<br />
|first=Dan<br />
|author-link=Dan Bollinger<br />
|last2=Boy's Health Advisory<br />
|title=Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths<br />
|journal=Thymos: Journal of Boyhood Studies<br />
|volume=4<br />
|issue=1<br />
|pages=78-90<br />
|url=http://www.mensstudies.com/content/b64n267w47m333x0/?p=7ebbd6b446d940cbbd4274c095754b12π=5<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.3149/thy.0401.78<br />
|date=2010-04-26<br />
|accessdate=2019-10-12<br />
}}</ref><ref>{{REFweb<br />
| quote=<br />
| url=http://www.icgi.org/2010/04/infant-circumcision-causes-100-deaths-each-year-in-us<br />
| title=Infant circumcision causes 100 deaths each year in US<br />
| last=<br />
| first=<br />
| publisher=ICGI<br />
| website=International Coalition for Genital Integrity<br />
| date=2010-04-26<br />
| accessdate=<br />
}}</ref> See also the list of [[fatalities]].<br />
<br />
== Forced circumcision ==<br />
<br />
<!--=== United States military ===<br />
<br />
American soldiers serving in World War II were subjected to regular inspections of their genitals. If uncircumcised, the soldiers risked being ordered to undergo immediate circumcision.<ref>{{REFbook<br />
|last=Schoen<br />
|first=Ed<br />
|author-link=Edgar J. Schoen<br />
|year=2005<br />
|title=On Circumcision<br />
|url=https://books.google.de/books?id=-zUhdvSt7cgC<br />
|work=<br />
|editor=Dianne Yeakey<br />
|edition=<br />
|volume=<br />
|chapter=<br />
|pages=72-73<br />
|location=Georgetown, Canada<br />
|publisher=RDR Books<br />
|isbn=1-157143-123-3<br />
|quote=For a critical view, see Sorrells, "The History of Circumcision," p. 333<br />
|accessdate=<br />
|note=<br />
}}</ref> This practice was discontinued at least six decades ago.--><br />
<br />
=== Non-therapeutic circumcision of male children ===<br />
<br />
Human babies, because they are not yet in possession of language, are incapable of giving or refusing consent for being circumcised. The element of force has led some scholars to view the circumcision of baby boys as a category of forced circumcision.<ref>For example, Frederick M. Hodges, a medical historian, writes: "In the late 1970s, as the Americans were growing increasingly aware of the abuses of power rampant throughout the nation's social institutions, influential grass-roots movements protesting the forced circumcision of American children sprang up nationwide." F. Hodges, "A Short History," p. 31; see also [[Leonard B. Glick|Glick]], ''Marked in Your Flesh'', pp. 273-281.</ref> There are, however, physicians in the United States who argue strongly for non-therapeutic circumcision of newborn babies; and circumcision is widely accepted as a postnatal procedure in American hospitals.<ref>{{REFbook<br />
|last=Fletcher<br />
|first=Christopher R.<br />
|year=1999<br />
|title=Circumcision in America in 1998: Attitudes, Beliefs, and Charges of American Physicians<br />
|url=http://www.springerlink.com/content/h2150v731233m177/<br />
|work=Male and Female Circumcision<br />
|editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]<br />
|edition=<br />
|volume=<br />
|chapter=Section 5<br />
|pages=259-271<br />
|location=New York<br />
|publisher=Kluwer Academic/Plenum Publishers<br />
|isbn=<br />
|quote=<br />
|accessdate=2019-10-12<br />
|note=ID 10.1007/978-0-585-39937-9_19<br />
}}</ref> Parental consent is required.<ref>See, e.g., Shephard and Shephard, ''The Complete Guide'', p. 125.</ref> A statement published by the American Academy of Pediatrics in 1999 declares that "parents should determine what is in the best interest of the child... It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in additions to the medical factors, when making a decision."<ref>Lannon and Bailey, "Circumcision Policy Statement," p. 691.</ref> In the United Kingdom, where non-therapeutic circumcision has now become far less prevalent than in the United States, a written consent of both parents is required, if a physician is to perform a non-therapeutic circumcision of a child.<ref>{{REFjournal<br />
|last=<br />
|first=<br />
|title=Re J (child's religious upbringing and circumcision)<br />
|journal=Family Court Reports<br />
|date=2000<br />
|volume=1<br />
|issue=<br />
|pages=307-314<br />
|url=http://www.cirp.org/library/legal/Re_J/2000.html<br />
|accessdate=2019-10-12<br />
}}</ref> (The National Health Service does not provide non-therapeutic circumcision.)<br />
<br />
In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<ref>See, e.g., Somerville, "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; Chessler, "Justifying the Unjustifiable"; Smith, "Male Circumcision."</ref> For example, critics have pointed out that, in the United States, more than 1.3% of male neonatal deaths are attributable to the complications of non-therapeutic circumcision surgery.<ref name="Bollinger 2010"/>refer<ref>{{REFweb<br />
|quote=<br />
|url=http://www.icgi.org/2010/04/infant-circumcision-causes-100-deaths-each-year-in-us<br />
|title=Infant circumcision causes 100 deaths each year in US<br />
|last=Bollinger<br />
|first=Dan<br />
|author-link=Dan Bollinger<br />
|publisher=International Coalition for Genital Integrity<br />
|date=2010-04-26<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
{{SEEALSO}}<br />
* [[Sexual effects of circumcision]]<br />
* [[FGM]]<br />
* [[MGM]]<br />
* [[Risks and complications]]<br />
* [[Documented severe complications of circumcision]]<br />
* [[Circumcision scar]]<br />
* [[Circumpendium]]<br />
* [[Human rights]]<br />
* [[Ethics of non-therapeutic child circumcision]]<br />
* [[Rights situation on circumcision]]<br />
* [[Circumcision methods]]<br />
* [[Case Histories]]<br />
* [[Lymphoedema]]<br />
* [[Psychological issues of male circumcision]]<br />
<br />
{{REF}}<br />
<br />
[[Category:From Intactipedia]]<br />
[[Category:From IntactWiki]]<br />
[[Category:Male circumcision]]<br />
[[Category:Genital surgery]]<br />
[[Category:Terms]]<br />
[[Category:Islam]]<br />
[[Category:Judaism]]<br />
[[Category:Circumcision]]<br />
[[de:Zirkumzision]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Child_circumcision&diff=14355Child circumcision2020-05-04T20:36:07Z<p>WikiModEn4: /* Search for prophylactic reasons */</p>
<hr />
<div>{{GraphicWarning}}<br />
"Male '''circumcision''' (from Latin ''circumcidere'', meaning "to cut around") is the surgical removal of the [[foreskin]] (prepuce) part of the human [[penis]]. The foreskin comprises ''more than fifty percent'' of the epithelium of the penis.<ref name="taylor1996">{{REFjournal<br />
|last=Taylor<br />
|first=J.R.<br />
|author-link=John R. Taylor<br />
|last2=Lockwood<br />
|first2=A.P.<br />
|author2-link=<br />
|last3=Taylor<br />
|first3=A.J.<br />
|title=The prepuce: specialized mucosa of the penis and its loss to circumcision<br />
|journal=Brit J Urol<br />
|date=1996<br />
|volume=77<br />
|issue=<br />
|pages=291-5<br />
|url=http://onlinelibrary.wiley.com/doi/10.1046/j.1464-410X.1996.85023.x/full<br />
|quote=<br />
|pubmedID=8800902<br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410X.1996.85023.x<br />
|accessdate=2019-10-14<br />
}}</ref> [...] The procedure is most often an elective non-therapeutic surgery performed on neonates and children for religious and cultural reasons, but in other cases may be indicated for both therapeutic and prophylactic reasons. It is a radical treatment option for pathological [[phimosis]], refractory [[Balanitis| balanoposthitis]] and chronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health. <br />
<br />
'''Posthectomy''' is a more accurate medical term that more accurately reflects the injury and loss of functional body tissue, but the Biblical euphemism, ''circumcision'', is more commonly used. <br />
<br />
With reference to involuntary, non-therapeutic circumcision of children, [[Child Genital Cutting (CGC)]] is a new term that has been introduced to avoid issues associated with more traditional terms.<br />
<br />
== Historical background ==<br />
<br />
The amputation of the [[foreskin]] is a very old ritual, whose exact origin cannot be verified beyond doubt. Medical historians assume that circumcision already served in ancient history as a way to control the sexuality of slaves and members of the lower classes without compromising their ability to reproduce. In religious history circumcision may be seen as a substitute for human sacrifice. In prehistoric times it was not uncommon to placate the gods with human sacrifice. Castration of slaves or conquered enemies was common as well. Following religious changes this sacrifice was altered, and only a part of the very organ responsible for the creation of new life was sacrificed.<br />
<br />
[[Image:Circumcision Sakkara 3.jpg|200px|right]] For the Aborigines, the Australian natives, the tradition of circumcision is said to go back to 10,000 BC. On the African continent, the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of circumcision date back to the time around 3000-2000 BC. The oldest known depiction<ref>{{REFweb<br />
|url=https://commons.wikimedia.org/wiki/File:Circumcision_Sakkara_3.jpg<br />
|title=File:Circumcision Sakkara 3.jpg<br />
|accessdate=2019-10-12<br />
}}</ref> is an Egyptian tomb relief from the 6th dynasty, approximately 2300-2000 BC. It is not known precisely who was circumcised and why in those times.<br />
<br />
In many cultures circumcision during puberty serves as a rite of passage, bringing adolescents into the community. As with other painful or humiliating initiation rites, proof of courage and mastering of critical situations are the key motivations. From some African tribes it is also known that the amputation of the [[foreskin]] is seen as the removal of an inborn piece of femininity from the boys, thus making them men.<br />
<br />
===Judaism===<br />
<br />
In the Jewish religion, the tradition of circumcision goes back to a passage in the Book of Genesis (17, 10-14). It is seen as a [[Abrahamic covenant| covenant between God and man]], dating back to the patriarch Abraham.<br />
<br />
{{Citation<br />
|Text=10 This is my covenant with you and your descendants after you, the covenant you are to keep: Every male among you shall be circumcised. 11 You are to undergo circumcision, and it will be the sign of the covenant between me and you. 12 For the generations to come every male among you who is eight days old must be circumcised, including those born in your household or bought with money from a foreigner—those who are not your offspring. 13 Whether born in your household or bought with your money, they must be circumcised. My covenant in your flesh is to be an everlasting covenant. 14 Any uncircumcised male, who has not been circumcised in the flesh, will be cut off from his people; he has broken my covenant.” <br />
|Author=Bible<br />
|Source=Gen 17, 10-14, NIV<br />
}}<br />
<br />
According to the anthropologist and sociologist Nissan Rubin, the Jewish form of circumcision, called ''[[Brit Milah| brit mila]]'', during the first two millennia did not include the later customary ''periah'', namely the complete scraping of the inner [[foreskin]] from the [[Glans penis|glans]]. This was only added around 135 AD, to make it impossible to restore the [[foreskin]] by stretching, which became popular in the wake of Hellenic influence. While originally only the tip of the [[foreskin]] was cut off, periah removes the entire [[foreskin]]. In the Greek society of the day, a denuded [[Glans penis|glans]] was considered obscene and risible. In ultra-orthodox communities, circumcision is followed by the ''[[mohel]]'', the ritual circumciser, sucking blood from the wound with his mouth. This practice is highly controversial, as it can result in an infection with [[herpes]] simplex type 1. In New York City, between 2000 and 2011 eleven children were infected with [[herpes]], 10 of whom had to be treated in hospital. Two of them suffered permanent brain damage, two others died. In the 12th century, the Jewish philosopher and doctor [[Moses Maimonides| Maimonides]] pointed out that circumcision was necessary, as it diminished sexual desires and reduced the pleasure to a degree just sufficient for mere reproduction.<br />
<br />
===Christianity===<br />
Jesus was born into a Jewish family in Israel, where Judaism was the prevailing religion, so he was circumcised on the eighth day.<ref name="luke2:21>{{REFweb<br />
|url=https://www.biblegateway.com/passage/?search=Luke+2%3A21&version=NASB<br />
|title=Gospel of Luke<br />
|trans-title=<br />
|language=<br />
|last=Luke<br />
|first=<br />
|author-link=<br />
|publisher=NASB<br />
|website=Bible Gateway<br />
|date=<br />
|accessdate=2019-11-10<br />
|format=<br />
|quote=And when eight days had passed, before His circumcision, His name was then called Jesus, the name given by the angel before He was conceived in the womb.<br />
}}</ref><br />
<br />
The first Christians had been born Jewish, so a question arose whether one must be circumcised to be a Christian. When Christian leaders met at the [[Council at Jerusalem]] in the First Century to decide what was required to be a Christian, a letter was written to explain the requirements, but circumcision was omitted from the requirements.<ref>{{REFweb<br />
|url=https://www.biblegateway.com/passage/?search=Acts+15%3A1-30&version=NASB<br />
|title=Acts 15:1-30<br />
|last=Luke<br />
|first=<br />
|accessdate=2019-11-10<br />
}}</ref><br />
<br />
In Christianity, circumcision is practiced only in a few Coptic churches. There is no general belief that circumcision is a requirement of Christianity.<ref name="hill2004">{{REFweb<br />
|url=http://www.cirp.org/pages/cultural/christian.html<br />
|title=The Holy Bible, Circumcision, False Prophets, and Christian Parents<br />
|trans-title=<br />
|language=<br />
|last=Hill<br />
|first=George<br />
|author-link=George Hill<br />
|publisher=Circumcision Reference Library<br />
|website=<br />
|date=2004-08-29<br />
|accessdate=2019-11-10<br />
|format=HTML<br />
|quote=The falseness of those who advocate circumcision is a recurrent theme in the New Testament. <br />
}}</ref><br />
<br />
Nevertheless, Christian moral notions had decisive influence on the spread of this practice. In the puritan influenced USA, circumcision of children was popular in the 19th century as a means to prevent [[masturbation]]. In those days, this so-called ‘self-abuse‘ was not only considered immoral, but was supposedly responsible for a variety of diseases. Masturbation, however, is not mentioned anywhere in the Holy Bible, so there is no support for the belief that it is somehow immoral or sinful. <br />
<br />
Even the mere existence of a [[foreskin]] was linked to many illnesses. Among them one could find syphilis, epilepsy, paralysis of the spine, bed wetting, scoliosis (spinal deformity), paralysis of the bladder, club foot, nerve pain in the lower abdomen, tuberculosis and lazy eye. One of the best known advocates of child circumcision was [[John Harvey Kellogg]], co-inventor of the corn flakes bearing his name. In 1888, he wrote:<br />
<br />
{{Citation<br />
|Text=A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of [[phimosis]]. The operation should be performed by a surgeon without administering an anaesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. In females, the author has found the application of pure carbolic acid to the clitoris an excellent means of allaying the abnormal excitement, and preventing the recurrence of the practice in those whose will-power has become so weakened that the patient is unable to exercise entire self-control. <br />
|Author=[[John Harvey Kellogg]]<br />
|Source=<br />
|ref=<ref>{{REFbook<br />
|url=https://archive.org/details/plainfaorold00kell/page/290<br />
|chapter=Treatment for Self-abuse and Its Effects<br />
|title=Plain Facts for Old and Young<br />
|location=Burlington, Iowa<br />
|publisher=F. Segner & Co.<br />
|year=1888<br />
|pages=107<br />
}}</ref><br />
}}<br />
<br />
===Islam===<br />
In Islam, circumcision is also religiously founded, even though there is no mention of it in the Koran itself. According to tradition, the Prophet Mohammed was born without a [[foreskin]]. It is seen as a sign of prophets that they are born without a [[foreskin]] already. It is considered an honour to "resemble the example of the Prophet", meaning to be circumcised. In Islam, unlike Judaism, there is no specific age at which the circumcision should be performed. Most circumcisions take place at ages between 6 and 10 years, but the range goes from birth to adulthood.<br />
<br />
== Rationale ==<br />
<br />
Reasons for performing circumcision range widely by culture, religion, location, and age.<br />
<br />
===Cultural===<br />
<br />
Many cultures perform circumcision as a rite of passage into manhood. This is common in the Middle East and amongst some indigenous African and Southeast Asian peoples.<br />
<br />
The United States and Israel are the only industrialized countries in the world to have a high incidence of non-therapeutic infant male circumcision. The vast majority of infant circumcisions performed in the United States are for non-religious, non-medical reasons. See [[History of circumcision]].<br />
<br />
===Religious===<br />
The circumcision of newborn boys is seen as a divine commandment in the Jewish faith. Though absent in the Koran, male circumcision is considered a religious requirement in Islam, and it is performed on male children of varying ages. Converts to these faiths may also choose to undergo circumcision, but it is not always required.<br />
<br />
===Medical indication===<br />
In some cases, circumcision is legitimately indicated; a patient may be suffering recurring infections, and other methods of treatment have failed. In other cases, a patient may be suffering from a severe case of [[phimosis]]. Overall, the actual medical necessity for circumcision is extremely rare. All circumcisions injure the patient by amputating the [[foreskin]] its with many protective, immunological, sensory, and sexual [[Foreskin#Physiological_functions| functions]]. <br />
<br />
# '''Deformed or malformed foreskin'''. A foreskin so deformed or malformed that it does not function properly may be removed by circumcision.<br />
<br />
# '''Traumatically injured foreskin'''. A foreskin so traumatically injured foreskin that cannot be surgically repaird is a valid medical reason for circumcision.<br />
<br />
# '''Diseased foreskin.''' A foreskin that is diseased is a valid indication for cirumcision. Some diseases that qualify are malignancy, lichen sclerosis, yeast infection in men with diabetes, and recurrent posthitis.<br />
<br />
In such cases, the benefit of removing the problem foreskin may exceed the maleficial results of tissue and function destruction.<br />
<br />
====Arguments of prophylaxia====<br />
Though the practice of ritual circumcision of males, both consenting and non-consenting, has existed for millenia, the search for "potential medical benefits" began relatively recently. The discussion of circumcision in the Ninth Edition of the ''Encyclopǽdia Britannica'' (1876) made no mention of any prophylactic, medical, or therapeutic value or function.<ref>{{REFweb<br />
|url=http://www.cirp.org/library/history/encyclopaediabritannica1876/<br />
|title=Circumcision<br />
|trans-title=<br />
|language=<br />
|last=Cheyne<br />
|first=T. K.<br />
|author-link=<br />
|publisher=Encyclopǽdia Brittanica<br />
|website=Circumcision Reference Library<br />
|date=1876<br />
|accessdate=2019-11-10<br />
|format=<br />
|quote=<br />
}}</ref><br />
<br />
Initially, circumcision was adopted as a way to stop boys and men from masturbating, where masturbation was seen as the cause for many diseases. As the myth that circumcision prevented [[masturbation]] became debunked, advocates of circumcision began the great search to find the "medical benefits" of circumcision. <br />
<br />
Male and female circumcision involves the removal and disruption of normal anatomical structures that are primary areas of sexual sensation.<ref name="taylor1996" /> In the past, some advocates of mass circumcision have considered the prepuce to be a "mistake of nature,"<ref><br />
<nowiki>{{Cold and Wiswell (1995)}} | [[Template:Cold and Wiswell (1995)|see more]]</nowiki></p><br />
</ref> but this notion has no validity because the prepuce is ubiquitous in primates and because it provides functional advantages.<ref name="cold-mcgrath1995">{{REFbook<br />
|last=Cold<br />
|first=Christopher<br />
|last2=McGrath<br />
|first2=Kenneth<br />
|author2-link=Ken McGrath<br />
|year=1999<br />
|title=Male and female circumcision: medical, legal, and ethical considerations in pediatric practice<br />
|url=http://www.cirp.org/library/anatomy/cold-mcgrath/<br />
|work=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=Anatomy and histology of the penile and clitoral prepuce in primates<br />
|pages=<br />
|location=New York<br />
|publisher=<br />
|isbn=0306461315<br />
|quote=<br />
|accessdate=2019-10-12<br />
|note=<br />
}}</ref><br />
<br />
===Search for prophylactic reasons===<br />
<br />
The practice of finding prophylactic reasons for infant circumcision started in Germany in the nineteenth century, when non-Jewish Germans criticized the Jewish practice of infant circumcision as being barbaric, Jewish doctors sprang to the defense of the religious practice by claiming health benefits.<ref name="ephron2001">{{REFbook<br />
|last=Ephron<br />
|first=John M.<br />
|author-link=<br />
|year=2001<br />
|title=Medicine and the German Jews<br />
|url=http://www.cirp.org/library/history/ephron1/<br />
|work=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=6<br />
|pages=222-233<br />
|location=New Haven<br />
|publisher=Yale University Press<br />
|isbn=0-300-08377-7<br />
|quote=<br />
|accessdate=2019-11-20<br />
|note=<br />
}}</ref> And so started the long tradition of Jewish doctors inventing reasons for circumcision (and deceving gentile doctors).<br />
<br />
Following the discovery of bacteria as a cause of many diseases – such as tuberculosis – the search began for other illnesses that could be prevented by circumcision.<br />
<br />
In 1870 the renowned Dr. Lewis A. Sayre of NYC’s famed Bellevue Hospital<ref>https://nypost.com/2016/12/03/bellevues-doctors-invented-the-procedures-you-take-for-granted/</ref> claimed to cure a boy’s paralyzed legs with circumcision. Sayre's wild advocacy of circumcision exemplified how some[https://intaction.org/circumcision-facts-and-myths/ circumcision fact and myths] originated. He also claimed to cure epilepsy, mental disorders, hip-joint pain, & hernias with circumcision. “Genital irritations” & masturbation were deemed to be the cause of these issues. Sayre was later elected as the President of the American Medical Association. <ref>American Medical Association. Transactions of the American Medical Association. 1870;21:205–11</ref> <br />
<br />
In the 1920s it was penile cancer. Abraham L. Wolbarst (1926) claims that circumcision can prevent penile cancer.<ref name="wolbarst1926">{{REFjournal<br />
|last=Wolbarst<br />
|first=Abraham L.<br />
|author-link=Abraham L. Wolbarst<br />
|title=Is circumcision a prophylactic against penis cancer?<br />
|journal=Cancer<br />
|date=Jul 1926<br />
|volume=3<br />
|issue=4<br />
|pages=301-10<br />
}}</ref>. <br />
<br />
In the 1940s, prostate and tongue cancer as well as STDs. Eugene H. Hand (1949) falsely explains that circumcision somehow protects against venereal diseases and tongue cancer.<ref name="hand1949">{{REFjournal<br />
|title=Circumcision and venereal disease.<br />
|last=Hand<br />
|first=Eugene H.<br />
|journal=Archives of Dermatology and Syphilology<br />
|date=Sep 1949<br />
|volume=60<br />
|issue=3<br />
|pages=341-346<br />
}}</ref>. <br />
<br />
In the 1950s it was cervical cancer. Abraham Ravich (1951) invents the myth that circumcision reduces the risk of women getting cervical cancer.<ref name="ravich1951">{{REFjournal<br />
|url=https://www.ncbi.nlm.nih.gov/pubmed/14853120<br />
|title=Prophylaxis of cancer of the prostate, penis, and cervix by circumcision<br />
|last=Ravich<br />
|first=Abraham<br />
|last2=Ravich<br />
|first2=R.A.<br />
|journal=New York State Journal of Medicine<br />
|date=Jun 1951<br />
|volume=51<br />
|issue=12<br />
|pages=1519-1520<br />
|pubmedID=14853120<br />
|accessdate=2019-10-12<br />
}}</ref> <br />
<br />
In the late 1960s it was neuroses. Morris Fishbein (1969) calls for circumcision to prevent nervousness and, of course, [[masturbation]].<ref>{{REFbook<br />
|last=Fishbein<br />
|first=Morris<br />
|chapter=Sex hygiene<br />
|title=Modern Home Medical Adviser<br />
|location=Garden City, New York<br />
|publisher=Doubleday & Co<br />
|year=1969<br />
|pages=90, 119<br />
|url=https://openlibrary.org/works/OL95362W/Modern_home_medical_adviser<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
In the 1970s bladder- and rectal cancer. Abraham Ravich (1971) claims that circumcision would prevent bladder cancer and rectal cancer.<ref>{{REFjournal<br />
|last=Ravich<br />
|first=Abraham<br />
|url=https://www.deepdyve.com/lp/wiley/viral-carcinogenesis-in-venereally-susceptible-organs-HCeWmTLmKl<br />
|title=Viral carcinogenesis in venereally susceptible organs<br />
|journal=Cancer<br />
|date=Jun 1971<br />
|volume=27<br />
|issue=6<br />
|pages=1493-1496<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
In the 1980s, UTIs. Thomas E. Wiswell (1985) claims that circumcision, using a methodologically flawed report, reduces the risk of urinary tract infections.<ref name="wiswell1985">{{REFjournal <br />
|last=Wiswell<br />
|first=Thomas E.<br />
|author-link=Thomas E. Wiswell<br />
|url=https://pediatrics.aappublications.org/content/75/5/901<br />
|title=Decreased incidence of urinary tract infections in circumcised male infants<br />
|journal=Pediatrics<br />
|date=May 1985<br />
|volume=75<br />
|issue=5<br />
|pages=901-903<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
Aaron J. Fink (1986), with no evidence whatsoever, claims that circumcision protects against AIDS followed.<ref name="fink1986">{{REFjournal<br />
|last=Fink<br />
|first=Aaron J.<br />
|author-link=Aaron J. Fink<br />
|title=A possible explanation for heterosexual male infection with AIDS<br />
|journal=New England Journal of Medicine<br />
|date=1986-10-30<br />
|volume=31<br />
|issue=18<br />
|pages=1167<br />
|url=https://www.nejm.org/doi/full/10.1056/NEJM198610303151818<br />
|DOI=10.1056/NEJM198610303151818<br />
|accessdate=2019-11-20<br />
}}</ref> <br />
<br />
Retrospectively, circumcision was always advertised as a cure for whatever disease was in the public spotlight at the time. [[Doctors Opposing Circumcision]] (2016) states:<br />
<blockquote><br />
These claims date originally from before the advent of evidence-based medicine, when doctors relied on the opinions of other clinicians to inform their practice, rather than on scientifically collected evidence.<ref name="doc2016">{{REFweb<br />
|url=https://www.doctorsopposingcircumcision.org/for-professionals/alleged-medical-benefits/<br />
|title=Alleged Medical Benefits<br />
|trans-title=<br />
|language=<br />
|last=<br />
|first=<br />
|author-link=<br />
|publisher=Doctors Opposing Circumcision<br />
|website=<br />
|date=2016-05<br />
|accessdate=2019-11-20<br />
|format=<br />
|quote=<br />
}}</ref><br />
</blockquote><br />
<br />
The sheer mass of studies and publications that were released during those almost 180 years on this topic are the reason that even arguments that have been disproved multiple times, especially regarding infant and child circumcision, tenaciously persist up until today.<br />
<br />
An ever-recurring element of initiation rites found in many different cultures is the fixation upon the genitalia.<br />
<br />
It reflects the fascination that emerges from the ability to create new life. In most cultures, fertility is seen as the most precious good, and the body parts involved frequently find themselves in the focus of ritual acts. In many parts of the world, those rites take place when the boy reaches puberty, and are meant to symbolize his transition from boy to man. The removal of the male [[foreskin]] is just one of many phenomena that developed in this context. They range from the removal of the frenulum in boys and men through partial or complete removal of the [[foreskin]] up to radical operations. Australian Aborigines, as mentioned above, have their [[foreskin]]s removed. It is also usual that, a few weeks later, young men have their [[penis]]es sliced open, resulting in a partly or completely divided urethra.<br />
<br />
Another known, particularly massive, intervention is the stripping of the entire skin off the [[penis]]. In Indonesia, boys have metal or bamboo balls inserted into their [[penis]] shaft or [[Glans penis|glans]] at the beginning of puberty, which form little "humps".<br />
<br />
For many cultures it is also common to perform similar rituals on girls. This can range from relatively small interventions such as piercing or cutting the clitoral hood, to its complete removal and up to radical removal of clitoral hood, clitoris, inner and outer labia followed by sewing up the vagina.<br />
<br />
''The following text is taken from the [[Circumpendium]].''<br />
<br />
=== Prophylactic reasons ===<br />
<br />
Some people claim that circumcision has prophylactic benefits. Especially in the USA those arguments have persisted for more then a 100 years, with ever changing diseases circumcision is said to protect against. At first, these were diseases where [[masturbation]] was believed to be the cause. After bacteria and viruses had been discovered, arguments changed, and one after another miscellaneous diseases were cited.<br />
<br />
* [[Phimosis]]: as mentioned earlier, true [[phimosis]] is rare and can be treated effectively without surgery. According to a study by Blalock ''et al.'' (2003)<ref>{{REFjournal<br />
|last=Blalock<br />
|first=H.J.<br />
|last2=Vemulakonda<br />
|first2=V.<br />
|last3=Ritchey<br />
|first3=M.L.<br />
|last4=Ribbeck<br />
|first4=M.<br />
|title=Outpatient management of [[phimosis]] Following newborn circumcision<br />
|journal=J Urol<br />
|date=2003<br />
|volume=169<br />
|issue=6<br />
|pages=2332-2334<br />
|url=http://www.cirp.org/library/complications/blalock1/<br />
|accessdate=2019-11-07<br />
}}</ref>, 2.9% of those circumcised develop a post-operative [[phimosis]], in which the circumcision scar constricts. In intact patients, the rate of [[phimosis]] is only 1% (see also the study by [[Jakob Øster]]). Therefore, circumcision is not a preventive measure for [[phimosis]].<br />
* Sexually Transmitted Diseases (STDs): a vast number of studies has been conducted on the subject of transmission of STDs.<br />
* First, it has to be noted that any form of protection against these diseases only affects people who are sexually active. Circumcision in childhood cannot be justified on these grounds, since any assumed protective effect will not occur before the boy is already old enough to decide about circumcision for himself.<br />
* As mentioned above, the [[foreskin]] keeps the [[Glans penis|glans]] moist. This subpreputial moisture contains, among other substances, the enzyme lysozyme, which breaks up the cell wall of bacteria, thereby providing a natural antibacterial screen. This explains the results of several studies, such as Laumann ''et al.''<ref>{{REFjournal<br />
|last=Laumann<br />
|first=E.O.<br />
|last2=Masi<br />
|first2=C.M.<br />
|last3=Zuckerman<br />
|first3=E.W.<br />
|title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice<br />
|journal=JAMA<br />
|date=1997<br />
|volume=277<br />
|issue=<br />
|pages=1052-1057<br />
|url=http://www.cirp.org/library/general/laumann/<br />
|accessdate=2019-11-06<br />
}}</ref>, which found a higher rate of infection with bacterial venereal diseases in circumcised than in intact men.<br />
* The studies by Fleiss ''et al.'' (1998) support this.<ref name="fleiss-hodges-vanhowe1998">{{REFjournal<br />
|last=Fleiss<br />
|first=P.M.<br />
|last2=Hodges<br />
|first2=F.M.<br />
|last3=Van Howe<br />
|first3=R.S.<br />
|title=Immunological functions of the human prepuce<br />
|journal=Sex Transm Inf<br />
|date=1998<br />
|volume=74<br />
|issue=<br />
|pages=364-367<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1758142/pdf/v074p00364.pdf<br />
|accessdate=2019-11-06<br />
}}</ref> According to the [[AAP]], the general sexual behaviour of the male - such as frequent change in partners and the use of condoms - has a much higher impact on sexually transmitted diseases then the circumcision status.<ref>{{REFjournal<br />
|last=Task Force on Circumcision<br />
|first=<br />
|title=Circumcision policy statement<br />
|journal=Pediatrics<br />
|date=1999<br />
|volume=103<br />
|issue=3<br />
|pages=686-93<br />
|url=http://www.cirp.org/library/statements/aap1999/<br />
|accessdate=2019-11-15<br />
}}</ref><br />
* HIV / AIDS: in the recent past, the argument that circumcision could help to contain the spread of HIV has been stated numerous times.<br />
*:First, two notes: for one, the use of condoms is still by far the most effective protection against an infection. During intercourse with that preventive measure, circumcision status does not make a difference.<br />
*:Secondly, the assumed protection would only affect healthy men who have intercourse with an infected woman. An infected man can infect a women by transmission of his bodily fluids, so that his circumcision status is irrelevant. Therefore, the use of condoms remains vital in containing the spread of HIV, which in return renders circumcision unnecessary<br />
* Due to the inevitable loss of sensitivity as a result of circumcision, there is also the temptation to go without condoms, in order not to lose even more sensitivity.<ref>{{REFjournal<br />
|last=Hooykaas<br />
|first=C.<br />
|last2=van der Velde<br />
|first2=F.W.<br />
|last3=van der Linden<br />
|first3=M.M.<br />
|etal=yes<br />
|title=The importance of ethnicity as a risk factor for STDs and sexual behaviour among heterosexuals<br />
|journal=Genitourin Med<br />
|date=1991<br />
|volume=67<br />
|issue=5<br />
|pages=378-383<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1194736/pdf/genitmed00041-0022.pdf<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Michael<br />
|first=R.T.<br />
|last2=Wadsworth<br />
|first2=J.<br />
|last3=Feinleib<br />
|first3=J.<br />
|etal=yes<br />
|title=Private sexual behavior, public opinion, and public health policy related to sexually transmitted diseases: a US-British comparison<br />
|journal=Am J Public Health<br />
|date=1998<br />
|volume=88<br />
|issue=5<br />
|pages=749-754<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1508929/pdf/amjph00017-0039.pdf<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Laumann<br />
|first=E.O.<br />
|last2=Masi<br />
|first2=C.M.<br />
|last3=Zuckerman<br />
|first3=E.W.<br />
|title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice<br />
|journal=JAMA<br />
|date=1997<br />
|volume=277<br />
|issue=<br />
|pages=1052-1057<br />
|url=http://www.cirp.org/library/general/laumann/<br />
|accessdate=2019-11-06<br />
}}</ref><br />
* Two studies that have been published in early 2007<ref>{{REFjournal<br />
|last=Gray, R.H. and colleagues<br />
|first=<br />
|title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial<br />
|journal=Lancet<br />
|date=2007<br />
|volume=369<br />
|issue=<br />
|pages=657-666<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=[[Robert C. Bailey|Bailey, R.C.]] and colleagues<br />
|first=<br />
|title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial<br />
|journal=Lancet<br />
|date=2007<br />
|volume=369<br />
|issue=<br />
|pages=643-656<br />
|url=<br />
|accessdate=<br />
}}</ref>, which investigated the effectiveness of circumcision as a means of reducing the spread of HIV from infected women to heterosexual men in African high risk areas, have been repeatedly subjected to strong criticism. Both studies were ended prematurely, which distorted the results. The men who had been circumcised for the study had to stay sexually inactive during the wound healing, which gave the intact control group more relative opportunity to become infected. These African randomized clinical trials have been demonstrated to have very serious methodological and statistical errors that distort the results in favor of circumcision.<ref name="boyle-hill2011">{{REFjournal<br />
|last=Boyle<br />
|first=Gregory J.<br />
|author-link=Gregory Boyle<br />
|last2=Hill<br />
|first2=George<br />
|author2-link=George Hill<br />
|title=Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns<br />
|journal=J Law Med<br />
|date=2011-12<br />
|volume=19<br />
|issue=2<br />
|pages=316-34<br />
|url=http://www.salem-news.com/fms/pdf/2011-12_JLM-Boyle-Hill.pdf<br />
|quote=<br />
|pubmedID=22320006<br />
|pubmedCID=<br />
|DOI=<br />
|accessdate=2019-11-09<br />
}}</ref><br />
<br />
The fact that the USA has both the highest rate of circumcised males in the western world, as well as the highest HIV infection rate, makes the studies look dubious. Besides that, several other studies concluded that circumcision does not have a significant impact on the risk of infection with HIV.<ref>{{REFjournal<br />
|last=Grosskurth<br />
|first=H.<br />
|last2=Mosha<br />
|first2=F.<br />
|last3=Todd<br />
|first3=J.<br />
|etal=yes<br />
|title=A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results<br />
|journal=AIDS<br />
|date=1995<br />
|volume=9<br />
|issue=8<br />
|pages=927-934<br />
|url=https://insights.ovid.com/aids/aids/1995/08/000/community-trial-impact-improved-sexually/15/00002030<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Barongo<br />
|first=L.R.<br />
|last2=Borgdorff<br />
|first2=M..W.<br />
|last3=Mosha<br />
|first3=F.F.<br />
|etal=yes<br />
|title=The epidemiology of HIV-1 infection in urban areas, roadside settlements and rural villages in Mwanza Region, Tanzania<br />
|journal=AIDS<br />
|date=1992<br />
|volume=6<br />
|issue=12<br />
|pages=1521-1528<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Changedia SM, Gilada IS<br />
|first=<br />
|title=Role of male circumcision in HIV transmission insignificant in conjugal relationship (abstract no. ThPeC7420)<br />
|url=<br />
|place=Barcelona, Spain<br />
|source=Presented at the Fourteenth International AIDS Conference<br />
|datefrom=2002-07-07<br />
|dateto=2002-07-12<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Connolly CA, Shishana O, Simbayi L, Colvin M<br />
|first=<br />
|title=HIV and circumcision in South Africa (Abstract No. MoPeC3491)<br />
|url=<br />
|place=Bangkok, Thailand<br />
|source=Presented at the 15th International AIDS Conference<br />
|datefrom=2004-07-11<br />
|dateto=2004-07-16<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Thomas AG, Bakhireva LN, Brodine SK, Shaffer RA<br />
|first=<br />
|title=Prevalence of male circumcision and its association with HIV and sexually transmitted infections in a U.S. navy population (Abstract no. TuPeC4861)<br />
|url=https://apps.dtic.mil/dtic/tr/fulltext/u2/a458066.pdf<br />
|place=Bangkok, Thailand<br />
|source=Presented at the 15th International AIDS Conference<br />
|datefrom=2004-07-11<br />
|dateto=2004-07-16<br />
|accessdate=2019-11-15<br />
}}</ref><br />
* Urinary tract infections (UTI): a UTI can be effectively treated with antibiotics, this was also proven by studies<ref>{{REFjournal<br />
|last=McCracken<br />
|first=G.<br />
|title=Options in antimicrobial management of urinary tract infections in infants and children<br />
|journal=Pediatr Infect Dis J<br />
|date=1989<br />
|volume=8<br />
|issue=8<br />
|pages=552-555<br />
|url=http://www.cirp.org/library/disease/UTI/mccracken/<br />
|accessdate=2019-11-19<br />
}}</ref><ref>{{REFjournal<br />
|last=Larcombe<br />
|first=J.<br />
|title=Urinary tract infection in children<br />
|journal=BMJ<br />
|date=1999<br />
|volume=319<br />
|issue=<br />
|pages=1173-1175<br />
|url=<br />
|accessdate=<br />
}}</ref>. A Swedish study <ref>{{REFjournal<br />
|last=Mårild<br />
|first=S.<br />
|last2=Jodal<br />
|first2=U.<br />
|title=Incidence rate of first–time symptomatic urinary tract infection in children under 6 years of age<br />
|journal=Acta Paediatr<br />
|date=1998<br />
|volume=87<br />
|issue=5<br />
|pages=549-552<br />
|url=<br />
|accessdate=<br />
}}</ref> found that, during the first 6 years of life, the incidence of UTIs in boys was 1.8%, but in girls was 6.6%. UTIs are less common in boys after the first year of life. Mueller ''et al.'' <ref>{{REFjournal<br />
|last=Mueller<br />
|first=E.R.<br />
|last2=Steinhardt<br />
|first2=G.<br />
|last3=Naseer<br />
|first3=S.<br />
|title=The incidence of genitourinary abnormalities in circumcised and uncircumcised boys presenting with an initial urinary tract infection by 6 months of age<br />
|journal=Pediatrics<br />
|date=1997<br />
|volume=100 (Supplement)<br />
|issue=<br />
|pages=580<br />
|url=<br />
|accessdate=<br />
}}</ref> did not find a significant difference in UTI rates between circumcised and intact boys with normal urinary tract anatomy.<br />
* Other studies suggest that circumcision is more likely to raise than to lower the generally low risk of acquiring UTI: multiple studies from Israel showed a strong correlation between ritual circumcision on the 8th day of life and postoperative UTI.<ref>{{REFjournal<br />
|last=Menahem<br />
|first=S.<br />
|title=Complications arising from ritual circumcision: pathogenesis and possible prevention<br />
|journal=Isr J Med Sci<br />
|date=1981<br />
|volume=17<br />
|issue=1<br />
|pages=45-48<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Cohen<br />
|first=H.A.<br />
|last2=Drucker<br />
|first2=M.M.<br />
|last3=Vainer<br />
|first3=S.<br />
|etal=yes<br />
|title=Postcircumcision urinary tract infection<br />
|journal=Clin Pediatr<br />
|date=1992<br />
|volume=31<br />
|issue=6<br />
|pages=322-324<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Goldman<br />
|first=M.<br />
|last2=Barr<br />
|first2=J.<br />
|last3=Bistritzer<br />
|first3=T.<br />
|last4=Aladjem<br />
|first4=M.<br />
|title=Urinary tract infection following ritual Jewish circumcision<br />
|journal=Isr J Med Sci<br />
|date=1996<br />
|volume=32<br />
|issue=<br />
|pages=1098-1102<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
* It can be concluded that circumcision is ineffective as a preventive measure against UTIs.<br />
* Penile and cervical cancer / HPV: first studies on those diseases and their assumed prevention by circumcision date back to 1932, a time when the cause for those illnesses was not yet fully understood<br />
<ref>{{REFjournal<br />
|last=Wolbarst<br />
|first=A.<br />
|title=Circumcision and penile cancer<br />
|journal=Lancet<br />
|date=1932<br />
|volume=1<br />
|issue=5655<br />
|pages=150-153<br />
|url=<br />
|accessdate=<br />
}}</ref>. Today, it is known that sexually transmitted human papillomavirus (HPV) is a major risk factor<ref>{{REFjournal<br />
|last=McCance<br />
|first=D.J.<br />
|last2=Kalache<br />
|first2=A.<br />
|last3=Ashdown<br />
|first3=K.<br />
|etal=yes<br />
|title=Human papillomavirus types 16 and 18 in carcinomas of the penis from Brazil<br />
|journal=Int J Cancer<br />
|date=1986<br />
|volume=37<br />
|issue=1<br />
|pages=55-59<br />
|url=<br />
|accessdate=<br />
}}</ref>, as well as smoking<ref>{{REFjournal<br />
|last=Harish<br />
|first=K.<br />
|last2=Ravi<br />
|first2=R.<br />
|title=The role of tobacco in penile carcinoma<br />
|journal=Brit J Urol<br />
|date=1995<br />
|volume=75<br />
|issue=3<br />
|pages=375-377<br />
|url=<br />
|accessdate=<br />
}}</ref>. Studies have shown that there is no significant difference in the risk of getting penile cancer between circumcised and intact men. To prevent a single case of penile cancer, it would statistically take 600 to 900 circumcisions<ref>{{REFdocument<br />
|title=Position Paper on Neonatal Circumcision<br />
|url=<br />
|contribution=<br />
|last=<br />
|first=<br />
|publisher=American Academy of Family Physicians (Leawood, Kansas)<br />
|format=<br />
|date=2002-02-14<br />
|accessdate=<br />
}}</ref>. The influence of circumcision on the infection risk of the female partner with cervical cancer has been refuted several times as well. HPV vaccination is an effective measure against carcinoma of the cervix.<br />
<br />
In conclusion, circumcision does not provide any proven benefits in preventive medicine.<br />
<br />
== Non-medical indications for circumcision ==<br />
<br />
Apart from the medical indication of pathological phimosis, there also are other reasons for circumcision.<br />
<br />
=== Aesthetic reasons ===<br />
<br />
The visual appearance of the [[penis]] is changed radically after circumcision. In this case, personal taste is decisive whether an intact or a cut [[penis]] is more appealing. Since a circumcision cannot be undone, it is essential to be fully informed about the risks and possible later complications before embarking on an aesthetically motivated circumcision, to decide whether the appearance will justify such bodily modification.<br />
<br />
Since this modification and its possible late effects will be the lifelong burden of the person who undertakes an aesthetically motivated circumcision to suit his personal preferences, a valid decision to proceed can only be made by the person to be circumcised himself, once he has reached the necessary age and level of maturity to make that decision. This should normally be the case when adulthood is reached.<br />
<br />
It should be noted that every circumcision operation leaves a life-long [[circumcision scar]] that encircles the shaft of the penis.<br />
<br />
===Financial reasons===<br />
<br />
In the United States, payment for non-therapeutic circumcision is made by most [[third-party payment| third-party payers]] without question. Doctors frequently perform medically-unnecessary, non-therapeutic circumcision of infants and children simply to collect a fee for the surgical operation. The only beneficiary of such surgery is the [[Financial Incentive| bank account of the medical doctor]].<br />
<br />
=== Moral reasons ===<br />
<br />
With the [[foreskin]], circumcision removes approximately 70% of the sensitive tissue of the [[penis]], lowering the potential for sexual stimulation accordingly. Due to the loss of around 50% of the entire penile skin, the [[penis]] loses the reserve skin that provides cutaneous mobility in the erect [[penis]] and the [[gliding action]].<br />
<br />
In the past, this circumstance was used to make it harder for boys to masturbate and [[masturbation]] less fun, as [[masturbation]] was viewed as immoral and was assumed to cause a variety of diseases. More on that can be found in the chapter "[[Circumcision#Historical_background|Historical background]]". Today, it is known that [[masturbation]] has no negative health effects, but can contribute positively to the child's sexual development. Sexuality is no longer a taboo nowadays, while [[masturbation]] is considered to be a natural part of human sexuality and is no longer seen as immoral. Therefore, circumcision for moral reasons - which would only affect boys too young to give informed consent - is no longer justifiable nowadays.<br />
<br />
=== Hygiene reasons ===<br />
<br />
''Hygiene'' refers to health and only secondarily to cleanliness. <br />
<br />
One should note that the human foreskin is endowed by nature with [[Foreskin#Immunological_functions| immunological functions]] that serve to protect the human body from disease.<ref name="fleiss-hodges-vanhowe1998" /> The glans penis receives blood through the frenular artery.<ref>{{REFjournal<br />
|last=Persad<br />
|first=R.<br />
|author-link=<br />
|last2=Sharma<br />
|first2=S.<br />
|author2-link=<br />
|last3=McTavish<br />
|first3=J.<br />
|author3-link=<br />
|etal=yes<br />
|title=Clinical presentation and pathophysiology of meatal stenosis following circumcision<br />
|journal=Brit J Urol<br />
|date=1995<br />
|volume=75<br />
|issue=1<br />
|pages=91-3<br />
|url=https://www.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.1995.tb07242.x<br />
|quote=<br />
|pubmedID=7850308 <br />
|pubmedCID=<br />
|DOI=10.1111/j.1464-410x.1995.tb07242.x<br />
|accessdate=2019-11-26<br />
}}</ref> These facts are generally overlooked in arguments for alleged hygienic benefits of circumcision.<br />
<br />
A common reason stated for circumcision is the assumption of hygienic benefits. This argument has to be viewed in the context of the environment the person in question grows up in. It is commonly known that bad hygienic circumstances, especially insufficient access to clean drinking water, pose a serious problem. The situation in disaster areas or refugee camps in the so-called third world keep reminding us of that.<br />
<br />
In western industrial nations, however, this problem does not exist, in view of the availability of clean water for daily personal hygiene. If the cleaning of the genitals is performed on a daily basis - and that may be assumed - no pathogens can accumulate under the [[foreskin]]. Cleaning of the [[Glans penis|glans]] and the area underneath the [[foreskin]] is easy - they are simply washed along with the rest of the body, just like the areas between the toes.<br />
<br />
In small boys, where the [[foreskin]] cannot be retracted yet, cleaning is not necessary, since the [[Synechia| membrane]] that fuses the [[foreskin]] to the [[Glans penis|glans]] prevents the accumulation of micro-organisms. The so-called "ballooning", where the [[foreskin]] inflates during urination, is not a serious problem.<br />
<br />
The opening of the [[foreskin]] in small boys is often quite narrow and serves as a one-way valve, allowing the urine to flow out, but preventing entry of microbes, for example from a dirty diaper. As long as the child is able to pass water, everything works as nature intended.<br />
<br />
But even in areas where there are poorer hygienic conditions and an insufficient access to medical care, the benefits of easier cleaning of a circumcised [[penis]] are to be viewed with a critical eye. Although even longer periods without personal hygiene will not result in an accumulation of germs under the [[foreskin]], circumcision itself is not without risk of complications. If the operation is carried out without proper sterility, there is a high risk of an infection of the wound. This also applies to the treatment of common complications like post-operative bleeding.<br />
<br />
The benefit of easier cleaning must be balanced against the risk of promoting serious infections - among others HIV - during the operation. In parts of Africa, several dozen of one tribe's boys die each year as a result of their circumcision.<br />
<br />
<br />
== Circumcision methods ==<br />
<br />
The [[Circumcision methods]] are discussed in a separate article.<br />
<br />
== Risks and late effects ==<br />
<br />
Just like tonsil or appendix surgery, circumcision is a surgical intervention and brings the usual risks related to surgical operations, alongside several specific risks of complications and late effects.<br />
<br />
=== Possible operative and postoperative complications ===<br />
<br />
Circumcision is surgery. Surgical complications of circumcision generally may be classified as hemorrhage, infection, or surgical misadventure up to and including loss of the penis and [[death]].<ref name="williams-kapilla1993">{{REFjournal<br />
|last=Williams<br />
|first=N<br />
|author-link=<br />
|last2=Kapilla<br />
|first2=L<br />
|author2-link=<br />
|etal=no<br />
|title=Complications of circumcision<br />
|trans-title=<br />
|language=<br />
|journal=Brit J Surg<br />
|location=<br />
|date=1993-10<br />
|volume=80<br />
|issue=10<br />
|pages=1231-6<br />
|url=http://www.cirp.org/library/complications/williams-kapila/<br />
|quote=<br />
|pubmedID=8242285<br />
|pubmedCID=<br />
|DOI=10.1002/bjs.1800801005<br />
|accessdate=2019-11-27<br />
}}</ref><br />
<br />
* Intolerance or allergic reactions to the narcotics used.<br />
* Especially in newborns, where the bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is often insufficient for the operation. Even in conjunction with regional anaesthesia of the dorsal nerve of the [[penis]], the rate of failure to provide sufficient anaesthetic even for experienced anaesthetists is still 5-10%. The general anaesthesia that would be needed for newborns, however, poses significant risks for the child, and, therefore, is only likely to be used in emergencies. A surgical operation without proper pain control can lead to the development of a specific pain memory<ref>{{REFweb<br />
|url=http://www.spiegel.de/spiegel/vorab/experte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-849534.html<br />
|title=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder<br />
|trans-title=Children's pain expert warns: Ritual circumcision changes the brain of children<br />
|language=German<br />
|last=Prof. Dr. med. Boris Zernikow<br />
|first=<br />
|publisher=Spiegel Online<br />
|website=<br />
|date=2012-08-12<br />
|accessdate=2019-10-11<br />
|format=<br />
|quote=<br />
}}</ref>. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation. Overall, their pain threshold was lower and the risk of chronic pain increased. Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFjournal<br />
|last=Garry<br />
|first=T.<br />
|title=Circumcision: a survey of fees and practices<br />
|journal=OBG Management<br />
|date=1994<br />
|volume=October<br />
|issue=<br />
|pages=34-36<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Howard<br />
|first=C.R.<br />
|last2=Howard<br />
|first2=F.M.<br />
|last3=Garfunkel<br />
|first3=L.C.<br />
|last4=de Blieck<br />
|first4=E.A.<br />
|last5=Weitzman<br />
|first5=M.<br />
|title=Neonatal circumcision and pain relief: current training practices<br />
|journal=Pediatrics<br />
|date=1998<br />
|volume=101<br />
|issue=<br />
|pages=423-428<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Stang<br />
|first=H.J.<br />
|last2=Snellman<br />
|first2=L.W.<br />
|title=Circumcision practice patterns in the United States<br />
|journal=Pediatrics<br />
|date=1998<br />
|volume=101<br />
|issue=e5<br />
|pages=<br />
|url=<br />
|accessdate=<br />
|note=Link to [[AAP]] website<br />
}}</ref>. During procedures which take several minutes, babies tend to fall into a state of stupor, which in the past was falsely interpreted as peaceful sleep, nurturing the belief that babies felt no pain. Measurements taken in those cases revealed a typically 3- to 4-fold increase in cortisol levels, which equals a state of severe shock.<ref>{{REFjournal<br />
|last=Gunnar<br />
|first=M.R.<br />
|last2=Fisch<br />
|first2=R.O.<br />
|last3=Korsvik<br />
|first3=S.<br />
|last4=Donhowe<br />
|first4=J.M.<br />
|title=The effects of circumcision on serum cortisol and behavior<br />
|journal=Psychoneuroendocrinology<br />
|date=1981<br />
|volume=6<br />
|issue=3<br />
|pages=269-275<br />
|url=http://www.cirp.org/library/pain/gunnar/<br />
|accessdate=2019-11-26<br />
}}</ref><br />
* Postoperative wound pain, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions.<br />
* Postoperative pain from the exposure of the sensitive glans penis to clothing. This pain will endure for several weeks or even longer in some cases.<br />
* Postoperative bleeding of the wound. This can have severe consequences especially for very young infants, if they are not treated promptly. Their blood volume is only about 85 ml per kilogram of body weight, and even moderate blood loss can lead to hypovolaemia, hypovolaemic shock and even death.<ref>{{REFbook<br />
|last=<br />
|first=<br />
|year=2000<br />
|title=Paediatric Handbook<br />
|url=<br />
|work=<br />
|editors=Smart J, Nolan T.<br />
|edition=6<br />
|volume=<br />
|chapter=<br />
|pages=82<br />
|location=Victoria, Australia<br />
|publisher=Blackwell Science Asia<br />
|isbn=<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref><ref>{{REFdocument<br />
|title=Autopsy of Demetrius Manker<br />
|url=<br />
|contribution=Case 93-1711<br />
|last=Wetli<br />
|first=CV<br />
|publisher=Miami: Dade County Medical Examiner Department<br />
|format=<br />
|date=1993-06-23<br />
|accessdate=<br />
}}</ref> <ref>{{REFjournal<br />
|last=Hiss<br />
|first=J.<br />
|last2=Horowitz<br />
|first2=A.<br />
|last3=Kahana<br />
|first3=T.<br />
|title=Fatal haemorrhage following male ritual circumcision<br />
|journal=J Clin Forensic Med<br />
|date=2000<br />
|volume=7<br />
|issue=<br />
|pages=32-34<br />
|url=http://www.cirp.org/library/death/hiss1/<br />
|accessdate=2019-11-06<br />
}}</ref><ref>{{REFdocument<br />
|title=Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan<br />
|url=http://www.circumstitions.com/death-exsang.html<br />
|contribution=<br />
|last=Newell<br />
|first=TEC<br />
|publisher=Burnaby, B.C.: B.C. Coroner's Service<br />
|format=<br />
|date=2004-01-19<br />
|accessdate=2019-11-26<br />
}}</ref><br />
* Post operative [[lymphoedema]].<br />
* Postoperative infections. This includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.<ref>{{REFconference<br />
|last=Dr. med. Hartmann<br />
|first=Wolfgang<br />
|url=<br />
|place=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German)<br />
|title=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German)<br />
|date=2012-11-26<br />
|accessdate=<br />
}}</ref><br />
* [http://www.circumstitions.com/Restric/Botched9wd.html Wound dehiscence], meaning the separation of the edges of the wound or the tissue after suturing.<br />
* Adhesion between the surface or rim of the [[Glans penis|glans]] with the neighbouring penile skin, causing skin pockets and bridges, as well as visually unpleasant results like uneven scars, which make a re-circumcision necessary.<br />
* Postoperative [[phimosis]]: a phimotic ring can develop during scarring, which makes a re-circumcision necessary. According to a study by Blalock ''et al.''<ref>{{REFjournal<br />
|last=Blalock<br />
|first=H.J.<br />
|last2=Vemulakonda<br />
|first2=V.<br />
|last3=Ritchey<br />
|first3=M.L.<br />
|last4=Ribbeck<br />
|first4=M.<br />
|title=Outpatient management of [[phimosis]] Following newborn circumcision<br />
|journal=J Urol<br />
|date=2003<br />
|volume=169<br />
|issue=6<br />
|pages=2332-2334<br />
|url=http://www.cirp.org/library/complications/blalock1/<br />
|accessdate=2019-11-26<br />
}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal<br />
|last=Leitch<br />
|first=I.O.W.<br />
|title=Circumcision - a continuing enigma<br />
|journal=Aust Paediatr J<br />
|date=1970<br />
|volume=6<br />
|issue=<br />
|pages=59-65<br />
|url=http://www.cirp.org/library/general/leitch1/<br />
|accessdate=2019-12-15<br />
}}</ref> 5.5%.<br />
*<br />
* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], is cut during circumcision without being clamped and sutured at its origin separately, it starts to develop new branches over time, which can lead to the development of knots.<br />
* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro-penis) and induratio [[penis]] plastica (skewed penis).<br />
* Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis|glans]] or the [[penis]] can occur.<br />
* In rare cases, necrosis, gangrene, ischaemia, keloid formation and circulatory problems may also occur.<br />
* When the circumcision is followed by the ultra-orthodox Jewish ritual of Metzitzah B'Peh (which consists of sucking blood from the wound with the mouth), there is a risk of infection with [[herpes]] simplex type 1, which can lead to brain damage or death.<ref>{{REFweb<br />
|url=http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritual.html?_r=0<br />
|title=Baby’s Death Renews Debate Over a Circumcision Ritual<br />
|last=Robbins<br />
|first=Liz<br />
|date=2012-03-07<br />
|accessdate=2019-10-11<br />
}}</ref><br />
<br />
=== Physical late effects ===<br />
<br />
* An unavoidable late effect of any circumcision is the permanent loss of sexual sensitivity. This is partly due to the removal of sensory tissue. The [[foreskin]] contains very many nerve endings and touch receptors, which account for the major part of male sexual sensation. If the [[foreskin]] is removed, they can no longer provide sexual stimulation. It is also partly due to the fact that the surface of the [[Glans penis|glans]] reacts to the missing protection from friction and drying out by developing a callus layer. This reduces the sensitivity of the remaining nerves in the [[Glans penis|glans]] gradually over the years. The study conducted by Sorrells ''et al.''<ref>{{REFjournal<br />
|last=Sorrells<br />
|first=M.L.<br />
|last2=Snyder<br />
|first2=J..L.<br />
|last3=Reiss<br />
|first3=M.D.<br />
|etal=yes<br />
|title=Fine-touch pressure thresholds in the adult [[penis]]<br />
|journal=BJU Int<br />
|date=2007<br />
|volume=99<br />
|issue=<br />
|pages=864-869<br />
|url=<br />
|accessdate=<br />
}}</ref> found a significant reduction of sensitivity to touch for circumcised compared to intact [[penis]]es in adult males. Other studies revealed that circumcised men use condoms significantly less often than intact men, since they further limit the sexual sensitivity (see above).<br />
<br />
* Painful tension can occur when there is too little reserve skin left to support a full erection<ref>{{REFjournal<br />
|last=Taylor<br />
|first=J.R.<br />
|last2=Lockwood<br />
|first2=A.P.<br />
|last3=Taylor<br />
|first3=A.J.<br />
|title=The prepuce: <q>Specialized mucosa of the [[penis]] and its loss to circumcision</q><br />
|journal=British Journal of Urology<br />
|date=1996<br />
|volume=77<br />
|issue=<br />
|pages=291-295<br />
|url=<br />
|accessdate=<br />
}}</ref>. This risk is partly dependent on the anatomy of the [[penis]]. While some [[penis]]es already have the majority of their full size when flaccid ([[Flesh Penis]], or "[[shower]]"), others are rather short when flaccid and double or more their size during an erection ([[Blood Penis]], or "[[grower]]"). Especially in children's circumcision, where the [[penis]] is not yet fully developed, the amount of reserve skin needed in adulthood cannot be estimated.<br />
<br />
* Erectile dysfunction: Both the damage inflicted to the blood vessels in the [[foreskin]] and the reduced sexual sensitivity can be causes for reduced erectile function with advancing age.<ref>{{REFjournal<br />
|last=Money<br />
|first=J.<br />
|last2=Davison<br />
|first2=J.<br />
|title=Adult penile circumcision: Erotosexual and cosmetic sequelae<br />
|journal=Journal of Sex Research<br />
|date=1983<br />
|volume=19<br />
|issue=<br />
|pages=289-292<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
<br />
* Orgasm problems: In the wake of reduced sexual sensitivity, due to the loss of sensory tissue and gradual keratinization of the surface of the [[Glans penis|glans]], orgasm problems may develop with increasing age. In this case, the sexual arousal created by intercourse or [[masturbation]] is not enough to achieve orgasm. A preliminary stage of this late effect is the prolonged time circumcised men need to reach an orgasm. This is often fielded as the "cut men have more endurance" argument for circumcision.<br />
* Vaginal dryness: Due to the loss of the natural gliding action, which comes from the mobility of the fore- and shaft skin, a much increased friction between [[penis]] and vagina occurs during intercourse. This can make intercourse painful for both partners and lead to abrasions<ref>{{REFjournal<br />
|last=Frisch<br />
|first=Morten<br />
|author-link=Morten Frisch<br />
|first2=Morten<br />
|last2=Lindholm<br />
|first3=Morten<br />
|last3=Grønbæk<br />
|title=Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark<br />
|journal=International Journal of Epidemiology<br />
|date=2011-10<br />
|volume=40<br />
|issue=5<br />
|pages=1367-1381<br />
|url=<br />
|pubmedID=21672947<br />
|DOI=10.1093/ije/dyr104<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Cortés-González<br />
|first=J.<br />
|last2=Arratia-Maqueo<br />
|first2=J.<br />
|last3=Gómez-Guerra<br />
|first3=L.<br />
|title=Does circumcision has an effect on female's perception of sexual satisfaction?<br />
|journal=Rev Invest Clin<br />
|date=2008<br />
|volume=60<br />
|issue=3<br />
|pages=227<br />
|url=<br />
|pubmedID=18807735<br />
|accessdate=<br />
}}</ref> The prolonged time it takes circumcised men to reach orgasm, as well as the often longer and more vigorous thrusting movements - compared to intact men - play a part in this.<ref>{{REFjournal<br />
|last=Cold<br />
|first=C.J.<br />
|last2=Taylor<br />
|first2=J.R.<br />
|title=The prepuce<br />
|journal=BJU Int<br />
|date=1999<br />
|volume=83<br />
|issue=Suppl. 1<br />
|pages=34-44<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Fink<br />
|first=K.S.<br />
|last2=Carson<br />
|first2=C.C.<br />
|last3=DeVellis<br />
|first3=R.F.<br />
|title=Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction<br />
|journal=J Urol<br />
|date=2002<br />
|volume=167<br />
|issue=5<br />
|pages=2113-2116<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
<br />
* [[Lymphoedema]] of the penis is a normal and expected complication of male circumcision.<br />
<br />
* [[Meatal stenosis]], a pathological narrowing of the opening of the urethra, which mostly occurs in infancy and early childhood. It is one of the most common complications of infant circumcision. A study from 2006 found meatal stenosis exclusively in previously circumcised boys. The incidence rate after a circumcision is approximately 10 to 20 percent.<ref name="vanhowe2006">{{REFjournal<br />
|last=Van Howe<br />
|first=R.S.<br />
|title=Incidence of meatal stenosis following neonatal circumcision in a primary care setting<br />
|journal=Clin Pediatr (Phila)<br />
|note=Jan-Feb 2006<br />
|date=2006-01<br />
|volume=45<br />
|issue=1<br />
|pages=49-54<br />
|url=https://www.academia.edu/6992015/Incidence_of_Meatal_Stenosis_following_Neonatal_Circumcision_in_a_Primary_Care_Setting<br />
|accessdate=2019-12-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Stenram<br />
|first=A.<br />
|last2=Malmfors<br />
|first2=G.<br />
|last3=Okmian<br />
|first3=L.<br />
|title=Circumcision for [[phimosis]]: a follow-up study<br />
|journal=Scandinavian journal of urology and nephrology<br />
|date=1986<br />
|volume=20<br />
|issue=2<br />
|pages=89<br />
|url=<br />
|pubmedID=3749823<br />
|accessdate=<br />
}} </ref><ref>{{REFweb<br />
|url=http://emedicine.medscape.com/article/1016016-overview<br />
|title=Meatal Stenosis<br />
|publisher=Medscape<br />
|accessdate=2019-10-11<br />
}}</ref><br />
<br />
=== Psychological late effects ===<br />
<br />
[[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effects]] are also possible after a circumcision, especially if the operation was carried out in childhood. On this occasion a variety of trauma may occur, which depend, among others, on age and circumstances of the circumcision. For example, whether the circumcision took place with or without sufficient anaesthesia, if the individual has been informed about the operation beforehand, if he was circumcised against his will or without his consent, and also, in the case of infant circumcision, if he was told about it during childhood or had to find it out coincidentally on his own.<br />
<br />
The psychological late effects of circumcision are not yet fully researched, and many studies took place on rather a small scale. This situation needs to be rectified, because the available studies, as well as the histories of negatively affected men, suggest that these late effects may have more impact than previously assumed.<br />
<br />
* It was observed that infants, following circumcision without pain control, had a disturbed bond with their mother<ref>{{REFjournal<br />
|last=Marshall<br />
|first=R.E.<br />
|last2=Porter<br />
|first2=F.L.<br />
|last3=Rogers<br />
|first3=A.G.<br />
|etal=yes<br />
|title=Circumcision: II effects upon mother-infant interaction<br />
|journal=Early Hum Dev<br />
|date=1982<br />
|volume=7<br />
|issue=4<br />
|pages=367-374<br />
|url=http://www.cirp.org/library/birth/marshall2/<br />
|accessdate=2020-02-01<br />
}}</ref>, as well as problems with nurturing, up to the point of refusal to be fed. The sleeping habits of these babies were also disturbed, with prolonged non-REM sleep and increased waking.<br />
<br />
* In boys circumcised in childhood, post traumatic stress disorder (PTSD) could be diagnosed. In a study on Philippine boys, in whom no PTSD was found prior to the operation, 69% of the boys circumcised in the traditional ritual and 51% of those circumcised by standard medical procedures (including anaesthesia) fulfilled the DSM-IV criteria for PTSD following the operation.<ref>{{REFbook<br />
|last=Ramos<br />
|first=S<br />
|last2=Boyle<br />
|first2=GJ<br />
|year=2001<br />
|title=Understanding circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem<br />
|url=https://link.springer.com/chapter/10.1007/978-1-4757-3351-8_14<br />
|work=<br />
|editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]<br />
|edition=<br />
|volume=<br />
|chapter=Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder<br />
|pages=253-270<br />
|location=New York<br />
|publisher=Kluwer Academic/Plenum Publishers<br />
|isbn=<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref><br />
* Circumcisions, especially those that happen without consent, can spark feelings of helplessness and alienation, which can persist as trauma. These feeling can also be triggered later, when someone circumcised as an infant becomes aware of his circumcision. In an online study, interviewed men stated they felt betrayed - 55% by the mother, 50% by the father, and 58% by the doctor, and 73% felt that their human rights had been violated.<ref name="GSoCH">{{REFweb<br />
|url=http://www.circumcisionharm.org/<br />
|title=Global Survey of Circumcision Harm<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* It can frequently be found that the loss is denied, much as happens with the loss of other body parts. This denial can lead to fathers having their sons circumcised in order not to be reminded of their own loss. In this process, their own body is defined as "normal" and the [[foreskin]] redefined as a foreign object. Their own parents are seen as "good", so that this image is projected onto the circumcision their parents carried out as well, in order to keep the positive emotion intact. The father wants to be a "good" father later in life as well, and so, following an idealised image of his own parents, circumcision, which has been redefined as a "good thing", is passed on to his son by having him circumcised as well.<ref>{{REFjournal<br />
|last=van der Kolk<br />
|first=B.A.<br />
|url=http://www.cirp.org/library/psych/vanderkolk/<br />
|title=The compulsion to repeat the trauma: re-enactment, revictimization, and masochism<br />
|journal=Psychiatr Clin North Am<br />
|date=1989<br />
|volume=12<br />
|issue=2<br />
|pages=389-411<br />
|accessdate=2019-10-12<br />
}}</ref><ref>{{REFjournal<br />
|last=Goldman<br />
|first=R.<br />
|author-link=Ronald Goldman<br />
|url=http://www.cirp.org/library/psych/goldman1/<br />
|title=The psychological impact of circumcision<br />
|journal=BJU Int<br />
|date=1999<br />
|volume=83<br />
|issue=Suppl. 1<br />
|pages=93-103<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* If the circumcised male feels incomplete, or due to the missing [[foreskin]] disadvantaged compared to intact males, an inferiority complex and depression may occur. This can be accompanied by conscious recognition of his own incompleteness, or the deficiency may remain completely subconscious<ref>{{REFjournal<br />
|last=Rhinehart<br />
|first=J.<br />
|url=http://www.cirp.org/library/psych/rhinehart1/<br />
|title=Neonatal circumcision reconsidered<br />
|journal=Transactional Analysis J<br />
|date=1999<br />
|volume=29<br />
|issue=3<br />
|pages=215-221<br />
|accessdate=2019-10-12<br />
}}</ref>. In an online study, 75% of those interviewed stated that they felt incomplete, and 66% said they felt inferior compared with intact males.<ref name="GSoCH"/><br />
* Cases in which children felt ill treated or punished have been documented as well. G. Cansever found in her study on 12 boys aged between 4 and 7 years, who had previously been prepared for their impending circumcision, that the children experienced the operation as an aggressive assault on their bodies.<ref>{{REFjournal<br />
|last=Cansever<br />
|first=G.<br />
|date=1965<br />
|url=http://www.cirp.org/library/psych/cansever/<br />
|title=Psychological effects of circumcision<br />
|journal=Brit. J. Med. Psychol<br />
|volume=38<br />
|pages=321-331<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* Fear of being alone or darkness.<ref name="Levy1945">{{REFjournal<br />
|last=Levy<br />
|first=David M.<br />
|url=http://www.cirp.org/library/psych/levy1/<br />
|title=Psychic trauma of operations in children; and a note on combat neurosis<br />
|journal=American Journal of Diseases of Children<br />
|volume=69<br />
|date=1945<br />
|pages=7-25<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* Fear of doctors, clinics and also closed rooms.<ref name="Levy1945"/><br />
* Relapse into the state of bed-wetting, even if the child was already dry before.<ref name="Levy1945"/><br />
* Circumcised males who become fathers frequently manifest [[adamant father syndrome]].<br />
<br />
== Rights and ethics ==<br />
<br />
The [[Rights situation on circumcision|rights situation]] is discussed in separate article.<br />
<br />
<br />
-----<br />
<br />
<br />
{{FromIntactWiki<br />
|URL=http://intactwiki.org/wiki/Circumcision<br />
|Title=Circumcision<br />
}}<br />
<br />
[[Image:Intact vs circumcised.JPG |thumbnail|right|300px| The intact and circumcised human penis, side by side.]]<br />
<br />
The term "circumcision" without a gender qualifier refers specifically to male circumcision. It means "to cut around," and it refers to the excision of the [[foreskin]] from the penis. Circumcision is most often performed in healthy males for [[Religion and Culture|religious or cultural]] reasons. The procedure may be performed on consenting adults, but it is most often performed on non-consenting minors, particularly newborn children, which is why the ritual is so controversial. Opponents of circumcision consider the circumcision of non-consenting minors to be unethical and a human rights violation, unless there is concrete medical indication. Proponents of circumcision consider the circumcision of non-consenting minors to be a "religious freedom" and a "parental right."<br />
<br />
== Complications ==<br />
=== Pain ===<br />
In the past, advocates of circumcision claimed that a newborn child's nerve system was not yet fully developed, and that as a result, the child felt no pain during the circumcision procedure. Anand & Hickey (1987) have shown that newborn children do in fact feel pain, and more acutely than adults.<ref name="anand-hickey1987">{{REFjournal<br />
|last=Anand<br />
|first=<br />
|author-link=<br />
|last2=Hickey<br />
|first2=<br />
|author2-link=<br />
|etal=no<br />
|title=Pain and its effects in the human neonate and fetus<br />
|trans-title=<br />
|language=<br />
|journal=New Engl J Med<br />
|location=<br />
|date=1987-11-19<br />
|volume=317<br />
|issue=21<br />
|pages=1321-9<br />
|url=http://www.cirp.org/library/pain/anand/<br />
|quote=<br />
|pubmedID=3317037<br />
|pubmedCID=<br />
|DOI=<br />
|accessdate=2019-11-08<br />
}}</ref> This has led American health associations to recommend doctors take measures to reduce the pain of circumcision in infants.<br />
<br />
The [[Position Statements on Infant Circumcision|AAP Circumcision Policy Statement]] states quite clearly that ''"There is considerable evidence that newborns who are circumcised without analgesia experience pain and physiologic stress"''. Furthermore, the pain is quite severe, and requires injections for proper pain management. Sucrose and Acetaminophen ''"cannot be recommended as the sole method of analgesia"''. Topical cream is no longer thought sufficient as ''"the analgesic effect is limited during the phases associated with extensive tissue trauma such as...tightening of the clamp"''.<ref>{{REFjournal<br />
|last=<br />
|first=<br />
|title=American Academy of Pediatrics: Circumcision Policy Statement; Task Force on Circumcision<br />
|journal=Pediatrics<br />
|date=1999-03<br />
|volume=103<br />
|issue=3<br />
|pages=686-693<br />
|url=https://pediatrics.aappublications.org/content/103/3/686#sec-9<br />
|accessdate=2019-11-26<br />
|note=Statement Reaffirmed Sept. 1, 2005<br />
}}</ref><br />
<br />
The [[AAFP]] states quite simply in their [[Position Statements on Infant Circumcision|position paper]], ''"Newborns experience pain during circumcision".''<ref>{{REFweb<br />
|title=Circumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed<br />
|website=Official American Academy of Family Physicians Website<br />
|url=http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html<br />
|accessdate=2011-05-02<br />
}}</ref> This is not a debatable fact, and yet, it is not widely accepted, even by some doctors. It might be hard for some doctors to accept, as they may have been taught that the infant does not feel pain, and may have performed countless circumcisions with this idea. Usage of anesthesia for infant circumcision is still by no means the rule.<br />
<br />
Penile injections of anesthetic are now recommended by all of the major medical institutions. In their [http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml Report 10 of the Council on Scientific Affairs], the AMA states ''"When the decision is made to proceed with circumcision, local anesthesia should be provided for the procedure. Ring block or dorsal penile blocks [injections] are most effective. EMLA cream has limited utility"''. Alarmingly, ''"Despite the clear evidence that newborn males generate brisk pain responses during circumcision, a recent survey of residency training programs found that 26% of programs that taught circumcision provided no instruction on the use of local anesthesia". The AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, and 25% of obstetricians"''.<ref>{{REFweb<br />
|title=Report 10 of the Council on Scientific Affairs (I-99): Neonatal Circumcision<br />
|website=American Medical Association Official Website<br />
|url=http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml<br />
|accessdate=2011-05-04<br />
}}</ref><br />
<br />
The AAP's [http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx Heatlhy Children website] suggests ''"Your pediatrician (or your obstetrician) should discuss the forms of analgesia that are available"''.<ref>{{REFweb<br />
|title=Where We Stand: Circumcision<br />
|publisher=[[AAP]]<br />
|date=2011-03-23<br />
|url=http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx<br />
|accessdate=2019-10-12<br />
}}</ref> Be that as it may, few forms of analgesia are recommended. There are basically two types of injections to choose from, and the website does not go into the difference between a 'dorsal nerve block' and a 'ring block' injection.<br />
<br />
Given what is known from aforementioned official documents, the AAP website may be more informative and effective if it would say ''"Make sure your doctor knows of the ineffectiveness of anything short of local anesthesia, and make sure your baby is given an injection. This is your responsibility, because your doctor may or may not be up to date on the latest understandings of infant sensitivity to pain during circumcision."'' The AAP may be holding back, however, perhaps because this would upset the doctor/parent power relationship, and may cause too much questioning of doctors in general. One may not expect to find this kind of advice on such a website, and yet, anything less than this is a dangerously weak statement.<br />
<br />
To control pain, some physicians that circumcise use Tylenol, sugar,<ref>{{REFweb<br />
| quote=To calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, and soothing music is played in the room.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-guide.html<br />
| title=Parents' Guide to Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2011-04-08<br />
}}</ref><ref>{{REFweb<br />
| quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> a topical cream,<ref>{{REFweb<br />
| quote=Then in our office, he will have topical anesthetic applied to his penis.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb<br />
| quote=We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-guide.html<br />
| title=Parents' Guide to Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2011-04-08<br />
}}</ref> Topical anaesthetic only serves to numb the area to lessen the pain of the injection, but studies have shown that a dorsal penile ring block is not always effective in stopping the pain of circumcision.<ref name='Journal of Perinatology April/May 2002'>{{REFjournal<br />
|last=Taeusch<br />
|first=H. William<br />
|last2=Martinez<br />
|first2=Alma M.<br />
|last3=Partridge<br />
|first3=J. Colin<br />
|last4=Sniderman<br />
|first4=Susan<br />
|last5=Armstrong-Wells<br />
|first5=Jennifer<br />
|last6=Fuentes-Afflick<br />
|first6=Elena<br />
|title=Pain During Mogen or Plastibell Circumcision<br />
|journal=Journal of Perinatology<br />
|volume=22<br />
|issue=3<br />
|pages=214-218<br />
|url=http://www.nature.com/jp/journal/v22/n3/full/7210653a.html<br />
|quote=...more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|note=April/May 2002<br />
|date=2002-04<br />
|accessdate=2011-04-08<br />
}}</ref><ref name='Clinical Pediatrics August 1986'>{{REFjournal<br />
|last=Williamson<br />
|first=Paul S.<br />
|last2=Evans<br />
|first2=Nolan Donovan<br />
|title=Neonatal Cortisol Response to Circumcision with Anesthesia<br />
|journal=Clinical Pediatrics<br />
|volume=25<br />
|issue=8<br />
|pages=412-416<br />
|url=http://cpj.sagepub.com/content/25/8/412.abstract<br />
|quote=The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=1986-08<br />
|accessdate=2011-04-08<br />
}}</ref> During circumcision, somp physicians give children sugar pacifiers to "reduce the perception of pain",<ref>{{REFweb<br />
| quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> but in at least one study, data shows that giving sugar to a child doesn't help to reduce the perception of pain in the child.<ref name='Lancet, The 2010-10-09'>{{REFjournal<br />
|last=Slater<br />
|first=Rebeccah<br />
|first2=Laura<br />
|last2=Cornelissen<br />
|first3=Lorenzo<br />
|last3=Fabrizi<br />
|first4=Debbie<br />
|last4=Patten<br />
|first5=Jan<br />
|last5=Yoxen<br />
|first6=Alan<br />
|last6=Worley<br />
|first7=Stewart<br />
|last7=Boyd<br />
|first8=Judith<br />
|last8=Meek<br />
|first9=Maria<br />
|last9=Prof. Fitzgerald<br />
|title=Oral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial<br />
|journal=The Lancet<br />
|volume=376<br />
|issue=9748<br />
|pages=1225-1232<br />
|url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2961303-7/fulltext<br />
|quote=Our data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuits, and therefore might not be an effective analgesic drug. The ability of sucrose to reduce clinical observational scores after noxious events in newborn infants should not be interpreted as pain relief.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=2010-10-09<br />
|accessdate=2011-04-08<br />
}}</ref> Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals.<br />
<br />
It has been shown that an infant's response to pain can be altered for years as a consequence of circumcision.<ref>{{REFjournal<br />
|last=Taddio<br />
|first=Anna<br />
|first2=Morton<br />
|last2=Goldbach<br />
|first3=Moshe<br />
|last3=Ipp<br />
|first4=Bonnie<br />
|last4=Stevens<br />
|first5=Gideon<br />
|last5=Koren<br />
|title=Effect of neonatal circumcision on pain responses during vaccination in boys<br />
|journal=The Lancet<br />
|volume=345<br />
|issue=8945<br />
|pages=291-2<br />
|url=http://www.cirp.org/library/pain/taddio/<br />
|quote=<br />
|pubmedID=7837863<br />
|pubmedCID=<br />
|DOI=<br />
|date=1995<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Taddio<br />
|first=Anna<br />
|last2=Katz<br />
|first2=J.<br />
|last3=Ilersich<br />
|first3=A.L.<br />
|last4=Koren<br />
|first4=G.<br />
|title=Effects of neonatal circumcision on pain response during subsequent routine vaccination<br />
|journal=The Lancet<br />
|volume=349<br />
|issue=9052<br />
|pages=599-603<br />
|url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)10316-0/fulltext<br />
|quote=<br />
|pubmedID=9057731<br />
|pubmedCID=<br />
|DOI=10.1016/S0140-6736(96)10316-0<br />
|date=1997-03<br />
|accessdate=<br />
}}</ref><br />
<br />
=== Sexual effects ===<br />
<br />
Circumcision and frenectomy remove tissues with heightened erogenous sensitivity. Boyle ''et al.'' (2002) wrote, "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings&mdash;many of which are lost to circumcision."<ref>{{REFjournal<br />
|last=Boyle<br />
|first=Gregory J.<br />
|author-link=Gregory Boyle<br />
|first2=Gillian A.<br />
|last2=Bensley<br />
|title=Adverse Sexual and Psychological Effects of Male Infant Circumcision<br />
|journal=Psychological reports<br />
|volume=88<br />
|issue=3, Part 2<br />
|pages=1105–1106<br />
|url=http://www.cirp.org/library/psych/boyle5/<br />
|quote=<br />
|pubmedID=11597060<br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410x.1999.0830s1085.x<br />
|date=July 2001<br />
|accessdate=<br />
}}</ref> They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well."<br />
<br />
The amputation of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the penis, leaving only the uninhibited protopathic sensibility of the artificially externalized glans penis. The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of the changes in sexual behavior noted in circumcised human males.<ref>{{REFjournal<br />
|last=Van Howe<br />
|first=R.S.<br />
|author-link=Robert Van Howe<br />
|last2=Cold<br />
|first2=C.J.<br />
|title=Advantages and Disadvantages of Neonatal Circumcision<br />
|journal=The Journal of the American Medical Association<br />
|volume=277<br />
|issue=13<br />
|pages=1052-7<br />
|url=http://www.ncbi.nlm.nih.gov/pubmed/9218663<br />
|quote=<br />
|pubmedID=9218663<br />
|pubmedCID=<br />
|DOI=<br />
|date=1997-04-02<br />
|accessdate=<br />
}}</ref><br />
<br />
Histology of the male circumcision scar shows amputation neuromas, Schwann cell proliferation and the bulbous collection of variably sized neurites. Amputation neuromas do not mediate normal sensation and are notorious for generating pain.<ref>{{REFjournal<br />
|last=Cold<br />
|first=C.J.<br />
|first2=J.R.<br />
|last2=Taylor<br />
|title=The prepuce<br />
|journal=British Journal of Urology International<br />
|volume=83<br />
|issue=<br />
|pages=34-44<br />
|url=http://www.cirp.org/library/anatomy/cold-taylor/<br />
|quote=<br />
|pubmedID=10349413<br />
|pubmedCID=<br />
|DOI=<br />
|date=1999-1<br />
|accessdate=<br />
}}</ref><br />
<br />
=== Death ===<br />
A study in 2010 estimated approximately 117 neonatal circumcision-related deaths occur annually in the United States, about one out of every 77 male neonatal deaths, more than suffocation, auto accidents, or even SIDS.<ref name="Bollinger 2010">{{REFjournal<br />
|last=Bollinger<br />
|first=Dan<br />
|author-link=Dan Bollinger<br />
|last2=Boy's Health Advisory<br />
|title=Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths<br />
|journal=Thymos: Journal of Boyhood Studies<br />
|volume=4<br />
|issue=1<br />
|pages=78-90<br />
|url=http://www.mensstudies.com/content/b64n267w47m333x0/?p=7ebbd6b446d940cbbd4274c095754b12π=5<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.3149/thy.0401.78<br />
|date=2010-04-26<br />
|accessdate=2019-10-12<br />
}}</ref><ref>{{REFweb<br />
| quote=<br />
| url=http://www.icgi.org/2010/04/infant-circumcision-causes-100-deaths-each-year-in-us<br />
| title=Infant circumcision causes 100 deaths each year in US<br />
| last=<br />
| first=<br />
| publisher=ICGI<br />
| website=International Coalition for Genital Integrity<br />
| date=2010-04-26<br />
| accessdate=<br />
}}</ref> See also the list of [[fatalities]].<br />
<br />
== Forced circumcision ==<br />
<br />
<!--=== United States military ===<br />
<br />
American soldiers serving in World War II were subjected to regular inspections of their genitals. If uncircumcised, the soldiers risked being ordered to undergo immediate circumcision.<ref>{{REFbook<br />
|last=Schoen<br />
|first=Ed<br />
|author-link=Edgar J. Schoen<br />
|year=2005<br />
|title=On Circumcision<br />
|url=https://books.google.de/books?id=-zUhdvSt7cgC<br />
|work=<br />
|editor=Dianne Yeakey<br />
|edition=<br />
|volume=<br />
|chapter=<br />
|pages=72-73<br />
|location=Georgetown, Canada<br />
|publisher=RDR Books<br />
|isbn=1-157143-123-3<br />
|quote=For a critical view, see Sorrells, "The History of Circumcision," p. 333<br />
|accessdate=<br />
|note=<br />
}}</ref> This practice was discontinued at least six decades ago.--><br />
<br />
=== Non-therapeutic circumcision of male children ===<br />
<br />
Human babies, because they are not yet in possession of language, are incapable of giving or refusing consent for being circumcised. The element of force has led some scholars to view the circumcision of baby boys as a category of forced circumcision.<ref>For example, Frederick M. Hodges, a medical historian, writes: "In the late 1970s, as the Americans were growing increasingly aware of the abuses of power rampant throughout the nation's social institutions, influential grass-roots movements protesting the forced circumcision of American children sprang up nationwide." F. Hodges, "A Short History," p. 31; see also [[Leonard B. Glick|Glick]], ''Marked in Your Flesh'', pp. 273-281.</ref> There are, however, physicians in the United States who argue strongly for non-therapeutic circumcision of newborn babies; and circumcision is widely accepted as a postnatal procedure in American hospitals.<ref>{{REFbook<br />
|last=Fletcher<br />
|first=Christopher R.<br />
|year=1999<br />
|title=Circumcision in America in 1998: Attitudes, Beliefs, and Charges of American Physicians<br />
|url=http://www.springerlink.com/content/h2150v731233m177/<br />
|work=Male and Female Circumcision<br />
|editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]<br />
|edition=<br />
|volume=<br />
|chapter=Section 5<br />
|pages=259-271<br />
|location=New York<br />
|publisher=Kluwer Academic/Plenum Publishers<br />
|isbn=<br />
|quote=<br />
|accessdate=2019-10-12<br />
|note=ID 10.1007/978-0-585-39937-9_19<br />
}}</ref> Parental consent is required.<ref>See, e.g., Shephard and Shephard, ''The Complete Guide'', p. 125.</ref> A statement published by the American Academy of Pediatrics in 1999 declares that "parents should determine what is in the best interest of the child... It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in additions to the medical factors, when making a decision."<ref>Lannon and Bailey, "Circumcision Policy Statement," p. 691.</ref> In the United Kingdom, where non-therapeutic circumcision has now become far less prevalent than in the United States, a written consent of both parents is required, if a physician is to perform a non-therapeutic circumcision of a child.<ref>{{REFjournal<br />
|last=<br />
|first=<br />
|title=Re J (child's religious upbringing and circumcision)<br />
|journal=Family Court Reports<br />
|date=2000<br />
|volume=1<br />
|issue=<br />
|pages=307-314<br />
|url=http://www.cirp.org/library/legal/Re_J/2000.html<br />
|accessdate=2019-10-12<br />
}}</ref> (The National Health Service does not provide non-therapeutic circumcision.)<br />
<br />
In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<ref>See, e.g., Somerville, "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; Chessler, "Justifying the Unjustifiable"; Smith, "Male Circumcision."</ref> For example, critics have pointed out that, in the United States, more than 1.3% of male neonatal deaths are attributable to the complications of non-therapeutic circumcision surgery.<ref name="Bollinger 2010"/>refer<ref>{{REFweb<br />
|quote=<br />
|url=http://www.icgi.org/2010/04/infant-circumcision-causes-100-deaths-each-year-in-us<br />
|title=Infant circumcision causes 100 deaths each year in US<br />
|last=Bollinger<br />
|first=Dan<br />
|author-link=Dan Bollinger<br />
|publisher=International Coalition for Genital Integrity<br />
|date=2010-04-26<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
{{SEEALSO}}<br />
* [[Sexual effects of circumcision]]<br />
* [[FGM]]<br />
* [[MGM]]<br />
* [[Risks and complications]]<br />
* [[Documented severe complications of circumcision]]<br />
* [[Circumcision scar]]<br />
* [[Circumpendium]]<br />
* [[Human rights]]<br />
* [[Ethics of non-therapeutic child circumcision]]<br />
* [[Rights situation on circumcision]]<br />
* [[Circumcision methods]]<br />
* [[Case Histories]]<br />
* [[Lymphoedema]]<br />
* [[Psychological issues of male circumcision]]<br />
<br />
{{REF}}<br />
<br />
[[Category:From Intactipedia]]<br />
[[Category:From IntactWiki]]<br />
[[Category:Male circumcision]]<br />
[[Category:Genital surgery]]<br />
[[Category:Terms]]<br />
[[Category:Islam]]<br />
[[Category:Judaism]]<br />
[[Category:Circumcision]]<br />
[[de:Zirkumzision]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Child_circumcision&diff=14354Child circumcision2020-05-04T20:34:49Z<p>WikiModEn4: /* Search for prophylactic reasons */</p>
<hr />
<div>{{GraphicWarning}}<br />
"Male '''circumcision''' (from Latin ''circumcidere'', meaning "to cut around") is the surgical removal of the [[foreskin]] (prepuce) part of the human [[penis]]. The foreskin comprises ''more than fifty percent'' of the epithelium of the penis.<ref name="taylor1996">{{REFjournal<br />
|last=Taylor<br />
|first=J.R.<br />
|author-link=John R. Taylor<br />
|last2=Lockwood<br />
|first2=A.P.<br />
|author2-link=<br />
|last3=Taylor<br />
|first3=A.J.<br />
|title=The prepuce: specialized mucosa of the penis and its loss to circumcision<br />
|journal=Brit J Urol<br />
|date=1996<br />
|volume=77<br />
|issue=<br />
|pages=291-5<br />
|url=http://onlinelibrary.wiley.com/doi/10.1046/j.1464-410X.1996.85023.x/full<br />
|quote=<br />
|pubmedID=8800902<br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410X.1996.85023.x<br />
|accessdate=2019-10-14<br />
}}</ref> [...] The procedure is most often an elective non-therapeutic surgery performed on neonates and children for religious and cultural reasons, but in other cases may be indicated for both therapeutic and prophylactic reasons. It is a radical treatment option for pathological [[phimosis]], refractory [[Balanitis| balanoposthitis]] and chronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health. <br />
<br />
'''Posthectomy''' is a more accurate medical term that more accurately reflects the injury and loss of functional body tissue, but the Biblical euphemism, ''circumcision'', is more commonly used. <br />
<br />
With reference to involuntary, non-therapeutic circumcision of children, [[Child Genital Cutting (CGC)]] is a new term that has been introduced to avoid issues associated with more traditional terms.<br />
<br />
== Historical background ==<br />
<br />
The amputation of the [[foreskin]] is a very old ritual, whose exact origin cannot be verified beyond doubt. Medical historians assume that circumcision already served in ancient history as a way to control the sexuality of slaves and members of the lower classes without compromising their ability to reproduce. In religious history circumcision may be seen as a substitute for human sacrifice. In prehistoric times it was not uncommon to placate the gods with human sacrifice. Castration of slaves or conquered enemies was common as well. Following religious changes this sacrifice was altered, and only a part of the very organ responsible for the creation of new life was sacrificed.<br />
<br />
[[Image:Circumcision Sakkara 3.jpg|200px|right]] For the Aborigines, the Australian natives, the tradition of circumcision is said to go back to 10,000 BC. On the African continent, the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of circumcision date back to the time around 3000-2000 BC. The oldest known depiction<ref>{{REFweb<br />
|url=https://commons.wikimedia.org/wiki/File:Circumcision_Sakkara_3.jpg<br />
|title=File:Circumcision Sakkara 3.jpg<br />
|accessdate=2019-10-12<br />
}}</ref> is an Egyptian tomb relief from the 6th dynasty, approximately 2300-2000 BC. It is not known precisely who was circumcised and why in those times.<br />
<br />
In many cultures circumcision during puberty serves as a rite of passage, bringing adolescents into the community. As with other painful or humiliating initiation rites, proof of courage and mastering of critical situations are the key motivations. From some African tribes it is also known that the amputation of the [[foreskin]] is seen as the removal of an inborn piece of femininity from the boys, thus making them men.<br />
<br />
===Judaism===<br />
<br />
In the Jewish religion, the tradition of circumcision goes back to a passage in the Book of Genesis (17, 10-14). It is seen as a [[Abrahamic covenant| covenant between God and man]], dating back to the patriarch Abraham.<br />
<br />
{{Citation<br />
|Text=10 This is my covenant with you and your descendants after you, the covenant you are to keep: Every male among you shall be circumcised. 11 You are to undergo circumcision, and it will be the sign of the covenant between me and you. 12 For the generations to come every male among you who is eight days old must be circumcised, including those born in your household or bought with money from a foreigner—those who are not your offspring. 13 Whether born in your household or bought with your money, they must be circumcised. My covenant in your flesh is to be an everlasting covenant. 14 Any uncircumcised male, who has not been circumcised in the flesh, will be cut off from his people; he has broken my covenant.” <br />
|Author=Bible<br />
|Source=Gen 17, 10-14, NIV<br />
}}<br />
<br />
According to the anthropologist and sociologist Nissan Rubin, the Jewish form of circumcision, called ''[[Brit Milah| brit mila]]'', during the first two millennia did not include the later customary ''periah'', namely the complete scraping of the inner [[foreskin]] from the [[Glans penis|glans]]. This was only added around 135 AD, to make it impossible to restore the [[foreskin]] by stretching, which became popular in the wake of Hellenic influence. While originally only the tip of the [[foreskin]] was cut off, periah removes the entire [[foreskin]]. In the Greek society of the day, a denuded [[Glans penis|glans]] was considered obscene and risible. In ultra-orthodox communities, circumcision is followed by the ''[[mohel]]'', the ritual circumciser, sucking blood from the wound with his mouth. This practice is highly controversial, as it can result in an infection with [[herpes]] simplex type 1. In New York City, between 2000 and 2011 eleven children were infected with [[herpes]], 10 of whom had to be treated in hospital. Two of them suffered permanent brain damage, two others died. In the 12th century, the Jewish philosopher and doctor [[Moses Maimonides| Maimonides]] pointed out that circumcision was necessary, as it diminished sexual desires and reduced the pleasure to a degree just sufficient for mere reproduction.<br />
<br />
===Christianity===<br />
Jesus was born into a Jewish family in Israel, where Judaism was the prevailing religion, so he was circumcised on the eighth day.<ref name="luke2:21>{{REFweb<br />
|url=https://www.biblegateway.com/passage/?search=Luke+2%3A21&version=NASB<br />
|title=Gospel of Luke<br />
|trans-title=<br />
|language=<br />
|last=Luke<br />
|first=<br />
|author-link=<br />
|publisher=NASB<br />
|website=Bible Gateway<br />
|date=<br />
|accessdate=2019-11-10<br />
|format=<br />
|quote=And when eight days had passed, before His circumcision, His name was then called Jesus, the name given by the angel before He was conceived in the womb.<br />
}}</ref><br />
<br />
The first Christians had been born Jewish, so a question arose whether one must be circumcised to be a Christian. When Christian leaders met at the [[Council at Jerusalem]] in the First Century to decide what was required to be a Christian, a letter was written to explain the requirements, but circumcision was omitted from the requirements.<ref>{{REFweb<br />
|url=https://www.biblegateway.com/passage/?search=Acts+15%3A1-30&version=NASB<br />
|title=Acts 15:1-30<br />
|last=Luke<br />
|first=<br />
|accessdate=2019-11-10<br />
}}</ref><br />
<br />
In Christianity, circumcision is practiced only in a few Coptic churches. There is no general belief that circumcision is a requirement of Christianity.<ref name="hill2004">{{REFweb<br />
|url=http://www.cirp.org/pages/cultural/christian.html<br />
|title=The Holy Bible, Circumcision, False Prophets, and Christian Parents<br />
|trans-title=<br />
|language=<br />
|last=Hill<br />
|first=George<br />
|author-link=George Hill<br />
|publisher=Circumcision Reference Library<br />
|website=<br />
|date=2004-08-29<br />
|accessdate=2019-11-10<br />
|format=HTML<br />
|quote=The falseness of those who advocate circumcision is a recurrent theme in the New Testament. <br />
}}</ref><br />
<br />
Nevertheless, Christian moral notions had decisive influence on the spread of this practice. In the puritan influenced USA, circumcision of children was popular in the 19th century as a means to prevent [[masturbation]]. In those days, this so-called ‘self-abuse‘ was not only considered immoral, but was supposedly responsible for a variety of diseases. Masturbation, however, is not mentioned anywhere in the Holy Bible, so there is no support for the belief that it is somehow immoral or sinful. <br />
<br />
Even the mere existence of a [[foreskin]] was linked to many illnesses. Among them one could find syphilis, epilepsy, paralysis of the spine, bed wetting, scoliosis (spinal deformity), paralysis of the bladder, club foot, nerve pain in the lower abdomen, tuberculosis and lazy eye. One of the best known advocates of child circumcision was [[John Harvey Kellogg]], co-inventor of the corn flakes bearing his name. In 1888, he wrote:<br />
<br />
{{Citation<br />
|Text=A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of [[phimosis]]. The operation should be performed by a surgeon without administering an anaesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. In females, the author has found the application of pure carbolic acid to the clitoris an excellent means of allaying the abnormal excitement, and preventing the recurrence of the practice in those whose will-power has become so weakened that the patient is unable to exercise entire self-control. <br />
|Author=[[John Harvey Kellogg]]<br />
|Source=<br />
|ref=<ref>{{REFbook<br />
|url=https://archive.org/details/plainfaorold00kell/page/290<br />
|chapter=Treatment for Self-abuse and Its Effects<br />
|title=Plain Facts for Old and Young<br />
|location=Burlington, Iowa<br />
|publisher=F. Segner & Co.<br />
|year=1888<br />
|pages=107<br />
}}</ref><br />
}}<br />
<br />
===Islam===<br />
In Islam, circumcision is also religiously founded, even though there is no mention of it in the Koran itself. According to tradition, the Prophet Mohammed was born without a [[foreskin]]. It is seen as a sign of prophets that they are born without a [[foreskin]] already. It is considered an honour to "resemble the example of the Prophet", meaning to be circumcised. In Islam, unlike Judaism, there is no specific age at which the circumcision should be performed. Most circumcisions take place at ages between 6 and 10 years, but the range goes from birth to adulthood.<br />
<br />
== Rationale ==<br />
<br />
Reasons for performing circumcision range widely by culture, religion, location, and age.<br />
<br />
===Cultural===<br />
<br />
Many cultures perform circumcision as a rite of passage into manhood. This is common in the Middle East and amongst some indigenous African and Southeast Asian peoples.<br />
<br />
The United States and Israel are the only industrialized countries in the world to have a high incidence of non-therapeutic infant male circumcision. The vast majority of infant circumcisions performed in the United States are for non-religious, non-medical reasons. See [[History of circumcision]].<br />
<br />
===Religious===<br />
The circumcision of newborn boys is seen as a divine commandment in the Jewish faith. Though absent in the Koran, male circumcision is considered a religious requirement in Islam, and it is performed on male children of varying ages. Converts to these faiths may also choose to undergo circumcision, but it is not always required.<br />
<br />
===Medical indication===<br />
In some cases, circumcision is legitimately indicated; a patient may be suffering recurring infections, and other methods of treatment have failed. In other cases, a patient may be suffering from a severe case of [[phimosis]]. Overall, the actual medical necessity for circumcision is extremely rare. All circumcisions injure the patient by amputating the [[foreskin]] its with many protective, immunological, sensory, and sexual [[Foreskin#Physiological_functions| functions]]. <br />
<br />
# '''Deformed or malformed foreskin'''. A foreskin so deformed or malformed that it does not function properly may be removed by circumcision.<br />
<br />
# '''Traumatically injured foreskin'''. A foreskin so traumatically injured foreskin that cannot be surgically repaird is a valid medical reason for circumcision.<br />
<br />
# '''Diseased foreskin.''' A foreskin that is diseased is a valid indication for cirumcision. Some diseases that qualify are malignancy, lichen sclerosis, yeast infection in men with diabetes, and recurrent posthitis.<br />
<br />
In such cases, the benefit of removing the problem foreskin may exceed the maleficial results of tissue and function destruction.<br />
<br />
====Arguments of prophylaxia====<br />
Though the practice of ritual circumcision of males, both consenting and non-consenting, has existed for millenia, the search for "potential medical benefits" began relatively recently. The discussion of circumcision in the Ninth Edition of the ''Encyclopǽdia Britannica'' (1876) made no mention of any prophylactic, medical, or therapeutic value or function.<ref>{{REFweb<br />
|url=http://www.cirp.org/library/history/encyclopaediabritannica1876/<br />
|title=Circumcision<br />
|trans-title=<br />
|language=<br />
|last=Cheyne<br />
|first=T. K.<br />
|author-link=<br />
|publisher=Encyclopǽdia Brittanica<br />
|website=Circumcision Reference Library<br />
|date=1876<br />
|accessdate=2019-11-10<br />
|format=<br />
|quote=<br />
}}</ref><br />
<br />
Initially, circumcision was adopted as a way to stop boys and men from masturbating, where masturbation was seen as the cause for many diseases. As the myth that circumcision prevented [[masturbation]] became debunked, advocates of circumcision began the great search to find the "medical benefits" of circumcision. <br />
<br />
Male and female circumcision involves the removal and disruption of normal anatomical structures that are primary areas of sexual sensation.<ref name="taylor1996" /> In the past, some advocates of mass circumcision have considered the prepuce to be a "mistake of nature,"<ref><br />
<nowiki>{{Cold and Wiswell (1995)}} | [[Template:Cold and Wiswell (1995)|see more]]</nowiki></p><br />
</ref> but this notion has no validity because the prepuce is ubiquitous in primates and because it provides functional advantages.<ref name="cold-mcgrath1995">{{REFbook<br />
|last=Cold<br />
|first=Christopher<br />
|last2=McGrath<br />
|first2=Kenneth<br />
|author2-link=Ken McGrath<br />
|year=1999<br />
|title=Male and female circumcision: medical, legal, and ethical considerations in pediatric practice<br />
|url=http://www.cirp.org/library/anatomy/cold-mcgrath/<br />
|work=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=Anatomy and histology of the penile and clitoral prepuce in primates<br />
|pages=<br />
|location=New York<br />
|publisher=<br />
|isbn=0306461315<br />
|quote=<br />
|accessdate=2019-10-12<br />
|note=<br />
}}</ref><br />
<br />
===Search for prophylactic reasons===<br />
<br />
The practice of finding prophylactic reasons for infant circumcision started in Germany in the nineteenth century, when non-Jewish Germans criticized the Jewish practice of infant circumcision as being barbaric, Jewish doctors sprang to the defense of the religious practice by claiming health benefits.<ref name="ephron2001">{{REFbook<br />
|last=Ephron<br />
|first=John M.<br />
|author-link=<br />
|year=2001<br />
|title=Medicine and the German Jews<br />
|url=http://www.cirp.org/library/history/ephron1/<br />
|work=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=6<br />
|pages=222-233<br />
|location=New Haven<br />
|publisher=Yale University Press<br />
|isbn=0-300-08377-7<br />
|quote=<br />
|accessdate=2019-11-20<br />
|note=<br />
}}</ref> And so started the long tradition of Jewish doctors inventing reasons for circumcision (and deceving gentile doctors).<br />
<br />
Following the discovery of bacteria as a cause of many diseases – such as tuberculosis – the search began for other illnesses that could be prevented by circumcision.<br />
<br />
In 1870 the renowned Dr. Lewis A. Sayre of NYC’s famed Bellevue Hospital claimed to cure a boy’s paralyzed legs with circumcision. Sayre's wild advocacy of circumcision exemplified how some[https://intaction.org/circumcision-facts-and-myths/ circumcision fact and myths] originated. He also claimed to cure epilepsy, mental disorders, hip-joint pain, & hernias with circumcision. “Genital irritations” & masturbation were deemed to be the cause of these issues. Sayre was later elected as the President of the American Medical Association. <ref>American Medical Association. Transactions of the American Medical Association. 1870;21:205–11</ref> <br />
<br />
In the 1920s it was penile cancer. Abraham L. Wolbarst (1926) claims that circumcision can prevent penile cancer.<ref name="wolbarst1926">{{REFjournal<br />
|last=Wolbarst<br />
|first=Abraham L.<br />
|author-link=Abraham L. Wolbarst<br />
|title=Is circumcision a prophylactic against penis cancer?<br />
|journal=Cancer<br />
|date=Jul 1926<br />
|volume=3<br />
|issue=4<br />
|pages=301-10<br />
}}</ref>. <br />
<br />
In the 1940s, prostate and tongue cancer as well as STDs. Eugene H. Hand (1949) falsely explains that circumcision somehow protects against venereal diseases and tongue cancer.<ref name="hand1949">{{REFjournal<br />
|title=Circumcision and venereal disease.<br />
|last=Hand<br />
|first=Eugene H.<br />
|journal=Archives of Dermatology and Syphilology<br />
|date=Sep 1949<br />
|volume=60<br />
|issue=3<br />
|pages=341-346<br />
}}</ref>. <br />
<br />
In the 1950s it was cervical cancer. Abraham Ravich (1951) invents the myth that circumcision reduces the risk of women getting cervical cancer.<ref name="ravich1951">{{REFjournal<br />
|url=https://www.ncbi.nlm.nih.gov/pubmed/14853120<br />
|title=Prophylaxis of cancer of the prostate, penis, and cervix by circumcision<br />
|last=Ravich<br />
|first=Abraham<br />
|last2=Ravich<br />
|first2=R.A.<br />
|journal=New York State Journal of Medicine<br />
|date=Jun 1951<br />
|volume=51<br />
|issue=12<br />
|pages=1519-1520<br />
|pubmedID=14853120<br />
|accessdate=2019-10-12<br />
}}</ref> <br />
<br />
In the late 1960s it was neuroses. Morris Fishbein (1969) calls for circumcision to prevent nervousness and, of course, [[masturbation]].<ref>{{REFbook<br />
|last=Fishbein<br />
|first=Morris<br />
|chapter=Sex hygiene<br />
|title=Modern Home Medical Adviser<br />
|location=Garden City, New York<br />
|publisher=Doubleday & Co<br />
|year=1969<br />
|pages=90, 119<br />
|url=https://openlibrary.org/works/OL95362W/Modern_home_medical_adviser<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
In the 1970s bladder- and rectal cancer. Abraham Ravich (1971) claims that circumcision would prevent bladder cancer and rectal cancer.<ref>{{REFjournal<br />
|last=Ravich<br />
|first=Abraham<br />
|url=https://www.deepdyve.com/lp/wiley/viral-carcinogenesis-in-venereally-susceptible-organs-HCeWmTLmKl<br />
|title=Viral carcinogenesis in venereally susceptible organs<br />
|journal=Cancer<br />
|date=Jun 1971<br />
|volume=27<br />
|issue=6<br />
|pages=1493-1496<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
In the 1980s, UTIs. Thomas E. Wiswell (1985) claims that circumcision, using a methodologically flawed report, reduces the risk of urinary tract infections.<ref name="wiswell1985">{{REFjournal <br />
|last=Wiswell<br />
|first=Thomas E.<br />
|author-link=Thomas E. Wiswell<br />
|url=https://pediatrics.aappublications.org/content/75/5/901<br />
|title=Decreased incidence of urinary tract infections in circumcised male infants<br />
|journal=Pediatrics<br />
|date=May 1985<br />
|volume=75<br />
|issue=5<br />
|pages=901-903<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
Aaron J. Fink (1986), with no evidence whatsoever, claims that circumcision protects against AIDS followed.<ref name="fink1986">{{REFjournal<br />
|last=Fink<br />
|first=Aaron J.<br />
|author-link=Aaron J. Fink<br />
|title=A possible explanation for heterosexual male infection with AIDS<br />
|journal=New England Journal of Medicine<br />
|date=1986-10-30<br />
|volume=31<br />
|issue=18<br />
|pages=1167<br />
|url=https://www.nejm.org/doi/full/10.1056/NEJM198610303151818<br />
|DOI=10.1056/NEJM198610303151818<br />
|accessdate=2019-11-20<br />
}}</ref> <br />
<br />
Retrospectively, circumcision was always advertised as a cure for whatever disease was in the public spotlight at the time. [[Doctors Opposing Circumcision]] (2016) states:<br />
<blockquote><br />
These claims date originally from before the advent of evidence-based medicine, when doctors relied on the opinions of other clinicians to inform their practice, rather than on scientifically collected evidence.<ref name="doc2016">{{REFweb<br />
|url=https://www.doctorsopposingcircumcision.org/for-professionals/alleged-medical-benefits/<br />
|title=Alleged Medical Benefits<br />
|trans-title=<br />
|language=<br />
|last=<br />
|first=<br />
|author-link=<br />
|publisher=Doctors Opposing Circumcision<br />
|website=<br />
|date=2016-05<br />
|accessdate=2019-11-20<br />
|format=<br />
|quote=<br />
}}</ref><br />
</blockquote><br />
<br />
The sheer mass of studies and publications that were released during those almost 180 years on this topic are the reason that even arguments that have been disproved multiple times, especially regarding infant and child circumcision, tenaciously persist up until today.<br />
<br />
An ever-recurring element of initiation rites found in many different cultures is the fixation upon the genitalia.<br />
<br />
It reflects the fascination that emerges from the ability to create new life. In most cultures, fertility is seen as the most precious good, and the body parts involved frequently find themselves in the focus of ritual acts. In many parts of the world, those rites take place when the boy reaches puberty, and are meant to symbolize his transition from boy to man. The removal of the male [[foreskin]] is just one of many phenomena that developed in this context. They range from the removal of the frenulum in boys and men through partial or complete removal of the [[foreskin]] up to radical operations. Australian Aborigines, as mentioned above, have their [[foreskin]]s removed. It is also usual that, a few weeks later, young men have their [[penis]]es sliced open, resulting in a partly or completely divided urethra.<br />
<br />
Another known, particularly massive, intervention is the stripping of the entire skin off the [[penis]]. In Indonesia, boys have metal or bamboo balls inserted into their [[penis]] shaft or [[Glans penis|glans]] at the beginning of puberty, which form little "humps".<br />
<br />
For many cultures it is also common to perform similar rituals on girls. This can range from relatively small interventions such as piercing or cutting the clitoral hood, to its complete removal and up to radical removal of clitoral hood, clitoris, inner and outer labia followed by sewing up the vagina.<br />
<br />
''The following text is taken from the [[Circumpendium]].''<br />
<br />
=== Prophylactic reasons ===<br />
<br />
Some people claim that circumcision has prophylactic benefits. Especially in the USA those arguments have persisted for more then a 100 years, with ever changing diseases circumcision is said to protect against. At first, these were diseases where [[masturbation]] was believed to be the cause. After bacteria and viruses had been discovered, arguments changed, and one after another miscellaneous diseases were cited.<br />
<br />
* [[Phimosis]]: as mentioned earlier, true [[phimosis]] is rare and can be treated effectively without surgery. According to a study by Blalock ''et al.'' (2003)<ref>{{REFjournal<br />
|last=Blalock<br />
|first=H.J.<br />
|last2=Vemulakonda<br />
|first2=V.<br />
|last3=Ritchey<br />
|first3=M.L.<br />
|last4=Ribbeck<br />
|first4=M.<br />
|title=Outpatient management of [[phimosis]] Following newborn circumcision<br />
|journal=J Urol<br />
|date=2003<br />
|volume=169<br />
|issue=6<br />
|pages=2332-2334<br />
|url=http://www.cirp.org/library/complications/blalock1/<br />
|accessdate=2019-11-07<br />
}}</ref>, 2.9% of those circumcised develop a post-operative [[phimosis]], in which the circumcision scar constricts. In intact patients, the rate of [[phimosis]] is only 1% (see also the study by [[Jakob Øster]]). Therefore, circumcision is not a preventive measure for [[phimosis]].<br />
* Sexually Transmitted Diseases (STDs): a vast number of studies has been conducted on the subject of transmission of STDs.<br />
* First, it has to be noted that any form of protection against these diseases only affects people who are sexually active. Circumcision in childhood cannot be justified on these grounds, since any assumed protective effect will not occur before the boy is already old enough to decide about circumcision for himself.<br />
* As mentioned above, the [[foreskin]] keeps the [[Glans penis|glans]] moist. This subpreputial moisture contains, among other substances, the enzyme lysozyme, which breaks up the cell wall of bacteria, thereby providing a natural antibacterial screen. This explains the results of several studies, such as Laumann ''et al.''<ref>{{REFjournal<br />
|last=Laumann<br />
|first=E.O.<br />
|last2=Masi<br />
|first2=C.M.<br />
|last3=Zuckerman<br />
|first3=E.W.<br />
|title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice<br />
|journal=JAMA<br />
|date=1997<br />
|volume=277<br />
|issue=<br />
|pages=1052-1057<br />
|url=http://www.cirp.org/library/general/laumann/<br />
|accessdate=2019-11-06<br />
}}</ref>, which found a higher rate of infection with bacterial venereal diseases in circumcised than in intact men.<br />
* The studies by Fleiss ''et al.'' (1998) support this.<ref name="fleiss-hodges-vanhowe1998">{{REFjournal<br />
|last=Fleiss<br />
|first=P.M.<br />
|last2=Hodges<br />
|first2=F.M.<br />
|last3=Van Howe<br />
|first3=R.S.<br />
|title=Immunological functions of the human prepuce<br />
|journal=Sex Transm Inf<br />
|date=1998<br />
|volume=74<br />
|issue=<br />
|pages=364-367<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1758142/pdf/v074p00364.pdf<br />
|accessdate=2019-11-06<br />
}}</ref> According to the [[AAP]], the general sexual behaviour of the male - such as frequent change in partners and the use of condoms - has a much higher impact on sexually transmitted diseases then the circumcision status.<ref>{{REFjournal<br />
|last=Task Force on Circumcision<br />
|first=<br />
|title=Circumcision policy statement<br />
|journal=Pediatrics<br />
|date=1999<br />
|volume=103<br />
|issue=3<br />
|pages=686-93<br />
|url=http://www.cirp.org/library/statements/aap1999/<br />
|accessdate=2019-11-15<br />
}}</ref><br />
* HIV / AIDS: in the recent past, the argument that circumcision could help to contain the spread of HIV has been stated numerous times.<br />
*:First, two notes: for one, the use of condoms is still by far the most effective protection against an infection. During intercourse with that preventive measure, circumcision status does not make a difference.<br />
*:Secondly, the assumed protection would only affect healthy men who have intercourse with an infected woman. An infected man can infect a women by transmission of his bodily fluids, so that his circumcision status is irrelevant. Therefore, the use of condoms remains vital in containing the spread of HIV, which in return renders circumcision unnecessary<br />
* Due to the inevitable loss of sensitivity as a result of circumcision, there is also the temptation to go without condoms, in order not to lose even more sensitivity.<ref>{{REFjournal<br />
|last=Hooykaas<br />
|first=C.<br />
|last2=van der Velde<br />
|first2=F.W.<br />
|last3=van der Linden<br />
|first3=M.M.<br />
|etal=yes<br />
|title=The importance of ethnicity as a risk factor for STDs and sexual behaviour among heterosexuals<br />
|journal=Genitourin Med<br />
|date=1991<br />
|volume=67<br />
|issue=5<br />
|pages=378-383<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1194736/pdf/genitmed00041-0022.pdf<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Michael<br />
|first=R.T.<br />
|last2=Wadsworth<br />
|first2=J.<br />
|last3=Feinleib<br />
|first3=J.<br />
|etal=yes<br />
|title=Private sexual behavior, public opinion, and public health policy related to sexually transmitted diseases: a US-British comparison<br />
|journal=Am J Public Health<br />
|date=1998<br />
|volume=88<br />
|issue=5<br />
|pages=749-754<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1508929/pdf/amjph00017-0039.pdf<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Laumann<br />
|first=E.O.<br />
|last2=Masi<br />
|first2=C.M.<br />
|last3=Zuckerman<br />
|first3=E.W.<br />
|title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice<br />
|journal=JAMA<br />
|date=1997<br />
|volume=277<br />
|issue=<br />
|pages=1052-1057<br />
|url=http://www.cirp.org/library/general/laumann/<br />
|accessdate=2019-11-06<br />
}}</ref><br />
* Two studies that have been published in early 2007<ref>{{REFjournal<br />
|last=Gray, R.H. and colleagues<br />
|first=<br />
|title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial<br />
|journal=Lancet<br />
|date=2007<br />
|volume=369<br />
|issue=<br />
|pages=657-666<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=[[Robert C. Bailey|Bailey, R.C.]] and colleagues<br />
|first=<br />
|title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial<br />
|journal=Lancet<br />
|date=2007<br />
|volume=369<br />
|issue=<br />
|pages=643-656<br />
|url=<br />
|accessdate=<br />
}}</ref>, which investigated the effectiveness of circumcision as a means of reducing the spread of HIV from infected women to heterosexual men in African high risk areas, have been repeatedly subjected to strong criticism. Both studies were ended prematurely, which distorted the results. The men who had been circumcised for the study had to stay sexually inactive during the wound healing, which gave the intact control group more relative opportunity to become infected. These African randomized clinical trials have been demonstrated to have very serious methodological and statistical errors that distort the results in favor of circumcision.<ref name="boyle-hill2011">{{REFjournal<br />
|last=Boyle<br />
|first=Gregory J.<br />
|author-link=Gregory Boyle<br />
|last2=Hill<br />
|first2=George<br />
|author2-link=George Hill<br />
|title=Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns<br />
|journal=J Law Med<br />
|date=2011-12<br />
|volume=19<br />
|issue=2<br />
|pages=316-34<br />
|url=http://www.salem-news.com/fms/pdf/2011-12_JLM-Boyle-Hill.pdf<br />
|quote=<br />
|pubmedID=22320006<br />
|pubmedCID=<br />
|DOI=<br />
|accessdate=2019-11-09<br />
}}</ref><br />
<br />
The fact that the USA has both the highest rate of circumcised males in the western world, as well as the highest HIV infection rate, makes the studies look dubious. Besides that, several other studies concluded that circumcision does not have a significant impact on the risk of infection with HIV.<ref>{{REFjournal<br />
|last=Grosskurth<br />
|first=H.<br />
|last2=Mosha<br />
|first2=F.<br />
|last3=Todd<br />
|first3=J.<br />
|etal=yes<br />
|title=A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results<br />
|journal=AIDS<br />
|date=1995<br />
|volume=9<br />
|issue=8<br />
|pages=927-934<br />
|url=https://insights.ovid.com/aids/aids/1995/08/000/community-trial-impact-improved-sexually/15/00002030<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Barongo<br />
|first=L.R.<br />
|last2=Borgdorff<br />
|first2=M..W.<br />
|last3=Mosha<br />
|first3=F.F.<br />
|etal=yes<br />
|title=The epidemiology of HIV-1 infection in urban areas, roadside settlements and rural villages in Mwanza Region, Tanzania<br />
|journal=AIDS<br />
|date=1992<br />
|volume=6<br />
|issue=12<br />
|pages=1521-1528<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Changedia SM, Gilada IS<br />
|first=<br />
|title=Role of male circumcision in HIV transmission insignificant in conjugal relationship (abstract no. ThPeC7420)<br />
|url=<br />
|place=Barcelona, Spain<br />
|source=Presented at the Fourteenth International AIDS Conference<br />
|datefrom=2002-07-07<br />
|dateto=2002-07-12<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Connolly CA, Shishana O, Simbayi L, Colvin M<br />
|first=<br />
|title=HIV and circumcision in South Africa (Abstract No. MoPeC3491)<br />
|url=<br />
|place=Bangkok, Thailand<br />
|source=Presented at the 15th International AIDS Conference<br />
|datefrom=2004-07-11<br />
|dateto=2004-07-16<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Thomas AG, Bakhireva LN, Brodine SK, Shaffer RA<br />
|first=<br />
|title=Prevalence of male circumcision and its association with HIV and sexually transmitted infections in a U.S. navy population (Abstract no. TuPeC4861)<br />
|url=https://apps.dtic.mil/dtic/tr/fulltext/u2/a458066.pdf<br />
|place=Bangkok, Thailand<br />
|source=Presented at the 15th International AIDS Conference<br />
|datefrom=2004-07-11<br />
|dateto=2004-07-16<br />
|accessdate=2019-11-15<br />
}}</ref><br />
* Urinary tract infections (UTI): a UTI can be effectively treated with antibiotics, this was also proven by studies<ref>{{REFjournal<br />
|last=McCracken<br />
|first=G.<br />
|title=Options in antimicrobial management of urinary tract infections in infants and children<br />
|journal=Pediatr Infect Dis J<br />
|date=1989<br />
|volume=8<br />
|issue=8<br />
|pages=552-555<br />
|url=http://www.cirp.org/library/disease/UTI/mccracken/<br />
|accessdate=2019-11-19<br />
}}</ref><ref>{{REFjournal<br />
|last=Larcombe<br />
|first=J.<br />
|title=Urinary tract infection in children<br />
|journal=BMJ<br />
|date=1999<br />
|volume=319<br />
|issue=<br />
|pages=1173-1175<br />
|url=<br />
|accessdate=<br />
}}</ref>. A Swedish study <ref>{{REFjournal<br />
|last=Mårild<br />
|first=S.<br />
|last2=Jodal<br />
|first2=U.<br />
|title=Incidence rate of first–time symptomatic urinary tract infection in children under 6 years of age<br />
|journal=Acta Paediatr<br />
|date=1998<br />
|volume=87<br />
|issue=5<br />
|pages=549-552<br />
|url=<br />
|accessdate=<br />
}}</ref> found that, during the first 6 years of life, the incidence of UTIs in boys was 1.8%, but in girls was 6.6%. UTIs are less common in boys after the first year of life. Mueller ''et al.'' <ref>{{REFjournal<br />
|last=Mueller<br />
|first=E.R.<br />
|last2=Steinhardt<br />
|first2=G.<br />
|last3=Naseer<br />
|first3=S.<br />
|title=The incidence of genitourinary abnormalities in circumcised and uncircumcised boys presenting with an initial urinary tract infection by 6 months of age<br />
|journal=Pediatrics<br />
|date=1997<br />
|volume=100 (Supplement)<br />
|issue=<br />
|pages=580<br />
|url=<br />
|accessdate=<br />
}}</ref> did not find a significant difference in UTI rates between circumcised and intact boys with normal urinary tract anatomy.<br />
* Other studies suggest that circumcision is more likely to raise than to lower the generally low risk of acquiring UTI: multiple studies from Israel showed a strong correlation between ritual circumcision on the 8th day of life and postoperative UTI.<ref>{{REFjournal<br />
|last=Menahem<br />
|first=S.<br />
|title=Complications arising from ritual circumcision: pathogenesis and possible prevention<br />
|journal=Isr J Med Sci<br />
|date=1981<br />
|volume=17<br />
|issue=1<br />
|pages=45-48<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Cohen<br />
|first=H.A.<br />
|last2=Drucker<br />
|first2=M.M.<br />
|last3=Vainer<br />
|first3=S.<br />
|etal=yes<br />
|title=Postcircumcision urinary tract infection<br />
|journal=Clin Pediatr<br />
|date=1992<br />
|volume=31<br />
|issue=6<br />
|pages=322-324<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Goldman<br />
|first=M.<br />
|last2=Barr<br />
|first2=J.<br />
|last3=Bistritzer<br />
|first3=T.<br />
|last4=Aladjem<br />
|first4=M.<br />
|title=Urinary tract infection following ritual Jewish circumcision<br />
|journal=Isr J Med Sci<br />
|date=1996<br />
|volume=32<br />
|issue=<br />
|pages=1098-1102<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
* It can be concluded that circumcision is ineffective as a preventive measure against UTIs.<br />
* Penile and cervical cancer / HPV: first studies on those diseases and their assumed prevention by circumcision date back to 1932, a time when the cause for those illnesses was not yet fully understood<br />
<ref>{{REFjournal<br />
|last=Wolbarst<br />
|first=A.<br />
|title=Circumcision and penile cancer<br />
|journal=Lancet<br />
|date=1932<br />
|volume=1<br />
|issue=5655<br />
|pages=150-153<br />
|url=<br />
|accessdate=<br />
}}</ref>. Today, it is known that sexually transmitted human papillomavirus (HPV) is a major risk factor<ref>{{REFjournal<br />
|last=McCance<br />
|first=D.J.<br />
|last2=Kalache<br />
|first2=A.<br />
|last3=Ashdown<br />
|first3=K.<br />
|etal=yes<br />
|title=Human papillomavirus types 16 and 18 in carcinomas of the penis from Brazil<br />
|journal=Int J Cancer<br />
|date=1986<br />
|volume=37<br />
|issue=1<br />
|pages=55-59<br />
|url=<br />
|accessdate=<br />
}}</ref>, as well as smoking<ref>{{REFjournal<br />
|last=Harish<br />
|first=K.<br />
|last2=Ravi<br />
|first2=R.<br />
|title=The role of tobacco in penile carcinoma<br />
|journal=Brit J Urol<br />
|date=1995<br />
|volume=75<br />
|issue=3<br />
|pages=375-377<br />
|url=<br />
|accessdate=<br />
}}</ref>. Studies have shown that there is no significant difference in the risk of getting penile cancer between circumcised and intact men. To prevent a single case of penile cancer, it would statistically take 600 to 900 circumcisions<ref>{{REFdocument<br />
|title=Position Paper on Neonatal Circumcision<br />
|url=<br />
|contribution=<br />
|last=<br />
|first=<br />
|publisher=American Academy of Family Physicians (Leawood, Kansas)<br />
|format=<br />
|date=2002-02-14<br />
|accessdate=<br />
}}</ref>. The influence of circumcision on the infection risk of the female partner with cervical cancer has been refuted several times as well. HPV vaccination is an effective measure against carcinoma of the cervix.<br />
<br />
In conclusion, circumcision does not provide any proven benefits in preventive medicine.<br />
<br />
== Non-medical indications for circumcision ==<br />
<br />
Apart from the medical indication of pathological phimosis, there also are other reasons for circumcision.<br />
<br />
=== Aesthetic reasons ===<br />
<br />
The visual appearance of the [[penis]] is changed radically after circumcision. In this case, personal taste is decisive whether an intact or a cut [[penis]] is more appealing. Since a circumcision cannot be undone, it is essential to be fully informed about the risks and possible later complications before embarking on an aesthetically motivated circumcision, to decide whether the appearance will justify such bodily modification.<br />
<br />
Since this modification and its possible late effects will be the lifelong burden of the person who undertakes an aesthetically motivated circumcision to suit his personal preferences, a valid decision to proceed can only be made by the person to be circumcised himself, once he has reached the necessary age and level of maturity to make that decision. This should normally be the case when adulthood is reached.<br />
<br />
It should be noted that every circumcision operation leaves a life-long [[circumcision scar]] that encircles the shaft of the penis.<br />
<br />
===Financial reasons===<br />
<br />
In the United States, payment for non-therapeutic circumcision is made by most [[third-party payment| third-party payers]] without question. Doctors frequently perform medically-unnecessary, non-therapeutic circumcision of infants and children simply to collect a fee for the surgical operation. The only beneficiary of such surgery is the [[Financial Incentive| bank account of the medical doctor]].<br />
<br />
=== Moral reasons ===<br />
<br />
With the [[foreskin]], circumcision removes approximately 70% of the sensitive tissue of the [[penis]], lowering the potential for sexual stimulation accordingly. Due to the loss of around 50% of the entire penile skin, the [[penis]] loses the reserve skin that provides cutaneous mobility in the erect [[penis]] and the [[gliding action]].<br />
<br />
In the past, this circumstance was used to make it harder for boys to masturbate and [[masturbation]] less fun, as [[masturbation]] was viewed as immoral and was assumed to cause a variety of diseases. More on that can be found in the chapter "[[Circumcision#Historical_background|Historical background]]". Today, it is known that [[masturbation]] has no negative health effects, but can contribute positively to the child's sexual development. Sexuality is no longer a taboo nowadays, while [[masturbation]] is considered to be a natural part of human sexuality and is no longer seen as immoral. Therefore, circumcision for moral reasons - which would only affect boys too young to give informed consent - is no longer justifiable nowadays.<br />
<br />
=== Hygiene reasons ===<br />
<br />
''Hygiene'' refers to health and only secondarily to cleanliness. <br />
<br />
One should note that the human foreskin is endowed by nature with [[Foreskin#Immunological_functions| immunological functions]] that serve to protect the human body from disease.<ref name="fleiss-hodges-vanhowe1998" /> The glans penis receives blood through the frenular artery.<ref>{{REFjournal<br />
|last=Persad<br />
|first=R.<br />
|author-link=<br />
|last2=Sharma<br />
|first2=S.<br />
|author2-link=<br />
|last3=McTavish<br />
|first3=J.<br />
|author3-link=<br />
|etal=yes<br />
|title=Clinical presentation and pathophysiology of meatal stenosis following circumcision<br />
|journal=Brit J Urol<br />
|date=1995<br />
|volume=75<br />
|issue=1<br />
|pages=91-3<br />
|url=https://www.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.1995.tb07242.x<br />
|quote=<br />
|pubmedID=7850308 <br />
|pubmedCID=<br />
|DOI=10.1111/j.1464-410x.1995.tb07242.x<br />
|accessdate=2019-11-26<br />
}}</ref> These facts are generally overlooked in arguments for alleged hygienic benefits of circumcision.<br />
<br />
A common reason stated for circumcision is the assumption of hygienic benefits. This argument has to be viewed in the context of the environment the person in question grows up in. It is commonly known that bad hygienic circumstances, especially insufficient access to clean drinking water, pose a serious problem. The situation in disaster areas or refugee camps in the so-called third world keep reminding us of that.<br />
<br />
In western industrial nations, however, this problem does not exist, in view of the availability of clean water for daily personal hygiene. If the cleaning of the genitals is performed on a daily basis - and that may be assumed - no pathogens can accumulate under the [[foreskin]]. Cleaning of the [[Glans penis|glans]] and the area underneath the [[foreskin]] is easy - they are simply washed along with the rest of the body, just like the areas between the toes.<br />
<br />
In small boys, where the [[foreskin]] cannot be retracted yet, cleaning is not necessary, since the [[Synechia| membrane]] that fuses the [[foreskin]] to the [[Glans penis|glans]] prevents the accumulation of micro-organisms. The so-called "ballooning", where the [[foreskin]] inflates during urination, is not a serious problem.<br />
<br />
The opening of the [[foreskin]] in small boys is often quite narrow and serves as a one-way valve, allowing the urine to flow out, but preventing entry of microbes, for example from a dirty diaper. As long as the child is able to pass water, everything works as nature intended.<br />
<br />
But even in areas where there are poorer hygienic conditions and an insufficient access to medical care, the benefits of easier cleaning of a circumcised [[penis]] are to be viewed with a critical eye. Although even longer periods without personal hygiene will not result in an accumulation of germs under the [[foreskin]], circumcision itself is not without risk of complications. If the operation is carried out without proper sterility, there is a high risk of an infection of the wound. This also applies to the treatment of common complications like post-operative bleeding.<br />
<br />
The benefit of easier cleaning must be balanced against the risk of promoting serious infections - among others HIV - during the operation. In parts of Africa, several dozen of one tribe's boys die each year as a result of their circumcision.<br />
<br />
<br />
== Circumcision methods ==<br />
<br />
The [[Circumcision methods]] are discussed in a separate article.<br />
<br />
== Risks and late effects ==<br />
<br />
Just like tonsil or appendix surgery, circumcision is a surgical intervention and brings the usual risks related to surgical operations, alongside several specific risks of complications and late effects.<br />
<br />
=== Possible operative and postoperative complications ===<br />
<br />
Circumcision is surgery. Surgical complications of circumcision generally may be classified as hemorrhage, infection, or surgical misadventure up to and including loss of the penis and [[death]].<ref name="williams-kapilla1993">{{REFjournal<br />
|last=Williams<br />
|first=N<br />
|author-link=<br />
|last2=Kapilla<br />
|first2=L<br />
|author2-link=<br />
|etal=no<br />
|title=Complications of circumcision<br />
|trans-title=<br />
|language=<br />
|journal=Brit J Surg<br />
|location=<br />
|date=1993-10<br />
|volume=80<br />
|issue=10<br />
|pages=1231-6<br />
|url=http://www.cirp.org/library/complications/williams-kapila/<br />
|quote=<br />
|pubmedID=8242285<br />
|pubmedCID=<br />
|DOI=10.1002/bjs.1800801005<br />
|accessdate=2019-11-27<br />
}}</ref><br />
<br />
* Intolerance or allergic reactions to the narcotics used.<br />
* Especially in newborns, where the bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is often insufficient for the operation. Even in conjunction with regional anaesthesia of the dorsal nerve of the [[penis]], the rate of failure to provide sufficient anaesthetic even for experienced anaesthetists is still 5-10%. The general anaesthesia that would be needed for newborns, however, poses significant risks for the child, and, therefore, is only likely to be used in emergencies. A surgical operation without proper pain control can lead to the development of a specific pain memory<ref>{{REFweb<br />
|url=http://www.spiegel.de/spiegel/vorab/experte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-849534.html<br />
|title=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder<br />
|trans-title=Children's pain expert warns: Ritual circumcision changes the brain of children<br />
|language=German<br />
|last=Prof. Dr. med. Boris Zernikow<br />
|first=<br />
|publisher=Spiegel Online<br />
|website=<br />
|date=2012-08-12<br />
|accessdate=2019-10-11<br />
|format=<br />
|quote=<br />
}}</ref>. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation. Overall, their pain threshold was lower and the risk of chronic pain increased. Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFjournal<br />
|last=Garry<br />
|first=T.<br />
|title=Circumcision: a survey of fees and practices<br />
|journal=OBG Management<br />
|date=1994<br />
|volume=October<br />
|issue=<br />
|pages=34-36<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Howard<br />
|first=C.R.<br />
|last2=Howard<br />
|first2=F.M.<br />
|last3=Garfunkel<br />
|first3=L.C.<br />
|last4=de Blieck<br />
|first4=E.A.<br />
|last5=Weitzman<br />
|first5=M.<br />
|title=Neonatal circumcision and pain relief: current training practices<br />
|journal=Pediatrics<br />
|date=1998<br />
|volume=101<br />
|issue=<br />
|pages=423-428<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Stang<br />
|first=H.J.<br />
|last2=Snellman<br />
|first2=L.W.<br />
|title=Circumcision practice patterns in the United States<br />
|journal=Pediatrics<br />
|date=1998<br />
|volume=101<br />
|issue=e5<br />
|pages=<br />
|url=<br />
|accessdate=<br />
|note=Link to [[AAP]] website<br />
}}</ref>. During procedures which take several minutes, babies tend to fall into a state of stupor, which in the past was falsely interpreted as peaceful sleep, nurturing the belief that babies felt no pain. Measurements taken in those cases revealed a typically 3- to 4-fold increase in cortisol levels, which equals a state of severe shock.<ref>{{REFjournal<br />
|last=Gunnar<br />
|first=M.R.<br />
|last2=Fisch<br />
|first2=R.O.<br />
|last3=Korsvik<br />
|first3=S.<br />
|last4=Donhowe<br />
|first4=J.M.<br />
|title=The effects of circumcision on serum cortisol and behavior<br />
|journal=Psychoneuroendocrinology<br />
|date=1981<br />
|volume=6<br />
|issue=3<br />
|pages=269-275<br />
|url=http://www.cirp.org/library/pain/gunnar/<br />
|accessdate=2019-11-26<br />
}}</ref><br />
* Postoperative wound pain, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions.<br />
* Postoperative pain from the exposure of the sensitive glans penis to clothing. This pain will endure for several weeks or even longer in some cases.<br />
* Postoperative bleeding of the wound. This can have severe consequences especially for very young infants, if they are not treated promptly. Their blood volume is only about 85 ml per kilogram of body weight, and even moderate blood loss can lead to hypovolaemia, hypovolaemic shock and even death.<ref>{{REFbook<br />
|last=<br />
|first=<br />
|year=2000<br />
|title=Paediatric Handbook<br />
|url=<br />
|work=<br />
|editors=Smart J, Nolan T.<br />
|edition=6<br />
|volume=<br />
|chapter=<br />
|pages=82<br />
|location=Victoria, Australia<br />
|publisher=Blackwell Science Asia<br />
|isbn=<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref><ref>{{REFdocument<br />
|title=Autopsy of Demetrius Manker<br />
|url=<br />
|contribution=Case 93-1711<br />
|last=Wetli<br />
|first=CV<br />
|publisher=Miami: Dade County Medical Examiner Department<br />
|format=<br />
|date=1993-06-23<br />
|accessdate=<br />
}}</ref> <ref>{{REFjournal<br />
|last=Hiss<br />
|first=J.<br />
|last2=Horowitz<br />
|first2=A.<br />
|last3=Kahana<br />
|first3=T.<br />
|title=Fatal haemorrhage following male ritual circumcision<br />
|journal=J Clin Forensic Med<br />
|date=2000<br />
|volume=7<br />
|issue=<br />
|pages=32-34<br />
|url=http://www.cirp.org/library/death/hiss1/<br />
|accessdate=2019-11-06<br />
}}</ref><ref>{{REFdocument<br />
|title=Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan<br />
|url=http://www.circumstitions.com/death-exsang.html<br />
|contribution=<br />
|last=Newell<br />
|first=TEC<br />
|publisher=Burnaby, B.C.: B.C. Coroner's Service<br />
|format=<br />
|date=2004-01-19<br />
|accessdate=2019-11-26<br />
}}</ref><br />
* Post operative [[lymphoedema]].<br />
* Postoperative infections. This includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.<ref>{{REFconference<br />
|last=Dr. med. Hartmann<br />
|first=Wolfgang<br />
|url=<br />
|place=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German)<br />
|title=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German)<br />
|date=2012-11-26<br />
|accessdate=<br />
}}</ref><br />
* [http://www.circumstitions.com/Restric/Botched9wd.html Wound dehiscence], meaning the separation of the edges of the wound or the tissue after suturing.<br />
* Adhesion between the surface or rim of the [[Glans penis|glans]] with the neighbouring penile skin, causing skin pockets and bridges, as well as visually unpleasant results like uneven scars, which make a re-circumcision necessary.<br />
* Postoperative [[phimosis]]: a phimotic ring can develop during scarring, which makes a re-circumcision necessary. According to a study by Blalock ''et al.''<ref>{{REFjournal<br />
|last=Blalock<br />
|first=H.J.<br />
|last2=Vemulakonda<br />
|first2=V.<br />
|last3=Ritchey<br />
|first3=M.L.<br />
|last4=Ribbeck<br />
|first4=M.<br />
|title=Outpatient management of [[phimosis]] Following newborn circumcision<br />
|journal=J Urol<br />
|date=2003<br />
|volume=169<br />
|issue=6<br />
|pages=2332-2334<br />
|url=http://www.cirp.org/library/complications/blalock1/<br />
|accessdate=2019-11-26<br />
}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal<br />
|last=Leitch<br />
|first=I.O.W.<br />
|title=Circumcision - a continuing enigma<br />
|journal=Aust Paediatr J<br />
|date=1970<br />
|volume=6<br />
|issue=<br />
|pages=59-65<br />
|url=http://www.cirp.org/library/general/leitch1/<br />
|accessdate=2019-12-15<br />
}}</ref> 5.5%.<br />
*<br />
* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], is cut during circumcision without being clamped and sutured at its origin separately, it starts to develop new branches over time, which can lead to the development of knots.<br />
* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro-penis) and induratio [[penis]] plastica (skewed penis).<br />
* Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis|glans]] or the [[penis]] can occur.<br />
* In rare cases, necrosis, gangrene, ischaemia, keloid formation and circulatory problems may also occur.<br />
* When the circumcision is followed by the ultra-orthodox Jewish ritual of Metzitzah B'Peh (which consists of sucking blood from the wound with the mouth), there is a risk of infection with [[herpes]] simplex type 1, which can lead to brain damage or death.<ref>{{REFweb<br />
|url=http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritual.html?_r=0<br />
|title=Baby’s Death Renews Debate Over a Circumcision Ritual<br />
|last=Robbins<br />
|first=Liz<br />
|date=2012-03-07<br />
|accessdate=2019-10-11<br />
}}</ref><br />
<br />
=== Physical late effects ===<br />
<br />
* An unavoidable late effect of any circumcision is the permanent loss of sexual sensitivity. This is partly due to the removal of sensory tissue. The [[foreskin]] contains very many nerve endings and touch receptors, which account for the major part of male sexual sensation. If the [[foreskin]] is removed, they can no longer provide sexual stimulation. It is also partly due to the fact that the surface of the [[Glans penis|glans]] reacts to the missing protection from friction and drying out by developing a callus layer. This reduces the sensitivity of the remaining nerves in the [[Glans penis|glans]] gradually over the years. The study conducted by Sorrells ''et al.''<ref>{{REFjournal<br />
|last=Sorrells<br />
|first=M.L.<br />
|last2=Snyder<br />
|first2=J..L.<br />
|last3=Reiss<br />
|first3=M.D.<br />
|etal=yes<br />
|title=Fine-touch pressure thresholds in the adult [[penis]]<br />
|journal=BJU Int<br />
|date=2007<br />
|volume=99<br />
|issue=<br />
|pages=864-869<br />
|url=<br />
|accessdate=<br />
}}</ref> found a significant reduction of sensitivity to touch for circumcised compared to intact [[penis]]es in adult males. Other studies revealed that circumcised men use condoms significantly less often than intact men, since they further limit the sexual sensitivity (see above).<br />
<br />
* Painful tension can occur when there is too little reserve skin left to support a full erection<ref>{{REFjournal<br />
|last=Taylor<br />
|first=J.R.<br />
|last2=Lockwood<br />
|first2=A.P.<br />
|last3=Taylor<br />
|first3=A.J.<br />
|title=The prepuce: <q>Specialized mucosa of the [[penis]] and its loss to circumcision</q><br />
|journal=British Journal of Urology<br />
|date=1996<br />
|volume=77<br />
|issue=<br />
|pages=291-295<br />
|url=<br />
|accessdate=<br />
}}</ref>. This risk is partly dependent on the anatomy of the [[penis]]. While some [[penis]]es already have the majority of their full size when flaccid ([[Flesh Penis]], or "[[shower]]"), others are rather short when flaccid and double or more their size during an erection ([[Blood Penis]], or "[[grower]]"). Especially in children's circumcision, where the [[penis]] is not yet fully developed, the amount of reserve skin needed in adulthood cannot be estimated.<br />
<br />
* Erectile dysfunction: Both the damage inflicted to the blood vessels in the [[foreskin]] and the reduced sexual sensitivity can be causes for reduced erectile function with advancing age.<ref>{{REFjournal<br />
|last=Money<br />
|first=J.<br />
|last2=Davison<br />
|first2=J.<br />
|title=Adult penile circumcision: Erotosexual and cosmetic sequelae<br />
|journal=Journal of Sex Research<br />
|date=1983<br />
|volume=19<br />
|issue=<br />
|pages=289-292<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
<br />
* Orgasm problems: In the wake of reduced sexual sensitivity, due to the loss of sensory tissue and gradual keratinization of the surface of the [[Glans penis|glans]], orgasm problems may develop with increasing age. In this case, the sexual arousal created by intercourse or [[masturbation]] is not enough to achieve orgasm. A preliminary stage of this late effect is the prolonged time circumcised men need to reach an orgasm. This is often fielded as the "cut men have more endurance" argument for circumcision.<br />
* Vaginal dryness: Due to the loss of the natural gliding action, which comes from the mobility of the fore- and shaft skin, a much increased friction between [[penis]] and vagina occurs during intercourse. This can make intercourse painful for both partners and lead to abrasions<ref>{{REFjournal<br />
|last=Frisch<br />
|first=Morten<br />
|author-link=Morten Frisch<br />
|first2=Morten<br />
|last2=Lindholm<br />
|first3=Morten<br />
|last3=Grønbæk<br />
|title=Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark<br />
|journal=International Journal of Epidemiology<br />
|date=2011-10<br />
|volume=40<br />
|issue=5<br />
|pages=1367-1381<br />
|url=<br />
|pubmedID=21672947<br />
|DOI=10.1093/ije/dyr104<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Cortés-González<br />
|first=J.<br />
|last2=Arratia-Maqueo<br />
|first2=J.<br />
|last3=Gómez-Guerra<br />
|first3=L.<br />
|title=Does circumcision has an effect on female's perception of sexual satisfaction?<br />
|journal=Rev Invest Clin<br />
|date=2008<br />
|volume=60<br />
|issue=3<br />
|pages=227<br />
|url=<br />
|pubmedID=18807735<br />
|accessdate=<br />
}}</ref> The prolonged time it takes circumcised men to reach orgasm, as well as the often longer and more vigorous thrusting movements - compared to intact men - play a part in this.<ref>{{REFjournal<br />
|last=Cold<br />
|first=C.J.<br />
|last2=Taylor<br />
|first2=J.R.<br />
|title=The prepuce<br />
|journal=BJU Int<br />
|date=1999<br />
|volume=83<br />
|issue=Suppl. 1<br />
|pages=34-44<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Fink<br />
|first=K.S.<br />
|last2=Carson<br />
|first2=C.C.<br />
|last3=DeVellis<br />
|first3=R.F.<br />
|title=Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction<br />
|journal=J Urol<br />
|date=2002<br />
|volume=167<br />
|issue=5<br />
|pages=2113-2116<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
<br />
* [[Lymphoedema]] of the penis is a normal and expected complication of male circumcision.<br />
<br />
* [[Meatal stenosis]], a pathological narrowing of the opening of the urethra, which mostly occurs in infancy and early childhood. It is one of the most common complications of infant circumcision. A study from 2006 found meatal stenosis exclusively in previously circumcised boys. The incidence rate after a circumcision is approximately 10 to 20 percent.<ref name="vanhowe2006">{{REFjournal<br />
|last=Van Howe<br />
|first=R.S.<br />
|title=Incidence of meatal stenosis following neonatal circumcision in a primary care setting<br />
|journal=Clin Pediatr (Phila)<br />
|note=Jan-Feb 2006<br />
|date=2006-01<br />
|volume=45<br />
|issue=1<br />
|pages=49-54<br />
|url=https://www.academia.edu/6992015/Incidence_of_Meatal_Stenosis_following_Neonatal_Circumcision_in_a_Primary_Care_Setting<br />
|accessdate=2019-12-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Stenram<br />
|first=A.<br />
|last2=Malmfors<br />
|first2=G.<br />
|last3=Okmian<br />
|first3=L.<br />
|title=Circumcision for [[phimosis]]: a follow-up study<br />
|journal=Scandinavian journal of urology and nephrology<br />
|date=1986<br />
|volume=20<br />
|issue=2<br />
|pages=89<br />
|url=<br />
|pubmedID=3749823<br />
|accessdate=<br />
}} </ref><ref>{{REFweb<br />
|url=http://emedicine.medscape.com/article/1016016-overview<br />
|title=Meatal Stenosis<br />
|publisher=Medscape<br />
|accessdate=2019-10-11<br />
}}</ref><br />
<br />
=== Psychological late effects ===<br />
<br />
[[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effects]] are also possible after a circumcision, especially if the operation was carried out in childhood. On this occasion a variety of trauma may occur, which depend, among others, on age and circumstances of the circumcision. For example, whether the circumcision took place with or without sufficient anaesthesia, if the individual has been informed about the operation beforehand, if he was circumcised against his will or without his consent, and also, in the case of infant circumcision, if he was told about it during childhood or had to find it out coincidentally on his own.<br />
<br />
The psychological late effects of circumcision are not yet fully researched, and many studies took place on rather a small scale. This situation needs to be rectified, because the available studies, as well as the histories of negatively affected men, suggest that these late effects may have more impact than previously assumed.<br />
<br />
* It was observed that infants, following circumcision without pain control, had a disturbed bond with their mother<ref>{{REFjournal<br />
|last=Marshall<br />
|first=R.E.<br />
|last2=Porter<br />
|first2=F.L.<br />
|last3=Rogers<br />
|first3=A.G.<br />
|etal=yes<br />
|title=Circumcision: II effects upon mother-infant interaction<br />
|journal=Early Hum Dev<br />
|date=1982<br />
|volume=7<br />
|issue=4<br />
|pages=367-374<br />
|url=http://www.cirp.org/library/birth/marshall2/<br />
|accessdate=2020-02-01<br />
}}</ref>, as well as problems with nurturing, up to the point of refusal to be fed. The sleeping habits of these babies were also disturbed, with prolonged non-REM sleep and increased waking.<br />
<br />
* In boys circumcised in childhood, post traumatic stress disorder (PTSD) could be diagnosed. In a study on Philippine boys, in whom no PTSD was found prior to the operation, 69% of the boys circumcised in the traditional ritual and 51% of those circumcised by standard medical procedures (including anaesthesia) fulfilled the DSM-IV criteria for PTSD following the operation.<ref>{{REFbook<br />
|last=Ramos<br />
|first=S<br />
|last2=Boyle<br />
|first2=GJ<br />
|year=2001<br />
|title=Understanding circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem<br />
|url=https://link.springer.com/chapter/10.1007/978-1-4757-3351-8_14<br />
|work=<br />
|editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]<br />
|edition=<br />
|volume=<br />
|chapter=Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder<br />
|pages=253-270<br />
|location=New York<br />
|publisher=Kluwer Academic/Plenum Publishers<br />
|isbn=<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref><br />
* Circumcisions, especially those that happen without consent, can spark feelings of helplessness and alienation, which can persist as trauma. These feeling can also be triggered later, when someone circumcised as an infant becomes aware of his circumcision. In an online study, interviewed men stated they felt betrayed - 55% by the mother, 50% by the father, and 58% by the doctor, and 73% felt that their human rights had been violated.<ref name="GSoCH">{{REFweb<br />
|url=http://www.circumcisionharm.org/<br />
|title=Global Survey of Circumcision Harm<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* It can frequently be found that the loss is denied, much as happens with the loss of other body parts. This denial can lead to fathers having their sons circumcised in order not to be reminded of their own loss. In this process, their own body is defined as "normal" and the [[foreskin]] redefined as a foreign object. Their own parents are seen as "good", so that this image is projected onto the circumcision their parents carried out as well, in order to keep the positive emotion intact. The father wants to be a "good" father later in life as well, and so, following an idealised image of his own parents, circumcision, which has been redefined as a "good thing", is passed on to his son by having him circumcised as well.<ref>{{REFjournal<br />
|last=van der Kolk<br />
|first=B.A.<br />
|url=http://www.cirp.org/library/psych/vanderkolk/<br />
|title=The compulsion to repeat the trauma: re-enactment, revictimization, and masochism<br />
|journal=Psychiatr Clin North Am<br />
|date=1989<br />
|volume=12<br />
|issue=2<br />
|pages=389-411<br />
|accessdate=2019-10-12<br />
}}</ref><ref>{{REFjournal<br />
|last=Goldman<br />
|first=R.<br />
|author-link=Ronald Goldman<br />
|url=http://www.cirp.org/library/psych/goldman1/<br />
|title=The psychological impact of circumcision<br />
|journal=BJU Int<br />
|date=1999<br />
|volume=83<br />
|issue=Suppl. 1<br />
|pages=93-103<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* If the circumcised male feels incomplete, or due to the missing [[foreskin]] disadvantaged compared to intact males, an inferiority complex and depression may occur. This can be accompanied by conscious recognition of his own incompleteness, or the deficiency may remain completely subconscious<ref>{{REFjournal<br />
|last=Rhinehart<br />
|first=J.<br />
|url=http://www.cirp.org/library/psych/rhinehart1/<br />
|title=Neonatal circumcision reconsidered<br />
|journal=Transactional Analysis J<br />
|date=1999<br />
|volume=29<br />
|issue=3<br />
|pages=215-221<br />
|accessdate=2019-10-12<br />
}}</ref>. In an online study, 75% of those interviewed stated that they felt incomplete, and 66% said they felt inferior compared with intact males.<ref name="GSoCH"/><br />
* Cases in which children felt ill treated or punished have been documented as well. G. Cansever found in her study on 12 boys aged between 4 and 7 years, who had previously been prepared for their impending circumcision, that the children experienced the operation as an aggressive assault on their bodies.<ref>{{REFjournal<br />
|last=Cansever<br />
|first=G.<br />
|date=1965<br />
|url=http://www.cirp.org/library/psych/cansever/<br />
|title=Psychological effects of circumcision<br />
|journal=Brit. J. Med. Psychol<br />
|volume=38<br />
|pages=321-331<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* Fear of being alone or darkness.<ref name="Levy1945">{{REFjournal<br />
|last=Levy<br />
|first=David M.<br />
|url=http://www.cirp.org/library/psych/levy1/<br />
|title=Psychic trauma of operations in children; and a note on combat neurosis<br />
|journal=American Journal of Diseases of Children<br />
|volume=69<br />
|date=1945<br />
|pages=7-25<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* Fear of doctors, clinics and also closed rooms.<ref name="Levy1945"/><br />
* Relapse into the state of bed-wetting, even if the child was already dry before.<ref name="Levy1945"/><br />
* Circumcised males who become fathers frequently manifest [[adamant father syndrome]].<br />
<br />
== Rights and ethics ==<br />
<br />
The [[Rights situation on circumcision|rights situation]] is discussed in separate article.<br />
<br />
<br />
-----<br />
<br />
<br />
{{FromIntactWiki<br />
|URL=http://intactwiki.org/wiki/Circumcision<br />
|Title=Circumcision<br />
}}<br />
<br />
[[Image:Intact vs circumcised.JPG |thumbnail|right|300px| The intact and circumcised human penis, side by side.]]<br />
<br />
The term "circumcision" without a gender qualifier refers specifically to male circumcision. It means "to cut around," and it refers to the excision of the [[foreskin]] from the penis. Circumcision is most often performed in healthy males for [[Religion and Culture|religious or cultural]] reasons. The procedure may be performed on consenting adults, but it is most often performed on non-consenting minors, particularly newborn children, which is why the ritual is so controversial. Opponents of circumcision consider the circumcision of non-consenting minors to be unethical and a human rights violation, unless there is concrete medical indication. Proponents of circumcision consider the circumcision of non-consenting minors to be a "religious freedom" and a "parental right."<br />
<br />
== Complications ==<br />
=== Pain ===<br />
In the past, advocates of circumcision claimed that a newborn child's nerve system was not yet fully developed, and that as a result, the child felt no pain during the circumcision procedure. Anand & Hickey (1987) have shown that newborn children do in fact feel pain, and more acutely than adults.<ref name="anand-hickey1987">{{REFjournal<br />
|last=Anand<br />
|first=<br />
|author-link=<br />
|last2=Hickey<br />
|first2=<br />
|author2-link=<br />
|etal=no<br />
|title=Pain and its effects in the human neonate and fetus<br />
|trans-title=<br />
|language=<br />
|journal=New Engl J Med<br />
|location=<br />
|date=1987-11-19<br />
|volume=317<br />
|issue=21<br />
|pages=1321-9<br />
|url=http://www.cirp.org/library/pain/anand/<br />
|quote=<br />
|pubmedID=3317037<br />
|pubmedCID=<br />
|DOI=<br />
|accessdate=2019-11-08<br />
}}</ref> This has led American health associations to recommend doctors take measures to reduce the pain of circumcision in infants.<br />
<br />
The [[Position Statements on Infant Circumcision|AAP Circumcision Policy Statement]] states quite clearly that ''"There is considerable evidence that newborns who are circumcised without analgesia experience pain and physiologic stress"''. Furthermore, the pain is quite severe, and requires injections for proper pain management. Sucrose and Acetaminophen ''"cannot be recommended as the sole method of analgesia"''. Topical cream is no longer thought sufficient as ''"the analgesic effect is limited during the phases associated with extensive tissue trauma such as...tightening of the clamp"''.<ref>{{REFjournal<br />
|last=<br />
|first=<br />
|title=American Academy of Pediatrics: Circumcision Policy Statement; Task Force on Circumcision<br />
|journal=Pediatrics<br />
|date=1999-03<br />
|volume=103<br />
|issue=3<br />
|pages=686-693<br />
|url=https://pediatrics.aappublications.org/content/103/3/686#sec-9<br />
|accessdate=2019-11-26<br />
|note=Statement Reaffirmed Sept. 1, 2005<br />
}}</ref><br />
<br />
The [[AAFP]] states quite simply in their [[Position Statements on Infant Circumcision|position paper]], ''"Newborns experience pain during circumcision".''<ref>{{REFweb<br />
|title=Circumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed<br />
|website=Official American Academy of Family Physicians Website<br />
|url=http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html<br />
|accessdate=2011-05-02<br />
}}</ref> This is not a debatable fact, and yet, it is not widely accepted, even by some doctors. It might be hard for some doctors to accept, as they may have been taught that the infant does not feel pain, and may have performed countless circumcisions with this idea. Usage of anesthesia for infant circumcision is still by no means the rule.<br />
<br />
Penile injections of anesthetic are now recommended by all of the major medical institutions. In their [http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml Report 10 of the Council on Scientific Affairs], the AMA states ''"When the decision is made to proceed with circumcision, local anesthesia should be provided for the procedure. Ring block or dorsal penile blocks [injections] are most effective. EMLA cream has limited utility"''. Alarmingly, ''"Despite the clear evidence that newborn males generate brisk pain responses during circumcision, a recent survey of residency training programs found that 26% of programs that taught circumcision provided no instruction on the use of local anesthesia". The AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, and 25% of obstetricians"''.<ref>{{REFweb<br />
|title=Report 10 of the Council on Scientific Affairs (I-99): Neonatal Circumcision<br />
|website=American Medical Association Official Website<br />
|url=http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml<br />
|accessdate=2011-05-04<br />
}}</ref><br />
<br />
The AAP's [http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx Heatlhy Children website] suggests ''"Your pediatrician (or your obstetrician) should discuss the forms of analgesia that are available"''.<ref>{{REFweb<br />
|title=Where We Stand: Circumcision<br />
|publisher=[[AAP]]<br />
|date=2011-03-23<br />
|url=http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx<br />
|accessdate=2019-10-12<br />
}}</ref> Be that as it may, few forms of analgesia are recommended. There are basically two types of injections to choose from, and the website does not go into the difference between a 'dorsal nerve block' and a 'ring block' injection.<br />
<br />
Given what is known from aforementioned official documents, the AAP website may be more informative and effective if it would say ''"Make sure your doctor knows of the ineffectiveness of anything short of local anesthesia, and make sure your baby is given an injection. This is your responsibility, because your doctor may or may not be up to date on the latest understandings of infant sensitivity to pain during circumcision."'' The AAP may be holding back, however, perhaps because this would upset the doctor/parent power relationship, and may cause too much questioning of doctors in general. One may not expect to find this kind of advice on such a website, and yet, anything less than this is a dangerously weak statement.<br />
<br />
To control pain, some physicians that circumcise use Tylenol, sugar,<ref>{{REFweb<br />
| quote=To calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, and soothing music is played in the room.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-guide.html<br />
| title=Parents' Guide to Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2011-04-08<br />
}}</ref><ref>{{REFweb<br />
| quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> a topical cream,<ref>{{REFweb<br />
| quote=Then in our office, he will have topical anesthetic applied to his penis.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb<br />
| quote=We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-guide.html<br />
| title=Parents' Guide to Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2011-04-08<br />
}}</ref> Topical anaesthetic only serves to numb the area to lessen the pain of the injection, but studies have shown that a dorsal penile ring block is not always effective in stopping the pain of circumcision.<ref name='Journal of Perinatology April/May 2002'>{{REFjournal<br />
|last=Taeusch<br />
|first=H. William<br />
|last2=Martinez<br />
|first2=Alma M.<br />
|last3=Partridge<br />
|first3=J. Colin<br />
|last4=Sniderman<br />
|first4=Susan<br />
|last5=Armstrong-Wells<br />
|first5=Jennifer<br />
|last6=Fuentes-Afflick<br />
|first6=Elena<br />
|title=Pain During Mogen or Plastibell Circumcision<br />
|journal=Journal of Perinatology<br />
|volume=22<br />
|issue=3<br />
|pages=214-218<br />
|url=http://www.nature.com/jp/journal/v22/n3/full/7210653a.html<br />
|quote=...more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|note=April/May 2002<br />
|date=2002-04<br />
|accessdate=2011-04-08<br />
}}</ref><ref name='Clinical Pediatrics August 1986'>{{REFjournal<br />
|last=Williamson<br />
|first=Paul S.<br />
|last2=Evans<br />
|first2=Nolan Donovan<br />
|title=Neonatal Cortisol Response to Circumcision with Anesthesia<br />
|journal=Clinical Pediatrics<br />
|volume=25<br />
|issue=8<br />
|pages=412-416<br />
|url=http://cpj.sagepub.com/content/25/8/412.abstract<br />
|quote=The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=1986-08<br />
|accessdate=2011-04-08<br />
}}</ref> During circumcision, somp physicians give children sugar pacifiers to "reduce the perception of pain",<ref>{{REFweb<br />
| quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> but in at least one study, data shows that giving sugar to a child doesn't help to reduce the perception of pain in the child.<ref name='Lancet, The 2010-10-09'>{{REFjournal<br />
|last=Slater<br />
|first=Rebeccah<br />
|first2=Laura<br />
|last2=Cornelissen<br />
|first3=Lorenzo<br />
|last3=Fabrizi<br />
|first4=Debbie<br />
|last4=Patten<br />
|first5=Jan<br />
|last5=Yoxen<br />
|first6=Alan<br />
|last6=Worley<br />
|first7=Stewart<br />
|last7=Boyd<br />
|first8=Judith<br />
|last8=Meek<br />
|first9=Maria<br />
|last9=Prof. Fitzgerald<br />
|title=Oral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial<br />
|journal=The Lancet<br />
|volume=376<br />
|issue=9748<br />
|pages=1225-1232<br />
|url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2961303-7/fulltext<br />
|quote=Our data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuits, and therefore might not be an effective analgesic drug. The ability of sucrose to reduce clinical observational scores after noxious events in newborn infants should not be interpreted as pain relief.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=2010-10-09<br />
|accessdate=2011-04-08<br />
}}</ref> Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals.<br />
<br />
It has been shown that an infant's response to pain can be altered for years as a consequence of circumcision.<ref>{{REFjournal<br />
|last=Taddio<br />
|first=Anna<br />
|first2=Morton<br />
|last2=Goldbach<br />
|first3=Moshe<br />
|last3=Ipp<br />
|first4=Bonnie<br />
|last4=Stevens<br />
|first5=Gideon<br />
|last5=Koren<br />
|title=Effect of neonatal circumcision on pain responses during vaccination in boys<br />
|journal=The Lancet<br />
|volume=345<br />
|issue=8945<br />
|pages=291-2<br />
|url=http://www.cirp.org/library/pain/taddio/<br />
|quote=<br />
|pubmedID=7837863<br />
|pubmedCID=<br />
|DOI=<br />
|date=1995<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Taddio<br />
|first=Anna<br />
|last2=Katz<br />
|first2=J.<br />
|last3=Ilersich<br />
|first3=A.L.<br />
|last4=Koren<br />
|first4=G.<br />
|title=Effects of neonatal circumcision on pain response during subsequent routine vaccination<br />
|journal=The Lancet<br />
|volume=349<br />
|issue=9052<br />
|pages=599-603<br />
|url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)10316-0/fulltext<br />
|quote=<br />
|pubmedID=9057731<br />
|pubmedCID=<br />
|DOI=10.1016/S0140-6736(96)10316-0<br />
|date=1997-03<br />
|accessdate=<br />
}}</ref><br />
<br />
=== Sexual effects ===<br />
<br />
Circumcision and frenectomy remove tissues with heightened erogenous sensitivity. Boyle ''et al.'' (2002) wrote, "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings&mdash;many of which are lost to circumcision."<ref>{{REFjournal<br />
|last=Boyle<br />
|first=Gregory J.<br />
|author-link=Gregory Boyle<br />
|first2=Gillian A.<br />
|last2=Bensley<br />
|title=Adverse Sexual and Psychological Effects of Male Infant Circumcision<br />
|journal=Psychological reports<br />
|volume=88<br />
|issue=3, Part 2<br />
|pages=1105–1106<br />
|url=http://www.cirp.org/library/psych/boyle5/<br />
|quote=<br />
|pubmedID=11597060<br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410x.1999.0830s1085.x<br />
|date=July 2001<br />
|accessdate=<br />
}}</ref> They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well."<br />
<br />
The amputation of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the penis, leaving only the uninhibited protopathic sensibility of the artificially externalized glans penis. The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of the changes in sexual behavior noted in circumcised human males.<ref>{{REFjournal<br />
|last=Van Howe<br />
|first=R.S.<br />
|author-link=Robert Van Howe<br />
|last2=Cold<br />
|first2=C.J.<br />
|title=Advantages and Disadvantages of Neonatal Circumcision<br />
|journal=The Journal of the American Medical Association<br />
|volume=277<br />
|issue=13<br />
|pages=1052-7<br />
|url=http://www.ncbi.nlm.nih.gov/pubmed/9218663<br />
|quote=<br />
|pubmedID=9218663<br />
|pubmedCID=<br />
|DOI=<br />
|date=1997-04-02<br />
|accessdate=<br />
}}</ref><br />
<br />
Histology of the male circumcision scar shows amputation neuromas, Schwann cell proliferation and the bulbous collection of variably sized neurites. Amputation neuromas do not mediate normal sensation and are notorious for generating pain.<ref>{{REFjournal<br />
|last=Cold<br />
|first=C.J.<br />
|first2=J.R.<br />
|last2=Taylor<br />
|title=The prepuce<br />
|journal=British Journal of Urology International<br />
|volume=83<br />
|issue=<br />
|pages=34-44<br />
|url=http://www.cirp.org/library/anatomy/cold-taylor/<br />
|quote=<br />
|pubmedID=10349413<br />
|pubmedCID=<br />
|DOI=<br />
|date=1999-1<br />
|accessdate=<br />
}}</ref><br />
<br />
=== Death ===<br />
A study in 2010 estimated approximately 117 neonatal circumcision-related deaths occur annually in the United States, about one out of every 77 male neonatal deaths, more than suffocation, auto accidents, or even SIDS.<ref name="Bollinger 2010">{{REFjournal<br />
|last=Bollinger<br />
|first=Dan<br />
|author-link=Dan Bollinger<br />
|last2=Boy's Health Advisory<br />
|title=Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths<br />
|journal=Thymos: Journal of Boyhood Studies<br />
|volume=4<br />
|issue=1<br />
|pages=78-90<br />
|url=http://www.mensstudies.com/content/b64n267w47m333x0/?p=7ebbd6b446d940cbbd4274c095754b12π=5<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.3149/thy.0401.78<br />
|date=2010-04-26<br />
|accessdate=2019-10-12<br />
}}</ref><ref>{{REFweb<br />
| quote=<br />
| url=http://www.icgi.org/2010/04/infant-circumcision-causes-100-deaths-each-year-in-us<br />
| title=Infant circumcision causes 100 deaths each year in US<br />
| last=<br />
| first=<br />
| publisher=ICGI<br />
| website=International Coalition for Genital Integrity<br />
| date=2010-04-26<br />
| accessdate=<br />
}}</ref> See also the list of [[fatalities]].<br />
<br />
== Forced circumcision ==<br />
<br />
<!--=== United States military ===<br />
<br />
American soldiers serving in World War II were subjected to regular inspections of their genitals. If uncircumcised, the soldiers risked being ordered to undergo immediate circumcision.<ref>{{REFbook<br />
|last=Schoen<br />
|first=Ed<br />
|author-link=Edgar J. Schoen<br />
|year=2005<br />
|title=On Circumcision<br />
|url=https://books.google.de/books?id=-zUhdvSt7cgC<br />
|work=<br />
|editor=Dianne Yeakey<br />
|edition=<br />
|volume=<br />
|chapter=<br />
|pages=72-73<br />
|location=Georgetown, Canada<br />
|publisher=RDR Books<br />
|isbn=1-157143-123-3<br />
|quote=For a critical view, see Sorrells, "The History of Circumcision," p. 333<br />
|accessdate=<br />
|note=<br />
}}</ref> This practice was discontinued at least six decades ago.--><br />
<br />
=== Non-therapeutic circumcision of male children ===<br />
<br />
Human babies, because they are not yet in possession of language, are incapable of giving or refusing consent for being circumcised. The element of force has led some scholars to view the circumcision of baby boys as a category of forced circumcision.<ref>For example, Frederick M. Hodges, a medical historian, writes: "In the late 1970s, as the Americans were growing increasingly aware of the abuses of power rampant throughout the nation's social institutions, influential grass-roots movements protesting the forced circumcision of American children sprang up nationwide." F. Hodges, "A Short History," p. 31; see also [[Leonard B. Glick|Glick]], ''Marked in Your Flesh'', pp. 273-281.</ref> There are, however, physicians in the United States who argue strongly for non-therapeutic circumcision of newborn babies; and circumcision is widely accepted as a postnatal procedure in American hospitals.<ref>{{REFbook<br />
|last=Fletcher<br />
|first=Christopher R.<br />
|year=1999<br />
|title=Circumcision in America in 1998: Attitudes, Beliefs, and Charges of American Physicians<br />
|url=http://www.springerlink.com/content/h2150v731233m177/<br />
|work=Male and Female Circumcision<br />
|editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]<br />
|edition=<br />
|volume=<br />
|chapter=Section 5<br />
|pages=259-271<br />
|location=New York<br />
|publisher=Kluwer Academic/Plenum Publishers<br />
|isbn=<br />
|quote=<br />
|accessdate=2019-10-12<br />
|note=ID 10.1007/978-0-585-39937-9_19<br />
}}</ref> Parental consent is required.<ref>See, e.g., Shephard and Shephard, ''The Complete Guide'', p. 125.</ref> A statement published by the American Academy of Pediatrics in 1999 declares that "parents should determine what is in the best interest of the child... It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in additions to the medical factors, when making a decision."<ref>Lannon and Bailey, "Circumcision Policy Statement," p. 691.</ref> In the United Kingdom, where non-therapeutic circumcision has now become far less prevalent than in the United States, a written consent of both parents is required, if a physician is to perform a non-therapeutic circumcision of a child.<ref>{{REFjournal<br />
|last=<br />
|first=<br />
|title=Re J (child's religious upbringing and circumcision)<br />
|journal=Family Court Reports<br />
|date=2000<br />
|volume=1<br />
|issue=<br />
|pages=307-314<br />
|url=http://www.cirp.org/library/legal/Re_J/2000.html<br />
|accessdate=2019-10-12<br />
}}</ref> (The National Health Service does not provide non-therapeutic circumcision.)<br />
<br />
In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<ref>See, e.g., Somerville, "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; Chessler, "Justifying the Unjustifiable"; Smith, "Male Circumcision."</ref> For example, critics have pointed out that, in the United States, more than 1.3% of male neonatal deaths are attributable to the complications of non-therapeutic circumcision surgery.<ref name="Bollinger 2010"/>refer<ref>{{REFweb<br />
|quote=<br />
|url=http://www.icgi.org/2010/04/infant-circumcision-causes-100-deaths-each-year-in-us<br />
|title=Infant circumcision causes 100 deaths each year in US<br />
|last=Bollinger<br />
|first=Dan<br />
|author-link=Dan Bollinger<br />
|publisher=International Coalition for Genital Integrity<br />
|date=2010-04-26<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
{{SEEALSO}}<br />
* [[Sexual effects of circumcision]]<br />
* [[FGM]]<br />
* [[MGM]]<br />
* [[Risks and complications]]<br />
* [[Documented severe complications of circumcision]]<br />
* [[Circumcision scar]]<br />
* [[Circumpendium]]<br />
* [[Human rights]]<br />
* [[Ethics of non-therapeutic child circumcision]]<br />
* [[Rights situation on circumcision]]<br />
* [[Circumcision methods]]<br />
* [[Case Histories]]<br />
* [[Lymphoedema]]<br />
* [[Psychological issues of male circumcision]]<br />
<br />
{{REF}}<br />
<br />
[[Category:From Intactipedia]]<br />
[[Category:From IntactWiki]]<br />
[[Category:Male circumcision]]<br />
[[Category:Genital surgery]]<br />
[[Category:Terms]]<br />
[[Category:Islam]]<br />
[[Category:Judaism]]<br />
[[Category:Circumcision]]<br />
[[de:Zirkumzision]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Child_circumcision&diff=14353Child circumcision2020-05-04T20:34:12Z<p>WikiModEn4: /* Search for prophylactic reasons */</p>
<hr />
<div>{{GraphicWarning}}<br />
"Male '''circumcision''' (from Latin ''circumcidere'', meaning "to cut around") is the surgical removal of the [[foreskin]] (prepuce) part of the human [[penis]]. The foreskin comprises ''more than fifty percent'' of the epithelium of the penis.<ref name="taylor1996">{{REFjournal<br />
|last=Taylor<br />
|first=J.R.<br />
|author-link=John R. Taylor<br />
|last2=Lockwood<br />
|first2=A.P.<br />
|author2-link=<br />
|last3=Taylor<br />
|first3=A.J.<br />
|title=The prepuce: specialized mucosa of the penis and its loss to circumcision<br />
|journal=Brit J Urol<br />
|date=1996<br />
|volume=77<br />
|issue=<br />
|pages=291-5<br />
|url=http://onlinelibrary.wiley.com/doi/10.1046/j.1464-410X.1996.85023.x/full<br />
|quote=<br />
|pubmedID=8800902<br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410X.1996.85023.x<br />
|accessdate=2019-10-14<br />
}}</ref> [...] The procedure is most often an elective non-therapeutic surgery performed on neonates and children for religious and cultural reasons, but in other cases may be indicated for both therapeutic and prophylactic reasons. It is a radical treatment option for pathological [[phimosis]], refractory [[Balanitis| balanoposthitis]] and chronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health. <br />
<br />
'''Posthectomy''' is a more accurate medical term that more accurately reflects the injury and loss of functional body tissue, but the Biblical euphemism, ''circumcision'', is more commonly used. <br />
<br />
With reference to involuntary, non-therapeutic circumcision of children, [[Child Genital Cutting (CGC)]] is a new term that has been introduced to avoid issues associated with more traditional terms.<br />
<br />
== Historical background ==<br />
<br />
The amputation of the [[foreskin]] is a very old ritual, whose exact origin cannot be verified beyond doubt. Medical historians assume that circumcision already served in ancient history as a way to control the sexuality of slaves and members of the lower classes without compromising their ability to reproduce. In religious history circumcision may be seen as a substitute for human sacrifice. In prehistoric times it was not uncommon to placate the gods with human sacrifice. Castration of slaves or conquered enemies was common as well. Following religious changes this sacrifice was altered, and only a part of the very organ responsible for the creation of new life was sacrificed.<br />
<br />
[[Image:Circumcision Sakkara 3.jpg|200px|right]] For the Aborigines, the Australian natives, the tradition of circumcision is said to go back to 10,000 BC. On the African continent, the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of circumcision date back to the time around 3000-2000 BC. The oldest known depiction<ref>{{REFweb<br />
|url=https://commons.wikimedia.org/wiki/File:Circumcision_Sakkara_3.jpg<br />
|title=File:Circumcision Sakkara 3.jpg<br />
|accessdate=2019-10-12<br />
}}</ref> is an Egyptian tomb relief from the 6th dynasty, approximately 2300-2000 BC. It is not known precisely who was circumcised and why in those times.<br />
<br />
In many cultures circumcision during puberty serves as a rite of passage, bringing adolescents into the community. As with other painful or humiliating initiation rites, proof of courage and mastering of critical situations are the key motivations. From some African tribes it is also known that the amputation of the [[foreskin]] is seen as the removal of an inborn piece of femininity from the boys, thus making them men.<br />
<br />
===Judaism===<br />
<br />
In the Jewish religion, the tradition of circumcision goes back to a passage in the Book of Genesis (17, 10-14). It is seen as a [[Abrahamic covenant| covenant between God and man]], dating back to the patriarch Abraham.<br />
<br />
{{Citation<br />
|Text=10 This is my covenant with you and your descendants after you, the covenant you are to keep: Every male among you shall be circumcised. 11 You are to undergo circumcision, and it will be the sign of the covenant between me and you. 12 For the generations to come every male among you who is eight days old must be circumcised, including those born in your household or bought with money from a foreigner—those who are not your offspring. 13 Whether born in your household or bought with your money, they must be circumcised. My covenant in your flesh is to be an everlasting covenant. 14 Any uncircumcised male, who has not been circumcised in the flesh, will be cut off from his people; he has broken my covenant.” <br />
|Author=Bible<br />
|Source=Gen 17, 10-14, NIV<br />
}}<br />
<br />
According to the anthropologist and sociologist Nissan Rubin, the Jewish form of circumcision, called ''[[Brit Milah| brit mila]]'', during the first two millennia did not include the later customary ''periah'', namely the complete scraping of the inner [[foreskin]] from the [[Glans penis|glans]]. This was only added around 135 AD, to make it impossible to restore the [[foreskin]] by stretching, which became popular in the wake of Hellenic influence. While originally only the tip of the [[foreskin]] was cut off, periah removes the entire [[foreskin]]. In the Greek society of the day, a denuded [[Glans penis|glans]] was considered obscene and risible. In ultra-orthodox communities, circumcision is followed by the ''[[mohel]]'', the ritual circumciser, sucking blood from the wound with his mouth. This practice is highly controversial, as it can result in an infection with [[herpes]] simplex type 1. In New York City, between 2000 and 2011 eleven children were infected with [[herpes]], 10 of whom had to be treated in hospital. Two of them suffered permanent brain damage, two others died. In the 12th century, the Jewish philosopher and doctor [[Moses Maimonides| Maimonides]] pointed out that circumcision was necessary, as it diminished sexual desires and reduced the pleasure to a degree just sufficient for mere reproduction.<br />
<br />
===Christianity===<br />
Jesus was born into a Jewish family in Israel, where Judaism was the prevailing religion, so he was circumcised on the eighth day.<ref name="luke2:21>{{REFweb<br />
|url=https://www.biblegateway.com/passage/?search=Luke+2%3A21&version=NASB<br />
|title=Gospel of Luke<br />
|trans-title=<br />
|language=<br />
|last=Luke<br />
|first=<br />
|author-link=<br />
|publisher=NASB<br />
|website=Bible Gateway<br />
|date=<br />
|accessdate=2019-11-10<br />
|format=<br />
|quote=And when eight days had passed, before His circumcision, His name was then called Jesus, the name given by the angel before He was conceived in the womb.<br />
}}</ref><br />
<br />
The first Christians had been born Jewish, so a question arose whether one must be circumcised to be a Christian. When Christian leaders met at the [[Council at Jerusalem]] in the First Century to decide what was required to be a Christian, a letter was written to explain the requirements, but circumcision was omitted from the requirements.<ref>{{REFweb<br />
|url=https://www.biblegateway.com/passage/?search=Acts+15%3A1-30&version=NASB<br />
|title=Acts 15:1-30<br />
|last=Luke<br />
|first=<br />
|accessdate=2019-11-10<br />
}}</ref><br />
<br />
In Christianity, circumcision is practiced only in a few Coptic churches. There is no general belief that circumcision is a requirement of Christianity.<ref name="hill2004">{{REFweb<br />
|url=http://www.cirp.org/pages/cultural/christian.html<br />
|title=The Holy Bible, Circumcision, False Prophets, and Christian Parents<br />
|trans-title=<br />
|language=<br />
|last=Hill<br />
|first=George<br />
|author-link=George Hill<br />
|publisher=Circumcision Reference Library<br />
|website=<br />
|date=2004-08-29<br />
|accessdate=2019-11-10<br />
|format=HTML<br />
|quote=The falseness of those who advocate circumcision is a recurrent theme in the New Testament. <br />
}}</ref><br />
<br />
Nevertheless, Christian moral notions had decisive influence on the spread of this practice. In the puritan influenced USA, circumcision of children was popular in the 19th century as a means to prevent [[masturbation]]. In those days, this so-called ‘self-abuse‘ was not only considered immoral, but was supposedly responsible for a variety of diseases. Masturbation, however, is not mentioned anywhere in the Holy Bible, so there is no support for the belief that it is somehow immoral or sinful. <br />
<br />
Even the mere existence of a [[foreskin]] was linked to many illnesses. Among them one could find syphilis, epilepsy, paralysis of the spine, bed wetting, scoliosis (spinal deformity), paralysis of the bladder, club foot, nerve pain in the lower abdomen, tuberculosis and lazy eye. One of the best known advocates of child circumcision was [[John Harvey Kellogg]], co-inventor of the corn flakes bearing his name. In 1888, he wrote:<br />
<br />
{{Citation<br />
|Text=A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of [[phimosis]]. The operation should be performed by a surgeon without administering an anaesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. In females, the author has found the application of pure carbolic acid to the clitoris an excellent means of allaying the abnormal excitement, and preventing the recurrence of the practice in those whose will-power has become so weakened that the patient is unable to exercise entire self-control. <br />
|Author=[[John Harvey Kellogg]]<br />
|Source=<br />
|ref=<ref>{{REFbook<br />
|url=https://archive.org/details/plainfaorold00kell/page/290<br />
|chapter=Treatment for Self-abuse and Its Effects<br />
|title=Plain Facts for Old and Young<br />
|location=Burlington, Iowa<br />
|publisher=F. Segner & Co.<br />
|year=1888<br />
|pages=107<br />
}}</ref><br />
}}<br />
<br />
===Islam===<br />
In Islam, circumcision is also religiously founded, even though there is no mention of it in the Koran itself. According to tradition, the Prophet Mohammed was born without a [[foreskin]]. It is seen as a sign of prophets that they are born without a [[foreskin]] already. It is considered an honour to "resemble the example of the Prophet", meaning to be circumcised. In Islam, unlike Judaism, there is no specific age at which the circumcision should be performed. Most circumcisions take place at ages between 6 and 10 years, but the range goes from birth to adulthood.<br />
<br />
== Rationale ==<br />
<br />
Reasons for performing circumcision range widely by culture, religion, location, and age.<br />
<br />
===Cultural===<br />
<br />
Many cultures perform circumcision as a rite of passage into manhood. This is common in the Middle East and amongst some indigenous African and Southeast Asian peoples.<br />
<br />
The United States and Israel are the only industrialized countries in the world to have a high incidence of non-therapeutic infant male circumcision. The vast majority of infant circumcisions performed in the United States are for non-religious, non-medical reasons. See [[History of circumcision]].<br />
<br />
===Religious===<br />
The circumcision of newborn boys is seen as a divine commandment in the Jewish faith. Though absent in the Koran, male circumcision is considered a religious requirement in Islam, and it is performed on male children of varying ages. Converts to these faiths may also choose to undergo circumcision, but it is not always required.<br />
<br />
===Medical indication===<br />
In some cases, circumcision is legitimately indicated; a patient may be suffering recurring infections, and other methods of treatment have failed. In other cases, a patient may be suffering from a severe case of [[phimosis]]. Overall, the actual medical necessity for circumcision is extremely rare. All circumcisions injure the patient by amputating the [[foreskin]] its with many protective, immunological, sensory, and sexual [[Foreskin#Physiological_functions| functions]]. <br />
<br />
# '''Deformed or malformed foreskin'''. A foreskin so deformed or malformed that it does not function properly may be removed by circumcision.<br />
<br />
# '''Traumatically injured foreskin'''. A foreskin so traumatically injured foreskin that cannot be surgically repaird is a valid medical reason for circumcision.<br />
<br />
# '''Diseased foreskin.''' A foreskin that is diseased is a valid indication for cirumcision. Some diseases that qualify are malignancy, lichen sclerosis, yeast infection in men with diabetes, and recurrent posthitis.<br />
<br />
In such cases, the benefit of removing the problem foreskin may exceed the maleficial results of tissue and function destruction.<br />
<br />
====Arguments of prophylaxia====<br />
Though the practice of ritual circumcision of males, both consenting and non-consenting, has existed for millenia, the search for "potential medical benefits" began relatively recently. The discussion of circumcision in the Ninth Edition of the ''Encyclopǽdia Britannica'' (1876) made no mention of any prophylactic, medical, or therapeutic value or function.<ref>{{REFweb<br />
|url=http://www.cirp.org/library/history/encyclopaediabritannica1876/<br />
|title=Circumcision<br />
|trans-title=<br />
|language=<br />
|last=Cheyne<br />
|first=T. K.<br />
|author-link=<br />
|publisher=Encyclopǽdia Brittanica<br />
|website=Circumcision Reference Library<br />
|date=1876<br />
|accessdate=2019-11-10<br />
|format=<br />
|quote=<br />
}}</ref><br />
<br />
Initially, circumcision was adopted as a way to stop boys and men from masturbating, where masturbation was seen as the cause for many diseases. As the myth that circumcision prevented [[masturbation]] became debunked, advocates of circumcision began the great search to find the "medical benefits" of circumcision. <br />
<br />
Male and female circumcision involves the removal and disruption of normal anatomical structures that are primary areas of sexual sensation.<ref name="taylor1996" /> In the past, some advocates of mass circumcision have considered the prepuce to be a "mistake of nature,"<ref><br />
<nowiki>{{Cold and Wiswell (1995)}} | [[Template:Cold and Wiswell (1995)|see more]]</nowiki></p><br />
</ref> but this notion has no validity because the prepuce is ubiquitous in primates and because it provides functional advantages.<ref name="cold-mcgrath1995">{{REFbook<br />
|last=Cold<br />
|first=Christopher<br />
|last2=McGrath<br />
|first2=Kenneth<br />
|author2-link=Ken McGrath<br />
|year=1999<br />
|title=Male and female circumcision: medical, legal, and ethical considerations in pediatric practice<br />
|url=http://www.cirp.org/library/anatomy/cold-mcgrath/<br />
|work=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=Anatomy and histology of the penile and clitoral prepuce in primates<br />
|pages=<br />
|location=New York<br />
|publisher=<br />
|isbn=0306461315<br />
|quote=<br />
|accessdate=2019-10-12<br />
|note=<br />
}}</ref><br />
<br />
===Search for prophylactic reasons===<br />
<br />
The practice of finding prophylactic reasons for infant circumcision started in Germany in the nineteenth century, when non-Jewish Germans criticized the Jewish practice of infant circumcision as being barbaric, Jewish doctors sprang to the defense of the religious practice by claiming health benefits.<ref name="ephron2001">{{REFbook<br />
|last=Ephron<br />
|first=John M.<br />
|author-link=<br />
|year=2001<br />
|title=Medicine and the German Jews<br />
|url=http://www.cirp.org/library/history/ephron1/<br />
|work=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=6<br />
|pages=222-233<br />
|location=New Haven<br />
|publisher=Yale University Press<br />
|isbn=0-300-08377-7<br />
|quote=<br />
|accessdate=2019-11-20<br />
|note=<br />
}}</ref> And so started the long tradition of Jewish doctors inventing reasons for circumcision (and deceving gentile doctors).<br />
<br />
Following the discovery of bacteria as a cause of many diseases – such as tuberculosis – the search began for other illnesses that could be prevented by circumcision.<br />
<br />
In 1870 the renowned Dr. Lewis A. Sayre of NYC’s famed Bellevue Hospital claimed to cure a boy’s paralyzed legs with circumcision. Sayre's wild advocacy of circumcision exemplified how [https://intaction.org/circumcision-facts-and-myths/ circumcision fact and myths] originated. He also claimed to cure epilepsy, mental disorders, hip-joint pain, & hernias with circumcision. “Genital irritations” & masturbation were deemed to be the cause of these issues. Sayre was later elected as the President of the American Medical Association. <ref>American Medical Association. Transactions of the American Medical Association. 1870;21:205–11</ref> <br />
<br />
In the 1920s it was penile cancer. Abraham L. Wolbarst (1926) claims that circumcision can prevent penile cancer.<ref name="wolbarst1926">{{REFjournal<br />
|last=Wolbarst<br />
|first=Abraham L.<br />
|author-link=Abraham L. Wolbarst<br />
|title=Is circumcision a prophylactic against penis cancer?<br />
|journal=Cancer<br />
|date=Jul 1926<br />
|volume=3<br />
|issue=4<br />
|pages=301-10<br />
}}</ref>. <br />
<br />
In the 1940s, prostate and tongue cancer as well as STDs. Eugene H. Hand (1949) falsely explains that circumcision somehow protects against venereal diseases and tongue cancer.<ref name="hand1949">{{REFjournal<br />
|title=Circumcision and venereal disease.<br />
|last=Hand<br />
|first=Eugene H.<br />
|journal=Archives of Dermatology and Syphilology<br />
|date=Sep 1949<br />
|volume=60<br />
|issue=3<br />
|pages=341-346<br />
}}</ref>. <br />
<br />
In the 1950s it was cervical cancer. Abraham Ravich (1951) invents the myth that circumcision reduces the risk of women getting cervical cancer.<ref name="ravich1951">{{REFjournal<br />
|url=https://www.ncbi.nlm.nih.gov/pubmed/14853120<br />
|title=Prophylaxis of cancer of the prostate, penis, and cervix by circumcision<br />
|last=Ravich<br />
|first=Abraham<br />
|last2=Ravich<br />
|first2=R.A.<br />
|journal=New York State Journal of Medicine<br />
|date=Jun 1951<br />
|volume=51<br />
|issue=12<br />
|pages=1519-1520<br />
|pubmedID=14853120<br />
|accessdate=2019-10-12<br />
}}</ref> <br />
<br />
In the late 1960s it was neuroses. Morris Fishbein (1969) calls for circumcision to prevent nervousness and, of course, [[masturbation]].<ref>{{REFbook<br />
|last=Fishbein<br />
|first=Morris<br />
|chapter=Sex hygiene<br />
|title=Modern Home Medical Adviser<br />
|location=Garden City, New York<br />
|publisher=Doubleday & Co<br />
|year=1969<br />
|pages=90, 119<br />
|url=https://openlibrary.org/works/OL95362W/Modern_home_medical_adviser<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
In the 1970s bladder- and rectal cancer. Abraham Ravich (1971) claims that circumcision would prevent bladder cancer and rectal cancer.<ref>{{REFjournal<br />
|last=Ravich<br />
|first=Abraham<br />
|url=https://www.deepdyve.com/lp/wiley/viral-carcinogenesis-in-venereally-susceptible-organs-HCeWmTLmKl<br />
|title=Viral carcinogenesis in venereally susceptible organs<br />
|journal=Cancer<br />
|date=Jun 1971<br />
|volume=27<br />
|issue=6<br />
|pages=1493-1496<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
In the 1980s, UTIs. Thomas E. Wiswell (1985) claims that circumcision, using a methodologically flawed report, reduces the risk of urinary tract infections.<ref name="wiswell1985">{{REFjournal <br />
|last=Wiswell<br />
|first=Thomas E.<br />
|author-link=Thomas E. Wiswell<br />
|url=https://pediatrics.aappublications.org/content/75/5/901<br />
|title=Decreased incidence of urinary tract infections in circumcised male infants<br />
|journal=Pediatrics<br />
|date=May 1985<br />
|volume=75<br />
|issue=5<br />
|pages=901-903<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
Aaron J. Fink (1986), with no evidence whatsoever, claims that circumcision protects against AIDS followed.<ref name="fink1986">{{REFjournal<br />
|last=Fink<br />
|first=Aaron J.<br />
|author-link=Aaron J. Fink<br />
|title=A possible explanation for heterosexual male infection with AIDS<br />
|journal=New England Journal of Medicine<br />
|date=1986-10-30<br />
|volume=31<br />
|issue=18<br />
|pages=1167<br />
|url=https://www.nejm.org/doi/full/10.1056/NEJM198610303151818<br />
|DOI=10.1056/NEJM198610303151818<br />
|accessdate=2019-11-20<br />
}}</ref> <br />
<br />
Retrospectively, circumcision was always advertised as a cure for whatever disease was in the public spotlight at the time. [[Doctors Opposing Circumcision]] (2016) states:<br />
<blockquote><br />
These claims date originally from before the advent of evidence-based medicine, when doctors relied on the opinions of other clinicians to inform their practice, rather than on scientifically collected evidence.<ref name="doc2016">{{REFweb<br />
|url=https://www.doctorsopposingcircumcision.org/for-professionals/alleged-medical-benefits/<br />
|title=Alleged Medical Benefits<br />
|trans-title=<br />
|language=<br />
|last=<br />
|first=<br />
|author-link=<br />
|publisher=Doctors Opposing Circumcision<br />
|website=<br />
|date=2016-05<br />
|accessdate=2019-11-20<br />
|format=<br />
|quote=<br />
}}</ref><br />
</blockquote><br />
<br />
The sheer mass of studies and publications that were released during those almost 180 years on this topic are the reason that even arguments that have been disproved multiple times, especially regarding infant and child circumcision, tenaciously persist up until today.<br />
<br />
An ever-recurring element of initiation rites found in many different cultures is the fixation upon the genitalia.<br />
<br />
It reflects the fascination that emerges from the ability to create new life. In most cultures, fertility is seen as the most precious good, and the body parts involved frequently find themselves in the focus of ritual acts. In many parts of the world, those rites take place when the boy reaches puberty, and are meant to symbolize his transition from boy to man. The removal of the male [[foreskin]] is just one of many phenomena that developed in this context. They range from the removal of the frenulum in boys and men through partial or complete removal of the [[foreskin]] up to radical operations. Australian Aborigines, as mentioned above, have their [[foreskin]]s removed. It is also usual that, a few weeks later, young men have their [[penis]]es sliced open, resulting in a partly or completely divided urethra.<br />
<br />
Another known, particularly massive, intervention is the stripping of the entire skin off the [[penis]]. In Indonesia, boys have metal or bamboo balls inserted into their [[penis]] shaft or [[Glans penis|glans]] at the beginning of puberty, which form little "humps".<br />
<br />
For many cultures it is also common to perform similar rituals on girls. This can range from relatively small interventions such as piercing or cutting the clitoral hood, to its complete removal and up to radical removal of clitoral hood, clitoris, inner and outer labia followed by sewing up the vagina.<br />
<br />
''The following text is taken from the [[Circumpendium]].''<br />
<br />
=== Prophylactic reasons ===<br />
<br />
Some people claim that circumcision has prophylactic benefits. Especially in the USA those arguments have persisted for more then a 100 years, with ever changing diseases circumcision is said to protect against. At first, these were diseases where [[masturbation]] was believed to be the cause. After bacteria and viruses had been discovered, arguments changed, and one after another miscellaneous diseases were cited.<br />
<br />
* [[Phimosis]]: as mentioned earlier, true [[phimosis]] is rare and can be treated effectively without surgery. According to a study by Blalock ''et al.'' (2003)<ref>{{REFjournal<br />
|last=Blalock<br />
|first=H.J.<br />
|last2=Vemulakonda<br />
|first2=V.<br />
|last3=Ritchey<br />
|first3=M.L.<br />
|last4=Ribbeck<br />
|first4=M.<br />
|title=Outpatient management of [[phimosis]] Following newborn circumcision<br />
|journal=J Urol<br />
|date=2003<br />
|volume=169<br />
|issue=6<br />
|pages=2332-2334<br />
|url=http://www.cirp.org/library/complications/blalock1/<br />
|accessdate=2019-11-07<br />
}}</ref>, 2.9% of those circumcised develop a post-operative [[phimosis]], in which the circumcision scar constricts. In intact patients, the rate of [[phimosis]] is only 1% (see also the study by [[Jakob Øster]]). Therefore, circumcision is not a preventive measure for [[phimosis]].<br />
* Sexually Transmitted Diseases (STDs): a vast number of studies has been conducted on the subject of transmission of STDs.<br />
* First, it has to be noted that any form of protection against these diseases only affects people who are sexually active. Circumcision in childhood cannot be justified on these grounds, since any assumed protective effect will not occur before the boy is already old enough to decide about circumcision for himself.<br />
* As mentioned above, the [[foreskin]] keeps the [[Glans penis|glans]] moist. This subpreputial moisture contains, among other substances, the enzyme lysozyme, which breaks up the cell wall of bacteria, thereby providing a natural antibacterial screen. This explains the results of several studies, such as Laumann ''et al.''<ref>{{REFjournal<br />
|last=Laumann<br />
|first=E.O.<br />
|last2=Masi<br />
|first2=C.M.<br />
|last3=Zuckerman<br />
|first3=E.W.<br />
|title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice<br />
|journal=JAMA<br />
|date=1997<br />
|volume=277<br />
|issue=<br />
|pages=1052-1057<br />
|url=http://www.cirp.org/library/general/laumann/<br />
|accessdate=2019-11-06<br />
}}</ref>, which found a higher rate of infection with bacterial venereal diseases in circumcised than in intact men.<br />
* The studies by Fleiss ''et al.'' (1998) support this.<ref name="fleiss-hodges-vanhowe1998">{{REFjournal<br />
|last=Fleiss<br />
|first=P.M.<br />
|last2=Hodges<br />
|first2=F.M.<br />
|last3=Van Howe<br />
|first3=R.S.<br />
|title=Immunological functions of the human prepuce<br />
|journal=Sex Transm Inf<br />
|date=1998<br />
|volume=74<br />
|issue=<br />
|pages=364-367<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1758142/pdf/v074p00364.pdf<br />
|accessdate=2019-11-06<br />
}}</ref> According to the [[AAP]], the general sexual behaviour of the male - such as frequent change in partners and the use of condoms - has a much higher impact on sexually transmitted diseases then the circumcision status.<ref>{{REFjournal<br />
|last=Task Force on Circumcision<br />
|first=<br />
|title=Circumcision policy statement<br />
|journal=Pediatrics<br />
|date=1999<br />
|volume=103<br />
|issue=3<br />
|pages=686-93<br />
|url=http://www.cirp.org/library/statements/aap1999/<br />
|accessdate=2019-11-15<br />
}}</ref><br />
* HIV / AIDS: in the recent past, the argument that circumcision could help to contain the spread of HIV has been stated numerous times.<br />
*:First, two notes: for one, the use of condoms is still by far the most effective protection against an infection. During intercourse with that preventive measure, circumcision status does not make a difference.<br />
*:Secondly, the assumed protection would only affect healthy men who have intercourse with an infected woman. An infected man can infect a women by transmission of his bodily fluids, so that his circumcision status is irrelevant. Therefore, the use of condoms remains vital in containing the spread of HIV, which in return renders circumcision unnecessary<br />
* Due to the inevitable loss of sensitivity as a result of circumcision, there is also the temptation to go without condoms, in order not to lose even more sensitivity.<ref>{{REFjournal<br />
|last=Hooykaas<br />
|first=C.<br />
|last2=van der Velde<br />
|first2=F.W.<br />
|last3=van der Linden<br />
|first3=M.M.<br />
|etal=yes<br />
|title=The importance of ethnicity as a risk factor for STDs and sexual behaviour among heterosexuals<br />
|journal=Genitourin Med<br />
|date=1991<br />
|volume=67<br />
|issue=5<br />
|pages=378-383<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1194736/pdf/genitmed00041-0022.pdf<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Michael<br />
|first=R.T.<br />
|last2=Wadsworth<br />
|first2=J.<br />
|last3=Feinleib<br />
|first3=J.<br />
|etal=yes<br />
|title=Private sexual behavior, public opinion, and public health policy related to sexually transmitted diseases: a US-British comparison<br />
|journal=Am J Public Health<br />
|date=1998<br />
|volume=88<br />
|issue=5<br />
|pages=749-754<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1508929/pdf/amjph00017-0039.pdf<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Laumann<br />
|first=E.O.<br />
|last2=Masi<br />
|first2=C.M.<br />
|last3=Zuckerman<br />
|first3=E.W.<br />
|title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice<br />
|journal=JAMA<br />
|date=1997<br />
|volume=277<br />
|issue=<br />
|pages=1052-1057<br />
|url=http://www.cirp.org/library/general/laumann/<br />
|accessdate=2019-11-06<br />
}}</ref><br />
* Two studies that have been published in early 2007<ref>{{REFjournal<br />
|last=Gray, R.H. and colleagues<br />
|first=<br />
|title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial<br />
|journal=Lancet<br />
|date=2007<br />
|volume=369<br />
|issue=<br />
|pages=657-666<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=[[Robert C. Bailey|Bailey, R.C.]] and colleagues<br />
|first=<br />
|title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial<br />
|journal=Lancet<br />
|date=2007<br />
|volume=369<br />
|issue=<br />
|pages=643-656<br />
|url=<br />
|accessdate=<br />
}}</ref>, which investigated the effectiveness of circumcision as a means of reducing the spread of HIV from infected women to heterosexual men in African high risk areas, have been repeatedly subjected to strong criticism. Both studies were ended prematurely, which distorted the results. The men who had been circumcised for the study had to stay sexually inactive during the wound healing, which gave the intact control group more relative opportunity to become infected. These African randomized clinical trials have been demonstrated to have very serious methodological and statistical errors that distort the results in favor of circumcision.<ref name="boyle-hill2011">{{REFjournal<br />
|last=Boyle<br />
|first=Gregory J.<br />
|author-link=Gregory Boyle<br />
|last2=Hill<br />
|first2=George<br />
|author2-link=George Hill<br />
|title=Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns<br />
|journal=J Law Med<br />
|date=2011-12<br />
|volume=19<br />
|issue=2<br />
|pages=316-34<br />
|url=http://www.salem-news.com/fms/pdf/2011-12_JLM-Boyle-Hill.pdf<br />
|quote=<br />
|pubmedID=22320006<br />
|pubmedCID=<br />
|DOI=<br />
|accessdate=2019-11-09<br />
}}</ref><br />
<br />
The fact that the USA has both the highest rate of circumcised males in the western world, as well as the highest HIV infection rate, makes the studies look dubious. Besides that, several other studies concluded that circumcision does not have a significant impact on the risk of infection with HIV.<ref>{{REFjournal<br />
|last=Grosskurth<br />
|first=H.<br />
|last2=Mosha<br />
|first2=F.<br />
|last3=Todd<br />
|first3=J.<br />
|etal=yes<br />
|title=A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results<br />
|journal=AIDS<br />
|date=1995<br />
|volume=9<br />
|issue=8<br />
|pages=927-934<br />
|url=https://insights.ovid.com/aids/aids/1995/08/000/community-trial-impact-improved-sexually/15/00002030<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Barongo<br />
|first=L.R.<br />
|last2=Borgdorff<br />
|first2=M..W.<br />
|last3=Mosha<br />
|first3=F.F.<br />
|etal=yes<br />
|title=The epidemiology of HIV-1 infection in urban areas, roadside settlements and rural villages in Mwanza Region, Tanzania<br />
|journal=AIDS<br />
|date=1992<br />
|volume=6<br />
|issue=12<br />
|pages=1521-1528<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Changedia SM, Gilada IS<br />
|first=<br />
|title=Role of male circumcision in HIV transmission insignificant in conjugal relationship (abstract no. ThPeC7420)<br />
|url=<br />
|place=Barcelona, Spain<br />
|source=Presented at the Fourteenth International AIDS Conference<br />
|datefrom=2002-07-07<br />
|dateto=2002-07-12<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Connolly CA, Shishana O, Simbayi L, Colvin M<br />
|first=<br />
|title=HIV and circumcision in South Africa (Abstract No. MoPeC3491)<br />
|url=<br />
|place=Bangkok, Thailand<br />
|source=Presented at the 15th International AIDS Conference<br />
|datefrom=2004-07-11<br />
|dateto=2004-07-16<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Thomas AG, Bakhireva LN, Brodine SK, Shaffer RA<br />
|first=<br />
|title=Prevalence of male circumcision and its association with HIV and sexually transmitted infections in a U.S. navy population (Abstract no. TuPeC4861)<br />
|url=https://apps.dtic.mil/dtic/tr/fulltext/u2/a458066.pdf<br />
|place=Bangkok, Thailand<br />
|source=Presented at the 15th International AIDS Conference<br />
|datefrom=2004-07-11<br />
|dateto=2004-07-16<br />
|accessdate=2019-11-15<br />
}}</ref><br />
* Urinary tract infections (UTI): a UTI can be effectively treated with antibiotics, this was also proven by studies<ref>{{REFjournal<br />
|last=McCracken<br />
|first=G.<br />
|title=Options in antimicrobial management of urinary tract infections in infants and children<br />
|journal=Pediatr Infect Dis J<br />
|date=1989<br />
|volume=8<br />
|issue=8<br />
|pages=552-555<br />
|url=http://www.cirp.org/library/disease/UTI/mccracken/<br />
|accessdate=2019-11-19<br />
}}</ref><ref>{{REFjournal<br />
|last=Larcombe<br />
|first=J.<br />
|title=Urinary tract infection in children<br />
|journal=BMJ<br />
|date=1999<br />
|volume=319<br />
|issue=<br />
|pages=1173-1175<br />
|url=<br />
|accessdate=<br />
}}</ref>. A Swedish study <ref>{{REFjournal<br />
|last=Mårild<br />
|first=S.<br />
|last2=Jodal<br />
|first2=U.<br />
|title=Incidence rate of first–time symptomatic urinary tract infection in children under 6 years of age<br />
|journal=Acta Paediatr<br />
|date=1998<br />
|volume=87<br />
|issue=5<br />
|pages=549-552<br />
|url=<br />
|accessdate=<br />
}}</ref> found that, during the first 6 years of life, the incidence of UTIs in boys was 1.8%, but in girls was 6.6%. UTIs are less common in boys after the first year of life. Mueller ''et al.'' <ref>{{REFjournal<br />
|last=Mueller<br />
|first=E.R.<br />
|last2=Steinhardt<br />
|first2=G.<br />
|last3=Naseer<br />
|first3=S.<br />
|title=The incidence of genitourinary abnormalities in circumcised and uncircumcised boys presenting with an initial urinary tract infection by 6 months of age<br />
|journal=Pediatrics<br />
|date=1997<br />
|volume=100 (Supplement)<br />
|issue=<br />
|pages=580<br />
|url=<br />
|accessdate=<br />
}}</ref> did not find a significant difference in UTI rates between circumcised and intact boys with normal urinary tract anatomy.<br />
* Other studies suggest that circumcision is more likely to raise than to lower the generally low risk of acquiring UTI: multiple studies from Israel showed a strong correlation between ritual circumcision on the 8th day of life and postoperative UTI.<ref>{{REFjournal<br />
|last=Menahem<br />
|first=S.<br />
|title=Complications arising from ritual circumcision: pathogenesis and possible prevention<br />
|journal=Isr J Med Sci<br />
|date=1981<br />
|volume=17<br />
|issue=1<br />
|pages=45-48<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Cohen<br />
|first=H.A.<br />
|last2=Drucker<br />
|first2=M.M.<br />
|last3=Vainer<br />
|first3=S.<br />
|etal=yes<br />
|title=Postcircumcision urinary tract infection<br />
|journal=Clin Pediatr<br />
|date=1992<br />
|volume=31<br />
|issue=6<br />
|pages=322-324<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Goldman<br />
|first=M.<br />
|last2=Barr<br />
|first2=J.<br />
|last3=Bistritzer<br />
|first3=T.<br />
|last4=Aladjem<br />
|first4=M.<br />
|title=Urinary tract infection following ritual Jewish circumcision<br />
|journal=Isr J Med Sci<br />
|date=1996<br />
|volume=32<br />
|issue=<br />
|pages=1098-1102<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
* It can be concluded that circumcision is ineffective as a preventive measure against UTIs.<br />
* Penile and cervical cancer / HPV: first studies on those diseases and their assumed prevention by circumcision date back to 1932, a time when the cause for those illnesses was not yet fully understood<br />
<ref>{{REFjournal<br />
|last=Wolbarst<br />
|first=A.<br />
|title=Circumcision and penile cancer<br />
|journal=Lancet<br />
|date=1932<br />
|volume=1<br />
|issue=5655<br />
|pages=150-153<br />
|url=<br />
|accessdate=<br />
}}</ref>. Today, it is known that sexually transmitted human papillomavirus (HPV) is a major risk factor<ref>{{REFjournal<br />
|last=McCance<br />
|first=D.J.<br />
|last2=Kalache<br />
|first2=A.<br />
|last3=Ashdown<br />
|first3=K.<br />
|etal=yes<br />
|title=Human papillomavirus types 16 and 18 in carcinomas of the penis from Brazil<br />
|journal=Int J Cancer<br />
|date=1986<br />
|volume=37<br />
|issue=1<br />
|pages=55-59<br />
|url=<br />
|accessdate=<br />
}}</ref>, as well as smoking<ref>{{REFjournal<br />
|last=Harish<br />
|first=K.<br />
|last2=Ravi<br />
|first2=R.<br />
|title=The role of tobacco in penile carcinoma<br />
|journal=Brit J Urol<br />
|date=1995<br />
|volume=75<br />
|issue=3<br />
|pages=375-377<br />
|url=<br />
|accessdate=<br />
}}</ref>. Studies have shown that there is no significant difference in the risk of getting penile cancer between circumcised and intact men. To prevent a single case of penile cancer, it would statistically take 600 to 900 circumcisions<ref>{{REFdocument<br />
|title=Position Paper on Neonatal Circumcision<br />
|url=<br />
|contribution=<br />
|last=<br />
|first=<br />
|publisher=American Academy of Family Physicians (Leawood, Kansas)<br />
|format=<br />
|date=2002-02-14<br />
|accessdate=<br />
}}</ref>. The influence of circumcision on the infection risk of the female partner with cervical cancer has been refuted several times as well. HPV vaccination is an effective measure against carcinoma of the cervix.<br />
<br />
In conclusion, circumcision does not provide any proven benefits in preventive medicine.<br />
<br />
== Non-medical indications for circumcision ==<br />
<br />
Apart from the medical indication of pathological phimosis, there also are other reasons for circumcision.<br />
<br />
=== Aesthetic reasons ===<br />
<br />
The visual appearance of the [[penis]] is changed radically after circumcision. In this case, personal taste is decisive whether an intact or a cut [[penis]] is more appealing. Since a circumcision cannot be undone, it is essential to be fully informed about the risks and possible later complications before embarking on an aesthetically motivated circumcision, to decide whether the appearance will justify such bodily modification.<br />
<br />
Since this modification and its possible late effects will be the lifelong burden of the person who undertakes an aesthetically motivated circumcision to suit his personal preferences, a valid decision to proceed can only be made by the person to be circumcised himself, once he has reached the necessary age and level of maturity to make that decision. This should normally be the case when adulthood is reached.<br />
<br />
It should be noted that every circumcision operation leaves a life-long [[circumcision scar]] that encircles the shaft of the penis.<br />
<br />
===Financial reasons===<br />
<br />
In the United States, payment for non-therapeutic circumcision is made by most [[third-party payment| third-party payers]] without question. Doctors frequently perform medically-unnecessary, non-therapeutic circumcision of infants and children simply to collect a fee for the surgical operation. The only beneficiary of such surgery is the [[Financial Incentive| bank account of the medical doctor]].<br />
<br />
=== Moral reasons ===<br />
<br />
With the [[foreskin]], circumcision removes approximately 70% of the sensitive tissue of the [[penis]], lowering the potential for sexual stimulation accordingly. Due to the loss of around 50% of the entire penile skin, the [[penis]] loses the reserve skin that provides cutaneous mobility in the erect [[penis]] and the [[gliding action]].<br />
<br />
In the past, this circumstance was used to make it harder for boys to masturbate and [[masturbation]] less fun, as [[masturbation]] was viewed as immoral and was assumed to cause a variety of diseases. More on that can be found in the chapter "[[Circumcision#Historical_background|Historical background]]". Today, it is known that [[masturbation]] has no negative health effects, but can contribute positively to the child's sexual development. Sexuality is no longer a taboo nowadays, while [[masturbation]] is considered to be a natural part of human sexuality and is no longer seen as immoral. Therefore, circumcision for moral reasons - which would only affect boys too young to give informed consent - is no longer justifiable nowadays.<br />
<br />
=== Hygiene reasons ===<br />
<br />
''Hygiene'' refers to health and only secondarily to cleanliness. <br />
<br />
One should note that the human foreskin is endowed by nature with [[Foreskin#Immunological_functions| immunological functions]] that serve to protect the human body from disease.<ref name="fleiss-hodges-vanhowe1998" /> The glans penis receives blood through the frenular artery.<ref>{{REFjournal<br />
|last=Persad<br />
|first=R.<br />
|author-link=<br />
|last2=Sharma<br />
|first2=S.<br />
|author2-link=<br />
|last3=McTavish<br />
|first3=J.<br />
|author3-link=<br />
|etal=yes<br />
|title=Clinical presentation and pathophysiology of meatal stenosis following circumcision<br />
|journal=Brit J Urol<br />
|date=1995<br />
|volume=75<br />
|issue=1<br />
|pages=91-3<br />
|url=https://www.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.1995.tb07242.x<br />
|quote=<br />
|pubmedID=7850308 <br />
|pubmedCID=<br />
|DOI=10.1111/j.1464-410x.1995.tb07242.x<br />
|accessdate=2019-11-26<br />
}}</ref> These facts are generally overlooked in arguments for alleged hygienic benefits of circumcision.<br />
<br />
A common reason stated for circumcision is the assumption of hygienic benefits. This argument has to be viewed in the context of the environment the person in question grows up in. It is commonly known that bad hygienic circumstances, especially insufficient access to clean drinking water, pose a serious problem. The situation in disaster areas or refugee camps in the so-called third world keep reminding us of that.<br />
<br />
In western industrial nations, however, this problem does not exist, in view of the availability of clean water for daily personal hygiene. If the cleaning of the genitals is performed on a daily basis - and that may be assumed - no pathogens can accumulate under the [[foreskin]]. Cleaning of the [[Glans penis|glans]] and the area underneath the [[foreskin]] is easy - they are simply washed along with the rest of the body, just like the areas between the toes.<br />
<br />
In small boys, where the [[foreskin]] cannot be retracted yet, cleaning is not necessary, since the [[Synechia| membrane]] that fuses the [[foreskin]] to the [[Glans penis|glans]] prevents the accumulation of micro-organisms. The so-called "ballooning", where the [[foreskin]] inflates during urination, is not a serious problem.<br />
<br />
The opening of the [[foreskin]] in small boys is often quite narrow and serves as a one-way valve, allowing the urine to flow out, but preventing entry of microbes, for example from a dirty diaper. As long as the child is able to pass water, everything works as nature intended.<br />
<br />
But even in areas where there are poorer hygienic conditions and an insufficient access to medical care, the benefits of easier cleaning of a circumcised [[penis]] are to be viewed with a critical eye. Although even longer periods without personal hygiene will not result in an accumulation of germs under the [[foreskin]], circumcision itself is not without risk of complications. If the operation is carried out without proper sterility, there is a high risk of an infection of the wound. This also applies to the treatment of common complications like post-operative bleeding.<br />
<br />
The benefit of easier cleaning must be balanced against the risk of promoting serious infections - among others HIV - during the operation. In parts of Africa, several dozen of one tribe's boys die each year as a result of their circumcision.<br />
<br />
<br />
== Circumcision methods ==<br />
<br />
The [[Circumcision methods]] are discussed in a separate article.<br />
<br />
== Risks and late effects ==<br />
<br />
Just like tonsil or appendix surgery, circumcision is a surgical intervention and brings the usual risks related to surgical operations, alongside several specific risks of complications and late effects.<br />
<br />
=== Possible operative and postoperative complications ===<br />
<br />
Circumcision is surgery. Surgical complications of circumcision generally may be classified as hemorrhage, infection, or surgical misadventure up to and including loss of the penis and [[death]].<ref name="williams-kapilla1993">{{REFjournal<br />
|last=Williams<br />
|first=N<br />
|author-link=<br />
|last2=Kapilla<br />
|first2=L<br />
|author2-link=<br />
|etal=no<br />
|title=Complications of circumcision<br />
|trans-title=<br />
|language=<br />
|journal=Brit J Surg<br />
|location=<br />
|date=1993-10<br />
|volume=80<br />
|issue=10<br />
|pages=1231-6<br />
|url=http://www.cirp.org/library/complications/williams-kapila/<br />
|quote=<br />
|pubmedID=8242285<br />
|pubmedCID=<br />
|DOI=10.1002/bjs.1800801005<br />
|accessdate=2019-11-27<br />
}}</ref><br />
<br />
* Intolerance or allergic reactions to the narcotics used.<br />
* Especially in newborns, where the bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is often insufficient for the operation. Even in conjunction with regional anaesthesia of the dorsal nerve of the [[penis]], the rate of failure to provide sufficient anaesthetic even for experienced anaesthetists is still 5-10%. The general anaesthesia that would be needed for newborns, however, poses significant risks for the child, and, therefore, is only likely to be used in emergencies. A surgical operation without proper pain control can lead to the development of a specific pain memory<ref>{{REFweb<br />
|url=http://www.spiegel.de/spiegel/vorab/experte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-849534.html<br />
|title=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder<br />
|trans-title=Children's pain expert warns: Ritual circumcision changes the brain of children<br />
|language=German<br />
|last=Prof. Dr. med. Boris Zernikow<br />
|first=<br />
|publisher=Spiegel Online<br />
|website=<br />
|date=2012-08-12<br />
|accessdate=2019-10-11<br />
|format=<br />
|quote=<br />
}}</ref>. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation. Overall, their pain threshold was lower and the risk of chronic pain increased. Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFjournal<br />
|last=Garry<br />
|first=T.<br />
|title=Circumcision: a survey of fees and practices<br />
|journal=OBG Management<br />
|date=1994<br />
|volume=October<br />
|issue=<br />
|pages=34-36<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Howard<br />
|first=C.R.<br />
|last2=Howard<br />
|first2=F.M.<br />
|last3=Garfunkel<br />
|first3=L.C.<br />
|last4=de Blieck<br />
|first4=E.A.<br />
|last5=Weitzman<br />
|first5=M.<br />
|title=Neonatal circumcision and pain relief: current training practices<br />
|journal=Pediatrics<br />
|date=1998<br />
|volume=101<br />
|issue=<br />
|pages=423-428<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Stang<br />
|first=H.J.<br />
|last2=Snellman<br />
|first2=L.W.<br />
|title=Circumcision practice patterns in the United States<br />
|journal=Pediatrics<br />
|date=1998<br />
|volume=101<br />
|issue=e5<br />
|pages=<br />
|url=<br />
|accessdate=<br />
|note=Link to [[AAP]] website<br />
}}</ref>. During procedures which take several minutes, babies tend to fall into a state of stupor, which in the past was falsely interpreted as peaceful sleep, nurturing the belief that babies felt no pain. Measurements taken in those cases revealed a typically 3- to 4-fold increase in cortisol levels, which equals a state of severe shock.<ref>{{REFjournal<br />
|last=Gunnar<br />
|first=M.R.<br />
|last2=Fisch<br />
|first2=R.O.<br />
|last3=Korsvik<br />
|first3=S.<br />
|last4=Donhowe<br />
|first4=J.M.<br />
|title=The effects of circumcision on serum cortisol and behavior<br />
|journal=Psychoneuroendocrinology<br />
|date=1981<br />
|volume=6<br />
|issue=3<br />
|pages=269-275<br />
|url=http://www.cirp.org/library/pain/gunnar/<br />
|accessdate=2019-11-26<br />
}}</ref><br />
* Postoperative wound pain, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions.<br />
* Postoperative pain from the exposure of the sensitive glans penis to clothing. This pain will endure for several weeks or even longer in some cases.<br />
* Postoperative bleeding of the wound. This can have severe consequences especially for very young infants, if they are not treated promptly. Their blood volume is only about 85 ml per kilogram of body weight, and even moderate blood loss can lead to hypovolaemia, hypovolaemic shock and even death.<ref>{{REFbook<br />
|last=<br />
|first=<br />
|year=2000<br />
|title=Paediatric Handbook<br />
|url=<br />
|work=<br />
|editors=Smart J, Nolan T.<br />
|edition=6<br />
|volume=<br />
|chapter=<br />
|pages=82<br />
|location=Victoria, Australia<br />
|publisher=Blackwell Science Asia<br />
|isbn=<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref><ref>{{REFdocument<br />
|title=Autopsy of Demetrius Manker<br />
|url=<br />
|contribution=Case 93-1711<br />
|last=Wetli<br />
|first=CV<br />
|publisher=Miami: Dade County Medical Examiner Department<br />
|format=<br />
|date=1993-06-23<br />
|accessdate=<br />
}}</ref> <ref>{{REFjournal<br />
|last=Hiss<br />
|first=J.<br />
|last2=Horowitz<br />
|first2=A.<br />
|last3=Kahana<br />
|first3=T.<br />
|title=Fatal haemorrhage following male ritual circumcision<br />
|journal=J Clin Forensic Med<br />
|date=2000<br />
|volume=7<br />
|issue=<br />
|pages=32-34<br />
|url=http://www.cirp.org/library/death/hiss1/<br />
|accessdate=2019-11-06<br />
}}</ref><ref>{{REFdocument<br />
|title=Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan<br />
|url=http://www.circumstitions.com/death-exsang.html<br />
|contribution=<br />
|last=Newell<br />
|first=TEC<br />
|publisher=Burnaby, B.C.: B.C. Coroner's Service<br />
|format=<br />
|date=2004-01-19<br />
|accessdate=2019-11-26<br />
}}</ref><br />
* Post operative [[lymphoedema]].<br />
* Postoperative infections. This includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.<ref>{{REFconference<br />
|last=Dr. med. Hartmann<br />
|first=Wolfgang<br />
|url=<br />
|place=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German)<br />
|title=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German)<br />
|date=2012-11-26<br />
|accessdate=<br />
}}</ref><br />
* [http://www.circumstitions.com/Restric/Botched9wd.html Wound dehiscence], meaning the separation of the edges of the wound or the tissue after suturing.<br />
* Adhesion between the surface or rim of the [[Glans penis|glans]] with the neighbouring penile skin, causing skin pockets and bridges, as well as visually unpleasant results like uneven scars, which make a re-circumcision necessary.<br />
* Postoperative [[phimosis]]: a phimotic ring can develop during scarring, which makes a re-circumcision necessary. According to a study by Blalock ''et al.''<ref>{{REFjournal<br />
|last=Blalock<br />
|first=H.J.<br />
|last2=Vemulakonda<br />
|first2=V.<br />
|last3=Ritchey<br />
|first3=M.L.<br />
|last4=Ribbeck<br />
|first4=M.<br />
|title=Outpatient management of [[phimosis]] Following newborn circumcision<br />
|journal=J Urol<br />
|date=2003<br />
|volume=169<br />
|issue=6<br />
|pages=2332-2334<br />
|url=http://www.cirp.org/library/complications/blalock1/<br />
|accessdate=2019-11-26<br />
}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal<br />
|last=Leitch<br />
|first=I.O.W.<br />
|title=Circumcision - a continuing enigma<br />
|journal=Aust Paediatr J<br />
|date=1970<br />
|volume=6<br />
|issue=<br />
|pages=59-65<br />
|url=http://www.cirp.org/library/general/leitch1/<br />
|accessdate=2019-12-15<br />
}}</ref> 5.5%.<br />
*<br />
* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], is cut during circumcision without being clamped and sutured at its origin separately, it starts to develop new branches over time, which can lead to the development of knots.<br />
* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro-penis) and induratio [[penis]] plastica (skewed penis).<br />
* Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis|glans]] or the [[penis]] can occur.<br />
* In rare cases, necrosis, gangrene, ischaemia, keloid formation and circulatory problems may also occur.<br />
* When the circumcision is followed by the ultra-orthodox Jewish ritual of Metzitzah B'Peh (which consists of sucking blood from the wound with the mouth), there is a risk of infection with [[herpes]] simplex type 1, which can lead to brain damage or death.<ref>{{REFweb<br />
|url=http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritual.html?_r=0<br />
|title=Baby’s Death Renews Debate Over a Circumcision Ritual<br />
|last=Robbins<br />
|first=Liz<br />
|date=2012-03-07<br />
|accessdate=2019-10-11<br />
}}</ref><br />
<br />
=== Physical late effects ===<br />
<br />
* An unavoidable late effect of any circumcision is the permanent loss of sexual sensitivity. This is partly due to the removal of sensory tissue. The [[foreskin]] contains very many nerve endings and touch receptors, which account for the major part of male sexual sensation. If the [[foreskin]] is removed, they can no longer provide sexual stimulation. It is also partly due to the fact that the surface of the [[Glans penis|glans]] reacts to the missing protection from friction and drying out by developing a callus layer. This reduces the sensitivity of the remaining nerves in the [[Glans penis|glans]] gradually over the years. The study conducted by Sorrells ''et al.''<ref>{{REFjournal<br />
|last=Sorrells<br />
|first=M.L.<br />
|last2=Snyder<br />
|first2=J..L.<br />
|last3=Reiss<br />
|first3=M.D.<br />
|etal=yes<br />
|title=Fine-touch pressure thresholds in the adult [[penis]]<br />
|journal=BJU Int<br />
|date=2007<br />
|volume=99<br />
|issue=<br />
|pages=864-869<br />
|url=<br />
|accessdate=<br />
}}</ref> found a significant reduction of sensitivity to touch for circumcised compared to intact [[penis]]es in adult males. Other studies revealed that circumcised men use condoms significantly less often than intact men, since they further limit the sexual sensitivity (see above).<br />
<br />
* Painful tension can occur when there is too little reserve skin left to support a full erection<ref>{{REFjournal<br />
|last=Taylor<br />
|first=J.R.<br />
|last2=Lockwood<br />
|first2=A.P.<br />
|last3=Taylor<br />
|first3=A.J.<br />
|title=The prepuce: <q>Specialized mucosa of the [[penis]] and its loss to circumcision</q><br />
|journal=British Journal of Urology<br />
|date=1996<br />
|volume=77<br />
|issue=<br />
|pages=291-295<br />
|url=<br />
|accessdate=<br />
}}</ref>. This risk is partly dependent on the anatomy of the [[penis]]. While some [[penis]]es already have the majority of their full size when flaccid ([[Flesh Penis]], or "[[shower]]"), others are rather short when flaccid and double or more their size during an erection ([[Blood Penis]], or "[[grower]]"). Especially in children's circumcision, where the [[penis]] is not yet fully developed, the amount of reserve skin needed in adulthood cannot be estimated.<br />
<br />
* Erectile dysfunction: Both the damage inflicted to the blood vessels in the [[foreskin]] and the reduced sexual sensitivity can be causes for reduced erectile function with advancing age.<ref>{{REFjournal<br />
|last=Money<br />
|first=J.<br />
|last2=Davison<br />
|first2=J.<br />
|title=Adult penile circumcision: Erotosexual and cosmetic sequelae<br />
|journal=Journal of Sex Research<br />
|date=1983<br />
|volume=19<br />
|issue=<br />
|pages=289-292<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
<br />
* Orgasm problems: In the wake of reduced sexual sensitivity, due to the loss of sensory tissue and gradual keratinization of the surface of the [[Glans penis|glans]], orgasm problems may develop with increasing age. In this case, the sexual arousal created by intercourse or [[masturbation]] is not enough to achieve orgasm. A preliminary stage of this late effect is the prolonged time circumcised men need to reach an orgasm. This is often fielded as the "cut men have more endurance" argument for circumcision.<br />
* Vaginal dryness: Due to the loss of the natural gliding action, which comes from the mobility of the fore- and shaft skin, a much increased friction between [[penis]] and vagina occurs during intercourse. This can make intercourse painful for both partners and lead to abrasions<ref>{{REFjournal<br />
|last=Frisch<br />
|first=Morten<br />
|author-link=Morten Frisch<br />
|first2=Morten<br />
|last2=Lindholm<br />
|first3=Morten<br />
|last3=Grønbæk<br />
|title=Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark<br />
|journal=International Journal of Epidemiology<br />
|date=2011-10<br />
|volume=40<br />
|issue=5<br />
|pages=1367-1381<br />
|url=<br />
|pubmedID=21672947<br />
|DOI=10.1093/ije/dyr104<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Cortés-González<br />
|first=J.<br />
|last2=Arratia-Maqueo<br />
|first2=J.<br />
|last3=Gómez-Guerra<br />
|first3=L.<br />
|title=Does circumcision has an effect on female's perception of sexual satisfaction?<br />
|journal=Rev Invest Clin<br />
|date=2008<br />
|volume=60<br />
|issue=3<br />
|pages=227<br />
|url=<br />
|pubmedID=18807735<br />
|accessdate=<br />
}}</ref> The prolonged time it takes circumcised men to reach orgasm, as well as the often longer and more vigorous thrusting movements - compared to intact men - play a part in this.<ref>{{REFjournal<br />
|last=Cold<br />
|first=C.J.<br />
|last2=Taylor<br />
|first2=J.R.<br />
|title=The prepuce<br />
|journal=BJU Int<br />
|date=1999<br />
|volume=83<br />
|issue=Suppl. 1<br />
|pages=34-44<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Fink<br />
|first=K.S.<br />
|last2=Carson<br />
|first2=C.C.<br />
|last3=DeVellis<br />
|first3=R.F.<br />
|title=Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction<br />
|journal=J Urol<br />
|date=2002<br />
|volume=167<br />
|issue=5<br />
|pages=2113-2116<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
<br />
* [[Lymphoedema]] of the penis is a normal and expected complication of male circumcision.<br />
<br />
* [[Meatal stenosis]], a pathological narrowing of the opening of the urethra, which mostly occurs in infancy and early childhood. It is one of the most common complications of infant circumcision. A study from 2006 found meatal stenosis exclusively in previously circumcised boys. The incidence rate after a circumcision is approximately 10 to 20 percent.<ref name="vanhowe2006">{{REFjournal<br />
|last=Van Howe<br />
|first=R.S.<br />
|title=Incidence of meatal stenosis following neonatal circumcision in a primary care setting<br />
|journal=Clin Pediatr (Phila)<br />
|note=Jan-Feb 2006<br />
|date=2006-01<br />
|volume=45<br />
|issue=1<br />
|pages=49-54<br />
|url=https://www.academia.edu/6992015/Incidence_of_Meatal_Stenosis_following_Neonatal_Circumcision_in_a_Primary_Care_Setting<br />
|accessdate=2019-12-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Stenram<br />
|first=A.<br />
|last2=Malmfors<br />
|first2=G.<br />
|last3=Okmian<br />
|first3=L.<br />
|title=Circumcision for [[phimosis]]: a follow-up study<br />
|journal=Scandinavian journal of urology and nephrology<br />
|date=1986<br />
|volume=20<br />
|issue=2<br />
|pages=89<br />
|url=<br />
|pubmedID=3749823<br />
|accessdate=<br />
}} </ref><ref>{{REFweb<br />
|url=http://emedicine.medscape.com/article/1016016-overview<br />
|title=Meatal Stenosis<br />
|publisher=Medscape<br />
|accessdate=2019-10-11<br />
}}</ref><br />
<br />
=== Psychological late effects ===<br />
<br />
[[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effects]] are also possible after a circumcision, especially if the operation was carried out in childhood. On this occasion a variety of trauma may occur, which depend, among others, on age and circumstances of the circumcision. For example, whether the circumcision took place with or without sufficient anaesthesia, if the individual has been informed about the operation beforehand, if he was circumcised against his will or without his consent, and also, in the case of infant circumcision, if he was told about it during childhood or had to find it out coincidentally on his own.<br />
<br />
The psychological late effects of circumcision are not yet fully researched, and many studies took place on rather a small scale. This situation needs to be rectified, because the available studies, as well as the histories of negatively affected men, suggest that these late effects may have more impact than previously assumed.<br />
<br />
* It was observed that infants, following circumcision without pain control, had a disturbed bond with their mother<ref>{{REFjournal<br />
|last=Marshall<br />
|first=R.E.<br />
|last2=Porter<br />
|first2=F.L.<br />
|last3=Rogers<br />
|first3=A.G.<br />
|etal=yes<br />
|title=Circumcision: II effects upon mother-infant interaction<br />
|journal=Early Hum Dev<br />
|date=1982<br />
|volume=7<br />
|issue=4<br />
|pages=367-374<br />
|url=http://www.cirp.org/library/birth/marshall2/<br />
|accessdate=2020-02-01<br />
}}</ref>, as well as problems with nurturing, up to the point of refusal to be fed. The sleeping habits of these babies were also disturbed, with prolonged non-REM sleep and increased waking.<br />
<br />
* In boys circumcised in childhood, post traumatic stress disorder (PTSD) could be diagnosed. In a study on Philippine boys, in whom no PTSD was found prior to the operation, 69% of the boys circumcised in the traditional ritual and 51% of those circumcised by standard medical procedures (including anaesthesia) fulfilled the DSM-IV criteria for PTSD following the operation.<ref>{{REFbook<br />
|last=Ramos<br />
|first=S<br />
|last2=Boyle<br />
|first2=GJ<br />
|year=2001<br />
|title=Understanding circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem<br />
|url=https://link.springer.com/chapter/10.1007/978-1-4757-3351-8_14<br />
|work=<br />
|editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]<br />
|edition=<br />
|volume=<br />
|chapter=Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder<br />
|pages=253-270<br />
|location=New York<br />
|publisher=Kluwer Academic/Plenum Publishers<br />
|isbn=<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref><br />
* Circumcisions, especially those that happen without consent, can spark feelings of helplessness and alienation, which can persist as trauma. These feeling can also be triggered later, when someone circumcised as an infant becomes aware of his circumcision. In an online study, interviewed men stated they felt betrayed - 55% by the mother, 50% by the father, and 58% by the doctor, and 73% felt that their human rights had been violated.<ref name="GSoCH">{{REFweb<br />
|url=http://www.circumcisionharm.org/<br />
|title=Global Survey of Circumcision Harm<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* It can frequently be found that the loss is denied, much as happens with the loss of other body parts. This denial can lead to fathers having their sons circumcised in order not to be reminded of their own loss. In this process, their own body is defined as "normal" and the [[foreskin]] redefined as a foreign object. Their own parents are seen as "good", so that this image is projected onto the circumcision their parents carried out as well, in order to keep the positive emotion intact. The father wants to be a "good" father later in life as well, and so, following an idealised image of his own parents, circumcision, which has been redefined as a "good thing", is passed on to his son by having him circumcised as well.<ref>{{REFjournal<br />
|last=van der Kolk<br />
|first=B.A.<br />
|url=http://www.cirp.org/library/psych/vanderkolk/<br />
|title=The compulsion to repeat the trauma: re-enactment, revictimization, and masochism<br />
|journal=Psychiatr Clin North Am<br />
|date=1989<br />
|volume=12<br />
|issue=2<br />
|pages=389-411<br />
|accessdate=2019-10-12<br />
}}</ref><ref>{{REFjournal<br />
|last=Goldman<br />
|first=R.<br />
|author-link=Ronald Goldman<br />
|url=http://www.cirp.org/library/psych/goldman1/<br />
|title=The psychological impact of circumcision<br />
|journal=BJU Int<br />
|date=1999<br />
|volume=83<br />
|issue=Suppl. 1<br />
|pages=93-103<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* If the circumcised male feels incomplete, or due to the missing [[foreskin]] disadvantaged compared to intact males, an inferiority complex and depression may occur. This can be accompanied by conscious recognition of his own incompleteness, or the deficiency may remain completely subconscious<ref>{{REFjournal<br />
|last=Rhinehart<br />
|first=J.<br />
|url=http://www.cirp.org/library/psych/rhinehart1/<br />
|title=Neonatal circumcision reconsidered<br />
|journal=Transactional Analysis J<br />
|date=1999<br />
|volume=29<br />
|issue=3<br />
|pages=215-221<br />
|accessdate=2019-10-12<br />
}}</ref>. In an online study, 75% of those interviewed stated that they felt incomplete, and 66% said they felt inferior compared with intact males.<ref name="GSoCH"/><br />
* Cases in which children felt ill treated or punished have been documented as well. G. Cansever found in her study on 12 boys aged between 4 and 7 years, who had previously been prepared for their impending circumcision, that the children experienced the operation as an aggressive assault on their bodies.<ref>{{REFjournal<br />
|last=Cansever<br />
|first=G.<br />
|date=1965<br />
|url=http://www.cirp.org/library/psych/cansever/<br />
|title=Psychological effects of circumcision<br />
|journal=Brit. J. Med. Psychol<br />
|volume=38<br />
|pages=321-331<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* Fear of being alone or darkness.<ref name="Levy1945">{{REFjournal<br />
|last=Levy<br />
|first=David M.<br />
|url=http://www.cirp.org/library/psych/levy1/<br />
|title=Psychic trauma of operations in children; and a note on combat neurosis<br />
|journal=American Journal of Diseases of Children<br />
|volume=69<br />
|date=1945<br />
|pages=7-25<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* Fear of doctors, clinics and also closed rooms.<ref name="Levy1945"/><br />
* Relapse into the state of bed-wetting, even if the child was already dry before.<ref name="Levy1945"/><br />
* Circumcised males who become fathers frequently manifest [[adamant father syndrome]].<br />
<br />
== Rights and ethics ==<br />
<br />
The [[Rights situation on circumcision|rights situation]] is discussed in separate article.<br />
<br />
<br />
-----<br />
<br />
<br />
{{FromIntactWiki<br />
|URL=http://intactwiki.org/wiki/Circumcision<br />
|Title=Circumcision<br />
}}<br />
<br />
[[Image:Intact vs circumcised.JPG |thumbnail|right|300px| The intact and circumcised human penis, side by side.]]<br />
<br />
The term "circumcision" without a gender qualifier refers specifically to male circumcision. It means "to cut around," and it refers to the excision of the [[foreskin]] from the penis. Circumcision is most often performed in healthy males for [[Religion and Culture|religious or cultural]] reasons. The procedure may be performed on consenting adults, but it is most often performed on non-consenting minors, particularly newborn children, which is why the ritual is so controversial. Opponents of circumcision consider the circumcision of non-consenting minors to be unethical and a human rights violation, unless there is concrete medical indication. Proponents of circumcision consider the circumcision of non-consenting minors to be a "religious freedom" and a "parental right."<br />
<br />
== Complications ==<br />
=== Pain ===<br />
In the past, advocates of circumcision claimed that a newborn child's nerve system was not yet fully developed, and that as a result, the child felt no pain during the circumcision procedure. Anand & Hickey (1987) have shown that newborn children do in fact feel pain, and more acutely than adults.<ref name="anand-hickey1987">{{REFjournal<br />
|last=Anand<br />
|first=<br />
|author-link=<br />
|last2=Hickey<br />
|first2=<br />
|author2-link=<br />
|etal=no<br />
|title=Pain and its effects in the human neonate and fetus<br />
|trans-title=<br />
|language=<br />
|journal=New Engl J Med<br />
|location=<br />
|date=1987-11-19<br />
|volume=317<br />
|issue=21<br />
|pages=1321-9<br />
|url=http://www.cirp.org/library/pain/anand/<br />
|quote=<br />
|pubmedID=3317037<br />
|pubmedCID=<br />
|DOI=<br />
|accessdate=2019-11-08<br />
}}</ref> This has led American health associations to recommend doctors take measures to reduce the pain of circumcision in infants.<br />
<br />
The [[Position Statements on Infant Circumcision|AAP Circumcision Policy Statement]] states quite clearly that ''"There is considerable evidence that newborns who are circumcised without analgesia experience pain and physiologic stress"''. Furthermore, the pain is quite severe, and requires injections for proper pain management. Sucrose and Acetaminophen ''"cannot be recommended as the sole method of analgesia"''. Topical cream is no longer thought sufficient as ''"the analgesic effect is limited during the phases associated with extensive tissue trauma such as...tightening of the clamp"''.<ref>{{REFjournal<br />
|last=<br />
|first=<br />
|title=American Academy of Pediatrics: Circumcision Policy Statement; Task Force on Circumcision<br />
|journal=Pediatrics<br />
|date=1999-03<br />
|volume=103<br />
|issue=3<br />
|pages=686-693<br />
|url=https://pediatrics.aappublications.org/content/103/3/686#sec-9<br />
|accessdate=2019-11-26<br />
|note=Statement Reaffirmed Sept. 1, 2005<br />
}}</ref><br />
<br />
The [[AAFP]] states quite simply in their [[Position Statements on Infant Circumcision|position paper]], ''"Newborns experience pain during circumcision".''<ref>{{REFweb<br />
|title=Circumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed<br />
|website=Official American Academy of Family Physicians Website<br />
|url=http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html<br />
|accessdate=2011-05-02<br />
}}</ref> This is not a debatable fact, and yet, it is not widely accepted, even by some doctors. It might be hard for some doctors to accept, as they may have been taught that the infant does not feel pain, and may have performed countless circumcisions with this idea. Usage of anesthesia for infant circumcision is still by no means the rule.<br />
<br />
Penile injections of anesthetic are now recommended by all of the major medical institutions. In their [http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml Report 10 of the Council on Scientific Affairs], the AMA states ''"When the decision is made to proceed with circumcision, local anesthesia should be provided for the procedure. Ring block or dorsal penile blocks [injections] are most effective. EMLA cream has limited utility"''. Alarmingly, ''"Despite the clear evidence that newborn males generate brisk pain responses during circumcision, a recent survey of residency training programs found that 26% of programs that taught circumcision provided no instruction on the use of local anesthesia". The AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, and 25% of obstetricians"''.<ref>{{REFweb<br />
|title=Report 10 of the Council on Scientific Affairs (I-99): Neonatal Circumcision<br />
|website=American Medical Association Official Website<br />
|url=http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml<br />
|accessdate=2011-05-04<br />
}}</ref><br />
<br />
The AAP's [http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx Heatlhy Children website] suggests ''"Your pediatrician (or your obstetrician) should discuss the forms of analgesia that are available"''.<ref>{{REFweb<br />
|title=Where We Stand: Circumcision<br />
|publisher=[[AAP]]<br />
|date=2011-03-23<br />
|url=http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx<br />
|accessdate=2019-10-12<br />
}}</ref> Be that as it may, few forms of analgesia are recommended. There are basically two types of injections to choose from, and the website does not go into the difference between a 'dorsal nerve block' and a 'ring block' injection.<br />
<br />
Given what is known from aforementioned official documents, the AAP website may be more informative and effective if it would say ''"Make sure your doctor knows of the ineffectiveness of anything short of local anesthesia, and make sure your baby is given an injection. This is your responsibility, because your doctor may or may not be up to date on the latest understandings of infant sensitivity to pain during circumcision."'' The AAP may be holding back, however, perhaps because this would upset the doctor/parent power relationship, and may cause too much questioning of doctors in general. One may not expect to find this kind of advice on such a website, and yet, anything less than this is a dangerously weak statement.<br />
<br />
To control pain, some physicians that circumcise use Tylenol, sugar,<ref>{{REFweb<br />
| quote=To calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, and soothing music is played in the room.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-guide.html<br />
| title=Parents' Guide to Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2011-04-08<br />
}}</ref><ref>{{REFweb<br />
| quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> a topical cream,<ref>{{REFweb<br />
| quote=Then in our office, he will have topical anesthetic applied to his penis.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb<br />
| quote=We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-guide.html<br />
| title=Parents' Guide to Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2011-04-08<br />
}}</ref> Topical anaesthetic only serves to numb the area to lessen the pain of the injection, but studies have shown that a dorsal penile ring block is not always effective in stopping the pain of circumcision.<ref name='Journal of Perinatology April/May 2002'>{{REFjournal<br />
|last=Taeusch<br />
|first=H. William<br />
|last2=Martinez<br />
|first2=Alma M.<br />
|last3=Partridge<br />
|first3=J. Colin<br />
|last4=Sniderman<br />
|first4=Susan<br />
|last5=Armstrong-Wells<br />
|first5=Jennifer<br />
|last6=Fuentes-Afflick<br />
|first6=Elena<br />
|title=Pain During Mogen or Plastibell Circumcision<br />
|journal=Journal of Perinatology<br />
|volume=22<br />
|issue=3<br />
|pages=214-218<br />
|url=http://www.nature.com/jp/journal/v22/n3/full/7210653a.html<br />
|quote=...more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|note=April/May 2002<br />
|date=2002-04<br />
|accessdate=2011-04-08<br />
}}</ref><ref name='Clinical Pediatrics August 1986'>{{REFjournal<br />
|last=Williamson<br />
|first=Paul S.<br />
|last2=Evans<br />
|first2=Nolan Donovan<br />
|title=Neonatal Cortisol Response to Circumcision with Anesthesia<br />
|journal=Clinical Pediatrics<br />
|volume=25<br />
|issue=8<br />
|pages=412-416<br />
|url=http://cpj.sagepub.com/content/25/8/412.abstract<br />
|quote=The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=1986-08<br />
|accessdate=2011-04-08<br />
}}</ref> During circumcision, somp physicians give children sugar pacifiers to "reduce the perception of pain",<ref>{{REFweb<br />
| quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> but in at least one study, data shows that giving sugar to a child doesn't help to reduce the perception of pain in the child.<ref name='Lancet, The 2010-10-09'>{{REFjournal<br />
|last=Slater<br />
|first=Rebeccah<br />
|first2=Laura<br />
|last2=Cornelissen<br />
|first3=Lorenzo<br />
|last3=Fabrizi<br />
|first4=Debbie<br />
|last4=Patten<br />
|first5=Jan<br />
|last5=Yoxen<br />
|first6=Alan<br />
|last6=Worley<br />
|first7=Stewart<br />
|last7=Boyd<br />
|first8=Judith<br />
|last8=Meek<br />
|first9=Maria<br />
|last9=Prof. Fitzgerald<br />
|title=Oral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial<br />
|journal=The Lancet<br />
|volume=376<br />
|issue=9748<br />
|pages=1225-1232<br />
|url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2961303-7/fulltext<br />
|quote=Our data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuits, and therefore might not be an effective analgesic drug. The ability of sucrose to reduce clinical observational scores after noxious events in newborn infants should not be interpreted as pain relief.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=2010-10-09<br />
|accessdate=2011-04-08<br />
}}</ref> Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals.<br />
<br />
It has been shown that an infant's response to pain can be altered for years as a consequence of circumcision.<ref>{{REFjournal<br />
|last=Taddio<br />
|first=Anna<br />
|first2=Morton<br />
|last2=Goldbach<br />
|first3=Moshe<br />
|last3=Ipp<br />
|first4=Bonnie<br />
|last4=Stevens<br />
|first5=Gideon<br />
|last5=Koren<br />
|title=Effect of neonatal circumcision on pain responses during vaccination in boys<br />
|journal=The Lancet<br />
|volume=345<br />
|issue=8945<br />
|pages=291-2<br />
|url=http://www.cirp.org/library/pain/taddio/<br />
|quote=<br />
|pubmedID=7837863<br />
|pubmedCID=<br />
|DOI=<br />
|date=1995<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Taddio<br />
|first=Anna<br />
|last2=Katz<br />
|first2=J.<br />
|last3=Ilersich<br />
|first3=A.L.<br />
|last4=Koren<br />
|first4=G.<br />
|title=Effects of neonatal circumcision on pain response during subsequent routine vaccination<br />
|journal=The Lancet<br />
|volume=349<br />
|issue=9052<br />
|pages=599-603<br />
|url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)10316-0/fulltext<br />
|quote=<br />
|pubmedID=9057731<br />
|pubmedCID=<br />
|DOI=10.1016/S0140-6736(96)10316-0<br />
|date=1997-03<br />
|accessdate=<br />
}}</ref><br />
<br />
=== Sexual effects ===<br />
<br />
Circumcision and frenectomy remove tissues with heightened erogenous sensitivity. Boyle ''et al.'' (2002) wrote, "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings&mdash;many of which are lost to circumcision."<ref>{{REFjournal<br />
|last=Boyle<br />
|first=Gregory J.<br />
|author-link=Gregory Boyle<br />
|first2=Gillian A.<br />
|last2=Bensley<br />
|title=Adverse Sexual and Psychological Effects of Male Infant Circumcision<br />
|journal=Psychological reports<br />
|volume=88<br />
|issue=3, Part 2<br />
|pages=1105–1106<br />
|url=http://www.cirp.org/library/psych/boyle5/<br />
|quote=<br />
|pubmedID=11597060<br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410x.1999.0830s1085.x<br />
|date=July 2001<br />
|accessdate=<br />
}}</ref> They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well."<br />
<br />
The amputation of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the penis, leaving only the uninhibited protopathic sensibility of the artificially externalized glans penis. The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of the changes in sexual behavior noted in circumcised human males.<ref>{{REFjournal<br />
|last=Van Howe<br />
|first=R.S.<br />
|author-link=Robert Van Howe<br />
|last2=Cold<br />
|first2=C.J.<br />
|title=Advantages and Disadvantages of Neonatal Circumcision<br />
|journal=The Journal of the American Medical Association<br />
|volume=277<br />
|issue=13<br />
|pages=1052-7<br />
|url=http://www.ncbi.nlm.nih.gov/pubmed/9218663<br />
|quote=<br />
|pubmedID=9218663<br />
|pubmedCID=<br />
|DOI=<br />
|date=1997-04-02<br />
|accessdate=<br />
}}</ref><br />
<br />
Histology of the male circumcision scar shows amputation neuromas, Schwann cell proliferation and the bulbous collection of variably sized neurites. Amputation neuromas do not mediate normal sensation and are notorious for generating pain.<ref>{{REFjournal<br />
|last=Cold<br />
|first=C.J.<br />
|first2=J.R.<br />
|last2=Taylor<br />
|title=The prepuce<br />
|journal=British Journal of Urology International<br />
|volume=83<br />
|issue=<br />
|pages=34-44<br />
|url=http://www.cirp.org/library/anatomy/cold-taylor/<br />
|quote=<br />
|pubmedID=10349413<br />
|pubmedCID=<br />
|DOI=<br />
|date=1999-1<br />
|accessdate=<br />
}}</ref><br />
<br />
=== Death ===<br />
A study in 2010 estimated approximately 117 neonatal circumcision-related deaths occur annually in the United States, about one out of every 77 male neonatal deaths, more than suffocation, auto accidents, or even SIDS.<ref name="Bollinger 2010">{{REFjournal<br />
|last=Bollinger<br />
|first=Dan<br />
|author-link=Dan Bollinger<br />
|last2=Boy's Health Advisory<br />
|title=Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths<br />
|journal=Thymos: Journal of Boyhood Studies<br />
|volume=4<br />
|issue=1<br />
|pages=78-90<br />
|url=http://www.mensstudies.com/content/b64n267w47m333x0/?p=7ebbd6b446d940cbbd4274c095754b12π=5<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.3149/thy.0401.78<br />
|date=2010-04-26<br />
|accessdate=2019-10-12<br />
}}</ref><ref>{{REFweb<br />
| quote=<br />
| url=http://www.icgi.org/2010/04/infant-circumcision-causes-100-deaths-each-year-in-us<br />
| title=Infant circumcision causes 100 deaths each year in US<br />
| last=<br />
| first=<br />
| publisher=ICGI<br />
| website=International Coalition for Genital Integrity<br />
| date=2010-04-26<br />
| accessdate=<br />
}}</ref> See also the list of [[fatalities]].<br />
<br />
== Forced circumcision ==<br />
<br />
<!--=== United States military ===<br />
<br />
American soldiers serving in World War II were subjected to regular inspections of their genitals. If uncircumcised, the soldiers risked being ordered to undergo immediate circumcision.<ref>{{REFbook<br />
|last=Schoen<br />
|first=Ed<br />
|author-link=Edgar J. Schoen<br />
|year=2005<br />
|title=On Circumcision<br />
|url=https://books.google.de/books?id=-zUhdvSt7cgC<br />
|work=<br />
|editor=Dianne Yeakey<br />
|edition=<br />
|volume=<br />
|chapter=<br />
|pages=72-73<br />
|location=Georgetown, Canada<br />
|publisher=RDR Books<br />
|isbn=1-157143-123-3<br />
|quote=For a critical view, see Sorrells, "The History of Circumcision," p. 333<br />
|accessdate=<br />
|note=<br />
}}</ref> This practice was discontinued at least six decades ago.--><br />
<br />
=== Non-therapeutic circumcision of male children ===<br />
<br />
Human babies, because they are not yet in possession of language, are incapable of giving or refusing consent for being circumcised. The element of force has led some scholars to view the circumcision of baby boys as a category of forced circumcision.<ref>For example, Frederick M. Hodges, a medical historian, writes: "In the late 1970s, as the Americans were growing increasingly aware of the abuses of power rampant throughout the nation's social institutions, influential grass-roots movements protesting the forced circumcision of American children sprang up nationwide." F. Hodges, "A Short History," p. 31; see also [[Leonard B. Glick|Glick]], ''Marked in Your Flesh'', pp. 273-281.</ref> There are, however, physicians in the United States who argue strongly for non-therapeutic circumcision of newborn babies; and circumcision is widely accepted as a postnatal procedure in American hospitals.<ref>{{REFbook<br />
|last=Fletcher<br />
|first=Christopher R.<br />
|year=1999<br />
|title=Circumcision in America in 1998: Attitudes, Beliefs, and Charges of American Physicians<br />
|url=http://www.springerlink.com/content/h2150v731233m177/<br />
|work=Male and Female Circumcision<br />
|editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]<br />
|edition=<br />
|volume=<br />
|chapter=Section 5<br />
|pages=259-271<br />
|location=New York<br />
|publisher=Kluwer Academic/Plenum Publishers<br />
|isbn=<br />
|quote=<br />
|accessdate=2019-10-12<br />
|note=ID 10.1007/978-0-585-39937-9_19<br />
}}</ref> Parental consent is required.<ref>See, e.g., Shephard and Shephard, ''The Complete Guide'', p. 125.</ref> A statement published by the American Academy of Pediatrics in 1999 declares that "parents should determine what is in the best interest of the child... It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in additions to the medical factors, when making a decision."<ref>Lannon and Bailey, "Circumcision Policy Statement," p. 691.</ref> In the United Kingdom, where non-therapeutic circumcision has now become far less prevalent than in the United States, a written consent of both parents is required, if a physician is to perform a non-therapeutic circumcision of a child.<ref>{{REFjournal<br />
|last=<br />
|first=<br />
|title=Re J (child's religious upbringing and circumcision)<br />
|journal=Family Court Reports<br />
|date=2000<br />
|volume=1<br />
|issue=<br />
|pages=307-314<br />
|url=http://www.cirp.org/library/legal/Re_J/2000.html<br />
|accessdate=2019-10-12<br />
}}</ref> (The National Health Service does not provide non-therapeutic circumcision.)<br />
<br />
In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<ref>See, e.g., Somerville, "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; Chessler, "Justifying the Unjustifiable"; Smith, "Male Circumcision."</ref> For example, critics have pointed out that, in the United States, more than 1.3% of male neonatal deaths are attributable to the complications of non-therapeutic circumcision surgery.<ref name="Bollinger 2010"/>refer<ref>{{REFweb<br />
|quote=<br />
|url=http://www.icgi.org/2010/04/infant-circumcision-causes-100-deaths-each-year-in-us<br />
|title=Infant circumcision causes 100 deaths each year in US<br />
|last=Bollinger<br />
|first=Dan<br />
|author-link=Dan Bollinger<br />
|publisher=International Coalition for Genital Integrity<br />
|date=2010-04-26<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
{{SEEALSO}}<br />
* [[Sexual effects of circumcision]]<br />
* [[FGM]]<br />
* [[MGM]]<br />
* [[Risks and complications]]<br />
* [[Documented severe complications of circumcision]]<br />
* [[Circumcision scar]]<br />
* [[Circumpendium]]<br />
* [[Human rights]]<br />
* [[Ethics of non-therapeutic child circumcision]]<br />
* [[Rights situation on circumcision]]<br />
* [[Circumcision methods]]<br />
* [[Case Histories]]<br />
* [[Lymphoedema]]<br />
* [[Psychological issues of male circumcision]]<br />
<br />
{{REF}}<br />
<br />
[[Category:From Intactipedia]]<br />
[[Category:From IntactWiki]]<br />
[[Category:Male circumcision]]<br />
[[Category:Genital surgery]]<br />
[[Category:Terms]]<br />
[[Category:Islam]]<br />
[[Category:Judaism]]<br />
[[Category:Circumcision]]<br />
[[de:Zirkumzision]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Child_circumcision&diff=14352Child circumcision2020-05-04T18:25:06Z<p>WikiModEn4: /* Search for prophylactic reasons */</p>
<hr />
<div>{{GraphicWarning}}<br />
"Male '''circumcision''' (from Latin ''circumcidere'', meaning "to cut around") is the surgical removal of the [[foreskin]] (prepuce) part of the human [[penis]]. The foreskin comprises ''more than fifty percent'' of the epithelium of the penis.<ref name="taylor1996">{{REFjournal<br />
|last=Taylor<br />
|first=J.R.<br />
|author-link=John R. Taylor<br />
|last2=Lockwood<br />
|first2=A.P.<br />
|author2-link=<br />
|last3=Taylor<br />
|first3=A.J.<br />
|title=The prepuce: specialized mucosa of the penis and its loss to circumcision<br />
|journal=Brit J Urol<br />
|date=1996<br />
|volume=77<br />
|issue=<br />
|pages=291-5<br />
|url=http://onlinelibrary.wiley.com/doi/10.1046/j.1464-410X.1996.85023.x/full<br />
|quote=<br />
|pubmedID=8800902<br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410X.1996.85023.x<br />
|accessdate=2019-10-14<br />
}}</ref> [...] The procedure is most often an elective non-therapeutic surgery performed on neonates and children for religious and cultural reasons, but in other cases may be indicated for both therapeutic and prophylactic reasons. It is a radical treatment option for pathological [[phimosis]], refractory [[Balanitis| balanoposthitis]] and chronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health. <br />
<br />
'''Posthectomy''' is a more accurate medical term that more accurately reflects the injury and loss of functional body tissue, but the Biblical euphemism, ''circumcision'', is more commonly used. <br />
<br />
With reference to involuntary, non-therapeutic circumcision of children, [[Child Genital Cutting (CGC)]] is a new term that has been introduced to avoid issues associated with more traditional terms.<br />
<br />
== Historical background ==<br />
<br />
The amputation of the [[foreskin]] is a very old ritual, whose exact origin cannot be verified beyond doubt. Medical historians assume that circumcision already served in ancient history as a way to control the sexuality of slaves and members of the lower classes without compromising their ability to reproduce. In religious history circumcision may be seen as a substitute for human sacrifice. In prehistoric times it was not uncommon to placate the gods with human sacrifice. Castration of slaves or conquered enemies was common as well. Following religious changes this sacrifice was altered, and only a part of the very organ responsible for the creation of new life was sacrificed.<br />
<br />
[[Image:Circumcision Sakkara 3.jpg|200px|right]] For the Aborigines, the Australian natives, the tradition of circumcision is said to go back to 10,000 BC. On the African continent, the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of circumcision date back to the time around 3000-2000 BC. The oldest known depiction<ref>{{REFweb<br />
|url=https://commons.wikimedia.org/wiki/File:Circumcision_Sakkara_3.jpg<br />
|title=File:Circumcision Sakkara 3.jpg<br />
|accessdate=2019-10-12<br />
}}</ref> is an Egyptian tomb relief from the 6th dynasty, approximately 2300-2000 BC. It is not known precisely who was circumcised and why in those times.<br />
<br />
In many cultures circumcision during puberty serves as a rite of passage, bringing adolescents into the community. As with other painful or humiliating initiation rites, proof of courage and mastering of critical situations are the key motivations. From some African tribes it is also known that the amputation of the [[foreskin]] is seen as the removal of an inborn piece of femininity from the boys, thus making them men.<br />
<br />
===Judaism===<br />
<br />
In the Jewish religion, the tradition of circumcision goes back to a passage in the Book of Genesis (17, 10-14). It is seen as a [[Abrahamic covenant| covenant between God and man]], dating back to the patriarch Abraham.<br />
<br />
{{Citation<br />
|Text=10 This is my covenant with you and your descendants after you, the covenant you are to keep: Every male among you shall be circumcised. 11 You are to undergo circumcision, and it will be the sign of the covenant between me and you. 12 For the generations to come every male among you who is eight days old must be circumcised, including those born in your household or bought with money from a foreigner—those who are not your offspring. 13 Whether born in your household or bought with your money, they must be circumcised. My covenant in your flesh is to be an everlasting covenant. 14 Any uncircumcised male, who has not been circumcised in the flesh, will be cut off from his people; he has broken my covenant.” <br />
|Author=Bible<br />
|Source=Gen 17, 10-14, NIV<br />
}}<br />
<br />
According to the anthropologist and sociologist Nissan Rubin, the Jewish form of circumcision, called ''[[Brit Milah| brit mila]]'', during the first two millennia did not include the later customary ''periah'', namely the complete scraping of the inner [[foreskin]] from the [[Glans penis|glans]]. This was only added around 135 AD, to make it impossible to restore the [[foreskin]] by stretching, which became popular in the wake of Hellenic influence. While originally only the tip of the [[foreskin]] was cut off, periah removes the entire [[foreskin]]. In the Greek society of the day, a denuded [[Glans penis|glans]] was considered obscene and risible. In ultra-orthodox communities, circumcision is followed by the ''[[mohel]]'', the ritual circumciser, sucking blood from the wound with his mouth. This practice is highly controversial, as it can result in an infection with [[herpes]] simplex type 1. In New York City, between 2000 and 2011 eleven children were infected with [[herpes]], 10 of whom had to be treated in hospital. Two of them suffered permanent brain damage, two others died. In the 12th century, the Jewish philosopher and doctor [[Moses Maimonides| Maimonides]] pointed out that circumcision was necessary, as it diminished sexual desires and reduced the pleasure to a degree just sufficient for mere reproduction.<br />
<br />
===Christianity===<br />
Jesus was born into a Jewish family in Israel, where Judaism was the prevailing religion, so he was circumcised on the eighth day.<ref name="luke2:21>{{REFweb<br />
|url=https://www.biblegateway.com/passage/?search=Luke+2%3A21&version=NASB<br />
|title=Gospel of Luke<br />
|trans-title=<br />
|language=<br />
|last=Luke<br />
|first=<br />
|author-link=<br />
|publisher=NASB<br />
|website=Bible Gateway<br />
|date=<br />
|accessdate=2019-11-10<br />
|format=<br />
|quote=And when eight days had passed, before His circumcision, His name was then called Jesus, the name given by the angel before He was conceived in the womb.<br />
}}</ref><br />
<br />
The first Christians had been born Jewish, so a question arose whether one must be circumcised to be a Christian. When Christian leaders met at the [[Council at Jerusalem]] in the First Century to decide what was required to be a Christian, a letter was written to explain the requirements, but circumcision was omitted from the requirements.<ref>{{REFweb<br />
|url=https://www.biblegateway.com/passage/?search=Acts+15%3A1-30&version=NASB<br />
|title=Acts 15:1-30<br />
|last=Luke<br />
|first=<br />
|accessdate=2019-11-10<br />
}}</ref><br />
<br />
In Christianity, circumcision is practiced only in a few Coptic churches. There is no general belief that circumcision is a requirement of Christianity.<ref name="hill2004">{{REFweb<br />
|url=http://www.cirp.org/pages/cultural/christian.html<br />
|title=The Holy Bible, Circumcision, False Prophets, and Christian Parents<br />
|trans-title=<br />
|language=<br />
|last=Hill<br />
|first=George<br />
|author-link=George Hill<br />
|publisher=Circumcision Reference Library<br />
|website=<br />
|date=2004-08-29<br />
|accessdate=2019-11-10<br />
|format=HTML<br />
|quote=The falseness of those who advocate circumcision is a recurrent theme in the New Testament. <br />
}}</ref><br />
<br />
Nevertheless, Christian moral notions had decisive influence on the spread of this practice. In the puritan influenced USA, circumcision of children was popular in the 19th century as a means to prevent [[masturbation]]. In those days, this so-called ‘self-abuse‘ was not only considered immoral, but was supposedly responsible for a variety of diseases. Masturbation, however, is not mentioned anywhere in the Holy Bible, so there is no support for the belief that it is somehow immoral or sinful. <br />
<br />
Even the mere existence of a [[foreskin]] was linked to many illnesses. Among them one could find syphilis, epilepsy, paralysis of the spine, bed wetting, scoliosis (spinal deformity), paralysis of the bladder, club foot, nerve pain in the lower abdomen, tuberculosis and lazy eye. One of the best known advocates of child circumcision was [[John Harvey Kellogg]], co-inventor of the corn flakes bearing his name. In 1888, he wrote:<br />
<br />
{{Citation<br />
|Text=A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of [[phimosis]]. The operation should be performed by a surgeon without administering an anaesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. In females, the author has found the application of pure carbolic acid to the clitoris an excellent means of allaying the abnormal excitement, and preventing the recurrence of the practice in those whose will-power has become so weakened that the patient is unable to exercise entire self-control. <br />
|Author=[[John Harvey Kellogg]]<br />
|Source=<br />
|ref=<ref>{{REFbook<br />
|url=https://archive.org/details/plainfaorold00kell/page/290<br />
|chapter=Treatment for Self-abuse and Its Effects<br />
|title=Plain Facts for Old and Young<br />
|location=Burlington, Iowa<br />
|publisher=F. Segner & Co.<br />
|year=1888<br />
|pages=107<br />
}}</ref><br />
}}<br />
<br />
===Islam===<br />
In Islam, circumcision is also religiously founded, even though there is no mention of it in the Koran itself. According to tradition, the Prophet Mohammed was born without a [[foreskin]]. It is seen as a sign of prophets that they are born without a [[foreskin]] already. It is considered an honour to "resemble the example of the Prophet", meaning to be circumcised. In Islam, unlike Judaism, there is no specific age at which the circumcision should be performed. Most circumcisions take place at ages between 6 and 10 years, but the range goes from birth to adulthood.<br />
<br />
== Rationale ==<br />
<br />
Reasons for performing circumcision range widely by culture, religion, location, and age.<br />
<br />
===Cultural===<br />
<br />
Many cultures perform circumcision as a rite of passage into manhood. This is common in the Middle East and amongst some indigenous African and Southeast Asian peoples.<br />
<br />
The United States and Israel are the only industrialized countries in the world to have a high incidence of non-therapeutic infant male circumcision. The vast majority of infant circumcisions performed in the United States are for non-religious, non-medical reasons. See [[History of circumcision]].<br />
<br />
===Religious===<br />
The circumcision of newborn boys is seen as a divine commandment in the Jewish faith. Though absent in the Koran, male circumcision is considered a religious requirement in Islam, and it is performed on male children of varying ages. Converts to these faiths may also choose to undergo circumcision, but it is not always required.<br />
<br />
===Medical indication===<br />
In some cases, circumcision is legitimately indicated; a patient may be suffering recurring infections, and other methods of treatment have failed. In other cases, a patient may be suffering from a severe case of [[phimosis]]. Overall, the actual medical necessity for circumcision is extremely rare. All circumcisions injure the patient by amputating the [[foreskin]] its with many protective, immunological, sensory, and sexual [[Foreskin#Physiological_functions| functions]]. <br />
<br />
# '''Deformed or malformed foreskin'''. A foreskin so deformed or malformed that it does not function properly may be removed by circumcision.<br />
<br />
# '''Traumatically injured foreskin'''. A foreskin so traumatically injured foreskin that cannot be surgically repaird is a valid medical reason for circumcision.<br />
<br />
# '''Diseased foreskin.''' A foreskin that is diseased is a valid indication for cirumcision. Some diseases that qualify are malignancy, lichen sclerosis, yeast infection in men with diabetes, and recurrent posthitis.<br />
<br />
In such cases, the benefit of removing the problem foreskin may exceed the maleficial results of tissue and function destruction.<br />
<br />
====Arguments of prophylaxia====<br />
Though the practice of ritual circumcision of males, both consenting and non-consenting, has existed for millenia, the search for "potential medical benefits" began relatively recently. The discussion of circumcision in the Ninth Edition of the ''Encyclopǽdia Britannica'' (1876) made no mention of any prophylactic, medical, or therapeutic value or function.<ref>{{REFweb<br />
|url=http://www.cirp.org/library/history/encyclopaediabritannica1876/<br />
|title=Circumcision<br />
|trans-title=<br />
|language=<br />
|last=Cheyne<br />
|first=T. K.<br />
|author-link=<br />
|publisher=Encyclopǽdia Brittanica<br />
|website=Circumcision Reference Library<br />
|date=1876<br />
|accessdate=2019-11-10<br />
|format=<br />
|quote=<br />
}}</ref><br />
<br />
Initially, circumcision was adopted as a way to stop boys and men from masturbating, where masturbation was seen as the cause for many diseases. As the myth that circumcision prevented [[masturbation]] became debunked, advocates of circumcision began the great search to find the "medical benefits" of circumcision. <br />
<br />
Male and female circumcision involves the removal and disruption of normal anatomical structures that are primary areas of sexual sensation.<ref name="taylor1996" /> In the past, some advocates of mass circumcision have considered the prepuce to be a "mistake of nature,"<ref><br />
<nowiki>{{Cold and Wiswell (1995)}} | [[Template:Cold and Wiswell (1995)|see more]]</nowiki></p><br />
</ref> but this notion has no validity because the prepuce is ubiquitous in primates and because it provides functional advantages.<ref name="cold-mcgrath1995">{{REFbook<br />
|last=Cold<br />
|first=Christopher<br />
|last2=McGrath<br />
|first2=Kenneth<br />
|author2-link=Ken McGrath<br />
|year=1999<br />
|title=Male and female circumcision: medical, legal, and ethical considerations in pediatric practice<br />
|url=http://www.cirp.org/library/anatomy/cold-mcgrath/<br />
|work=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=Anatomy and histology of the penile and clitoral prepuce in primates<br />
|pages=<br />
|location=New York<br />
|publisher=<br />
|isbn=0306461315<br />
|quote=<br />
|accessdate=2019-10-12<br />
|note=<br />
}}</ref><br />
<br />
===Search for prophylactic reasons===<br />
<br />
The practice of finding prophylactic reasons for infant circumcision started in Germany in the nineteenth century, when non-Jewish Germans criticized the Jewish practice of infant circumcision as being barbaric, Jewish doctors sprang to the defense of the religious practice by claiming health benefits.<ref name="ephron2001">{{REFbook<br />
|last=Ephron<br />
|first=John M.<br />
|author-link=<br />
|year=2001<br />
|title=Medicine and the German Jews<br />
|url=http://www.cirp.org/library/history/ephron1/<br />
|work=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=6<br />
|pages=222-233<br />
|location=New Haven<br />
|publisher=Yale University Press<br />
|isbn=0-300-08377-7<br />
|quote=<br />
|accessdate=2019-11-20<br />
|note=<br />
}}</ref> And so started the long tradition of Jewish doctors inventing reasons for circumcision (and deceving gentile doctors).<br />
<br />
Following the discovery of bacteria as a cause of many diseases – such as tuberculosis – the search began for other illnesses that could be prevented by circumcision.<br />
<br />
In 1870 the renowned Dr. Lewis A. Sayre of NYC’s Bellevue Hospital claimed to cure a boy’s paralyzed legs with circumcision. Sayre's advocacy of circumcision exemplified how [https://intaction.org/circumcision-facts-and-myths/ circumcision myths] originated and facts were disregarded. He also claimed to cure epilepsy, mental disorders, hip-joint pain, & hernias with circumcision. “Genital irritations” & masturbation were deemed to be the cause of these issues.<ref>American Medical Association. Transactions of the American Medical Association. 1870;21:205–11</ref> <br />
<br />
In the 1920s it was penile cancer. Abraham L. Wolbarst (1926) claims that circumcision can prevent penile cancer.<ref name="wolbarst1926">{{REFjournal<br />
|last=Wolbarst<br />
|first=Abraham L.<br />
|author-link=Abraham L. Wolbarst<br />
|title=Is circumcision a prophylactic against penis cancer?<br />
|journal=Cancer<br />
|date=Jul 1926<br />
|volume=3<br />
|issue=4<br />
|pages=301-10<br />
}}</ref>. <br />
<br />
In the 1940s, prostate and tongue cancer as well as STDs. Eugene H. Hand (1949) falsely explains that circumcision somehow protects against venereal diseases and tongue cancer.<ref name="hand1949">{{REFjournal<br />
|title=Circumcision and venereal disease.<br />
|last=Hand<br />
|first=Eugene H.<br />
|journal=Archives of Dermatology and Syphilology<br />
|date=Sep 1949<br />
|volume=60<br />
|issue=3<br />
|pages=341-346<br />
}}</ref>. <br />
<br />
In the 1950s it was cervical cancer. Abraham Ravich (1951) invents the myth that circumcision reduces the risk of women getting cervical cancer.<ref name="ravich1951">{{REFjournal<br />
|url=https://www.ncbi.nlm.nih.gov/pubmed/14853120<br />
|title=Prophylaxis of cancer of the prostate, penis, and cervix by circumcision<br />
|last=Ravich<br />
|first=Abraham<br />
|last2=Ravich<br />
|first2=R.A.<br />
|journal=New York State Journal of Medicine<br />
|date=Jun 1951<br />
|volume=51<br />
|issue=12<br />
|pages=1519-1520<br />
|pubmedID=14853120<br />
|accessdate=2019-10-12<br />
}}</ref> <br />
<br />
In the late 1960s it was neuroses. Morris Fishbein (1969) calls for circumcision to prevent nervousness and, of course, [[masturbation]].<ref>{{REFbook<br />
|last=Fishbein<br />
|first=Morris<br />
|chapter=Sex hygiene<br />
|title=Modern Home Medical Adviser<br />
|location=Garden City, New York<br />
|publisher=Doubleday & Co<br />
|year=1969<br />
|pages=90, 119<br />
|url=https://openlibrary.org/works/OL95362W/Modern_home_medical_adviser<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
In the 1970s bladder- and rectal cancer. Abraham Ravich (1971) claims that circumcision would prevent bladder cancer and rectal cancer.<ref>{{REFjournal<br />
|last=Ravich<br />
|first=Abraham<br />
|url=https://www.deepdyve.com/lp/wiley/viral-carcinogenesis-in-venereally-susceptible-organs-HCeWmTLmKl<br />
|title=Viral carcinogenesis in venereally susceptible organs<br />
|journal=Cancer<br />
|date=Jun 1971<br />
|volume=27<br />
|issue=6<br />
|pages=1493-1496<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
In the 1980s, UTIs. Thomas E. Wiswell (1985) claims that circumcision, using a methodologically flawed report, reduces the risk of urinary tract infections.<ref name="wiswell1985">{{REFjournal <br />
|last=Wiswell<br />
|first=Thomas E.<br />
|author-link=Thomas E. Wiswell<br />
|url=https://pediatrics.aappublications.org/content/75/5/901<br />
|title=Decreased incidence of urinary tract infections in circumcised male infants<br />
|journal=Pediatrics<br />
|date=May 1985<br />
|volume=75<br />
|issue=5<br />
|pages=901-903<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
Aaron J. Fink (1986), with no evidence whatsoever, claims that circumcision protects against AIDS followed.<ref name="fink1986">{{REFjournal<br />
|last=Fink<br />
|first=Aaron J.<br />
|author-link=Aaron J. Fink<br />
|title=A possible explanation for heterosexual male infection with AIDS<br />
|journal=New England Journal of Medicine<br />
|date=1986-10-30<br />
|volume=31<br />
|issue=18<br />
|pages=1167<br />
|url=https://www.nejm.org/doi/full/10.1056/NEJM198610303151818<br />
|DOI=10.1056/NEJM198610303151818<br />
|accessdate=2019-11-20<br />
}}</ref> <br />
<br />
Retrospectively, circumcision was always advertised as a cure for whatever disease was in the public spotlight at the time. [[Doctors Opposing Circumcision]] (2016) states:<br />
<blockquote><br />
These claims date originally from before the advent of evidence-based medicine, when doctors relied on the opinions of other clinicians to inform their practice, rather than on scientifically collected evidence.<ref name="doc2016">{{REFweb<br />
|url=https://www.doctorsopposingcircumcision.org/for-professionals/alleged-medical-benefits/<br />
|title=Alleged Medical Benefits<br />
|trans-title=<br />
|language=<br />
|last=<br />
|first=<br />
|author-link=<br />
|publisher=Doctors Opposing Circumcision<br />
|website=<br />
|date=2016-05<br />
|accessdate=2019-11-20<br />
|format=<br />
|quote=<br />
}}</ref><br />
</blockquote><br />
<br />
The sheer mass of studies and publications that were released during those almost 180 years on this topic are the reason that even arguments that have been disproved multiple times, especially regarding infant and child circumcision, tenaciously persist up until today.<br />
<br />
An ever-recurring element of initiation rites found in many different cultures is the fixation upon the genitalia.<br />
<br />
It reflects the fascination that emerges from the ability to create new life. In most cultures, fertility is seen as the most precious good, and the body parts involved frequently find themselves in the focus of ritual acts. In many parts of the world, those rites take place when the boy reaches puberty, and are meant to symbolize his transition from boy to man. The removal of the male [[foreskin]] is just one of many phenomena that developed in this context. They range from the removal of the frenulum in boys and men through partial or complete removal of the [[foreskin]] up to radical operations. Australian Aborigines, as mentioned above, have their [[foreskin]]s removed. It is also usual that, a few weeks later, young men have their [[penis]]es sliced open, resulting in a partly or completely divided urethra.<br />
<br />
Another known, particularly massive, intervention is the stripping of the entire skin off the [[penis]]. In Indonesia, boys have metal or bamboo balls inserted into their [[penis]] shaft or [[Glans penis|glans]] at the beginning of puberty, which form little "humps".<br />
<br />
For many cultures it is also common to perform similar rituals on girls. This can range from relatively small interventions such as piercing or cutting the clitoral hood, to its complete removal and up to radical removal of clitoral hood, clitoris, inner and outer labia followed by sewing up the vagina.<br />
<br />
''The following text is taken from the [[Circumpendium]].''<br />
<br />
=== Prophylactic reasons ===<br />
<br />
Some people claim that circumcision has prophylactic benefits. Especially in the USA those arguments have persisted for more then a 100 years, with ever changing diseases circumcision is said to protect against. At first, these were diseases where [[masturbation]] was believed to be the cause. After bacteria and viruses had been discovered, arguments changed, and one after another miscellaneous diseases were cited.<br />
<br />
* [[Phimosis]]: as mentioned earlier, true [[phimosis]] is rare and can be treated effectively without surgery. According to a study by Blalock ''et al.'' (2003)<ref>{{REFjournal<br />
|last=Blalock<br />
|first=H.J.<br />
|last2=Vemulakonda<br />
|first2=V.<br />
|last3=Ritchey<br />
|first3=M.L.<br />
|last4=Ribbeck<br />
|first4=M.<br />
|title=Outpatient management of [[phimosis]] Following newborn circumcision<br />
|journal=J Urol<br />
|date=2003<br />
|volume=169<br />
|issue=6<br />
|pages=2332-2334<br />
|url=http://www.cirp.org/library/complications/blalock1/<br />
|accessdate=2019-11-07<br />
}}</ref>, 2.9% of those circumcised develop a post-operative [[phimosis]], in which the circumcision scar constricts. In intact patients, the rate of [[phimosis]] is only 1% (see also the study by [[Jakob Øster]]). Therefore, circumcision is not a preventive measure for [[phimosis]].<br />
* Sexually Transmitted Diseases (STDs): a vast number of studies has been conducted on the subject of transmission of STDs.<br />
* First, it has to be noted that any form of protection against these diseases only affects people who are sexually active. Circumcision in childhood cannot be justified on these grounds, since any assumed protective effect will not occur before the boy is already old enough to decide about circumcision for himself.<br />
* As mentioned above, the [[foreskin]] keeps the [[Glans penis|glans]] moist. This subpreputial moisture contains, among other substances, the enzyme lysozyme, which breaks up the cell wall of bacteria, thereby providing a natural antibacterial screen. This explains the results of several studies, such as Laumann ''et al.''<ref>{{REFjournal<br />
|last=Laumann<br />
|first=E.O.<br />
|last2=Masi<br />
|first2=C.M.<br />
|last3=Zuckerman<br />
|first3=E.W.<br />
|title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice<br />
|journal=JAMA<br />
|date=1997<br />
|volume=277<br />
|issue=<br />
|pages=1052-1057<br />
|url=http://www.cirp.org/library/general/laumann/<br />
|accessdate=2019-11-06<br />
}}</ref>, which found a higher rate of infection with bacterial venereal diseases in circumcised than in intact men.<br />
* The studies by Fleiss ''et al.'' (1998) support this.<ref name="fleiss-hodges-vanhowe1998">{{REFjournal<br />
|last=Fleiss<br />
|first=P.M.<br />
|last2=Hodges<br />
|first2=F.M.<br />
|last3=Van Howe<br />
|first3=R.S.<br />
|title=Immunological functions of the human prepuce<br />
|journal=Sex Transm Inf<br />
|date=1998<br />
|volume=74<br />
|issue=<br />
|pages=364-367<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1758142/pdf/v074p00364.pdf<br />
|accessdate=2019-11-06<br />
}}</ref> According to the [[AAP]], the general sexual behaviour of the male - such as frequent change in partners and the use of condoms - has a much higher impact on sexually transmitted diseases then the circumcision status.<ref>{{REFjournal<br />
|last=Task Force on Circumcision<br />
|first=<br />
|title=Circumcision policy statement<br />
|journal=Pediatrics<br />
|date=1999<br />
|volume=103<br />
|issue=3<br />
|pages=686-93<br />
|url=http://www.cirp.org/library/statements/aap1999/<br />
|accessdate=2019-11-15<br />
}}</ref><br />
* HIV / AIDS: in the recent past, the argument that circumcision could help to contain the spread of HIV has been stated numerous times.<br />
*:First, two notes: for one, the use of condoms is still by far the most effective protection against an infection. During intercourse with that preventive measure, circumcision status does not make a difference.<br />
*:Secondly, the assumed protection would only affect healthy men who have intercourse with an infected woman. An infected man can infect a women by transmission of his bodily fluids, so that his circumcision status is irrelevant. Therefore, the use of condoms remains vital in containing the spread of HIV, which in return renders circumcision unnecessary<br />
* Due to the inevitable loss of sensitivity as a result of circumcision, there is also the temptation to go without condoms, in order not to lose even more sensitivity.<ref>{{REFjournal<br />
|last=Hooykaas<br />
|first=C.<br />
|last2=van der Velde<br />
|first2=F.W.<br />
|last3=van der Linden<br />
|first3=M.M.<br />
|etal=yes<br />
|title=The importance of ethnicity as a risk factor for STDs and sexual behaviour among heterosexuals<br />
|journal=Genitourin Med<br />
|date=1991<br />
|volume=67<br />
|issue=5<br />
|pages=378-383<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1194736/pdf/genitmed00041-0022.pdf<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Michael<br />
|first=R.T.<br />
|last2=Wadsworth<br />
|first2=J.<br />
|last3=Feinleib<br />
|first3=J.<br />
|etal=yes<br />
|title=Private sexual behavior, public opinion, and public health policy related to sexually transmitted diseases: a US-British comparison<br />
|journal=Am J Public Health<br />
|date=1998<br />
|volume=88<br />
|issue=5<br />
|pages=749-754<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1508929/pdf/amjph00017-0039.pdf<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Laumann<br />
|first=E.O.<br />
|last2=Masi<br />
|first2=C.M.<br />
|last3=Zuckerman<br />
|first3=E.W.<br />
|title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice<br />
|journal=JAMA<br />
|date=1997<br />
|volume=277<br />
|issue=<br />
|pages=1052-1057<br />
|url=http://www.cirp.org/library/general/laumann/<br />
|accessdate=2019-11-06<br />
}}</ref><br />
* Two studies that have been published in early 2007<ref>{{REFjournal<br />
|last=Gray, R.H. and colleagues<br />
|first=<br />
|title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial<br />
|journal=Lancet<br />
|date=2007<br />
|volume=369<br />
|issue=<br />
|pages=657-666<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=[[Robert C. Bailey|Bailey, R.C.]] and colleagues<br />
|first=<br />
|title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial<br />
|journal=Lancet<br />
|date=2007<br />
|volume=369<br />
|issue=<br />
|pages=643-656<br />
|url=<br />
|accessdate=<br />
}}</ref>, which investigated the effectiveness of circumcision as a means of reducing the spread of HIV from infected women to heterosexual men in African high risk areas, have been repeatedly subjected to strong criticism. Both studies were ended prematurely, which distorted the results. The men who had been circumcised for the study had to stay sexually inactive during the wound healing, which gave the intact control group more relative opportunity to become infected. These African randomized clinical trials have been demonstrated to have very serious methodological and statistical errors that distort the results in favor of circumcision.<ref name="boyle-hill2011">{{REFjournal<br />
|last=Boyle<br />
|first=Gregory J.<br />
|author-link=Gregory Boyle<br />
|last2=Hill<br />
|first2=George<br />
|author2-link=George Hill<br />
|title=Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns<br />
|journal=J Law Med<br />
|date=2011-12<br />
|volume=19<br />
|issue=2<br />
|pages=316-34<br />
|url=http://www.salem-news.com/fms/pdf/2011-12_JLM-Boyle-Hill.pdf<br />
|quote=<br />
|pubmedID=22320006<br />
|pubmedCID=<br />
|DOI=<br />
|accessdate=2019-11-09<br />
}}</ref><br />
<br />
The fact that the USA has both the highest rate of circumcised males in the western world, as well as the highest HIV infection rate, makes the studies look dubious. Besides that, several other studies concluded that circumcision does not have a significant impact on the risk of infection with HIV.<ref>{{REFjournal<br />
|last=Grosskurth<br />
|first=H.<br />
|last2=Mosha<br />
|first2=F.<br />
|last3=Todd<br />
|first3=J.<br />
|etal=yes<br />
|title=A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results<br />
|journal=AIDS<br />
|date=1995<br />
|volume=9<br />
|issue=8<br />
|pages=927-934<br />
|url=https://insights.ovid.com/aids/aids/1995/08/000/community-trial-impact-improved-sexually/15/00002030<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Barongo<br />
|first=L.R.<br />
|last2=Borgdorff<br />
|first2=M..W.<br />
|last3=Mosha<br />
|first3=F.F.<br />
|etal=yes<br />
|title=The epidemiology of HIV-1 infection in urban areas, roadside settlements and rural villages in Mwanza Region, Tanzania<br />
|journal=AIDS<br />
|date=1992<br />
|volume=6<br />
|issue=12<br />
|pages=1521-1528<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Changedia SM, Gilada IS<br />
|first=<br />
|title=Role of male circumcision in HIV transmission insignificant in conjugal relationship (abstract no. ThPeC7420)<br />
|url=<br />
|place=Barcelona, Spain<br />
|source=Presented at the Fourteenth International AIDS Conference<br />
|datefrom=2002-07-07<br />
|dateto=2002-07-12<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Connolly CA, Shishana O, Simbayi L, Colvin M<br />
|first=<br />
|title=HIV and circumcision in South Africa (Abstract No. MoPeC3491)<br />
|url=<br />
|place=Bangkok, Thailand<br />
|source=Presented at the 15th International AIDS Conference<br />
|datefrom=2004-07-11<br />
|dateto=2004-07-16<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Thomas AG, Bakhireva LN, Brodine SK, Shaffer RA<br />
|first=<br />
|title=Prevalence of male circumcision and its association with HIV and sexually transmitted infections in a U.S. navy population (Abstract no. TuPeC4861)<br />
|url=https://apps.dtic.mil/dtic/tr/fulltext/u2/a458066.pdf<br />
|place=Bangkok, Thailand<br />
|source=Presented at the 15th International AIDS Conference<br />
|datefrom=2004-07-11<br />
|dateto=2004-07-16<br />
|accessdate=2019-11-15<br />
}}</ref><br />
* Urinary tract infections (UTI): a UTI can be effectively treated with antibiotics, this was also proven by studies<ref>{{REFjournal<br />
|last=McCracken<br />
|first=G.<br />
|title=Options in antimicrobial management of urinary tract infections in infants and children<br />
|journal=Pediatr Infect Dis J<br />
|date=1989<br />
|volume=8<br />
|issue=8<br />
|pages=552-555<br />
|url=http://www.cirp.org/library/disease/UTI/mccracken/<br />
|accessdate=2019-11-19<br />
}}</ref><ref>{{REFjournal<br />
|last=Larcombe<br />
|first=J.<br />
|title=Urinary tract infection in children<br />
|journal=BMJ<br />
|date=1999<br />
|volume=319<br />
|issue=<br />
|pages=1173-1175<br />
|url=<br />
|accessdate=<br />
}}</ref>. A Swedish study <ref>{{REFjournal<br />
|last=Mårild<br />
|first=S.<br />
|last2=Jodal<br />
|first2=U.<br />
|title=Incidence rate of first–time symptomatic urinary tract infection in children under 6 years of age<br />
|journal=Acta Paediatr<br />
|date=1998<br />
|volume=87<br />
|issue=5<br />
|pages=549-552<br />
|url=<br />
|accessdate=<br />
}}</ref> found that, during the first 6 years of life, the incidence of UTIs in boys was 1.8%, but in girls was 6.6%. UTIs are less common in boys after the first year of life. Mueller ''et al.'' <ref>{{REFjournal<br />
|last=Mueller<br />
|first=E.R.<br />
|last2=Steinhardt<br />
|first2=G.<br />
|last3=Naseer<br />
|first3=S.<br />
|title=The incidence of genitourinary abnormalities in circumcised and uncircumcised boys presenting with an initial urinary tract infection by 6 months of age<br />
|journal=Pediatrics<br />
|date=1997<br />
|volume=100 (Supplement)<br />
|issue=<br />
|pages=580<br />
|url=<br />
|accessdate=<br />
}}</ref> did not find a significant difference in UTI rates between circumcised and intact boys with normal urinary tract anatomy.<br />
* Other studies suggest that circumcision is more likely to raise than to lower the generally low risk of acquiring UTI: multiple studies from Israel showed a strong correlation between ritual circumcision on the 8th day of life and postoperative UTI.<ref>{{REFjournal<br />
|last=Menahem<br />
|first=S.<br />
|title=Complications arising from ritual circumcision: pathogenesis and possible prevention<br />
|journal=Isr J Med Sci<br />
|date=1981<br />
|volume=17<br />
|issue=1<br />
|pages=45-48<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Cohen<br />
|first=H.A.<br />
|last2=Drucker<br />
|first2=M.M.<br />
|last3=Vainer<br />
|first3=S.<br />
|etal=yes<br />
|title=Postcircumcision urinary tract infection<br />
|journal=Clin Pediatr<br />
|date=1992<br />
|volume=31<br />
|issue=6<br />
|pages=322-324<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Goldman<br />
|first=M.<br />
|last2=Barr<br />
|first2=J.<br />
|last3=Bistritzer<br />
|first3=T.<br />
|last4=Aladjem<br />
|first4=M.<br />
|title=Urinary tract infection following ritual Jewish circumcision<br />
|journal=Isr J Med Sci<br />
|date=1996<br />
|volume=32<br />
|issue=<br />
|pages=1098-1102<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
* It can be concluded that circumcision is ineffective as a preventive measure against UTIs.<br />
* Penile and cervical cancer / HPV: first studies on those diseases and their assumed prevention by circumcision date back to 1932, a time when the cause for those illnesses was not yet fully understood<br />
<ref>{{REFjournal<br />
|last=Wolbarst<br />
|first=A.<br />
|title=Circumcision and penile cancer<br />
|journal=Lancet<br />
|date=1932<br />
|volume=1<br />
|issue=5655<br />
|pages=150-153<br />
|url=<br />
|accessdate=<br />
}}</ref>. Today, it is known that sexually transmitted human papillomavirus (HPV) is a major risk factor<ref>{{REFjournal<br />
|last=McCance<br />
|first=D.J.<br />
|last2=Kalache<br />
|first2=A.<br />
|last3=Ashdown<br />
|first3=K.<br />
|etal=yes<br />
|title=Human papillomavirus types 16 and 18 in carcinomas of the penis from Brazil<br />
|journal=Int J Cancer<br />
|date=1986<br />
|volume=37<br />
|issue=1<br />
|pages=55-59<br />
|url=<br />
|accessdate=<br />
}}</ref>, as well as smoking<ref>{{REFjournal<br />
|last=Harish<br />
|first=K.<br />
|last2=Ravi<br />
|first2=R.<br />
|title=The role of tobacco in penile carcinoma<br />
|journal=Brit J Urol<br />
|date=1995<br />
|volume=75<br />
|issue=3<br />
|pages=375-377<br />
|url=<br />
|accessdate=<br />
}}</ref>. Studies have shown that there is no significant difference in the risk of getting penile cancer between circumcised and intact men. To prevent a single case of penile cancer, it would statistically take 600 to 900 circumcisions<ref>{{REFdocument<br />
|title=Position Paper on Neonatal Circumcision<br />
|url=<br />
|contribution=<br />
|last=<br />
|first=<br />
|publisher=American Academy of Family Physicians (Leawood, Kansas)<br />
|format=<br />
|date=2002-02-14<br />
|accessdate=<br />
}}</ref>. The influence of circumcision on the infection risk of the female partner with cervical cancer has been refuted several times as well. HPV vaccination is an effective measure against carcinoma of the cervix.<br />
<br />
In conclusion, circumcision does not provide any proven benefits in preventive medicine.<br />
<br />
== Non-medical indications for circumcision ==<br />
<br />
Apart from the medical indication of pathological phimosis, there also are other reasons for circumcision.<br />
<br />
=== Aesthetic reasons ===<br />
<br />
The visual appearance of the [[penis]] is changed radically after circumcision. In this case, personal taste is decisive whether an intact or a cut [[penis]] is more appealing. Since a circumcision cannot be undone, it is essential to be fully informed about the risks and possible later complications before embarking on an aesthetically motivated circumcision, to decide whether the appearance will justify such bodily modification.<br />
<br />
Since this modification and its possible late effects will be the lifelong burden of the person who undertakes an aesthetically motivated circumcision to suit his personal preferences, a valid decision to proceed can only be made by the person to be circumcised himself, once he has reached the necessary age and level of maturity to make that decision. This should normally be the case when adulthood is reached.<br />
<br />
It should be noted that every circumcision operation leaves a life-long [[circumcision scar]] that encircles the shaft of the penis.<br />
<br />
===Financial reasons===<br />
<br />
In the United States, payment for non-therapeutic circumcision is made by most [[third-party payment| third-party payers]] without question. Doctors frequently perform medically-unnecessary, non-therapeutic circumcision of infants and children simply to collect a fee for the surgical operation. The only beneficiary of such surgery is the [[Financial Incentive| bank account of the medical doctor]].<br />
<br />
=== Moral reasons ===<br />
<br />
With the [[foreskin]], circumcision removes approximately 70% of the sensitive tissue of the [[penis]], lowering the potential for sexual stimulation accordingly. Due to the loss of around 50% of the entire penile skin, the [[penis]] loses the reserve skin that provides cutaneous mobility in the erect [[penis]] and the [[gliding action]].<br />
<br />
In the past, this circumstance was used to make it harder for boys to masturbate and [[masturbation]] less fun, as [[masturbation]] was viewed as immoral and was assumed to cause a variety of diseases. More on that can be found in the chapter "[[Circumcision#Historical_background|Historical background]]". Today, it is known that [[masturbation]] has no negative health effects, but can contribute positively to the child's sexual development. Sexuality is no longer a taboo nowadays, while [[masturbation]] is considered to be a natural part of human sexuality and is no longer seen as immoral. Therefore, circumcision for moral reasons - which would only affect boys too young to give informed consent - is no longer justifiable nowadays.<br />
<br />
=== Hygiene reasons ===<br />
<br />
''Hygiene'' refers to health and only secondarily to cleanliness. <br />
<br />
One should note that the human foreskin is endowed by nature with [[Foreskin#Immunological_functions| immunological functions]] that serve to protect the human body from disease.<ref name="fleiss-hodges-vanhowe1998" /> The glans penis receives blood through the frenular artery.<ref>{{REFjournal<br />
|last=Persad<br />
|first=R.<br />
|author-link=<br />
|last2=Sharma<br />
|first2=S.<br />
|author2-link=<br />
|last3=McTavish<br />
|first3=J.<br />
|author3-link=<br />
|etal=yes<br />
|title=Clinical presentation and pathophysiology of meatal stenosis following circumcision<br />
|journal=Brit J Urol<br />
|date=1995<br />
|volume=75<br />
|issue=1<br />
|pages=91-3<br />
|url=https://www.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.1995.tb07242.x<br />
|quote=<br />
|pubmedID=7850308 <br />
|pubmedCID=<br />
|DOI=10.1111/j.1464-410x.1995.tb07242.x<br />
|accessdate=2019-11-26<br />
}}</ref> These facts are generally overlooked in arguments for alleged hygienic benefits of circumcision.<br />
<br />
A common reason stated for circumcision is the assumption of hygienic benefits. This argument has to be viewed in the context of the environment the person in question grows up in. It is commonly known that bad hygienic circumstances, especially insufficient access to clean drinking water, pose a serious problem. The situation in disaster areas or refugee camps in the so-called third world keep reminding us of that.<br />
<br />
In western industrial nations, however, this problem does not exist, in view of the availability of clean water for daily personal hygiene. If the cleaning of the genitals is performed on a daily basis - and that may be assumed - no pathogens can accumulate under the [[foreskin]]. Cleaning of the [[Glans penis|glans]] and the area underneath the [[foreskin]] is easy - they are simply washed along with the rest of the body, just like the areas between the toes.<br />
<br />
In small boys, where the [[foreskin]] cannot be retracted yet, cleaning is not necessary, since the [[Synechia| membrane]] that fuses the [[foreskin]] to the [[Glans penis|glans]] prevents the accumulation of micro-organisms. The so-called "ballooning", where the [[foreskin]] inflates during urination, is not a serious problem.<br />
<br />
The opening of the [[foreskin]] in small boys is often quite narrow and serves as a one-way valve, allowing the urine to flow out, but preventing entry of microbes, for example from a dirty diaper. As long as the child is able to pass water, everything works as nature intended.<br />
<br />
But even in areas where there are poorer hygienic conditions and an insufficient access to medical care, the benefits of easier cleaning of a circumcised [[penis]] are to be viewed with a critical eye. Although even longer periods without personal hygiene will not result in an accumulation of germs under the [[foreskin]], circumcision itself is not without risk of complications. If the operation is carried out without proper sterility, there is a high risk of an infection of the wound. This also applies to the treatment of common complications like post-operative bleeding.<br />
<br />
The benefit of easier cleaning must be balanced against the risk of promoting serious infections - among others HIV - during the operation. In parts of Africa, several dozen of one tribe's boys die each year as a result of their circumcision.<br />
<br />
<br />
== Circumcision methods ==<br />
<br />
The [[Circumcision methods]] are discussed in a separate article.<br />
<br />
== Risks and late effects ==<br />
<br />
Just like tonsil or appendix surgery, circumcision is a surgical intervention and brings the usual risks related to surgical operations, alongside several specific risks of complications and late effects.<br />
<br />
=== Possible operative and postoperative complications ===<br />
<br />
Circumcision is surgery. Surgical complications of circumcision generally may be classified as hemorrhage, infection, or surgical misadventure up to and including loss of the penis and [[death]].<ref name="williams-kapilla1993">{{REFjournal<br />
|last=Williams<br />
|first=N<br />
|author-link=<br />
|last2=Kapilla<br />
|first2=L<br />
|author2-link=<br />
|etal=no<br />
|title=Complications of circumcision<br />
|trans-title=<br />
|language=<br />
|journal=Brit J Surg<br />
|location=<br />
|date=1993-10<br />
|volume=80<br />
|issue=10<br />
|pages=1231-6<br />
|url=http://www.cirp.org/library/complications/williams-kapila/<br />
|quote=<br />
|pubmedID=8242285<br />
|pubmedCID=<br />
|DOI=10.1002/bjs.1800801005<br />
|accessdate=2019-11-27<br />
}}</ref><br />
<br />
* Intolerance or allergic reactions to the narcotics used.<br />
* Especially in newborns, where the bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is often insufficient for the operation. Even in conjunction with regional anaesthesia of the dorsal nerve of the [[penis]], the rate of failure to provide sufficient anaesthetic even for experienced anaesthetists is still 5-10%. The general anaesthesia that would be needed for newborns, however, poses significant risks for the child, and, therefore, is only likely to be used in emergencies. A surgical operation without proper pain control can lead to the development of a specific pain memory<ref>{{REFweb<br />
|url=http://www.spiegel.de/spiegel/vorab/experte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-849534.html<br />
|title=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder<br />
|trans-title=Children's pain expert warns: Ritual circumcision changes the brain of children<br />
|language=German<br />
|last=Prof. Dr. med. Boris Zernikow<br />
|first=<br />
|publisher=Spiegel Online<br />
|website=<br />
|date=2012-08-12<br />
|accessdate=2019-10-11<br />
|format=<br />
|quote=<br />
}}</ref>. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation. Overall, their pain threshold was lower and the risk of chronic pain increased. Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFjournal<br />
|last=Garry<br />
|first=T.<br />
|title=Circumcision: a survey of fees and practices<br />
|journal=OBG Management<br />
|date=1994<br />
|volume=October<br />
|issue=<br />
|pages=34-36<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Howard<br />
|first=C.R.<br />
|last2=Howard<br />
|first2=F.M.<br />
|last3=Garfunkel<br />
|first3=L.C.<br />
|last4=de Blieck<br />
|first4=E.A.<br />
|last5=Weitzman<br />
|first5=M.<br />
|title=Neonatal circumcision and pain relief: current training practices<br />
|journal=Pediatrics<br />
|date=1998<br />
|volume=101<br />
|issue=<br />
|pages=423-428<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Stang<br />
|first=H.J.<br />
|last2=Snellman<br />
|first2=L.W.<br />
|title=Circumcision practice patterns in the United States<br />
|journal=Pediatrics<br />
|date=1998<br />
|volume=101<br />
|issue=e5<br />
|pages=<br />
|url=<br />
|accessdate=<br />
|note=Link to [[AAP]] website<br />
}}</ref>. During procedures which take several minutes, babies tend to fall into a state of stupor, which in the past was falsely interpreted as peaceful sleep, nurturing the belief that babies felt no pain. Measurements taken in those cases revealed a typically 3- to 4-fold increase in cortisol levels, which equals a state of severe shock.<ref>{{REFjournal<br />
|last=Gunnar<br />
|first=M.R.<br />
|last2=Fisch<br />
|first2=R.O.<br />
|last3=Korsvik<br />
|first3=S.<br />
|last4=Donhowe<br />
|first4=J.M.<br />
|title=The effects of circumcision on serum cortisol and behavior<br />
|journal=Psychoneuroendocrinology<br />
|date=1981<br />
|volume=6<br />
|issue=3<br />
|pages=269-275<br />
|url=http://www.cirp.org/library/pain/gunnar/<br />
|accessdate=2019-11-26<br />
}}</ref><br />
* Postoperative wound pain, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions.<br />
* Postoperative pain from the exposure of the sensitive glans penis to clothing. This pain will endure for several weeks or even longer in some cases.<br />
* Postoperative bleeding of the wound. This can have severe consequences especially for very young infants, if they are not treated promptly. Their blood volume is only about 85 ml per kilogram of body weight, and even moderate blood loss can lead to hypovolaemia, hypovolaemic shock and even death.<ref>{{REFbook<br />
|last=<br />
|first=<br />
|year=2000<br />
|title=Paediatric Handbook<br />
|url=<br />
|work=<br />
|editors=Smart J, Nolan T.<br />
|edition=6<br />
|volume=<br />
|chapter=<br />
|pages=82<br />
|location=Victoria, Australia<br />
|publisher=Blackwell Science Asia<br />
|isbn=<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref><ref>{{REFdocument<br />
|title=Autopsy of Demetrius Manker<br />
|url=<br />
|contribution=Case 93-1711<br />
|last=Wetli<br />
|first=CV<br />
|publisher=Miami: Dade County Medical Examiner Department<br />
|format=<br />
|date=1993-06-23<br />
|accessdate=<br />
}}</ref> <ref>{{REFjournal<br />
|last=Hiss<br />
|first=J.<br />
|last2=Horowitz<br />
|first2=A.<br />
|last3=Kahana<br />
|first3=T.<br />
|title=Fatal haemorrhage following male ritual circumcision<br />
|journal=J Clin Forensic Med<br />
|date=2000<br />
|volume=7<br />
|issue=<br />
|pages=32-34<br />
|url=http://www.cirp.org/library/death/hiss1/<br />
|accessdate=2019-11-06<br />
}}</ref><ref>{{REFdocument<br />
|title=Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan<br />
|url=http://www.circumstitions.com/death-exsang.html<br />
|contribution=<br />
|last=Newell<br />
|first=TEC<br />
|publisher=Burnaby, B.C.: B.C. Coroner's Service<br />
|format=<br />
|date=2004-01-19<br />
|accessdate=2019-11-26<br />
}}</ref><br />
* Post operative [[lymphoedema]].<br />
* Postoperative infections. This includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.<ref>{{REFconference<br />
|last=Dr. med. Hartmann<br />
|first=Wolfgang<br />
|url=<br />
|place=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German)<br />
|title=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German)<br />
|date=2012-11-26<br />
|accessdate=<br />
}}</ref><br />
* [http://www.circumstitions.com/Restric/Botched9wd.html Wound dehiscence], meaning the separation of the edges of the wound or the tissue after suturing.<br />
* Adhesion between the surface or rim of the [[Glans penis|glans]] with the neighbouring penile skin, causing skin pockets and bridges, as well as visually unpleasant results like uneven scars, which make a re-circumcision necessary.<br />
* Postoperative [[phimosis]]: a phimotic ring can develop during scarring, which makes a re-circumcision necessary. According to a study by Blalock ''et al.''<ref>{{REFjournal<br />
|last=Blalock<br />
|first=H.J.<br />
|last2=Vemulakonda<br />
|first2=V.<br />
|last3=Ritchey<br />
|first3=M.L.<br />
|last4=Ribbeck<br />
|first4=M.<br />
|title=Outpatient management of [[phimosis]] Following newborn circumcision<br />
|journal=J Urol<br />
|date=2003<br />
|volume=169<br />
|issue=6<br />
|pages=2332-2334<br />
|url=http://www.cirp.org/library/complications/blalock1/<br />
|accessdate=2019-11-26<br />
}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal<br />
|last=Leitch<br />
|first=I.O.W.<br />
|title=Circumcision - a continuing enigma<br />
|journal=Aust Paediatr J<br />
|date=1970<br />
|volume=6<br />
|issue=<br />
|pages=59-65<br />
|url=http://www.cirp.org/library/general/leitch1/<br />
|accessdate=2019-12-15<br />
}}</ref> 5.5%.<br />
*<br />
* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], is cut during circumcision without being clamped and sutured at its origin separately, it starts to develop new branches over time, which can lead to the development of knots.<br />
* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro-penis) and induratio [[penis]] plastica (skewed penis).<br />
* Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis|glans]] or the [[penis]] can occur.<br />
* In rare cases, necrosis, gangrene, ischaemia, keloid formation and circulatory problems may also occur.<br />
* When the circumcision is followed by the ultra-orthodox Jewish ritual of Metzitzah B'Peh (which consists of sucking blood from the wound with the mouth), there is a risk of infection with [[herpes]] simplex type 1, which can lead to brain damage or death.<ref>{{REFweb<br />
|url=http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritual.html?_r=0<br />
|title=Baby’s Death Renews Debate Over a Circumcision Ritual<br />
|last=Robbins<br />
|first=Liz<br />
|date=2012-03-07<br />
|accessdate=2019-10-11<br />
}}</ref><br />
<br />
=== Physical late effects ===<br />
<br />
* An unavoidable late effect of any circumcision is the permanent loss of sexual sensitivity. This is partly due to the removal of sensory tissue. The [[foreskin]] contains very many nerve endings and touch receptors, which account for the major part of male sexual sensation. If the [[foreskin]] is removed, they can no longer provide sexual stimulation. It is also partly due to the fact that the surface of the [[Glans penis|glans]] reacts to the missing protection from friction and drying out by developing a callus layer. This reduces the sensitivity of the remaining nerves in the [[Glans penis|glans]] gradually over the years. The study conducted by Sorrells ''et al.''<ref>{{REFjournal<br />
|last=Sorrells<br />
|first=M.L.<br />
|last2=Snyder<br />
|first2=J..L.<br />
|last3=Reiss<br />
|first3=M.D.<br />
|etal=yes<br />
|title=Fine-touch pressure thresholds in the adult [[penis]]<br />
|journal=BJU Int<br />
|date=2007<br />
|volume=99<br />
|issue=<br />
|pages=864-869<br />
|url=<br />
|accessdate=<br />
}}</ref> found a significant reduction of sensitivity to touch for circumcised compared to intact [[penis]]es in adult males. Other studies revealed that circumcised men use condoms significantly less often than intact men, since they further limit the sexual sensitivity (see above).<br />
<br />
* Painful tension can occur when there is too little reserve skin left to support a full erection<ref>{{REFjournal<br />
|last=Taylor<br />
|first=J.R.<br />
|last2=Lockwood<br />
|first2=A.P.<br />
|last3=Taylor<br />
|first3=A.J.<br />
|title=The prepuce: <q>Specialized mucosa of the [[penis]] and its loss to circumcision</q><br />
|journal=British Journal of Urology<br />
|date=1996<br />
|volume=77<br />
|issue=<br />
|pages=291-295<br />
|url=<br />
|accessdate=<br />
}}</ref>. This risk is partly dependent on the anatomy of the [[penis]]. While some [[penis]]es already have the majority of their full size when flaccid ([[Flesh Penis]], or "[[shower]]"), others are rather short when flaccid and double or more their size during an erection ([[Blood Penis]], or "[[grower]]"). Especially in children's circumcision, where the [[penis]] is not yet fully developed, the amount of reserve skin needed in adulthood cannot be estimated.<br />
<br />
* Erectile dysfunction: Both the damage inflicted to the blood vessels in the [[foreskin]] and the reduced sexual sensitivity can be causes for reduced erectile function with advancing age.<ref>{{REFjournal<br />
|last=Money<br />
|first=J.<br />
|last2=Davison<br />
|first2=J.<br />
|title=Adult penile circumcision: Erotosexual and cosmetic sequelae<br />
|journal=Journal of Sex Research<br />
|date=1983<br />
|volume=19<br />
|issue=<br />
|pages=289-292<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
<br />
* Orgasm problems: In the wake of reduced sexual sensitivity, due to the loss of sensory tissue and gradual keratinization of the surface of the [[Glans penis|glans]], orgasm problems may develop with increasing age. In this case, the sexual arousal created by intercourse or [[masturbation]] is not enough to achieve orgasm. A preliminary stage of this late effect is the prolonged time circumcised men need to reach an orgasm. This is often fielded as the "cut men have more endurance" argument for circumcision.<br />
* Vaginal dryness: Due to the loss of the natural gliding action, which comes from the mobility of the fore- and shaft skin, a much increased friction between [[penis]] and vagina occurs during intercourse. This can make intercourse painful for both partners and lead to abrasions<ref>{{REFjournal<br />
|last=Frisch<br />
|first=Morten<br />
|author-link=Morten Frisch<br />
|first2=Morten<br />
|last2=Lindholm<br />
|first3=Morten<br />
|last3=Grønbæk<br />
|title=Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark<br />
|journal=International Journal of Epidemiology<br />
|date=2011-10<br />
|volume=40<br />
|issue=5<br />
|pages=1367-1381<br />
|url=<br />
|pubmedID=21672947<br />
|DOI=10.1093/ije/dyr104<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Cortés-González<br />
|first=J.<br />
|last2=Arratia-Maqueo<br />
|first2=J.<br />
|last3=Gómez-Guerra<br />
|first3=L.<br />
|title=Does circumcision has an effect on female's perception of sexual satisfaction?<br />
|journal=Rev Invest Clin<br />
|date=2008<br />
|volume=60<br />
|issue=3<br />
|pages=227<br />
|url=<br />
|pubmedID=18807735<br />
|accessdate=<br />
}}</ref> The prolonged time it takes circumcised men to reach orgasm, as well as the often longer and more vigorous thrusting movements - compared to intact men - play a part in this.<ref>{{REFjournal<br />
|last=Cold<br />
|first=C.J.<br />
|last2=Taylor<br />
|first2=J.R.<br />
|title=The prepuce<br />
|journal=BJU Int<br />
|date=1999<br />
|volume=83<br />
|issue=Suppl. 1<br />
|pages=34-44<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Fink<br />
|first=K.S.<br />
|last2=Carson<br />
|first2=C.C.<br />
|last3=DeVellis<br />
|first3=R.F.<br />
|title=Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction<br />
|journal=J Urol<br />
|date=2002<br />
|volume=167<br />
|issue=5<br />
|pages=2113-2116<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
<br />
* [[Lymphoedema]] of the penis is a normal and expected complication of male circumcision.<br />
<br />
* [[Meatal stenosis]], a pathological narrowing of the opening of the urethra, which mostly occurs in infancy and early childhood. It is one of the most common complications of infant circumcision. A study from 2006 found meatal stenosis exclusively in previously circumcised boys. The incidence rate after a circumcision is approximately 10 to 20 percent.<ref name="vanhowe2006">{{REFjournal<br />
|last=Van Howe<br />
|first=R.S.<br />
|title=Incidence of meatal stenosis following neonatal circumcision in a primary care setting<br />
|journal=Clin Pediatr (Phila)<br />
|note=Jan-Feb 2006<br />
|date=2006-01<br />
|volume=45<br />
|issue=1<br />
|pages=49-54<br />
|url=https://www.academia.edu/6992015/Incidence_of_Meatal_Stenosis_following_Neonatal_Circumcision_in_a_Primary_Care_Setting<br />
|accessdate=2019-12-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Stenram<br />
|first=A.<br />
|last2=Malmfors<br />
|first2=G.<br />
|last3=Okmian<br />
|first3=L.<br />
|title=Circumcision for [[phimosis]]: a follow-up study<br />
|journal=Scandinavian journal of urology and nephrology<br />
|date=1986<br />
|volume=20<br />
|issue=2<br />
|pages=89<br />
|url=<br />
|pubmedID=3749823<br />
|accessdate=<br />
}} </ref><ref>{{REFweb<br />
|url=http://emedicine.medscape.com/article/1016016-overview<br />
|title=Meatal Stenosis<br />
|publisher=Medscape<br />
|accessdate=2019-10-11<br />
}}</ref><br />
<br />
=== Psychological late effects ===<br />
<br />
[[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effects]] are also possible after a circumcision, especially if the operation was carried out in childhood. On this occasion a variety of trauma may occur, which depend, among others, on age and circumstances of the circumcision. For example, whether the circumcision took place with or without sufficient anaesthesia, if the individual has been informed about the operation beforehand, if he was circumcised against his will or without his consent, and also, in the case of infant circumcision, if he was told about it during childhood or had to find it out coincidentally on his own.<br />
<br />
The psychological late effects of circumcision are not yet fully researched, and many studies took place on rather a small scale. This situation needs to be rectified, because the available studies, as well as the histories of negatively affected men, suggest that these late effects may have more impact than previously assumed.<br />
<br />
* It was observed that infants, following circumcision without pain control, had a disturbed bond with their mother<ref>{{REFjournal<br />
|last=Marshall<br />
|first=R.E.<br />
|last2=Porter<br />
|first2=F.L.<br />
|last3=Rogers<br />
|first3=A.G.<br />
|etal=yes<br />
|title=Circumcision: II effects upon mother-infant interaction<br />
|journal=Early Hum Dev<br />
|date=1982<br />
|volume=7<br />
|issue=4<br />
|pages=367-374<br />
|url=http://www.cirp.org/library/birth/marshall2/<br />
|accessdate=2020-02-01<br />
}}</ref>, as well as problems with nurturing, up to the point of refusal to be fed. The sleeping habits of these babies were also disturbed, with prolonged non-REM sleep and increased waking.<br />
<br />
* In boys circumcised in childhood, post traumatic stress disorder (PTSD) could be diagnosed. In a study on Philippine boys, in whom no PTSD was found prior to the operation, 69% of the boys circumcised in the traditional ritual and 51% of those circumcised by standard medical procedures (including anaesthesia) fulfilled the DSM-IV criteria for PTSD following the operation.<ref>{{REFbook<br />
|last=Ramos<br />
|first=S<br />
|last2=Boyle<br />
|first2=GJ<br />
|year=2001<br />
|title=Understanding circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem<br />
|url=https://link.springer.com/chapter/10.1007/978-1-4757-3351-8_14<br />
|work=<br />
|editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]<br />
|edition=<br />
|volume=<br />
|chapter=Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder<br />
|pages=253-270<br />
|location=New York<br />
|publisher=Kluwer Academic/Plenum Publishers<br />
|isbn=<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref><br />
* Circumcisions, especially those that happen without consent, can spark feelings of helplessness and alienation, which can persist as trauma. These feeling can also be triggered later, when someone circumcised as an infant becomes aware of his circumcision. In an online study, interviewed men stated they felt betrayed - 55% by the mother, 50% by the father, and 58% by the doctor, and 73% felt that their human rights had been violated.<ref name="GSoCH">{{REFweb<br />
|url=http://www.circumcisionharm.org/<br />
|title=Global Survey of Circumcision Harm<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* It can frequently be found that the loss is denied, much as happens with the loss of other body parts. This denial can lead to fathers having their sons circumcised in order not to be reminded of their own loss. In this process, their own body is defined as "normal" and the [[foreskin]] redefined as a foreign object. Their own parents are seen as "good", so that this image is projected onto the circumcision their parents carried out as well, in order to keep the positive emotion intact. The father wants to be a "good" father later in life as well, and so, following an idealised image of his own parents, circumcision, which has been redefined as a "good thing", is passed on to his son by having him circumcised as well.<ref>{{REFjournal<br />
|last=van der Kolk<br />
|first=B.A.<br />
|url=http://www.cirp.org/library/psych/vanderkolk/<br />
|title=The compulsion to repeat the trauma: re-enactment, revictimization, and masochism<br />
|journal=Psychiatr Clin North Am<br />
|date=1989<br />
|volume=12<br />
|issue=2<br />
|pages=389-411<br />
|accessdate=2019-10-12<br />
}}</ref><ref>{{REFjournal<br />
|last=Goldman<br />
|first=R.<br />
|author-link=Ronald Goldman<br />
|url=http://www.cirp.org/library/psych/goldman1/<br />
|title=The psychological impact of circumcision<br />
|journal=BJU Int<br />
|date=1999<br />
|volume=83<br />
|issue=Suppl. 1<br />
|pages=93-103<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* If the circumcised male feels incomplete, or due to the missing [[foreskin]] disadvantaged compared to intact males, an inferiority complex and depression may occur. This can be accompanied by conscious recognition of his own incompleteness, or the deficiency may remain completely subconscious<ref>{{REFjournal<br />
|last=Rhinehart<br />
|first=J.<br />
|url=http://www.cirp.org/library/psych/rhinehart1/<br />
|title=Neonatal circumcision reconsidered<br />
|journal=Transactional Analysis J<br />
|date=1999<br />
|volume=29<br />
|issue=3<br />
|pages=215-221<br />
|accessdate=2019-10-12<br />
}}</ref>. In an online study, 75% of those interviewed stated that they felt incomplete, and 66% said they felt inferior compared with intact males.<ref name="GSoCH"/><br />
* Cases in which children felt ill treated or punished have been documented as well. G. Cansever found in her study on 12 boys aged between 4 and 7 years, who had previously been prepared for their impending circumcision, that the children experienced the operation as an aggressive assault on their bodies.<ref>{{REFjournal<br />
|last=Cansever<br />
|first=G.<br />
|date=1965<br />
|url=http://www.cirp.org/library/psych/cansever/<br />
|title=Psychological effects of circumcision<br />
|journal=Brit. J. Med. Psychol<br />
|volume=38<br />
|pages=321-331<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* Fear of being alone or darkness.<ref name="Levy1945">{{REFjournal<br />
|last=Levy<br />
|first=David M.<br />
|url=http://www.cirp.org/library/psych/levy1/<br />
|title=Psychic trauma of operations in children; and a note on combat neurosis<br />
|journal=American Journal of Diseases of Children<br />
|volume=69<br />
|date=1945<br />
|pages=7-25<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* Fear of doctors, clinics and also closed rooms.<ref name="Levy1945"/><br />
* Relapse into the state of bed-wetting, even if the child was already dry before.<ref name="Levy1945"/><br />
* Circumcised males who become fathers frequently manifest [[adamant father syndrome]].<br />
<br />
== Rights and ethics ==<br />
<br />
The [[Rights situation on circumcision|rights situation]] is discussed in separate article.<br />
<br />
<br />
-----<br />
<br />
<br />
{{FromIntactWiki<br />
|URL=http://intactwiki.org/wiki/Circumcision<br />
|Title=Circumcision<br />
}}<br />
<br />
[[Image:Intact vs circumcised.JPG |thumbnail|right|300px| The intact and circumcised human penis, side by side.]]<br />
<br />
The term "circumcision" without a gender qualifier refers specifically to male circumcision. It means "to cut around," and it refers to the excision of the [[foreskin]] from the penis. Circumcision is most often performed in healthy males for [[Religion and Culture|religious or cultural]] reasons. The procedure may be performed on consenting adults, but it is most often performed on non-consenting minors, particularly newborn children, which is why the ritual is so controversial. Opponents of circumcision consider the circumcision of non-consenting minors to be unethical and a human rights violation, unless there is concrete medical indication. Proponents of circumcision consider the circumcision of non-consenting minors to be a "religious freedom" and a "parental right."<br />
<br />
== Complications ==<br />
=== Pain ===<br />
In the past, advocates of circumcision claimed that a newborn child's nerve system was not yet fully developed, and that as a result, the child felt no pain during the circumcision procedure. Anand & Hickey (1987) have shown that newborn children do in fact feel pain, and more acutely than adults.<ref name="anand-hickey1987">{{REFjournal<br />
|last=Anand<br />
|first=<br />
|author-link=<br />
|last2=Hickey<br />
|first2=<br />
|author2-link=<br />
|etal=no<br />
|title=Pain and its effects in the human neonate and fetus<br />
|trans-title=<br />
|language=<br />
|journal=New Engl J Med<br />
|location=<br />
|date=1987-11-19<br />
|volume=317<br />
|issue=21<br />
|pages=1321-9<br />
|url=http://www.cirp.org/library/pain/anand/<br />
|quote=<br />
|pubmedID=3317037<br />
|pubmedCID=<br />
|DOI=<br />
|accessdate=2019-11-08<br />
}}</ref> This has led American health associations to recommend doctors take measures to reduce the pain of circumcision in infants.<br />
<br />
The [[Position Statements on Infant Circumcision|AAP Circumcision Policy Statement]] states quite clearly that ''"There is considerable evidence that newborns who are circumcised without analgesia experience pain and physiologic stress"''. Furthermore, the pain is quite severe, and requires injections for proper pain management. Sucrose and Acetaminophen ''"cannot be recommended as the sole method of analgesia"''. Topical cream is no longer thought sufficient as ''"the analgesic effect is limited during the phases associated with extensive tissue trauma such as...tightening of the clamp"''.<ref>{{REFjournal<br />
|last=<br />
|first=<br />
|title=American Academy of Pediatrics: Circumcision Policy Statement; Task Force on Circumcision<br />
|journal=Pediatrics<br />
|date=1999-03<br />
|volume=103<br />
|issue=3<br />
|pages=686-693<br />
|url=https://pediatrics.aappublications.org/content/103/3/686#sec-9<br />
|accessdate=2019-11-26<br />
|note=Statement Reaffirmed Sept. 1, 2005<br />
}}</ref><br />
<br />
The [[AAFP]] states quite simply in their [[Position Statements on Infant Circumcision|position paper]], ''"Newborns experience pain during circumcision".''<ref>{{REFweb<br />
|title=Circumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed<br />
|website=Official American Academy of Family Physicians Website<br />
|url=http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html<br />
|accessdate=2011-05-02<br />
}}</ref> This is not a debatable fact, and yet, it is not widely accepted, even by some doctors. It might be hard for some doctors to accept, as they may have been taught that the infant does not feel pain, and may have performed countless circumcisions with this idea. Usage of anesthesia for infant circumcision is still by no means the rule.<br />
<br />
Penile injections of anesthetic are now recommended by all of the major medical institutions. In their [http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml Report 10 of the Council on Scientific Affairs], the AMA states ''"When the decision is made to proceed with circumcision, local anesthesia should be provided for the procedure. Ring block or dorsal penile blocks [injections] are most effective. EMLA cream has limited utility"''. Alarmingly, ''"Despite the clear evidence that newborn males generate brisk pain responses during circumcision, a recent survey of residency training programs found that 26% of programs that taught circumcision provided no instruction on the use of local anesthesia". The AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, and 25% of obstetricians"''.<ref>{{REFweb<br />
|title=Report 10 of the Council on Scientific Affairs (I-99): Neonatal Circumcision<br />
|website=American Medical Association Official Website<br />
|url=http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml<br />
|accessdate=2011-05-04<br />
}}</ref><br />
<br />
The AAP's [http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx Heatlhy Children website] suggests ''"Your pediatrician (or your obstetrician) should discuss the forms of analgesia that are available"''.<ref>{{REFweb<br />
|title=Where We Stand: Circumcision<br />
|publisher=[[AAP]]<br />
|date=2011-03-23<br />
|url=http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx<br />
|accessdate=2019-10-12<br />
}}</ref> Be that as it may, few forms of analgesia are recommended. There are basically two types of injections to choose from, and the website does not go into the difference between a 'dorsal nerve block' and a 'ring block' injection.<br />
<br />
Given what is known from aforementioned official documents, the AAP website may be more informative and effective if it would say ''"Make sure your doctor knows of the ineffectiveness of anything short of local anesthesia, and make sure your baby is given an injection. This is your responsibility, because your doctor may or may not be up to date on the latest understandings of infant sensitivity to pain during circumcision."'' The AAP may be holding back, however, perhaps because this would upset the doctor/parent power relationship, and may cause too much questioning of doctors in general. One may not expect to find this kind of advice on such a website, and yet, anything less than this is a dangerously weak statement.<br />
<br />
To control pain, some physicians that circumcise use Tylenol, sugar,<ref>{{REFweb<br />
| quote=To calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, and soothing music is played in the room.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-guide.html<br />
| title=Parents' Guide to Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2011-04-08<br />
}}</ref><ref>{{REFweb<br />
| quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> a topical cream,<ref>{{REFweb<br />
| quote=Then in our office, he will have topical anesthetic applied to his penis.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb<br />
| quote=We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-guide.html<br />
| title=Parents' Guide to Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2011-04-08<br />
}}</ref> Topical anaesthetic only serves to numb the area to lessen the pain of the injection, but studies have shown that a dorsal penile ring block is not always effective in stopping the pain of circumcision.<ref name='Journal of Perinatology April/May 2002'>{{REFjournal<br />
|last=Taeusch<br />
|first=H. William<br />
|last2=Martinez<br />
|first2=Alma M.<br />
|last3=Partridge<br />
|first3=J. Colin<br />
|last4=Sniderman<br />
|first4=Susan<br />
|last5=Armstrong-Wells<br />
|first5=Jennifer<br />
|last6=Fuentes-Afflick<br />
|first6=Elena<br />
|title=Pain During Mogen or Plastibell Circumcision<br />
|journal=Journal of Perinatology<br />
|volume=22<br />
|issue=3<br />
|pages=214-218<br />
|url=http://www.nature.com/jp/journal/v22/n3/full/7210653a.html<br />
|quote=...more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|note=April/May 2002<br />
|date=2002-04<br />
|accessdate=2011-04-08<br />
}}</ref><ref name='Clinical Pediatrics August 1986'>{{REFjournal<br />
|last=Williamson<br />
|first=Paul S.<br />
|last2=Evans<br />
|first2=Nolan Donovan<br />
|title=Neonatal Cortisol Response to Circumcision with Anesthesia<br />
|journal=Clinical Pediatrics<br />
|volume=25<br />
|issue=8<br />
|pages=412-416<br />
|url=http://cpj.sagepub.com/content/25/8/412.abstract<br />
|quote=The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=1986-08<br />
|accessdate=2011-04-08<br />
}}</ref> During circumcision, somp physicians give children sugar pacifiers to "reduce the perception of pain",<ref>{{REFweb<br />
| quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> but in at least one study, data shows that giving sugar to a child doesn't help to reduce the perception of pain in the child.<ref name='Lancet, The 2010-10-09'>{{REFjournal<br />
|last=Slater<br />
|first=Rebeccah<br />
|first2=Laura<br />
|last2=Cornelissen<br />
|first3=Lorenzo<br />
|last3=Fabrizi<br />
|first4=Debbie<br />
|last4=Patten<br />
|first5=Jan<br />
|last5=Yoxen<br />
|first6=Alan<br />
|last6=Worley<br />
|first7=Stewart<br />
|last7=Boyd<br />
|first8=Judith<br />
|last8=Meek<br />
|first9=Maria<br />
|last9=Prof. Fitzgerald<br />
|title=Oral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial<br />
|journal=The Lancet<br />
|volume=376<br />
|issue=9748<br />
|pages=1225-1232<br />
|url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2961303-7/fulltext<br />
|quote=Our data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuits, and therefore might not be an effective analgesic drug. The ability of sucrose to reduce clinical observational scores after noxious events in newborn infants should not be interpreted as pain relief.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=2010-10-09<br />
|accessdate=2011-04-08<br />
}}</ref> Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals.<br />
<br />
It has been shown that an infant's response to pain can be altered for years as a consequence of circumcision.<ref>{{REFjournal<br />
|last=Taddio<br />
|first=Anna<br />
|first2=Morton<br />
|last2=Goldbach<br />
|first3=Moshe<br />
|last3=Ipp<br />
|first4=Bonnie<br />
|last4=Stevens<br />
|first5=Gideon<br />
|last5=Koren<br />
|title=Effect of neonatal circumcision on pain responses during vaccination in boys<br />
|journal=The Lancet<br />
|volume=345<br />
|issue=8945<br />
|pages=291-2<br />
|url=http://www.cirp.org/library/pain/taddio/<br />
|quote=<br />
|pubmedID=7837863<br />
|pubmedCID=<br />
|DOI=<br />
|date=1995<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Taddio<br />
|first=Anna<br />
|last2=Katz<br />
|first2=J.<br />
|last3=Ilersich<br />
|first3=A.L.<br />
|last4=Koren<br />
|first4=G.<br />
|title=Effects of neonatal circumcision on pain response during subsequent routine vaccination<br />
|journal=The Lancet<br />
|volume=349<br />
|issue=9052<br />
|pages=599-603<br />
|url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)10316-0/fulltext<br />
|quote=<br />
|pubmedID=9057731<br />
|pubmedCID=<br />
|DOI=10.1016/S0140-6736(96)10316-0<br />
|date=1997-03<br />
|accessdate=<br />
}}</ref><br />
<br />
=== Sexual effects ===<br />
<br />
Circumcision and frenectomy remove tissues with heightened erogenous sensitivity. Boyle ''et al.'' (2002) wrote, "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings&mdash;many of which are lost to circumcision."<ref>{{REFjournal<br />
|last=Boyle<br />
|first=Gregory J.<br />
|author-link=Gregory Boyle<br />
|first2=Gillian A.<br />
|last2=Bensley<br />
|title=Adverse Sexual and Psychological Effects of Male Infant Circumcision<br />
|journal=Psychological reports<br />
|volume=88<br />
|issue=3, Part 2<br />
|pages=1105–1106<br />
|url=http://www.cirp.org/library/psych/boyle5/<br />
|quote=<br />
|pubmedID=11597060<br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410x.1999.0830s1085.x<br />
|date=July 2001<br />
|accessdate=<br />
}}</ref> They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well."<br />
<br />
The amputation of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the penis, leaving only the uninhibited protopathic sensibility of the artificially externalized glans penis. The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of the changes in sexual behavior noted in circumcised human males.<ref>{{REFjournal<br />
|last=Van Howe<br />
|first=R.S.<br />
|author-link=Robert Van Howe<br />
|last2=Cold<br />
|first2=C.J.<br />
|title=Advantages and Disadvantages of Neonatal Circumcision<br />
|journal=The Journal of the American Medical Association<br />
|volume=277<br />
|issue=13<br />
|pages=1052-7<br />
|url=http://www.ncbi.nlm.nih.gov/pubmed/9218663<br />
|quote=<br />
|pubmedID=9218663<br />
|pubmedCID=<br />
|DOI=<br />
|date=1997-04-02<br />
|accessdate=<br />
}}</ref><br />
<br />
Histology of the male circumcision scar shows amputation neuromas, Schwann cell proliferation and the bulbous collection of variably sized neurites. Amputation neuromas do not mediate normal sensation and are notorious for generating pain.<ref>{{REFjournal<br />
|last=Cold<br />
|first=C.J.<br />
|first2=J.R.<br />
|last2=Taylor<br />
|title=The prepuce<br />
|journal=British Journal of Urology International<br />
|volume=83<br />
|issue=<br />
|pages=34-44<br />
|url=http://www.cirp.org/library/anatomy/cold-taylor/<br />
|quote=<br />
|pubmedID=10349413<br />
|pubmedCID=<br />
|DOI=<br />
|date=1999-1<br />
|accessdate=<br />
}}</ref><br />
<br />
=== Death ===<br />
A study in 2010 estimated approximately 117 neonatal circumcision-related deaths occur annually in the United States, about one out of every 77 male neonatal deaths, more than suffocation, auto accidents, or even SIDS.<ref name="Bollinger 2010">{{REFjournal<br />
|last=Bollinger<br />
|first=Dan<br />
|author-link=Dan Bollinger<br />
|last2=Boy's Health Advisory<br />
|title=Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths<br />
|journal=Thymos: Journal of Boyhood Studies<br />
|volume=4<br />
|issue=1<br />
|pages=78-90<br />
|url=http://www.mensstudies.com/content/b64n267w47m333x0/?p=7ebbd6b446d940cbbd4274c095754b12π=5<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.3149/thy.0401.78<br />
|date=2010-04-26<br />
|accessdate=2019-10-12<br />
}}</ref><ref>{{REFweb<br />
| quote=<br />
| url=http://www.icgi.org/2010/04/infant-circumcision-causes-100-deaths-each-year-in-us<br />
| title=Infant circumcision causes 100 deaths each year in US<br />
| last=<br />
| first=<br />
| publisher=ICGI<br />
| website=International Coalition for Genital Integrity<br />
| date=2010-04-26<br />
| accessdate=<br />
}}</ref> See also the list of [[fatalities]].<br />
<br />
== Forced circumcision ==<br />
<br />
<!--=== United States military ===<br />
<br />
American soldiers serving in World War II were subjected to regular inspections of their genitals. If uncircumcised, the soldiers risked being ordered to undergo immediate circumcision.<ref>{{REFbook<br />
|last=Schoen<br />
|first=Ed<br />
|author-link=Edgar J. Schoen<br />
|year=2005<br />
|title=On Circumcision<br />
|url=https://books.google.de/books?id=-zUhdvSt7cgC<br />
|work=<br />
|editor=Dianne Yeakey<br />
|edition=<br />
|volume=<br />
|chapter=<br />
|pages=72-73<br />
|location=Georgetown, Canada<br />
|publisher=RDR Books<br />
|isbn=1-157143-123-3<br />
|quote=For a critical view, see Sorrells, "The History of Circumcision," p. 333<br />
|accessdate=<br />
|note=<br />
}}</ref> This practice was discontinued at least six decades ago.--><br />
<br />
=== Non-therapeutic circumcision of male children ===<br />
<br />
Human babies, because they are not yet in possession of language, are incapable of giving or refusing consent for being circumcised. The element of force has led some scholars to view the circumcision of baby boys as a category of forced circumcision.<ref>For example, Frederick M. Hodges, a medical historian, writes: "In the late 1970s, as the Americans were growing increasingly aware of the abuses of power rampant throughout the nation's social institutions, influential grass-roots movements protesting the forced circumcision of American children sprang up nationwide." F. Hodges, "A Short History," p. 31; see also [[Leonard B. Glick|Glick]], ''Marked in Your Flesh'', pp. 273-281.</ref> There are, however, physicians in the United States who argue strongly for non-therapeutic circumcision of newborn babies; and circumcision is widely accepted as a postnatal procedure in American hospitals.<ref>{{REFbook<br />
|last=Fletcher<br />
|first=Christopher R.<br />
|year=1999<br />
|title=Circumcision in America in 1998: Attitudes, Beliefs, and Charges of American Physicians<br />
|url=http://www.springerlink.com/content/h2150v731233m177/<br />
|work=Male and Female Circumcision<br />
|editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]<br />
|edition=<br />
|volume=<br />
|chapter=Section 5<br />
|pages=259-271<br />
|location=New York<br />
|publisher=Kluwer Academic/Plenum Publishers<br />
|isbn=<br />
|quote=<br />
|accessdate=2019-10-12<br />
|note=ID 10.1007/978-0-585-39937-9_19<br />
}}</ref> Parental consent is required.<ref>See, e.g., Shephard and Shephard, ''The Complete Guide'', p. 125.</ref> A statement published by the American Academy of Pediatrics in 1999 declares that "parents should determine what is in the best interest of the child... It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in additions to the medical factors, when making a decision."<ref>Lannon and Bailey, "Circumcision Policy Statement," p. 691.</ref> In the United Kingdom, where non-therapeutic circumcision has now become far less prevalent than in the United States, a written consent of both parents is required, if a physician is to perform a non-therapeutic circumcision of a child.<ref>{{REFjournal<br />
|last=<br />
|first=<br />
|title=Re J (child's religious upbringing and circumcision)<br />
|journal=Family Court Reports<br />
|date=2000<br />
|volume=1<br />
|issue=<br />
|pages=307-314<br />
|url=http://www.cirp.org/library/legal/Re_J/2000.html<br />
|accessdate=2019-10-12<br />
}}</ref> (The National Health Service does not provide non-therapeutic circumcision.)<br />
<br />
In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<ref>See, e.g., Somerville, "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; Chessler, "Justifying the Unjustifiable"; Smith, "Male Circumcision."</ref> For example, critics have pointed out that, in the United States, more than 1.3% of male neonatal deaths are attributable to the complications of non-therapeutic circumcision surgery.<ref name="Bollinger 2010"/>refer<ref>{{REFweb<br />
|quote=<br />
|url=http://www.icgi.org/2010/04/infant-circumcision-causes-100-deaths-each-year-in-us<br />
|title=Infant circumcision causes 100 deaths each year in US<br />
|last=Bollinger<br />
|first=Dan<br />
|author-link=Dan Bollinger<br />
|publisher=International Coalition for Genital Integrity<br />
|date=2010-04-26<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
{{SEEALSO}}<br />
* [[Sexual effects of circumcision]]<br />
* [[FGM]]<br />
* [[MGM]]<br />
* [[Risks and complications]]<br />
* [[Documented severe complications of circumcision]]<br />
* [[Circumcision scar]]<br />
* [[Circumpendium]]<br />
* [[Human rights]]<br />
* [[Ethics of non-therapeutic child circumcision]]<br />
* [[Rights situation on circumcision]]<br />
* [[Circumcision methods]]<br />
* [[Case Histories]]<br />
* [[Lymphoedema]]<br />
* [[Psychological issues of male circumcision]]<br />
<br />
{{REF}}<br />
<br />
[[Category:From Intactipedia]]<br />
[[Category:From IntactWiki]]<br />
[[Category:Male circumcision]]<br />
[[Category:Genital surgery]]<br />
[[Category:Terms]]<br />
[[Category:Islam]]<br />
[[Category:Judaism]]<br />
[[Category:Circumcision]]<br />
[[de:Zirkumzision]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Child_circumcision&diff=14351Child circumcision2020-05-04T18:24:32Z<p>WikiModEn4: /* Search for prophylactic reasons */</p>
<hr />
<div>{{GraphicWarning}}<br />
"Male '''circumcision''' (from Latin ''circumcidere'', meaning "to cut around") is the surgical removal of the [[foreskin]] (prepuce) part of the human [[penis]]. The foreskin comprises ''more than fifty percent'' of the epithelium of the penis.<ref name="taylor1996">{{REFjournal<br />
|last=Taylor<br />
|first=J.R.<br />
|author-link=John R. Taylor<br />
|last2=Lockwood<br />
|first2=A.P.<br />
|author2-link=<br />
|last3=Taylor<br />
|first3=A.J.<br />
|title=The prepuce: specialized mucosa of the penis and its loss to circumcision<br />
|journal=Brit J Urol<br />
|date=1996<br />
|volume=77<br />
|issue=<br />
|pages=291-5<br />
|url=http://onlinelibrary.wiley.com/doi/10.1046/j.1464-410X.1996.85023.x/full<br />
|quote=<br />
|pubmedID=8800902<br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410X.1996.85023.x<br />
|accessdate=2019-10-14<br />
}}</ref> [...] The procedure is most often an elective non-therapeutic surgery performed on neonates and children for religious and cultural reasons, but in other cases may be indicated for both therapeutic and prophylactic reasons. It is a radical treatment option for pathological [[phimosis]], refractory [[Balanitis| balanoposthitis]] and chronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health. <br />
<br />
'''Posthectomy''' is a more accurate medical term that more accurately reflects the injury and loss of functional body tissue, but the Biblical euphemism, ''circumcision'', is more commonly used. <br />
<br />
With reference to involuntary, non-therapeutic circumcision of children, [[Child Genital Cutting (CGC)]] is a new term that has been introduced to avoid issues associated with more traditional terms.<br />
<br />
== Historical background ==<br />
<br />
The amputation of the [[foreskin]] is a very old ritual, whose exact origin cannot be verified beyond doubt. Medical historians assume that circumcision already served in ancient history as a way to control the sexuality of slaves and members of the lower classes without compromising their ability to reproduce. In religious history circumcision may be seen as a substitute for human sacrifice. In prehistoric times it was not uncommon to placate the gods with human sacrifice. Castration of slaves or conquered enemies was common as well. Following religious changes this sacrifice was altered, and only a part of the very organ responsible for the creation of new life was sacrificed.<br />
<br />
[[Image:Circumcision Sakkara 3.jpg|200px|right]] For the Aborigines, the Australian natives, the tradition of circumcision is said to go back to 10,000 BC. On the African continent, the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of circumcision date back to the time around 3000-2000 BC. The oldest known depiction<ref>{{REFweb<br />
|url=https://commons.wikimedia.org/wiki/File:Circumcision_Sakkara_3.jpg<br />
|title=File:Circumcision Sakkara 3.jpg<br />
|accessdate=2019-10-12<br />
}}</ref> is an Egyptian tomb relief from the 6th dynasty, approximately 2300-2000 BC. It is not known precisely who was circumcised and why in those times.<br />
<br />
In many cultures circumcision during puberty serves as a rite of passage, bringing adolescents into the community. As with other painful or humiliating initiation rites, proof of courage and mastering of critical situations are the key motivations. From some African tribes it is also known that the amputation of the [[foreskin]] is seen as the removal of an inborn piece of femininity from the boys, thus making them men.<br />
<br />
===Judaism===<br />
<br />
In the Jewish religion, the tradition of circumcision goes back to a passage in the Book of Genesis (17, 10-14). It is seen as a [[Abrahamic covenant| covenant between God and man]], dating back to the patriarch Abraham.<br />
<br />
{{Citation<br />
|Text=10 This is my covenant with you and your descendants after you, the covenant you are to keep: Every male among you shall be circumcised. 11 You are to undergo circumcision, and it will be the sign of the covenant between me and you. 12 For the generations to come every male among you who is eight days old must be circumcised, including those born in your household or bought with money from a foreigner—those who are not your offspring. 13 Whether born in your household or bought with your money, they must be circumcised. My covenant in your flesh is to be an everlasting covenant. 14 Any uncircumcised male, who has not been circumcised in the flesh, will be cut off from his people; he has broken my covenant.” <br />
|Author=Bible<br />
|Source=Gen 17, 10-14, NIV<br />
}}<br />
<br />
According to the anthropologist and sociologist Nissan Rubin, the Jewish form of circumcision, called ''[[Brit Milah| brit mila]]'', during the first two millennia did not include the later customary ''periah'', namely the complete scraping of the inner [[foreskin]] from the [[Glans penis|glans]]. This was only added around 135 AD, to make it impossible to restore the [[foreskin]] by stretching, which became popular in the wake of Hellenic influence. While originally only the tip of the [[foreskin]] was cut off, periah removes the entire [[foreskin]]. In the Greek society of the day, a denuded [[Glans penis|glans]] was considered obscene and risible. In ultra-orthodox communities, circumcision is followed by the ''[[mohel]]'', the ritual circumciser, sucking blood from the wound with his mouth. This practice is highly controversial, as it can result in an infection with [[herpes]] simplex type 1. In New York City, between 2000 and 2011 eleven children were infected with [[herpes]], 10 of whom had to be treated in hospital. Two of them suffered permanent brain damage, two others died. In the 12th century, the Jewish philosopher and doctor [[Moses Maimonides| Maimonides]] pointed out that circumcision was necessary, as it diminished sexual desires and reduced the pleasure to a degree just sufficient for mere reproduction.<br />
<br />
===Christianity===<br />
Jesus was born into a Jewish family in Israel, where Judaism was the prevailing religion, so he was circumcised on the eighth day.<ref name="luke2:21>{{REFweb<br />
|url=https://www.biblegateway.com/passage/?search=Luke+2%3A21&version=NASB<br />
|title=Gospel of Luke<br />
|trans-title=<br />
|language=<br />
|last=Luke<br />
|first=<br />
|author-link=<br />
|publisher=NASB<br />
|website=Bible Gateway<br />
|date=<br />
|accessdate=2019-11-10<br />
|format=<br />
|quote=And when eight days had passed, before His circumcision, His name was then called Jesus, the name given by the angel before He was conceived in the womb.<br />
}}</ref><br />
<br />
The first Christians had been born Jewish, so a question arose whether one must be circumcised to be a Christian. When Christian leaders met at the [[Council at Jerusalem]] in the First Century to decide what was required to be a Christian, a letter was written to explain the requirements, but circumcision was omitted from the requirements.<ref>{{REFweb<br />
|url=https://www.biblegateway.com/passage/?search=Acts+15%3A1-30&version=NASB<br />
|title=Acts 15:1-30<br />
|last=Luke<br />
|first=<br />
|accessdate=2019-11-10<br />
}}</ref><br />
<br />
In Christianity, circumcision is practiced only in a few Coptic churches. There is no general belief that circumcision is a requirement of Christianity.<ref name="hill2004">{{REFweb<br />
|url=http://www.cirp.org/pages/cultural/christian.html<br />
|title=The Holy Bible, Circumcision, False Prophets, and Christian Parents<br />
|trans-title=<br />
|language=<br />
|last=Hill<br />
|first=George<br />
|author-link=George Hill<br />
|publisher=Circumcision Reference Library<br />
|website=<br />
|date=2004-08-29<br />
|accessdate=2019-11-10<br />
|format=HTML<br />
|quote=The falseness of those who advocate circumcision is a recurrent theme in the New Testament. <br />
}}</ref><br />
<br />
Nevertheless, Christian moral notions had decisive influence on the spread of this practice. In the puritan influenced USA, circumcision of children was popular in the 19th century as a means to prevent [[masturbation]]. In those days, this so-called ‘self-abuse‘ was not only considered immoral, but was supposedly responsible for a variety of diseases. Masturbation, however, is not mentioned anywhere in the Holy Bible, so there is no support for the belief that it is somehow immoral or sinful. <br />
<br />
Even the mere existence of a [[foreskin]] was linked to many illnesses. Among them one could find syphilis, epilepsy, paralysis of the spine, bed wetting, scoliosis (spinal deformity), paralysis of the bladder, club foot, nerve pain in the lower abdomen, tuberculosis and lazy eye. One of the best known advocates of child circumcision was [[John Harvey Kellogg]], co-inventor of the corn flakes bearing his name. In 1888, he wrote:<br />
<br />
{{Citation<br />
|Text=A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of [[phimosis]]. The operation should be performed by a surgeon without administering an anaesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. In females, the author has found the application of pure carbolic acid to the clitoris an excellent means of allaying the abnormal excitement, and preventing the recurrence of the practice in those whose will-power has become so weakened that the patient is unable to exercise entire self-control. <br />
|Author=[[John Harvey Kellogg]]<br />
|Source=<br />
|ref=<ref>{{REFbook<br />
|url=https://archive.org/details/plainfaorold00kell/page/290<br />
|chapter=Treatment for Self-abuse and Its Effects<br />
|title=Plain Facts for Old and Young<br />
|location=Burlington, Iowa<br />
|publisher=F. Segner & Co.<br />
|year=1888<br />
|pages=107<br />
}}</ref><br />
}}<br />
<br />
===Islam===<br />
In Islam, circumcision is also religiously founded, even though there is no mention of it in the Koran itself. According to tradition, the Prophet Mohammed was born without a [[foreskin]]. It is seen as a sign of prophets that they are born without a [[foreskin]] already. It is considered an honour to "resemble the example of the Prophet", meaning to be circumcised. In Islam, unlike Judaism, there is no specific age at which the circumcision should be performed. Most circumcisions take place at ages between 6 and 10 years, but the range goes from birth to adulthood.<br />
<br />
== Rationale ==<br />
<br />
Reasons for performing circumcision range widely by culture, religion, location, and age.<br />
<br />
===Cultural===<br />
<br />
Many cultures perform circumcision as a rite of passage into manhood. This is common in the Middle East and amongst some indigenous African and Southeast Asian peoples.<br />
<br />
The United States and Israel are the only industrialized countries in the world to have a high incidence of non-therapeutic infant male circumcision. The vast majority of infant circumcisions performed in the United States are for non-religious, non-medical reasons. See [[History of circumcision]].<br />
<br />
===Religious===<br />
The circumcision of newborn boys is seen as a divine commandment in the Jewish faith. Though absent in the Koran, male circumcision is considered a religious requirement in Islam, and it is performed on male children of varying ages. Converts to these faiths may also choose to undergo circumcision, but it is not always required.<br />
<br />
===Medical indication===<br />
In some cases, circumcision is legitimately indicated; a patient may be suffering recurring infections, and other methods of treatment have failed. In other cases, a patient may be suffering from a severe case of [[phimosis]]. Overall, the actual medical necessity for circumcision is extremely rare. All circumcisions injure the patient by amputating the [[foreskin]] its with many protective, immunological, sensory, and sexual [[Foreskin#Physiological_functions| functions]]. <br />
<br />
# '''Deformed or malformed foreskin'''. A foreskin so deformed or malformed that it does not function properly may be removed by circumcision.<br />
<br />
# '''Traumatically injured foreskin'''. A foreskin so traumatically injured foreskin that cannot be surgically repaird is a valid medical reason for circumcision.<br />
<br />
# '''Diseased foreskin.''' A foreskin that is diseased is a valid indication for cirumcision. Some diseases that qualify are malignancy, lichen sclerosis, yeast infection in men with diabetes, and recurrent posthitis.<br />
<br />
In such cases, the benefit of removing the problem foreskin may exceed the maleficial results of tissue and function destruction.<br />
<br />
====Arguments of prophylaxia====<br />
Though the practice of ritual circumcision of males, both consenting and non-consenting, has existed for millenia, the search for "potential medical benefits" began relatively recently. The discussion of circumcision in the Ninth Edition of the ''Encyclopǽdia Britannica'' (1876) made no mention of any prophylactic, medical, or therapeutic value or function.<ref>{{REFweb<br />
|url=http://www.cirp.org/library/history/encyclopaediabritannica1876/<br />
|title=Circumcision<br />
|trans-title=<br />
|language=<br />
|last=Cheyne<br />
|first=T. K.<br />
|author-link=<br />
|publisher=Encyclopǽdia Brittanica<br />
|website=Circumcision Reference Library<br />
|date=1876<br />
|accessdate=2019-11-10<br />
|format=<br />
|quote=<br />
}}</ref><br />
<br />
Initially, circumcision was adopted as a way to stop boys and men from masturbating, where masturbation was seen as the cause for many diseases. As the myth that circumcision prevented [[masturbation]] became debunked, advocates of circumcision began the great search to find the "medical benefits" of circumcision. <br />
<br />
Male and female circumcision involves the removal and disruption of normal anatomical structures that are primary areas of sexual sensation.<ref name="taylor1996" /> In the past, some advocates of mass circumcision have considered the prepuce to be a "mistake of nature,"<ref><br />
<nowiki>{{Cold and Wiswell (1995)}} | [[Template:Cold and Wiswell (1995)|see more]]</nowiki></p><br />
</ref> but this notion has no validity because the prepuce is ubiquitous in primates and because it provides functional advantages.<ref name="cold-mcgrath1995">{{REFbook<br />
|last=Cold<br />
|first=Christopher<br />
|last2=McGrath<br />
|first2=Kenneth<br />
|author2-link=Ken McGrath<br />
|year=1999<br />
|title=Male and female circumcision: medical, legal, and ethical considerations in pediatric practice<br />
|url=http://www.cirp.org/library/anatomy/cold-mcgrath/<br />
|work=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=Anatomy and histology of the penile and clitoral prepuce in primates<br />
|pages=<br />
|location=New York<br />
|publisher=<br />
|isbn=0306461315<br />
|quote=<br />
|accessdate=2019-10-12<br />
|note=<br />
}}</ref><br />
<br />
===Search for prophylactic reasons===<br />
<br />
The practice of finding prophylactic reasons for infant circumcision started in Germany in the nineteenth century, when non-Jewish Germans criticized the Jewish practice of infant circumcision as being barbaric, Jewish doctors sprang to the defense of the religious practice by claiming health benefits.<ref name="ephron2001">{{REFbook<br />
|last=Ephron<br />
|first=John M.<br />
|author-link=<br />
|year=2001<br />
|title=Medicine and the German Jews<br />
|url=http://www.cirp.org/library/history/ephron1/<br />
|work=<br />
|editor=<br />
|edition=<br />
|volume=<br />
|chapter=6<br />
|pages=222-233<br />
|location=New Haven<br />
|publisher=Yale University Press<br />
|isbn=0-300-08377-7<br />
|quote=<br />
|accessdate=2019-11-20<br />
|note=<br />
}}</ref> And so started the long tradition of Jewish doctors inventing reasons for circumcision (and deceving gentile doctors).<br />
<br />
Following the discovery of bacteria as a cause of many diseases – such as tuberculosis – the search began for other illnesses that could be prevented by circumcision.<br />
<br />
In 1870 the renowned Dr. Lewis A. Sayre of NYC’s Bellevue Hospital claimed to cure a boy’s paralyzed legs with circumcision. Sayre advocacy of circumcision exemplified how [https://intaction.org/circumcision-facts-and-myths/ circumcision myths] originated and facts were disregarded. He also claimed to cure epilepsy, mental disorders, hip-joint pain, & hernias with circumcision. “Genital irritations” & masturbation were deemed to be the cause of these issues.<ref>American Medical Association. Transactions of the American Medical Association. 1870;21:205–11</ref> <br />
<br />
In the 1920s it was penile cancer. Abraham L. Wolbarst (1926) claims that circumcision can prevent penile cancer.<ref name="wolbarst1926">{{REFjournal<br />
|last=Wolbarst<br />
|first=Abraham L.<br />
|author-link=Abraham L. Wolbarst<br />
|title=Is circumcision a prophylactic against penis cancer?<br />
|journal=Cancer<br />
|date=Jul 1926<br />
|volume=3<br />
|issue=4<br />
|pages=301-10<br />
}}</ref>. <br />
<br />
In the 1940s, prostate and tongue cancer as well as STDs. Eugene H. Hand (1949) falsely explains that circumcision somehow protects against venereal diseases and tongue cancer.<ref name="hand1949">{{REFjournal<br />
|title=Circumcision and venereal disease.<br />
|last=Hand<br />
|first=Eugene H.<br />
|journal=Archives of Dermatology and Syphilology<br />
|date=Sep 1949<br />
|volume=60<br />
|issue=3<br />
|pages=341-346<br />
}}</ref>. <br />
<br />
In the 1950s it was cervical cancer. Abraham Ravich (1951) invents the myth that circumcision reduces the risk of women getting cervical cancer.<ref name="ravich1951">{{REFjournal<br />
|url=https://www.ncbi.nlm.nih.gov/pubmed/14853120<br />
|title=Prophylaxis of cancer of the prostate, penis, and cervix by circumcision<br />
|last=Ravich<br />
|first=Abraham<br />
|last2=Ravich<br />
|first2=R.A.<br />
|journal=New York State Journal of Medicine<br />
|date=Jun 1951<br />
|volume=51<br />
|issue=12<br />
|pages=1519-1520<br />
|pubmedID=14853120<br />
|accessdate=2019-10-12<br />
}}</ref> <br />
<br />
In the late 1960s it was neuroses. Morris Fishbein (1969) calls for circumcision to prevent nervousness and, of course, [[masturbation]].<ref>{{REFbook<br />
|last=Fishbein<br />
|first=Morris<br />
|chapter=Sex hygiene<br />
|title=Modern Home Medical Adviser<br />
|location=Garden City, New York<br />
|publisher=Doubleday & Co<br />
|year=1969<br />
|pages=90, 119<br />
|url=https://openlibrary.org/works/OL95362W/Modern_home_medical_adviser<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
In the 1970s bladder- and rectal cancer. Abraham Ravich (1971) claims that circumcision would prevent bladder cancer and rectal cancer.<ref>{{REFjournal<br />
|last=Ravich<br />
|first=Abraham<br />
|url=https://www.deepdyve.com/lp/wiley/viral-carcinogenesis-in-venereally-susceptible-organs-HCeWmTLmKl<br />
|title=Viral carcinogenesis in venereally susceptible organs<br />
|journal=Cancer<br />
|date=Jun 1971<br />
|volume=27<br />
|issue=6<br />
|pages=1493-1496<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
In the 1980s, UTIs. Thomas E. Wiswell (1985) claims that circumcision, using a methodologically flawed report, reduces the risk of urinary tract infections.<ref name="wiswell1985">{{REFjournal <br />
|last=Wiswell<br />
|first=Thomas E.<br />
|author-link=Thomas E. Wiswell<br />
|url=https://pediatrics.aappublications.org/content/75/5/901<br />
|title=Decreased incidence of urinary tract infections in circumcised male infants<br />
|journal=Pediatrics<br />
|date=May 1985<br />
|volume=75<br />
|issue=5<br />
|pages=901-903<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
Aaron J. Fink (1986), with no evidence whatsoever, claims that circumcision protects against AIDS followed.<ref name="fink1986">{{REFjournal<br />
|last=Fink<br />
|first=Aaron J.<br />
|author-link=Aaron J. Fink<br />
|title=A possible explanation for heterosexual male infection with AIDS<br />
|journal=New England Journal of Medicine<br />
|date=1986-10-30<br />
|volume=31<br />
|issue=18<br />
|pages=1167<br />
|url=https://www.nejm.org/doi/full/10.1056/NEJM198610303151818<br />
|DOI=10.1056/NEJM198610303151818<br />
|accessdate=2019-11-20<br />
}}</ref> <br />
<br />
Retrospectively, circumcision was always advertised as a cure for whatever disease was in the public spotlight at the time. [[Doctors Opposing Circumcision]] (2016) states:<br />
<blockquote><br />
These claims date originally from before the advent of evidence-based medicine, when doctors relied on the opinions of other clinicians to inform their practice, rather than on scientifically collected evidence.<ref name="doc2016">{{REFweb<br />
|url=https://www.doctorsopposingcircumcision.org/for-professionals/alleged-medical-benefits/<br />
|title=Alleged Medical Benefits<br />
|trans-title=<br />
|language=<br />
|last=<br />
|first=<br />
|author-link=<br />
|publisher=Doctors Opposing Circumcision<br />
|website=<br />
|date=2016-05<br />
|accessdate=2019-11-20<br />
|format=<br />
|quote=<br />
}}</ref><br />
</blockquote><br />
<br />
The sheer mass of studies and publications that were released during those almost 180 years on this topic are the reason that even arguments that have been disproved multiple times, especially regarding infant and child circumcision, tenaciously persist up until today.<br />
<br />
An ever-recurring element of initiation rites found in many different cultures is the fixation upon the genitalia.<br />
<br />
It reflects the fascination that emerges from the ability to create new life. In most cultures, fertility is seen as the most precious good, and the body parts involved frequently find themselves in the focus of ritual acts. In many parts of the world, those rites take place when the boy reaches puberty, and are meant to symbolize his transition from boy to man. The removal of the male [[foreskin]] is just one of many phenomena that developed in this context. They range from the removal of the frenulum in boys and men through partial or complete removal of the [[foreskin]] up to radical operations. Australian Aborigines, as mentioned above, have their [[foreskin]]s removed. It is also usual that, a few weeks later, young men have their [[penis]]es sliced open, resulting in a partly or completely divided urethra.<br />
<br />
Another known, particularly massive, intervention is the stripping of the entire skin off the [[penis]]. In Indonesia, boys have metal or bamboo balls inserted into their [[penis]] shaft or [[Glans penis|glans]] at the beginning of puberty, which form little "humps".<br />
<br />
For many cultures it is also common to perform similar rituals on girls. This can range from relatively small interventions such as piercing or cutting the clitoral hood, to its complete removal and up to radical removal of clitoral hood, clitoris, inner and outer labia followed by sewing up the vagina.<br />
<br />
''The following text is taken from the [[Circumpendium]].''<br />
<br />
=== Prophylactic reasons ===<br />
<br />
Some people claim that circumcision has prophylactic benefits. Especially in the USA those arguments have persisted for more then a 100 years, with ever changing diseases circumcision is said to protect against. At first, these were diseases where [[masturbation]] was believed to be the cause. After bacteria and viruses had been discovered, arguments changed, and one after another miscellaneous diseases were cited.<br />
<br />
* [[Phimosis]]: as mentioned earlier, true [[phimosis]] is rare and can be treated effectively without surgery. According to a study by Blalock ''et al.'' (2003)<ref>{{REFjournal<br />
|last=Blalock<br />
|first=H.J.<br />
|last2=Vemulakonda<br />
|first2=V.<br />
|last3=Ritchey<br />
|first3=M.L.<br />
|last4=Ribbeck<br />
|first4=M.<br />
|title=Outpatient management of [[phimosis]] Following newborn circumcision<br />
|journal=J Urol<br />
|date=2003<br />
|volume=169<br />
|issue=6<br />
|pages=2332-2334<br />
|url=http://www.cirp.org/library/complications/blalock1/<br />
|accessdate=2019-11-07<br />
}}</ref>, 2.9% of those circumcised develop a post-operative [[phimosis]], in which the circumcision scar constricts. In intact patients, the rate of [[phimosis]] is only 1% (see also the study by [[Jakob Øster]]). Therefore, circumcision is not a preventive measure for [[phimosis]].<br />
* Sexually Transmitted Diseases (STDs): a vast number of studies has been conducted on the subject of transmission of STDs.<br />
* First, it has to be noted that any form of protection against these diseases only affects people who are sexually active. Circumcision in childhood cannot be justified on these grounds, since any assumed protective effect will not occur before the boy is already old enough to decide about circumcision for himself.<br />
* As mentioned above, the [[foreskin]] keeps the [[Glans penis|glans]] moist. This subpreputial moisture contains, among other substances, the enzyme lysozyme, which breaks up the cell wall of bacteria, thereby providing a natural antibacterial screen. This explains the results of several studies, such as Laumann ''et al.''<ref>{{REFjournal<br />
|last=Laumann<br />
|first=E.O.<br />
|last2=Masi<br />
|first2=C.M.<br />
|last3=Zuckerman<br />
|first3=E.W.<br />
|title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice<br />
|journal=JAMA<br />
|date=1997<br />
|volume=277<br />
|issue=<br />
|pages=1052-1057<br />
|url=http://www.cirp.org/library/general/laumann/<br />
|accessdate=2019-11-06<br />
}}</ref>, which found a higher rate of infection with bacterial venereal diseases in circumcised than in intact men.<br />
* The studies by Fleiss ''et al.'' (1998) support this.<ref name="fleiss-hodges-vanhowe1998">{{REFjournal<br />
|last=Fleiss<br />
|first=P.M.<br />
|last2=Hodges<br />
|first2=F.M.<br />
|last3=Van Howe<br />
|first3=R.S.<br />
|title=Immunological functions of the human prepuce<br />
|journal=Sex Transm Inf<br />
|date=1998<br />
|volume=74<br />
|issue=<br />
|pages=364-367<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1758142/pdf/v074p00364.pdf<br />
|accessdate=2019-11-06<br />
}}</ref> According to the [[AAP]], the general sexual behaviour of the male - such as frequent change in partners and the use of condoms - has a much higher impact on sexually transmitted diseases then the circumcision status.<ref>{{REFjournal<br />
|last=Task Force on Circumcision<br />
|first=<br />
|title=Circumcision policy statement<br />
|journal=Pediatrics<br />
|date=1999<br />
|volume=103<br />
|issue=3<br />
|pages=686-93<br />
|url=http://www.cirp.org/library/statements/aap1999/<br />
|accessdate=2019-11-15<br />
}}</ref><br />
* HIV / AIDS: in the recent past, the argument that circumcision could help to contain the spread of HIV has been stated numerous times.<br />
*:First, two notes: for one, the use of condoms is still by far the most effective protection against an infection. During intercourse with that preventive measure, circumcision status does not make a difference.<br />
*:Secondly, the assumed protection would only affect healthy men who have intercourse with an infected woman. An infected man can infect a women by transmission of his bodily fluids, so that his circumcision status is irrelevant. Therefore, the use of condoms remains vital in containing the spread of HIV, which in return renders circumcision unnecessary<br />
* Due to the inevitable loss of sensitivity as a result of circumcision, there is also the temptation to go without condoms, in order not to lose even more sensitivity.<ref>{{REFjournal<br />
|last=Hooykaas<br />
|first=C.<br />
|last2=van der Velde<br />
|first2=F.W.<br />
|last3=van der Linden<br />
|first3=M.M.<br />
|etal=yes<br />
|title=The importance of ethnicity as a risk factor for STDs and sexual behaviour among heterosexuals<br />
|journal=Genitourin Med<br />
|date=1991<br />
|volume=67<br />
|issue=5<br />
|pages=378-383<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1194736/pdf/genitmed00041-0022.pdf<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Michael<br />
|first=R.T.<br />
|last2=Wadsworth<br />
|first2=J.<br />
|last3=Feinleib<br />
|first3=J.<br />
|etal=yes<br />
|title=Private sexual behavior, public opinion, and public health policy related to sexually transmitted diseases: a US-British comparison<br />
|journal=Am J Public Health<br />
|date=1998<br />
|volume=88<br />
|issue=5<br />
|pages=749-754<br />
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1508929/pdf/amjph00017-0039.pdf<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Laumann<br />
|first=E.O.<br />
|last2=Masi<br />
|first2=C.M.<br />
|last3=Zuckerman<br />
|first3=E.W.<br />
|title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice<br />
|journal=JAMA<br />
|date=1997<br />
|volume=277<br />
|issue=<br />
|pages=1052-1057<br />
|url=http://www.cirp.org/library/general/laumann/<br />
|accessdate=2019-11-06<br />
}}</ref><br />
* Two studies that have been published in early 2007<ref>{{REFjournal<br />
|last=Gray, R.H. and colleagues<br />
|first=<br />
|title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial<br />
|journal=Lancet<br />
|date=2007<br />
|volume=369<br />
|issue=<br />
|pages=657-666<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=[[Robert C. Bailey|Bailey, R.C.]] and colleagues<br />
|first=<br />
|title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial<br />
|journal=Lancet<br />
|date=2007<br />
|volume=369<br />
|issue=<br />
|pages=643-656<br />
|url=<br />
|accessdate=<br />
}}</ref>, which investigated the effectiveness of circumcision as a means of reducing the spread of HIV from infected women to heterosexual men in African high risk areas, have been repeatedly subjected to strong criticism. Both studies were ended prematurely, which distorted the results. The men who had been circumcised for the study had to stay sexually inactive during the wound healing, which gave the intact control group more relative opportunity to become infected. These African randomized clinical trials have been demonstrated to have very serious methodological and statistical errors that distort the results in favor of circumcision.<ref name="boyle-hill2011">{{REFjournal<br />
|last=Boyle<br />
|first=Gregory J.<br />
|author-link=Gregory Boyle<br />
|last2=Hill<br />
|first2=George<br />
|author2-link=George Hill<br />
|title=Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns<br />
|journal=J Law Med<br />
|date=2011-12<br />
|volume=19<br />
|issue=2<br />
|pages=316-34<br />
|url=http://www.salem-news.com/fms/pdf/2011-12_JLM-Boyle-Hill.pdf<br />
|quote=<br />
|pubmedID=22320006<br />
|pubmedCID=<br />
|DOI=<br />
|accessdate=2019-11-09<br />
}}</ref><br />
<br />
The fact that the USA has both the highest rate of circumcised males in the western world, as well as the highest HIV infection rate, makes the studies look dubious. Besides that, several other studies concluded that circumcision does not have a significant impact on the risk of infection with HIV.<ref>{{REFjournal<br />
|last=Grosskurth<br />
|first=H.<br />
|last2=Mosha<br />
|first2=F.<br />
|last3=Todd<br />
|first3=J.<br />
|etal=yes<br />
|title=A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results<br />
|journal=AIDS<br />
|date=1995<br />
|volume=9<br />
|issue=8<br />
|pages=927-934<br />
|url=https://insights.ovid.com/aids/aids/1995/08/000/community-trial-impact-improved-sexually/15/00002030<br />
|accessdate=2019-11-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Barongo<br />
|first=L.R.<br />
|last2=Borgdorff<br />
|first2=M..W.<br />
|last3=Mosha<br />
|first3=F.F.<br />
|etal=yes<br />
|title=The epidemiology of HIV-1 infection in urban areas, roadside settlements and rural villages in Mwanza Region, Tanzania<br />
|journal=AIDS<br />
|date=1992<br />
|volume=6<br />
|issue=12<br />
|pages=1521-1528<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Changedia SM, Gilada IS<br />
|first=<br />
|title=Role of male circumcision in HIV transmission insignificant in conjugal relationship (abstract no. ThPeC7420)<br />
|url=<br />
|place=Barcelona, Spain<br />
|source=Presented at the Fourteenth International AIDS Conference<br />
|datefrom=2002-07-07<br />
|dateto=2002-07-12<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Connolly CA, Shishana O, Simbayi L, Colvin M<br />
|first=<br />
|title=HIV and circumcision in South Africa (Abstract No. MoPeC3491)<br />
|url=<br />
|place=Bangkok, Thailand<br />
|source=Presented at the 15th International AIDS Conference<br />
|datefrom=2004-07-11<br />
|dateto=2004-07-16<br />
|accessdate=<br />
}}</ref><ref>{{REFconference<br />
|last=Thomas AG, Bakhireva LN, Brodine SK, Shaffer RA<br />
|first=<br />
|title=Prevalence of male circumcision and its association with HIV and sexually transmitted infections in a U.S. navy population (Abstract no. TuPeC4861)<br />
|url=https://apps.dtic.mil/dtic/tr/fulltext/u2/a458066.pdf<br />
|place=Bangkok, Thailand<br />
|source=Presented at the 15th International AIDS Conference<br />
|datefrom=2004-07-11<br />
|dateto=2004-07-16<br />
|accessdate=2019-11-15<br />
}}</ref><br />
* Urinary tract infections (UTI): a UTI can be effectively treated with antibiotics, this was also proven by studies<ref>{{REFjournal<br />
|last=McCracken<br />
|first=G.<br />
|title=Options in antimicrobial management of urinary tract infections in infants and children<br />
|journal=Pediatr Infect Dis J<br />
|date=1989<br />
|volume=8<br />
|issue=8<br />
|pages=552-555<br />
|url=http://www.cirp.org/library/disease/UTI/mccracken/<br />
|accessdate=2019-11-19<br />
}}</ref><ref>{{REFjournal<br />
|last=Larcombe<br />
|first=J.<br />
|title=Urinary tract infection in children<br />
|journal=BMJ<br />
|date=1999<br />
|volume=319<br />
|issue=<br />
|pages=1173-1175<br />
|url=<br />
|accessdate=<br />
}}</ref>. A Swedish study <ref>{{REFjournal<br />
|last=Mårild<br />
|first=S.<br />
|last2=Jodal<br />
|first2=U.<br />
|title=Incidence rate of first–time symptomatic urinary tract infection in children under 6 years of age<br />
|journal=Acta Paediatr<br />
|date=1998<br />
|volume=87<br />
|issue=5<br />
|pages=549-552<br />
|url=<br />
|accessdate=<br />
}}</ref> found that, during the first 6 years of life, the incidence of UTIs in boys was 1.8%, but in girls was 6.6%. UTIs are less common in boys after the first year of life. Mueller ''et al.'' <ref>{{REFjournal<br />
|last=Mueller<br />
|first=E.R.<br />
|last2=Steinhardt<br />
|first2=G.<br />
|last3=Naseer<br />
|first3=S.<br />
|title=The incidence of genitourinary abnormalities in circumcised and uncircumcised boys presenting with an initial urinary tract infection by 6 months of age<br />
|journal=Pediatrics<br />
|date=1997<br />
|volume=100 (Supplement)<br />
|issue=<br />
|pages=580<br />
|url=<br />
|accessdate=<br />
}}</ref> did not find a significant difference in UTI rates between circumcised and intact boys with normal urinary tract anatomy.<br />
* Other studies suggest that circumcision is more likely to raise than to lower the generally low risk of acquiring UTI: multiple studies from Israel showed a strong correlation between ritual circumcision on the 8th day of life and postoperative UTI.<ref>{{REFjournal<br />
|last=Menahem<br />
|first=S.<br />
|title=Complications arising from ritual circumcision: pathogenesis and possible prevention<br />
|journal=Isr J Med Sci<br />
|date=1981<br />
|volume=17<br />
|issue=1<br />
|pages=45-48<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Cohen<br />
|first=H.A.<br />
|last2=Drucker<br />
|first2=M.M.<br />
|last3=Vainer<br />
|first3=S.<br />
|etal=yes<br />
|title=Postcircumcision urinary tract infection<br />
|journal=Clin Pediatr<br />
|date=1992<br />
|volume=31<br />
|issue=6<br />
|pages=322-324<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Goldman<br />
|first=M.<br />
|last2=Barr<br />
|first2=J.<br />
|last3=Bistritzer<br />
|first3=T.<br />
|last4=Aladjem<br />
|first4=M.<br />
|title=Urinary tract infection following ritual Jewish circumcision<br />
|journal=Isr J Med Sci<br />
|date=1996<br />
|volume=32<br />
|issue=<br />
|pages=1098-1102<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
* It can be concluded that circumcision is ineffective as a preventive measure against UTIs.<br />
* Penile and cervical cancer / HPV: first studies on those diseases and their assumed prevention by circumcision date back to 1932, a time when the cause for those illnesses was not yet fully understood<br />
<ref>{{REFjournal<br />
|last=Wolbarst<br />
|first=A.<br />
|title=Circumcision and penile cancer<br />
|journal=Lancet<br />
|date=1932<br />
|volume=1<br />
|issue=5655<br />
|pages=150-153<br />
|url=<br />
|accessdate=<br />
}}</ref>. Today, it is known that sexually transmitted human papillomavirus (HPV) is a major risk factor<ref>{{REFjournal<br />
|last=McCance<br />
|first=D.J.<br />
|last2=Kalache<br />
|first2=A.<br />
|last3=Ashdown<br />
|first3=K.<br />
|etal=yes<br />
|title=Human papillomavirus types 16 and 18 in carcinomas of the penis from Brazil<br />
|journal=Int J Cancer<br />
|date=1986<br />
|volume=37<br />
|issue=1<br />
|pages=55-59<br />
|url=<br />
|accessdate=<br />
}}</ref>, as well as smoking<ref>{{REFjournal<br />
|last=Harish<br />
|first=K.<br />
|last2=Ravi<br />
|first2=R.<br />
|title=The role of tobacco in penile carcinoma<br />
|journal=Brit J Urol<br />
|date=1995<br />
|volume=75<br />
|issue=3<br />
|pages=375-377<br />
|url=<br />
|accessdate=<br />
}}</ref>. Studies have shown that there is no significant difference in the risk of getting penile cancer between circumcised and intact men. To prevent a single case of penile cancer, it would statistically take 600 to 900 circumcisions<ref>{{REFdocument<br />
|title=Position Paper on Neonatal Circumcision<br />
|url=<br />
|contribution=<br />
|last=<br />
|first=<br />
|publisher=American Academy of Family Physicians (Leawood, Kansas)<br />
|format=<br />
|date=2002-02-14<br />
|accessdate=<br />
}}</ref>. The influence of circumcision on the infection risk of the female partner with cervical cancer has been refuted several times as well. HPV vaccination is an effective measure against carcinoma of the cervix.<br />
<br />
In conclusion, circumcision does not provide any proven benefits in preventive medicine.<br />
<br />
== Non-medical indications for circumcision ==<br />
<br />
Apart from the medical indication of pathological phimosis, there also are other reasons for circumcision.<br />
<br />
=== Aesthetic reasons ===<br />
<br />
The visual appearance of the [[penis]] is changed radically after circumcision. In this case, personal taste is decisive whether an intact or a cut [[penis]] is more appealing. Since a circumcision cannot be undone, it is essential to be fully informed about the risks and possible later complications before embarking on an aesthetically motivated circumcision, to decide whether the appearance will justify such bodily modification.<br />
<br />
Since this modification and its possible late effects will be the lifelong burden of the person who undertakes an aesthetically motivated circumcision to suit his personal preferences, a valid decision to proceed can only be made by the person to be circumcised himself, once he has reached the necessary age and level of maturity to make that decision. This should normally be the case when adulthood is reached.<br />
<br />
It should be noted that every circumcision operation leaves a life-long [[circumcision scar]] that encircles the shaft of the penis.<br />
<br />
===Financial reasons===<br />
<br />
In the United States, payment for non-therapeutic circumcision is made by most [[third-party payment| third-party payers]] without question. Doctors frequently perform medically-unnecessary, non-therapeutic circumcision of infants and children simply to collect a fee for the surgical operation. The only beneficiary of such surgery is the [[Financial Incentive| bank account of the medical doctor]].<br />
<br />
=== Moral reasons ===<br />
<br />
With the [[foreskin]], circumcision removes approximately 70% of the sensitive tissue of the [[penis]], lowering the potential for sexual stimulation accordingly. Due to the loss of around 50% of the entire penile skin, the [[penis]] loses the reserve skin that provides cutaneous mobility in the erect [[penis]] and the [[gliding action]].<br />
<br />
In the past, this circumstance was used to make it harder for boys to masturbate and [[masturbation]] less fun, as [[masturbation]] was viewed as immoral and was assumed to cause a variety of diseases. More on that can be found in the chapter "[[Circumcision#Historical_background|Historical background]]". Today, it is known that [[masturbation]] has no negative health effects, but can contribute positively to the child's sexual development. Sexuality is no longer a taboo nowadays, while [[masturbation]] is considered to be a natural part of human sexuality and is no longer seen as immoral. Therefore, circumcision for moral reasons - which would only affect boys too young to give informed consent - is no longer justifiable nowadays.<br />
<br />
=== Hygiene reasons ===<br />
<br />
''Hygiene'' refers to health and only secondarily to cleanliness. <br />
<br />
One should note that the human foreskin is endowed by nature with [[Foreskin#Immunological_functions| immunological functions]] that serve to protect the human body from disease.<ref name="fleiss-hodges-vanhowe1998" /> The glans penis receives blood through the frenular artery.<ref>{{REFjournal<br />
|last=Persad<br />
|first=R.<br />
|author-link=<br />
|last2=Sharma<br />
|first2=S.<br />
|author2-link=<br />
|last3=McTavish<br />
|first3=J.<br />
|author3-link=<br />
|etal=yes<br />
|title=Clinical presentation and pathophysiology of meatal stenosis following circumcision<br />
|journal=Brit J Urol<br />
|date=1995<br />
|volume=75<br />
|issue=1<br />
|pages=91-3<br />
|url=https://www.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.1995.tb07242.x<br />
|quote=<br />
|pubmedID=7850308 <br />
|pubmedCID=<br />
|DOI=10.1111/j.1464-410x.1995.tb07242.x<br />
|accessdate=2019-11-26<br />
}}</ref> These facts are generally overlooked in arguments for alleged hygienic benefits of circumcision.<br />
<br />
A common reason stated for circumcision is the assumption of hygienic benefits. This argument has to be viewed in the context of the environment the person in question grows up in. It is commonly known that bad hygienic circumstances, especially insufficient access to clean drinking water, pose a serious problem. The situation in disaster areas or refugee camps in the so-called third world keep reminding us of that.<br />
<br />
In western industrial nations, however, this problem does not exist, in view of the availability of clean water for daily personal hygiene. If the cleaning of the genitals is performed on a daily basis - and that may be assumed - no pathogens can accumulate under the [[foreskin]]. Cleaning of the [[Glans penis|glans]] and the area underneath the [[foreskin]] is easy - they are simply washed along with the rest of the body, just like the areas between the toes.<br />
<br />
In small boys, where the [[foreskin]] cannot be retracted yet, cleaning is not necessary, since the [[Synechia| membrane]] that fuses the [[foreskin]] to the [[Glans penis|glans]] prevents the accumulation of micro-organisms. The so-called "ballooning", where the [[foreskin]] inflates during urination, is not a serious problem.<br />
<br />
The opening of the [[foreskin]] in small boys is often quite narrow and serves as a one-way valve, allowing the urine to flow out, but preventing entry of microbes, for example from a dirty diaper. As long as the child is able to pass water, everything works as nature intended.<br />
<br />
But even in areas where there are poorer hygienic conditions and an insufficient access to medical care, the benefits of easier cleaning of a circumcised [[penis]] are to be viewed with a critical eye. Although even longer periods without personal hygiene will not result in an accumulation of germs under the [[foreskin]], circumcision itself is not without risk of complications. If the operation is carried out without proper sterility, there is a high risk of an infection of the wound. This also applies to the treatment of common complications like post-operative bleeding.<br />
<br />
The benefit of easier cleaning must be balanced against the risk of promoting serious infections - among others HIV - during the operation. In parts of Africa, several dozen of one tribe's boys die each year as a result of their circumcision.<br />
<br />
<br />
== Circumcision methods ==<br />
<br />
The [[Circumcision methods]] are discussed in a separate article.<br />
<br />
== Risks and late effects ==<br />
<br />
Just like tonsil or appendix surgery, circumcision is a surgical intervention and brings the usual risks related to surgical operations, alongside several specific risks of complications and late effects.<br />
<br />
=== Possible operative and postoperative complications ===<br />
<br />
Circumcision is surgery. Surgical complications of circumcision generally may be classified as hemorrhage, infection, or surgical misadventure up to and including loss of the penis and [[death]].<ref name="williams-kapilla1993">{{REFjournal<br />
|last=Williams<br />
|first=N<br />
|author-link=<br />
|last2=Kapilla<br />
|first2=L<br />
|author2-link=<br />
|etal=no<br />
|title=Complications of circumcision<br />
|trans-title=<br />
|language=<br />
|journal=Brit J Surg<br />
|location=<br />
|date=1993-10<br />
|volume=80<br />
|issue=10<br />
|pages=1231-6<br />
|url=http://www.cirp.org/library/complications/williams-kapila/<br />
|quote=<br />
|pubmedID=8242285<br />
|pubmedCID=<br />
|DOI=10.1002/bjs.1800801005<br />
|accessdate=2019-11-27<br />
}}</ref><br />
<br />
* Intolerance or allergic reactions to the narcotics used.<br />
* Especially in newborns, where the bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is often insufficient for the operation. Even in conjunction with regional anaesthesia of the dorsal nerve of the [[penis]], the rate of failure to provide sufficient anaesthetic even for experienced anaesthetists is still 5-10%. The general anaesthesia that would be needed for newborns, however, poses significant risks for the child, and, therefore, is only likely to be used in emergencies. A surgical operation without proper pain control can lead to the development of a specific pain memory<ref>{{REFweb<br />
|url=http://www.spiegel.de/spiegel/vorab/experte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-849534.html<br />
|title=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder<br />
|trans-title=Children's pain expert warns: Ritual circumcision changes the brain of children<br />
|language=German<br />
|last=Prof. Dr. med. Boris Zernikow<br />
|first=<br />
|publisher=Spiegel Online<br />
|website=<br />
|date=2012-08-12<br />
|accessdate=2019-10-11<br />
|format=<br />
|quote=<br />
}}</ref>. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation. Overall, their pain threshold was lower and the risk of chronic pain increased. Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFjournal<br />
|last=Garry<br />
|first=T.<br />
|title=Circumcision: a survey of fees and practices<br />
|journal=OBG Management<br />
|date=1994<br />
|volume=October<br />
|issue=<br />
|pages=34-36<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Howard<br />
|first=C.R.<br />
|last2=Howard<br />
|first2=F.M.<br />
|last3=Garfunkel<br />
|first3=L.C.<br />
|last4=de Blieck<br />
|first4=E.A.<br />
|last5=Weitzman<br />
|first5=M.<br />
|title=Neonatal circumcision and pain relief: current training practices<br />
|journal=Pediatrics<br />
|date=1998<br />
|volume=101<br />
|issue=<br />
|pages=423-428<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Stang<br />
|first=H.J.<br />
|last2=Snellman<br />
|first2=L.W.<br />
|title=Circumcision practice patterns in the United States<br />
|journal=Pediatrics<br />
|date=1998<br />
|volume=101<br />
|issue=e5<br />
|pages=<br />
|url=<br />
|accessdate=<br />
|note=Link to [[AAP]] website<br />
}}</ref>. During procedures which take several minutes, babies tend to fall into a state of stupor, which in the past was falsely interpreted as peaceful sleep, nurturing the belief that babies felt no pain. Measurements taken in those cases revealed a typically 3- to 4-fold increase in cortisol levels, which equals a state of severe shock.<ref>{{REFjournal<br />
|last=Gunnar<br />
|first=M.R.<br />
|last2=Fisch<br />
|first2=R.O.<br />
|last3=Korsvik<br />
|first3=S.<br />
|last4=Donhowe<br />
|first4=J.M.<br />
|title=The effects of circumcision on serum cortisol and behavior<br />
|journal=Psychoneuroendocrinology<br />
|date=1981<br />
|volume=6<br />
|issue=3<br />
|pages=269-275<br />
|url=http://www.cirp.org/library/pain/gunnar/<br />
|accessdate=2019-11-26<br />
}}</ref><br />
* Postoperative wound pain, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions.<br />
* Postoperative pain from the exposure of the sensitive glans penis to clothing. This pain will endure for several weeks or even longer in some cases.<br />
* Postoperative bleeding of the wound. This can have severe consequences especially for very young infants, if they are not treated promptly. Their blood volume is only about 85 ml per kilogram of body weight, and even moderate blood loss can lead to hypovolaemia, hypovolaemic shock and even death.<ref>{{REFbook<br />
|last=<br />
|first=<br />
|year=2000<br />
|title=Paediatric Handbook<br />
|url=<br />
|work=<br />
|editors=Smart J, Nolan T.<br />
|edition=6<br />
|volume=<br />
|chapter=<br />
|pages=82<br />
|location=Victoria, Australia<br />
|publisher=Blackwell Science Asia<br />
|isbn=<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref><ref>{{REFdocument<br />
|title=Autopsy of Demetrius Manker<br />
|url=<br />
|contribution=Case 93-1711<br />
|last=Wetli<br />
|first=CV<br />
|publisher=Miami: Dade County Medical Examiner Department<br />
|format=<br />
|date=1993-06-23<br />
|accessdate=<br />
}}</ref> <ref>{{REFjournal<br />
|last=Hiss<br />
|first=J.<br />
|last2=Horowitz<br />
|first2=A.<br />
|last3=Kahana<br />
|first3=T.<br />
|title=Fatal haemorrhage following male ritual circumcision<br />
|journal=J Clin Forensic Med<br />
|date=2000<br />
|volume=7<br />
|issue=<br />
|pages=32-34<br />
|url=http://www.cirp.org/library/death/hiss1/<br />
|accessdate=2019-11-06<br />
}}</ref><ref>{{REFdocument<br />
|title=Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan<br />
|url=http://www.circumstitions.com/death-exsang.html<br />
|contribution=<br />
|last=Newell<br />
|first=TEC<br />
|publisher=Burnaby, B.C.: B.C. Coroner's Service<br />
|format=<br />
|date=2004-01-19<br />
|accessdate=2019-11-26<br />
}}</ref><br />
* Post operative [[lymphoedema]].<br />
* Postoperative infections. This includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.<ref>{{REFconference<br />
|last=Dr. med. Hartmann<br />
|first=Wolfgang<br />
|url=<br />
|place=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German)<br />
|title=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German)<br />
|date=2012-11-26<br />
|accessdate=<br />
}}</ref><br />
* [http://www.circumstitions.com/Restric/Botched9wd.html Wound dehiscence], meaning the separation of the edges of the wound or the tissue after suturing.<br />
* Adhesion between the surface or rim of the [[Glans penis|glans]] with the neighbouring penile skin, causing skin pockets and bridges, as well as visually unpleasant results like uneven scars, which make a re-circumcision necessary.<br />
* Postoperative [[phimosis]]: a phimotic ring can develop during scarring, which makes a re-circumcision necessary. According to a study by Blalock ''et al.''<ref>{{REFjournal<br />
|last=Blalock<br />
|first=H.J.<br />
|last2=Vemulakonda<br />
|first2=V.<br />
|last3=Ritchey<br />
|first3=M.L.<br />
|last4=Ribbeck<br />
|first4=M.<br />
|title=Outpatient management of [[phimosis]] Following newborn circumcision<br />
|journal=J Urol<br />
|date=2003<br />
|volume=169<br />
|issue=6<br />
|pages=2332-2334<br />
|url=http://www.cirp.org/library/complications/blalock1/<br />
|accessdate=2019-11-26<br />
}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal<br />
|last=Leitch<br />
|first=I.O.W.<br />
|title=Circumcision - a continuing enigma<br />
|journal=Aust Paediatr J<br />
|date=1970<br />
|volume=6<br />
|issue=<br />
|pages=59-65<br />
|url=http://www.cirp.org/library/general/leitch1/<br />
|accessdate=2019-12-15<br />
}}</ref> 5.5%.<br />
*<br />
* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], is cut during circumcision without being clamped and sutured at its origin separately, it starts to develop new branches over time, which can lead to the development of knots.<br />
* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro-penis) and induratio [[penis]] plastica (skewed penis).<br />
* Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis|glans]] or the [[penis]] can occur.<br />
* In rare cases, necrosis, gangrene, ischaemia, keloid formation and circulatory problems may also occur.<br />
* When the circumcision is followed by the ultra-orthodox Jewish ritual of Metzitzah B'Peh (which consists of sucking blood from the wound with the mouth), there is a risk of infection with [[herpes]] simplex type 1, which can lead to brain damage or death.<ref>{{REFweb<br />
|url=http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritual.html?_r=0<br />
|title=Baby’s Death Renews Debate Over a Circumcision Ritual<br />
|last=Robbins<br />
|first=Liz<br />
|date=2012-03-07<br />
|accessdate=2019-10-11<br />
}}</ref><br />
<br />
=== Physical late effects ===<br />
<br />
* An unavoidable late effect of any circumcision is the permanent loss of sexual sensitivity. This is partly due to the removal of sensory tissue. The [[foreskin]] contains very many nerve endings and touch receptors, which account for the major part of male sexual sensation. If the [[foreskin]] is removed, they can no longer provide sexual stimulation. It is also partly due to the fact that the surface of the [[Glans penis|glans]] reacts to the missing protection from friction and drying out by developing a callus layer. This reduces the sensitivity of the remaining nerves in the [[Glans penis|glans]] gradually over the years. The study conducted by Sorrells ''et al.''<ref>{{REFjournal<br />
|last=Sorrells<br />
|first=M.L.<br />
|last2=Snyder<br />
|first2=J..L.<br />
|last3=Reiss<br />
|first3=M.D.<br />
|etal=yes<br />
|title=Fine-touch pressure thresholds in the adult [[penis]]<br />
|journal=BJU Int<br />
|date=2007<br />
|volume=99<br />
|issue=<br />
|pages=864-869<br />
|url=<br />
|accessdate=<br />
}}</ref> found a significant reduction of sensitivity to touch for circumcised compared to intact [[penis]]es in adult males. Other studies revealed that circumcised men use condoms significantly less often than intact men, since they further limit the sexual sensitivity (see above).<br />
<br />
* Painful tension can occur when there is too little reserve skin left to support a full erection<ref>{{REFjournal<br />
|last=Taylor<br />
|first=J.R.<br />
|last2=Lockwood<br />
|first2=A.P.<br />
|last3=Taylor<br />
|first3=A.J.<br />
|title=The prepuce: <q>Specialized mucosa of the [[penis]] and its loss to circumcision</q><br />
|journal=British Journal of Urology<br />
|date=1996<br />
|volume=77<br />
|issue=<br />
|pages=291-295<br />
|url=<br />
|accessdate=<br />
}}</ref>. This risk is partly dependent on the anatomy of the [[penis]]. While some [[penis]]es already have the majority of their full size when flaccid ([[Flesh Penis]], or "[[shower]]"), others are rather short when flaccid and double or more their size during an erection ([[Blood Penis]], or "[[grower]]"). Especially in children's circumcision, where the [[penis]] is not yet fully developed, the amount of reserve skin needed in adulthood cannot be estimated.<br />
<br />
* Erectile dysfunction: Both the damage inflicted to the blood vessels in the [[foreskin]] and the reduced sexual sensitivity can be causes for reduced erectile function with advancing age.<ref>{{REFjournal<br />
|last=Money<br />
|first=J.<br />
|last2=Davison<br />
|first2=J.<br />
|title=Adult penile circumcision: Erotosexual and cosmetic sequelae<br />
|journal=Journal of Sex Research<br />
|date=1983<br />
|volume=19<br />
|issue=<br />
|pages=289-292<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
<br />
* Orgasm problems: In the wake of reduced sexual sensitivity, due to the loss of sensory tissue and gradual keratinization of the surface of the [[Glans penis|glans]], orgasm problems may develop with increasing age. In this case, the sexual arousal created by intercourse or [[masturbation]] is not enough to achieve orgasm. A preliminary stage of this late effect is the prolonged time circumcised men need to reach an orgasm. This is often fielded as the "cut men have more endurance" argument for circumcision.<br />
* Vaginal dryness: Due to the loss of the natural gliding action, which comes from the mobility of the fore- and shaft skin, a much increased friction between [[penis]] and vagina occurs during intercourse. This can make intercourse painful for both partners and lead to abrasions<ref>{{REFjournal<br />
|last=Frisch<br />
|first=Morten<br />
|author-link=Morten Frisch<br />
|first2=Morten<br />
|last2=Lindholm<br />
|first3=Morten<br />
|last3=Grønbæk<br />
|title=Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark<br />
|journal=International Journal of Epidemiology<br />
|date=2011-10<br />
|volume=40<br />
|issue=5<br />
|pages=1367-1381<br />
|url=<br />
|pubmedID=21672947<br />
|DOI=10.1093/ije/dyr104<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Cortés-González<br />
|first=J.<br />
|last2=Arratia-Maqueo<br />
|first2=J.<br />
|last3=Gómez-Guerra<br />
|first3=L.<br />
|title=Does circumcision has an effect on female's perception of sexual satisfaction?<br />
|journal=Rev Invest Clin<br />
|date=2008<br />
|volume=60<br />
|issue=3<br />
|pages=227<br />
|url=<br />
|pubmedID=18807735<br />
|accessdate=<br />
}}</ref> The prolonged time it takes circumcised men to reach orgasm, as well as the often longer and more vigorous thrusting movements - compared to intact men - play a part in this.<ref>{{REFjournal<br />
|last=Cold<br />
|first=C.J.<br />
|last2=Taylor<br />
|first2=J.R.<br />
|title=The prepuce<br />
|journal=BJU Int<br />
|date=1999<br />
|volume=83<br />
|issue=Suppl. 1<br />
|pages=34-44<br />
|url=<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Fink<br />
|first=K.S.<br />
|last2=Carson<br />
|first2=C.C.<br />
|last3=DeVellis<br />
|first3=R.F.<br />
|title=Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction<br />
|journal=J Urol<br />
|date=2002<br />
|volume=167<br />
|issue=5<br />
|pages=2113-2116<br />
|url=<br />
|accessdate=<br />
}}</ref><br />
<br />
* [[Lymphoedema]] of the penis is a normal and expected complication of male circumcision.<br />
<br />
* [[Meatal stenosis]], a pathological narrowing of the opening of the urethra, which mostly occurs in infancy and early childhood. It is one of the most common complications of infant circumcision. A study from 2006 found meatal stenosis exclusively in previously circumcised boys. The incidence rate after a circumcision is approximately 10 to 20 percent.<ref name="vanhowe2006">{{REFjournal<br />
|last=Van Howe<br />
|first=R.S.<br />
|title=Incidence of meatal stenosis following neonatal circumcision in a primary care setting<br />
|journal=Clin Pediatr (Phila)<br />
|note=Jan-Feb 2006<br />
|date=2006-01<br />
|volume=45<br />
|issue=1<br />
|pages=49-54<br />
|url=https://www.academia.edu/6992015/Incidence_of_Meatal_Stenosis_following_Neonatal_Circumcision_in_a_Primary_Care_Setting<br />
|accessdate=2019-12-15<br />
}}</ref><ref>{{REFjournal<br />
|last=Stenram<br />
|first=A.<br />
|last2=Malmfors<br />
|first2=G.<br />
|last3=Okmian<br />
|first3=L.<br />
|title=Circumcision for [[phimosis]]: a follow-up study<br />
|journal=Scandinavian journal of urology and nephrology<br />
|date=1986<br />
|volume=20<br />
|issue=2<br />
|pages=89<br />
|url=<br />
|pubmedID=3749823<br />
|accessdate=<br />
}} </ref><ref>{{REFweb<br />
|url=http://emedicine.medscape.com/article/1016016-overview<br />
|title=Meatal Stenosis<br />
|publisher=Medscape<br />
|accessdate=2019-10-11<br />
}}</ref><br />
<br />
=== Psychological late effects ===<br />
<br />
[[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effects]] are also possible after a circumcision, especially if the operation was carried out in childhood. On this occasion a variety of trauma may occur, which depend, among others, on age and circumstances of the circumcision. For example, whether the circumcision took place with or without sufficient anaesthesia, if the individual has been informed about the operation beforehand, if he was circumcised against his will or without his consent, and also, in the case of infant circumcision, if he was told about it during childhood or had to find it out coincidentally on his own.<br />
<br />
The psychological late effects of circumcision are not yet fully researched, and many studies took place on rather a small scale. This situation needs to be rectified, because the available studies, as well as the histories of negatively affected men, suggest that these late effects may have more impact than previously assumed.<br />
<br />
* It was observed that infants, following circumcision without pain control, had a disturbed bond with their mother<ref>{{REFjournal<br />
|last=Marshall<br />
|first=R.E.<br />
|last2=Porter<br />
|first2=F.L.<br />
|last3=Rogers<br />
|first3=A.G.<br />
|etal=yes<br />
|title=Circumcision: II effects upon mother-infant interaction<br />
|journal=Early Hum Dev<br />
|date=1982<br />
|volume=7<br />
|issue=4<br />
|pages=367-374<br />
|url=http://www.cirp.org/library/birth/marshall2/<br />
|accessdate=2020-02-01<br />
}}</ref>, as well as problems with nurturing, up to the point of refusal to be fed. The sleeping habits of these babies were also disturbed, with prolonged non-REM sleep and increased waking.<br />
<br />
* In boys circumcised in childhood, post traumatic stress disorder (PTSD) could be diagnosed. In a study on Philippine boys, in whom no PTSD was found prior to the operation, 69% of the boys circumcised in the traditional ritual and 51% of those circumcised by standard medical procedures (including anaesthesia) fulfilled the DSM-IV criteria for PTSD following the operation.<ref>{{REFbook<br />
|last=Ramos<br />
|first=S<br />
|last2=Boyle<br />
|first2=GJ<br />
|year=2001<br />
|title=Understanding circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem<br />
|url=https://link.springer.com/chapter/10.1007/978-1-4757-3351-8_14<br />
|work=<br />
|editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]<br />
|edition=<br />
|volume=<br />
|chapter=Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder<br />
|pages=253-270<br />
|location=New York<br />
|publisher=Kluwer Academic/Plenum Publishers<br />
|isbn=<br />
|quote=<br />
|accessdate=<br />
|note=<br />
}}</ref><br />
* Circumcisions, especially those that happen without consent, can spark feelings of helplessness and alienation, which can persist as trauma. These feeling can also be triggered later, when someone circumcised as an infant becomes aware of his circumcision. In an online study, interviewed men stated they felt betrayed - 55% by the mother, 50% by the father, and 58% by the doctor, and 73% felt that their human rights had been violated.<ref name="GSoCH">{{REFweb<br />
|url=http://www.circumcisionharm.org/<br />
|title=Global Survey of Circumcision Harm<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* It can frequently be found that the loss is denied, much as happens with the loss of other body parts. This denial can lead to fathers having their sons circumcised in order not to be reminded of their own loss. In this process, their own body is defined as "normal" and the [[foreskin]] redefined as a foreign object. Their own parents are seen as "good", so that this image is projected onto the circumcision their parents carried out as well, in order to keep the positive emotion intact. The father wants to be a "good" father later in life as well, and so, following an idealised image of his own parents, circumcision, which has been redefined as a "good thing", is passed on to his son by having him circumcised as well.<ref>{{REFjournal<br />
|last=van der Kolk<br />
|first=B.A.<br />
|url=http://www.cirp.org/library/psych/vanderkolk/<br />
|title=The compulsion to repeat the trauma: re-enactment, revictimization, and masochism<br />
|journal=Psychiatr Clin North Am<br />
|date=1989<br />
|volume=12<br />
|issue=2<br />
|pages=389-411<br />
|accessdate=2019-10-12<br />
}}</ref><ref>{{REFjournal<br />
|last=Goldman<br />
|first=R.<br />
|author-link=Ronald Goldman<br />
|url=http://www.cirp.org/library/psych/goldman1/<br />
|title=The psychological impact of circumcision<br />
|journal=BJU Int<br />
|date=1999<br />
|volume=83<br />
|issue=Suppl. 1<br />
|pages=93-103<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* If the circumcised male feels incomplete, or due to the missing [[foreskin]] disadvantaged compared to intact males, an inferiority complex and depression may occur. This can be accompanied by conscious recognition of his own incompleteness, or the deficiency may remain completely subconscious<ref>{{REFjournal<br />
|last=Rhinehart<br />
|first=J.<br />
|url=http://www.cirp.org/library/psych/rhinehart1/<br />
|title=Neonatal circumcision reconsidered<br />
|journal=Transactional Analysis J<br />
|date=1999<br />
|volume=29<br />
|issue=3<br />
|pages=215-221<br />
|accessdate=2019-10-12<br />
}}</ref>. In an online study, 75% of those interviewed stated that they felt incomplete, and 66% said they felt inferior compared with intact males.<ref name="GSoCH"/><br />
* Cases in which children felt ill treated or punished have been documented as well. G. Cansever found in her study on 12 boys aged between 4 and 7 years, who had previously been prepared for their impending circumcision, that the children experienced the operation as an aggressive assault on their bodies.<ref>{{REFjournal<br />
|last=Cansever<br />
|first=G.<br />
|date=1965<br />
|url=http://www.cirp.org/library/psych/cansever/<br />
|title=Psychological effects of circumcision<br />
|journal=Brit. J. Med. Psychol<br />
|volume=38<br />
|pages=321-331<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* Fear of being alone or darkness.<ref name="Levy1945">{{REFjournal<br />
|last=Levy<br />
|first=David M.<br />
|url=http://www.cirp.org/library/psych/levy1/<br />
|title=Psychic trauma of operations in children; and a note on combat neurosis<br />
|journal=American Journal of Diseases of Children<br />
|volume=69<br />
|date=1945<br />
|pages=7-25<br />
|accessdate=2019-10-12<br />
}}</ref><br />
* Fear of doctors, clinics and also closed rooms.<ref name="Levy1945"/><br />
* Relapse into the state of bed-wetting, even if the child was already dry before.<ref name="Levy1945"/><br />
* Circumcised males who become fathers frequently manifest [[adamant father syndrome]].<br />
<br />
== Rights and ethics ==<br />
<br />
The [[Rights situation on circumcision|rights situation]] is discussed in separate article.<br />
<br />
<br />
-----<br />
<br />
<br />
{{FromIntactWiki<br />
|URL=http://intactwiki.org/wiki/Circumcision<br />
|Title=Circumcision<br />
}}<br />
<br />
[[Image:Intact vs circumcised.JPG |thumbnail|right|300px| The intact and circumcised human penis, side by side.]]<br />
<br />
The term "circumcision" without a gender qualifier refers specifically to male circumcision. It means "to cut around," and it refers to the excision of the [[foreskin]] from the penis. Circumcision is most often performed in healthy males for [[Religion and Culture|religious or cultural]] reasons. The procedure may be performed on consenting adults, but it is most often performed on non-consenting minors, particularly newborn children, which is why the ritual is so controversial. Opponents of circumcision consider the circumcision of non-consenting minors to be unethical and a human rights violation, unless there is concrete medical indication. Proponents of circumcision consider the circumcision of non-consenting minors to be a "religious freedom" and a "parental right."<br />
<br />
== Complications ==<br />
=== Pain ===<br />
In the past, advocates of circumcision claimed that a newborn child's nerve system was not yet fully developed, and that as a result, the child felt no pain during the circumcision procedure. Anand & Hickey (1987) have shown that newborn children do in fact feel pain, and more acutely than adults.<ref name="anand-hickey1987">{{REFjournal<br />
|last=Anand<br />
|first=<br />
|author-link=<br />
|last2=Hickey<br />
|first2=<br />
|author2-link=<br />
|etal=no<br />
|title=Pain and its effects in the human neonate and fetus<br />
|trans-title=<br />
|language=<br />
|journal=New Engl J Med<br />
|location=<br />
|date=1987-11-19<br />
|volume=317<br />
|issue=21<br />
|pages=1321-9<br />
|url=http://www.cirp.org/library/pain/anand/<br />
|quote=<br />
|pubmedID=3317037<br />
|pubmedCID=<br />
|DOI=<br />
|accessdate=2019-11-08<br />
}}</ref> This has led American health associations to recommend doctors take measures to reduce the pain of circumcision in infants.<br />
<br />
The [[Position Statements on Infant Circumcision|AAP Circumcision Policy Statement]] states quite clearly that ''"There is considerable evidence that newborns who are circumcised without analgesia experience pain and physiologic stress"''. Furthermore, the pain is quite severe, and requires injections for proper pain management. Sucrose and Acetaminophen ''"cannot be recommended as the sole method of analgesia"''. Topical cream is no longer thought sufficient as ''"the analgesic effect is limited during the phases associated with extensive tissue trauma such as...tightening of the clamp"''.<ref>{{REFjournal<br />
|last=<br />
|first=<br />
|title=American Academy of Pediatrics: Circumcision Policy Statement; Task Force on Circumcision<br />
|journal=Pediatrics<br />
|date=1999-03<br />
|volume=103<br />
|issue=3<br />
|pages=686-693<br />
|url=https://pediatrics.aappublications.org/content/103/3/686#sec-9<br />
|accessdate=2019-11-26<br />
|note=Statement Reaffirmed Sept. 1, 2005<br />
}}</ref><br />
<br />
The [[AAFP]] states quite simply in their [[Position Statements on Infant Circumcision|position paper]], ''"Newborns experience pain during circumcision".''<ref>{{REFweb<br />
|title=Circumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed<br />
|website=Official American Academy of Family Physicians Website<br />
|url=http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html<br />
|accessdate=2011-05-02<br />
}}</ref> This is not a debatable fact, and yet, it is not widely accepted, even by some doctors. It might be hard for some doctors to accept, as they may have been taught that the infant does not feel pain, and may have performed countless circumcisions with this idea. Usage of anesthesia for infant circumcision is still by no means the rule.<br />
<br />
Penile injections of anesthetic are now recommended by all of the major medical institutions. In their [http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml Report 10 of the Council on Scientific Affairs], the AMA states ''"When the decision is made to proceed with circumcision, local anesthesia should be provided for the procedure. Ring block or dorsal penile blocks [injections] are most effective. EMLA cream has limited utility"''. Alarmingly, ''"Despite the clear evidence that newborn males generate brisk pain responses during circumcision, a recent survey of residency training programs found that 26% of programs that taught circumcision provided no instruction on the use of local anesthesia". The AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, and 25% of obstetricians"''.<ref>{{REFweb<br />
|title=Report 10 of the Council on Scientific Affairs (I-99): Neonatal Circumcision<br />
|website=American Medical Association Official Website<br />
|url=http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml<br />
|accessdate=2011-05-04<br />
}}</ref><br />
<br />
The AAP's [http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx Heatlhy Children website] suggests ''"Your pediatrician (or your obstetrician) should discuss the forms of analgesia that are available"''.<ref>{{REFweb<br />
|title=Where We Stand: Circumcision<br />
|publisher=[[AAP]]<br />
|date=2011-03-23<br />
|url=http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx<br />
|accessdate=2019-10-12<br />
}}</ref> Be that as it may, few forms of analgesia are recommended. There are basically two types of injections to choose from, and the website does not go into the difference between a 'dorsal nerve block' and a 'ring block' injection.<br />
<br />
Given what is known from aforementioned official documents, the AAP website may be more informative and effective if it would say ''"Make sure your doctor knows of the ineffectiveness of anything short of local anesthesia, and make sure your baby is given an injection. This is your responsibility, because your doctor may or may not be up to date on the latest understandings of infant sensitivity to pain during circumcision."'' The AAP may be holding back, however, perhaps because this would upset the doctor/parent power relationship, and may cause too much questioning of doctors in general. One may not expect to find this kind of advice on such a website, and yet, anything less than this is a dangerously weak statement.<br />
<br />
To control pain, some physicians that circumcise use Tylenol, sugar,<ref>{{REFweb<br />
| quote=To calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, and soothing music is played in the room.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-guide.html<br />
| title=Parents' Guide to Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2011-04-08<br />
}}</ref><ref>{{REFweb<br />
| quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> a topical cream,<ref>{{REFweb<br />
| quote=Then in our office, he will have topical anesthetic applied to his penis.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb<br />
| quote=We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-guide.html<br />
| title=Parents' Guide to Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=<br />
| accessdate=2011-04-08<br />
}}</ref> Topical anaesthetic only serves to numb the area to lessen the pain of the injection, but studies have shown that a dorsal penile ring block is not always effective in stopping the pain of circumcision.<ref name='Journal of Perinatology April/May 2002'>{{REFjournal<br />
|last=Taeusch<br />
|first=H. William<br />
|last2=Martinez<br />
|first2=Alma M.<br />
|last3=Partridge<br />
|first3=J. Colin<br />
|last4=Sniderman<br />
|first4=Susan<br />
|last5=Armstrong-Wells<br />
|first5=Jennifer<br />
|last6=Fuentes-Afflick<br />
|first6=Elena<br />
|title=Pain During Mogen or Plastibell Circumcision<br />
|journal=Journal of Perinatology<br />
|volume=22<br />
|issue=3<br />
|pages=214-218<br />
|url=http://www.nature.com/jp/journal/v22/n3/full/7210653a.html<br />
|quote=...more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|note=April/May 2002<br />
|date=2002-04<br />
|accessdate=2011-04-08<br />
}}</ref><ref name='Clinical Pediatrics August 1986'>{{REFjournal<br />
|last=Williamson<br />
|first=Paul S.<br />
|last2=Evans<br />
|first2=Nolan Donovan<br />
|title=Neonatal Cortisol Response to Circumcision with Anesthesia<br />
|journal=Clinical Pediatrics<br />
|volume=25<br />
|issue=8<br />
|pages=412-416<br />
|url=http://cpj.sagepub.com/content/25/8/412.abstract<br />
|quote=The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=1986-08<br />
|accessdate=2011-04-08<br />
}}</ref> During circumcision, somp physicians give children sugar pacifiers to "reduce the perception of pain",<ref>{{REFweb<br />
| quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.<br />
| url=http://www.pollockclinics.com/circumcision/circumcision-before.html<br />
| title=Before the Circumcision<br />
| last=<br />
| first=<br />
| publisher=<br />
| work=<br />
| date=2011-04-08<br />
| accessdate=2011-04-08<br />
}}</ref> but in at least one study, data shows that giving sugar to a child doesn't help to reduce the perception of pain in the child.<ref name='Lancet, The 2010-10-09'>{{REFjournal<br />
|last=Slater<br />
|first=Rebeccah<br />
|first2=Laura<br />
|last2=Cornelissen<br />
|first3=Lorenzo<br />
|last3=Fabrizi<br />
|first4=Debbie<br />
|last4=Patten<br />
|first5=Jan<br />
|last5=Yoxen<br />
|first6=Alan<br />
|last6=Worley<br />
|first7=Stewart<br />
|last7=Boyd<br />
|first8=Judith<br />
|last8=Meek<br />
|first9=Maria<br />
|last9=Prof. Fitzgerald<br />
|title=Oral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial<br />
|journal=The Lancet<br />
|volume=376<br />
|issue=9748<br />
|pages=1225-1232<br />
|url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2961303-7/fulltext<br />
|quote=Our data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuits, and therefore might not be an effective analgesic drug. The ability of sucrose to reduce clinical observational scores after noxious events in newborn infants should not be interpreted as pain relief.<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=<br />
|date=2010-10-09<br />
|accessdate=2011-04-08<br />
}}</ref> Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals.<br />
<br />
It has been shown that an infant's response to pain can be altered for years as a consequence of circumcision.<ref>{{REFjournal<br />
|last=Taddio<br />
|first=Anna<br />
|first2=Morton<br />
|last2=Goldbach<br />
|first3=Moshe<br />
|last3=Ipp<br />
|first4=Bonnie<br />
|last4=Stevens<br />
|first5=Gideon<br />
|last5=Koren<br />
|title=Effect of neonatal circumcision on pain responses during vaccination in boys<br />
|journal=The Lancet<br />
|volume=345<br />
|issue=8945<br />
|pages=291-2<br />
|url=http://www.cirp.org/library/pain/taddio/<br />
|quote=<br />
|pubmedID=7837863<br />
|pubmedCID=<br />
|DOI=<br />
|date=1995<br />
|accessdate=<br />
}}</ref><ref>{{REFjournal<br />
|last=Taddio<br />
|first=Anna<br />
|last2=Katz<br />
|first2=J.<br />
|last3=Ilersich<br />
|first3=A.L.<br />
|last4=Koren<br />
|first4=G.<br />
|title=Effects of neonatal circumcision on pain response during subsequent routine vaccination<br />
|journal=The Lancet<br />
|volume=349<br />
|issue=9052<br />
|pages=599-603<br />
|url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)10316-0/fulltext<br />
|quote=<br />
|pubmedID=9057731<br />
|pubmedCID=<br />
|DOI=10.1016/S0140-6736(96)10316-0<br />
|date=1997-03<br />
|accessdate=<br />
}}</ref><br />
<br />
=== Sexual effects ===<br />
<br />
Circumcision and frenectomy remove tissues with heightened erogenous sensitivity. Boyle ''et al.'' (2002) wrote, "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings&mdash;many of which are lost to circumcision."<ref>{{REFjournal<br />
|last=Boyle<br />
|first=Gregory J.<br />
|author-link=Gregory Boyle<br />
|first2=Gillian A.<br />
|last2=Bensley<br />
|title=Adverse Sexual and Psychological Effects of Male Infant Circumcision<br />
|journal=Psychological reports<br />
|volume=88<br />
|issue=3, Part 2<br />
|pages=1105–1106<br />
|url=http://www.cirp.org/library/psych/boyle5/<br />
|quote=<br />
|pubmedID=11597060<br />
|pubmedCID=<br />
|DOI=10.1046/j.1464-410x.1999.0830s1085.x<br />
|date=July 2001<br />
|accessdate=<br />
}}</ref> They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well."<br />
<br />
The amputation of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the penis, leaving only the uninhibited protopathic sensibility of the artificially externalized glans penis. The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of the changes in sexual behavior noted in circumcised human males.<ref>{{REFjournal<br />
|last=Van Howe<br />
|first=R.S.<br />
|author-link=Robert Van Howe<br />
|last2=Cold<br />
|first2=C.J.<br />
|title=Advantages and Disadvantages of Neonatal Circumcision<br />
|journal=The Journal of the American Medical Association<br />
|volume=277<br />
|issue=13<br />
|pages=1052-7<br />
|url=http://www.ncbi.nlm.nih.gov/pubmed/9218663<br />
|quote=<br />
|pubmedID=9218663<br />
|pubmedCID=<br />
|DOI=<br />
|date=1997-04-02<br />
|accessdate=<br />
}}</ref><br />
<br />
Histology of the male circumcision scar shows amputation neuromas, Schwann cell proliferation and the bulbous collection of variably sized neurites. Amputation neuromas do not mediate normal sensation and are notorious for generating pain.<ref>{{REFjournal<br />
|last=Cold<br />
|first=C.J.<br />
|first2=J.R.<br />
|last2=Taylor<br />
|title=The prepuce<br />
|journal=British Journal of Urology International<br />
|volume=83<br />
|issue=<br />
|pages=34-44<br />
|url=http://www.cirp.org/library/anatomy/cold-taylor/<br />
|quote=<br />
|pubmedID=10349413<br />
|pubmedCID=<br />
|DOI=<br />
|date=1999-1<br />
|accessdate=<br />
}}</ref><br />
<br />
=== Death ===<br />
A study in 2010 estimated approximately 117 neonatal circumcision-related deaths occur annually in the United States, about one out of every 77 male neonatal deaths, more than suffocation, auto accidents, or even SIDS.<ref name="Bollinger 2010">{{REFjournal<br />
|last=Bollinger<br />
|first=Dan<br />
|author-link=Dan Bollinger<br />
|last2=Boy's Health Advisory<br />
|title=Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths<br />
|journal=Thymos: Journal of Boyhood Studies<br />
|volume=4<br />
|issue=1<br />
|pages=78-90<br />
|url=http://www.mensstudies.com/content/b64n267w47m333x0/?p=7ebbd6b446d940cbbd4274c095754b12π=5<br />
|quote=<br />
|pubmedID=<br />
|pubmedCID=<br />
|DOI=10.3149/thy.0401.78<br />
|date=2010-04-26<br />
|accessdate=2019-10-12<br />
}}</ref><ref>{{REFweb<br />
| quote=<br />
| url=http://www.icgi.org/2010/04/infant-circumcision-causes-100-deaths-each-year-in-us<br />
| title=Infant circumcision causes 100 deaths each year in US<br />
| last=<br />
| first=<br />
| publisher=ICGI<br />
| website=International Coalition for Genital Integrity<br />
| date=2010-04-26<br />
| accessdate=<br />
}}</ref> See also the list of [[fatalities]].<br />
<br />
== Forced circumcision ==<br />
<br />
<!--=== United States military ===<br />
<br />
American soldiers serving in World War II were subjected to regular inspections of their genitals. If uncircumcised, the soldiers risked being ordered to undergo immediate circumcision.<ref>{{REFbook<br />
|last=Schoen<br />
|first=Ed<br />
|author-link=Edgar J. Schoen<br />
|year=2005<br />
|title=On Circumcision<br />
|url=https://books.google.de/books?id=-zUhdvSt7cgC<br />
|work=<br />
|editor=Dianne Yeakey<br />
|edition=<br />
|volume=<br />
|chapter=<br />
|pages=72-73<br />
|location=Georgetown, Canada<br />
|publisher=RDR Books<br />
|isbn=1-157143-123-3<br />
|quote=For a critical view, see Sorrells, "The History of Circumcision," p. 333<br />
|accessdate=<br />
|note=<br />
}}</ref> This practice was discontinued at least six decades ago.--><br />
<br />
=== Non-therapeutic circumcision of male children ===<br />
<br />
Human babies, because they are not yet in possession of language, are incapable of giving or refusing consent for being circumcised. The element of force has led some scholars to view the circumcision of baby boys as a category of forced circumcision.<ref>For example, Frederick M. Hodges, a medical historian, writes: "In the late 1970s, as the Americans were growing increasingly aware of the abuses of power rampant throughout the nation's social institutions, influential grass-roots movements protesting the forced circumcision of American children sprang up nationwide." F. Hodges, "A Short History," p. 31; see also [[Leonard B. Glick|Glick]], ''Marked in Your Flesh'', pp. 273-281.</ref> There are, however, physicians in the United States who argue strongly for non-therapeutic circumcision of newborn babies; and circumcision is widely accepted as a postnatal procedure in American hospitals.<ref>{{REFbook<br />
|last=Fletcher<br />
|first=Christopher R.<br />
|year=1999<br />
|title=Circumcision in America in 1998: Attitudes, Beliefs, and Charges of American Physicians<br />
|url=http://www.springerlink.com/content/h2150v731233m177/<br />
|work=Male and Female Circumcision<br />
|editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]<br />
|edition=<br />
|volume=<br />
|chapter=Section 5<br />
|pages=259-271<br />
|location=New York<br />
|publisher=Kluwer Academic/Plenum Publishers<br />
|isbn=<br />
|quote=<br />
|accessdate=2019-10-12<br />
|note=ID 10.1007/978-0-585-39937-9_19<br />
}}</ref> Parental consent is required.<ref>See, e.g., Shephard and Shephard, ''The Complete Guide'', p. 125.</ref> A statement published by the American Academy of Pediatrics in 1999 declares that "parents should determine what is in the best interest of the child... It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in additions to the medical factors, when making a decision."<ref>Lannon and Bailey, "Circumcision Policy Statement," p. 691.</ref> In the United Kingdom, where non-therapeutic circumcision has now become far less prevalent than in the United States, a written consent of both parents is required, if a physician is to perform a non-therapeutic circumcision of a child.<ref>{{REFjournal<br />
|last=<br />
|first=<br />
|title=Re J (child's religious upbringing and circumcision)<br />
|journal=Family Court Reports<br />
|date=2000<br />
|volume=1<br />
|issue=<br />
|pages=307-314<br />
|url=http://www.cirp.org/library/legal/Re_J/2000.html<br />
|accessdate=2019-10-12<br />
}}</ref> (The National Health Service does not provide non-therapeutic circumcision.)<br />
<br />
In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<ref>See, e.g., Somerville, "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; Chessler, "Justifying the Unjustifiable"; Smith, "Male Circumcision."</ref> For example, critics have pointed out that, in the United States, more than 1.3% of male neonatal deaths are attributable to the complications of non-therapeutic circumcision surgery.<ref name="Bollinger 2010"/>refer<ref>{{REFweb<br />
|quote=<br />
|url=http://www.icgi.org/2010/04/infant-circumcision-causes-100-deaths-each-year-in-us<br />
|title=Infant circumcision causes 100 deaths each year in US<br />
|last=Bollinger<br />
|first=Dan<br />
|author-link=Dan Bollinger<br />
|publisher=International Coalition for Genital Integrity<br />
|date=2010-04-26<br />
|accessdate=2019-10-12<br />
}}</ref><br />
<br />
{{SEEALSO}}<br />
* [[Sexual effects of circumcision]]<br />
* [[FGM]]<br />
* [[MGM]]<br />
* [[Risks and complications]]<br />
* [[Documented severe complications of circumcision]]<br />
* [[Circumcision scar]]<br />
* [[Circumpendium]]<br />
* [[Human rights]]<br />
* [[Ethics of non-therapeutic child circumcision]]<br />
* [[Rights situation on circumcision]]<br />
* [[Circumcision methods]]<br />
* [[Case Histories]]<br />
* [[Lymphoedema]]<br />
* [[Psychological issues of male circumcision]]<br />
<br />
{{REF}}<br />
<br />
[[Category:From Intactipedia]]<br />
[[Category:From IntactWiki]]<br />
[[Category:Male circumcision]]<br />
[[Category:Genital surgery]]<br />
[[Category:Terms]]<br />
[[Category:Islam]]<br />
[[Category:Judaism]]<br />
[[Category:Circumcision]]<br />
[[de:Zirkumzision]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14346Intact America2020-05-04T14:50:18Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America Logo|175px]]<br />
|imagestyle = <br />
|caption = Intact America Logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2008<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|https://intactamerica.org}}<br />
}}<br />
'''Intact America''' (IA) is a New York 501(c)(3) nonprofit organization founded in 2008, as part of the Hudson Center for Health Equity & Quality Inc. It was founded by [[Georganne Chapin]], a healthcare leader, CEO and intactivist. IA's founding was facilitated by Texas businessman Dean Pisani who pledged $1 million to Intact America because, he said, he and his wife were pressured in 1999 by a physician at Northwestern Memorial Hospital to circumcise their first child, a boy. The Pisani's rebuffed the doctor's pressure tactics, and in turn funded the creation of IA.<ref>https://www.inquirer.com/philly/health/Medical_groups_may_recommend_procedure_on_boys_but_opponents_say_benefits_exaggerated.html</ref><br />
<br />
'''Mission:''' 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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
'''Vision:''' Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
Intact America (IA) was registered to exhibit at the 2012 [[American Academy of Pediatrics]] (AAP) convention "trade show" in New Orleans, Louisiana. However the AAP revoked Intact America's registration over concerns that IA's presence would exacerbate the controversy over the AAP's recently released 2012 circumcision policy statement. IA then organized a protest of the AAP which attracted [[intactivists]] from across America to demonstrate at the New Orleans Ernest N. Morial Convention Center.<ref>https://www.washingtonpost.com/national/on-faith/anti-circumcision-activists-confront-pediatricians/2012/10/22/f6b7c468-1c88-11e2-8817-41b9a7aaabc7_story.html</ref> The protest was the place were the intactivist protest group [[Bloodstained Men]] was conceived. <br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website designed for non-intactivists. It is meant to be a source of information on issues about male circumcision.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
{{REF}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14345Intact America2020-05-04T14:47:27Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America Logo|175px]]<br />
|imagestyle = <br />
|caption = Intact America Logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2008<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|https://intactamerica.org}}<br />
}}<br />
'''Intact America''' (IA) is a U.S. 501(c)(3) nonprofit organization founded in 2008. It was founded by [[Georganne Chapin]], a healthcare leader, CEO and intactivist. IA's founding was facilitated by Texas businessman Dean Pisani who pledged $1 million to Intact America because, he said, he and his wife were pressured in 1999 by a physician at Northwestern Memorial Hospital to circumcise their first child, a boy. The Pisani's rebuffed the doctor's pressure tactics, and in turn funded the creation of IA.<ref>https://www.inquirer.com/philly/health/Medical_groups_may_recommend_procedure_on_boys_but_opponents_say_benefits_exaggerated.html</ref><br />
<br />
'''Mission:''' 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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
'''Vision:''' Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
Intact America (IA) was registered to exhibit at the 2012 [[American Academy of Pediatrics]] (AAP) convention "trade show" in New Orleans, Louisiana. However the AAP revoked Intact America's registration over concerns that IA's presence would exacerbate the controversy over the AAP's recently released 2012 circumcision policy statement. IA then organized a protest of the AAP which attracted [[intactivists]] from across America to demonstrate at the New Orleans Ernest N. Morial Convention Center.<ref>https://www.washingtonpost.com/national/on-faith/anti-circumcision-activists-confront-pediatricians/2012/10/22/f6b7c468-1c88-11e2-8817-41b9a7aaabc7_story.html</ref> The protest was the place were the intactivist protest group [[Bloodstained Men]] was conceived. <br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website designed for non-intactivists. It is meant to be a source of information on issues about male circumcision.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
{{REF}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14344Intact America2020-05-04T14:45:43Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America Logo|175px]]<br />
|imagestyle = <br />
|caption = Intact America Logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2007<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|https://intactamerica.org}}<br />
}}<br />
'''Intact America''' (IA) is a U.S. 501(c)(3) nonprofit organization founded in 2007. It was founded by [[Georganne Chapin]], a healthcare leader, CEO and intactivist. IA's founding was facilitated by Texas businessman Dean Pisani who pledged $1 million to Intact America because, he said, he and his wife were pressured in 1999 by a physician at Northwestern Memorial Hospital to circumcise their first child, a boy. The Pisani's rebuffed the doctor's pressure tactics, and in turn funded the creation of IA.<ref>https://www.inquirer.com/philly/health/Medical_groups_may_recommend_procedure_on_boys_but_opponents_say_benefits_exaggerated.html</ref><br />
<br />
'''Mission:''' 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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
'''Vision:''' Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
Intact America (IA) was registered to exhibit at the 2012 [[American Academy of Pediatrics]] (AAP) convention "trade show" in New Orleans, Louisiana. However the AAP revoked Intact America's registration over concerns that IA's presence would exacerbate the controversy over the AAP's recently released 2012 circumcision policy statement. IA then organized a protest of the AAP which attracted [[intactivists]] from across America to demonstrate at the New Orleans Ernest N. Morial Convention Center.<ref>https://www.washingtonpost.com/national/on-faith/anti-circumcision-activists-confront-pediatricians/2012/10/22/f6b7c468-1c88-11e2-8817-41b9a7aaabc7_story.html</ref> The protest was the place were the intactivist protest group [[Bloodstained Men]] was conceived. <br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website designed for non-intactivists. It is meant to be a source of information on issues about male circumcision.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
{{REF}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14343Intact America2020-05-04T14:45:27Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America Logo|175px]]<br />
|imagestyle = <br />
|caption = Intact America Logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2007<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|https://intactamerica.org}}<br />
}}<br />
'''Intact America''' (IA) is a U.S. 501(c)(3) nonprofit organization founded in 2007. It was founded by [[Georganne Chapin]], a healthcare leader, CEO and intactivist. IA's founding was facilitated by Texas businessman Dean Pisani who pledged $1 million to Intact America because, he said, he and his wife were pressured in 1999 by a physician at Northwestern Memorial Hospital to circumcise their first child, a boy. The Pisani's rebuffed the doctor's pressure tactics, and in turn funded the creation of IA.<ref>https://www.inquirer.com/philly/health/Medical_groups_may_recommend_procedure_on_boys_but_opponents_say_benefits_exaggerated.html</ref><br />
<br />
'''Mission:''' 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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
'''Vision:''' Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
Intact America (IA) was registered to exhibit at the 2012 [[American Academy of Pediatrics]] (AAP) convention "trade show" in New Orleans, Louisiana. However the AAP revoked Intact America's registration over concerns that IA's presence would exacerbate the controversy over the AAP's recently released 2012 circumcision policy statement. IA then organized a protest of the AAP which attracted [[intactivists]] from across America to demonstrate at the New Orleans Ernest N. Morial Convention Center.<ref>https://www.washingtonpost.com/national/on-faith/anti-circumcision-activists-confront-pediatricians/2012/10/22/f6b7c468-1c88-11e2-8817-41b9a7aaabc7_story.html</ref> The protest was the place were the intactivist protest group [[Bloodstained Men]] was conceived. <br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website designed for non-intactivists. It is meant to be a source of information on issues over male circumcision.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
{{REF}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14342Intact America2020-05-04T14:43:46Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America Logo|175px]]<br />
|imagestyle = <br />
|caption = Intact America Logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2007<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|https://intactamerica.org}}<br />
}}<br />
'''Intact America''' (IA) is a U.S. 501(c)(3) nonprofit organization founded in 2007. It was founded by [[Georganne Chapin]], a healthcare leader, CEO and intactivist. IA's founding was facilitated by Texas businessman Dean Pisani who pledged $1 million to Intact America because, he said, he and his wife were pressured in 1999 by a physician at Northwestern Memorial Hospital to circumcise their first child, a boy. The Pisani's rebuffed the doctor's pressure tactics, and in turn funded the creation of IA.<ref>https://www.inquirer.com/philly/health/Medical_groups_may_recommend_procedure_on_boys_but_opponents_say_benefits_exaggerated.html</ref><br />
<br />
'''Mission:''' 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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
'''Vision:''' Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
Intact America (IA) was registered to exhibit at the 2012 [[American Academy of Pediatrics]] (AAP) convention "trade show" in New Orleans, Louisiana. However the AAP revoked Intact America's registration over concerns that IA's presence would exacerbate the controversy over the AAP's recently released 2012 circumcision policy statement. IA then organized a protest of the AAP which attracted [[intactivists]] from across America to demonstrate at the New Orleans Ernest N. Morial Convention Center.<ref>https://www.washingtonpost.com/national/on-faith/anti-circumcision-activists-confront-pediatricians/2012/10/22/f6b7c468-1c88-11e2-8817-41b9a7aaabc7_story.html</ref> The protest was the place were the intactivist protest group [[Bloodstained Men]] was conceived. <br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website designed for non-intactivists to better understand the issues.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
{{REF}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14341Intact America2020-05-04T14:22:09Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America Logo|175px]]<br />
|imagestyle = <br />
|caption = Intact America Logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2007<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|https://intactamerica.org}}<br />
}}<br />
'''Intact America''' (IA) is a U.S. 501(c)(3) nonprofit organization founded in 2007. It was founded by [[Georganne Chapin]], a healthcare leader, CEO and intactivist. IA's founding was facilitated by Texas businessman Dean Pisani who pledged $1 million to Intact America because, he said, he and his wife were pressured in 1999 by a physician at Northwestern Memorial Hospital to circumcise their first child, a boy. The Pisani's rebuffed the doctor's pressure tactics, and in turn funded the creation of IA.<ref>https://www.inquirer.com/philly/health/Medical_groups_may_recommend_procedure_on_boys_but_opponents_say_benefits_exaggerated.html</ref><br />
<br />
'''Mission:''' 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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
'''Vision:''' Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
Intact America (IA) was registered to exhibit at the 2012 [[American Academy of Pediatrics]] (AAP) convention "trade show" in New Orleans, Louisiana. However the AAP revoked Intact America's registration over concerns that IA's presence would exacerbate the controversy over the AAP's recently released 2012 circumcision policy statement. IA then organized a protest of the AAP which attracted [[intactivists]] from across the America to demonstrate at the New Orleans Ernest N. Morial Convention Center.<ref>https://www.washingtonpost.com/national/on-faith/anti-circumcision-activists-confront-pediatricians/2012/10/22/f6b7c468-1c88-11e2-8817-41b9a7aaabc7_story.html</ref> The protest was the place were the intactivist protest group [[Bloodstained Men]] was conceived. <br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website designed for non-intactivists to better understand the issues.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
{{REF}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14340Intact America2020-05-04T14:21:52Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America Logo|175px]]<br />
|imagestyle = <br />
|caption = Intact America Logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2007<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|https://intactamerica.org}}<br />
}}<br />
'''Intact America''' (IA) is a U.S. 501(c)(3) nonprofit organization founded in 2007. It was founded by [[Georganne Chapin]], a healthcare leader, CEO and intactivist. IA's founding was facilitated by Texas businessman Dean Pisani who pledged $1 million to Intact America because, he said, he and his wife were pressured in 1999 by a physician at Northwestern Memorial Hospital to circumcise their first child, a boy. The Pisani's rebuffed the doctor's pressure tactics, and in turn assisted in the creation of IA.<ref>https://www.inquirer.com/philly/health/Medical_groups_may_recommend_procedure_on_boys_but_opponents_say_benefits_exaggerated.html</ref><br />
<br />
'''Mission:''' 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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
'''Vision:''' Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
Intact America (IA) was registered to exhibit at the 2012 [[American Academy of Pediatrics]] (AAP) convention "trade show" in New Orleans, Louisiana. However the AAP revoked Intact America's registration over concerns that IA's presence would exacerbate the controversy over the AAP's recently released 2012 circumcision policy statement. IA then organized a protest of the AAP which attracted [[intactivists]] from across the America to demonstrate at the New Orleans Ernest N. Morial Convention Center.<ref>https://www.washingtonpost.com/national/on-faith/anti-circumcision-activists-confront-pediatricians/2012/10/22/f6b7c468-1c88-11e2-8817-41b9a7aaabc7_story.html</ref> The protest was the place were the intactivist protest group [[Bloodstained Men]] was conceived. <br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website designed for non-intactivists to better understand the issues.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
{{REF}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14339Intact America2020-05-04T14:20:41Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America Logo|175px]]<br />
|imagestyle = <br />
|caption = Intact America Logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2007<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|https://intactamerica.org}}<br />
}}<br />
'''Intact America''' (IA) is a U.S. 501(c)(3) nonprofit organization founded in 2007. It was founded by [[Georganne Chapin]], a healthcare leader, CEO and intactivist. IA's founding was facilitated by Texas businessman Dean Pisani who pledged $1 million to Intact America because, he said, he and his wife were pressured in 1999 by a physician at Northwestern Memorial Hospital to circumcise their first child, a boy. They refused the doctor's pressure, and in turn assisted in the creation of IA.<ref>https://www.inquirer.com/philly/health/Medical_groups_may_recommend_procedure_on_boys_but_opponents_say_benefits_exaggerated.html</ref><br />
<br />
'''Mission:''' 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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
'''Vision:''' Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
Intact America (IA) was registered to exhibit at the 2012 [[American Academy of Pediatrics]] (AAP) convention "trade show" in New Orleans, Louisiana. However the AAP revoked Intact America's registration over concerns that IA's presence would exacerbate the controversy over the AAP's recently released 2012 circumcision policy statement. IA then organized a protest of the AAP which attracted [[intactivists]] from across the America to demonstrate at the New Orleans Ernest N. Morial Convention Center.<ref>https://www.washingtonpost.com/national/on-faith/anti-circumcision-activists-confront-pediatricians/2012/10/22/f6b7c468-1c88-11e2-8817-41b9a7aaabc7_story.html</ref> The protest was the place were the intactivist protest group [[Bloodstained Men]] was conceived. <br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website designed for non-intactivists to better understand the issues.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
{{REF}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14338Intact America2020-05-04T14:19:49Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America Logo|175px]]<br />
|imagestyle = <br />
|caption = Intact America Logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2007<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|https://intactamerica.org}}<br />
}}<br />
'''Intact America''' (IA) is a U.S. 501(c)(3) nonprofit organization founded in 2007. It was founded by [[Georganne Chapin]], a healthcare leader, CEO and intactivist. IA's founding was facilitated by Texas businessman Dean Pisani who pledged $1 million to Intact America because, he said, he and his wife were pressured in 1999 by a physician at Northwestern Memorial Hospital to circumcise their first child, a boy. They refused.Pisani.<ref>https://www.inquirer.com/philly/health/Medical_groups_may_recommend_procedure_on_boys_but_opponents_say_benefits_exaggerated.html</ref><br />
<br />
'''Mission:''' 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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
'''Vision:''' Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
Intact America (IA) was registered to exhibit at the 2012 [[American Academy of Pediatrics]] (AAP) convention "trade show" in New Orleans, Louisiana. However the AAP revoked Intact America's registration over concerns that IA's presence would exacerbate the controversy over the AAP's recently released 2012 circumcision policy statement. IA then organized a protest of the AAP which attracted [[intactivists]] from across the America to demonstrate at the New Orleans Ernest N. Morial Convention Center.<ref>https://www.washingtonpost.com/national/on-faith/anti-circumcision-activists-confront-pediatricians/2012/10/22/f6b7c468-1c88-11e2-8817-41b9a7aaabc7_story.html</ref> The protest was the place were the intactivist protest group [[Bloodstained Men]] was conceived. <br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website designed for non-intactivists to better understand the issues.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
{{REF}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14337Intact America2020-05-04T13:45:31Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America Logo|175px]]<br />
|imagestyle = <br />
|caption = Intact America Logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2007<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|https://intactamerica.org}}<br />
}}<br />
'''Intact America''' is a U.S. 501(c)(3) nonprofit organization founded in 2007. It was founded by [[Georganne Chapin]], a healthcare leader, CEO and intactivist. <br />
<br />
'''Mission:''' 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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
'''Vision:''' Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
Intact America (IA) was registered to exhibit at the 2012 [[American Academy of Pediatrics]] (AAP) convention "trade show" in New Orleans, Louisiana. However the AAP revoked Intact America's registration over concerns that IA's presence would exacerbate the controversy over the AAP's recently released 2012 circumcision policy statement. IA then organized a protest of the AAP which attracted [[intactivists]] from across the America to demonstrate at the New Orleans Ernest N. Morial Convention Center.<ref>https://www.washingtonpost.com/national/on-faith/anti-circumcision-activists-confront-pediatricians/2012/10/22/f6b7c468-1c88-11e2-8817-41b9a7aaabc7_story.html</ref> The protest was the place were the intactivist protest group [[Bloodstained Men]] was conceived. <br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website designed for non-intactivists to better understand the issues.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
{{REF}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14336Intact America2020-05-04T13:41:45Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America Logo|175px]]<br />
|imagestyle = <br />
|caption = Intact America Logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2007<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|https://intactamerica.org}}<br />
}}<br />
'''Intact America''' is a U.S. 501(c)(3) nonprofit organization founded in 2007. It was founded by Georganne Chapin, a corporate CEO and intactivist. <br />
<br />
'''Mission:''' 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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
'''Vision:''' Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
Intact America (IA) was registered to exhibit at the 2012 [[American Academy of Pediatrics]] (AAP) convention "trade show" in New Orleans, Louisiana. However the AAP revoked Intact America's registration over concerns that IA's presence would exacerbate the controversy over the AAP's recently released 2012 circumcision policy statement. IA then organized a protest of the AAP which attracted [[intactivists]] from across the America to demonstrate at the New Orleans Ernest N. Morial Convention Center.<ref>https://www.washingtonpost.com/national/on-faith/anti-circumcision-activists-confront-pediatricians/2012/10/22/f6b7c468-1c88-11e2-8817-41b9a7aaabc7_story.html</ref> The protest was the place were the intactivist protest group [[Bloodstained Men]] was conceived. <br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website designed for non-intactivists to better understand the issues.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
{{REF}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14335Intact America2020-05-04T13:40:14Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America Logo|175px]]<br />
|imagestyle = <br />
|caption = Intact America Logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2007<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|https://intactamerica.org}}<br />
}}<br />
'''Intact America''' is a U.S. 501(c)(3) nonprofit organization founded in 2007. It was founded by Georganne Chapin, a corporate CEO and intactivist. <br />
<br />
'''Mission:''' 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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
'''Vision:''' Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
Intact America (IA) was registered to exhibit at the 2012 [[American Academy of Pediatrics]] (AAP) convention "trade show" in New Orleans, Louisiana. However the AAP revoked Intact America's registration over concerns that IA's presence would exacerbate the controversy over the AAP's recently released 2012 circumcision policy statement. IA then organized a protest of the AAP which attracted [[intactivists]] from across the America to demonstrate at the New Orleans Ernest N. Morial Convention Center.<ref>https://www.washingtonpost.com/national/on-faith/anti-circumcision-activists-confront-pediatricians/2012/10/22/f6b7c468-1c88-11e2-8817-41b9a7aaabc7_story.html</ref> The protest was the place were the intactivist protest group [[Bloodstained Men]] was conceived. <br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website designed for non-intactivists to better understand the issues.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14334Intact America2020-05-04T13:37:45Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America Logo|175px]]<br />
|imagestyle = <br />
|caption = Intact America Logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2007<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|https://intactamerica.org}}<br />
}}<br />
'''Intact America''' is a U.S. 501(c)(3) nonprofit organization founded in 2007. It was founded by Georganne Chapin, a corporate CEO and intactivist. <br />
<br />
'''Mission:''' 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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
'''Vision:''' Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
Intact America (IA) was registered to exhibit at the 2012 [[American Academy of Pediatrics]] (AAP) convention "trade show" in New Orleans, Louisiana. However the AAP revoked Intact America's registration over concerns that IA's presence would exacerbate the controversy over the AAP's recently released 2012 circumcision policy statement. IA then organized a protest of the AAP which attracted [[intactivists]] from across the America to demonstrate at the New Orleans Ernest N. Morial Convention Center. The protest was the place were the intactivist protest group [[Bloodstained Men]] was conceived. <br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website designed for non-intactivists to better understand the issues.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14333Intact America2020-05-04T13:35:17Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America Logo|175px]]<br />
|imagestyle = <br />
|caption = Intact America Logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2007<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|http://intactamerica.org}}<br />
}}<br />
'''Intact America''' is a U.S. 501(c)(3) nonprofit organization founded in 2007. It was founded by Georganne Chapin, a corporate CEO and intactivist. <br />
<br />
'''Mission:''' 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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
'''Vision:''' Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
Intact America (IA) was registered to exhibit at the 2012 American Academy of Pediatrics (AAP) convention "trade show" in New Orleans, Louisiana. However the AAP revoked Intact America's registration over concerns that IA's presence would exacerbate the controversy over the AAP's recently released 2012 circumcision policy statement. IA then organized a protest of the AAP which attracted [[intactivists]] from across the America to demonstrate at the New Orleans Ernest N. Morial Convention Center. The protest was the place were the intactivist protest group [[Bloodstained Men]] was conceived. <br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website designed for non-intactivists to better understand the issues.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intact_America&diff=14332Intact America2020-05-04T13:19:40Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intact America<br />
|titlestyle = color:black;<br />
|image = [[File:Intact America Logo|175px]]<br />
|imagestyle = <br />
|caption = Intact America Logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2007<br />
|header3 = Founder:<br />
|data4 = [[Georganne Chapin]]<br />
|header5 = Founding location:<br />
|data6 = Tarrytown<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Tarrytown, New York, USA<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|http://intactamerica.org}}<br />
}}<br />
'''Intact America''' is a U.S. 501(c)(3) nonprofit organization founded in 2007. It was founded by Georganne Chapin, a corporate CEO and intactivist. <br />
<br />
'''Mission:''' 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. They do this through creative messaging, advocacy, education, public policy reform, and the empowerment of their supporters, partners and volunteers.<br />
<br />
'''Vision:''' Intact America envisions a world where children are free from medically unnecessary surgeries carried out on them without their consent in the name of culture, religion, profit, or parental preference.<br />
<br />
Intact America is an advocacy organization seeking to end [http://intactamerica.org circumcision] in America, and to ensure healthy sexual futures for all people.<br />
<br />
[http://circumcisiondebate.com The Circumcision Debate] is Intact America's entry-level companion website.<br />
<br />
Intact America has no chapters and is not affiliated with other groups imitating its name [e.g. Intact (geographic name)].<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.intactamerica.org/|2019-09-15}}<br />
* {{URL-FBpage|intactamerica|2019-09-15}}<br />
* [http://circumcisiondebate.org/ The Circumcision Debate]<br />
* [http://adversechildhoodexperiences.net Child Genital Cutting as an Adverse Childhood Experience (ACE)]<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intact America]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Susan_Blank&diff=14304Susan Blank2020-05-03T19:49:24Z<p>WikiModEn4: </p>
<hr />
<div>{| class="infobox vcard" style="175px; font-size:90%" border="0" cellspacing="4" align="right" <br />
|- <br />
| [[Image:Blank_Susan.jpg|175px|center]]<br />
|-<br />
| align="center" | [[{{FULLPAGENAME}}]]<br />
|-<br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Colleagues & benefactors:'''<br />
|-<br />
| align="center" | [[Douglas Diekema]]<br>[[Andrew Freedman]] <br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Member of:'''<br />
|-<br />
| align="center" | [[AAP Circumcision Task Force 2012]]<br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Associates with:'''<br />
|-<br />
| align="center" | [[American Academy of Pediatrics]]<br />
|-<br />
|}<br />
<br />
'''Susan Blank''', MD, MPH, was the Chairwoman of the [[AAP Circumcision Task Force 2012]]. The Task force released a new policy statement on circumcision on 27 August 2012.<br />
<br />
She has worked at the New York City Department of Health and Mental Hygiene since 1992. She is affiliated with the CDC and works at the DOHMH as an assignee from the Division of Sexually Transmitted Disease Prevention at the CDC. Currently she is the Director and Assistant Commissioner of the Bureau of STD Control.<ref>{{REFweb<br />
|quote=<br />
|url=http://cdc.confex.com/cdc/std2010/webprogram/Person21221.html<br />
|title=Susan Blank, MD, MPH<br />
|last=<br />
|first=<br />
|publisher=<br />
|date=<br />
|accessdate=2019-10-04<br />
}}</ref> She appears to be convinced of the medical advantages of circumcision.<br />
<br />
{{Citation<br />
|Title=<br />
|Text="There's no argument that the trials that have been done are really compelling," says Susan Blank, chairwoman of the academy's task force on neonatal circumcision. "That is just one piece in the discussion of circumcision." The academy's panel also includes experts on urinary-tract infections, ethics and health-care finance among others, she says.<small>(119)</small><br />
|Author=<br />
|Source=Wall Street Journal<br />
|ref=<ref>{{REFweb |url=http://online.wsj.com/article/SB123802256715541879.html |title=Circumcision Decreases Risk of Contracting STDs, Study Says |website=Wall Street Journal |date=2009-03-26 |accessdate=2019-10-04}}</ref><br />
}}<br />
<br />
{{Citation<br />
|Title=<br />
|Text=This statement really is not neutral. There is clear evidence that supports the health benefits of male circumcision.<br />
|Author=<br />
|Source=Community Radio for Northern Colorado<br />
|ref=<ref>{{REFweb<br />
|url=http://kunc.org/post/pediatricians-decide-boys-are-better-circumcised-not<br />
|title=Pediatricians Decide Boys Are Better Off Circumcised Than Not<br />
|website=Community Radio for Northern Colorado<br />
|date=2012-08-31<br />
|accessdate=2019-10-04<br />
}}</ref><br />
}}<br />
<br />
Blank was an Assistant Commissioner at the New York City Department of Health and Mental Hygiene at the time that a ''mohel'' was believed to have infected three infants with [[herpes]] after performing mouth suction on their penis wounds.<ref>{{REFweb<br />
|quote=<br />
|url=http://cid.oxfordjournals.org/content/40/7/iii.full<br />
|title=New York Officials Bar Rabbi from Circumcision Ritual<br />
|last=<br />
|first=<br />
|publisher=<br />
|date=2005-02<br />
|accessdate=2019-10-04<br />
}}</ref> One of those infants died and another was believed to have brain damage. [[Thomas R. Frieden]] also worked at DOHMH at the time. It appears that Blank helped do research for the letter that Frieden later published as "An Open Letter to the Jewish Community", in response to these events.<ref>{{REFdocument<br />
|url=https://web.archive.org/web/20071009055505/http://www.nyp-rpc.org/pdf/2005_health_alert46.pdf<br />
|title=2005 Health Alert #46: Neonatal herpes infection with herpes simplex virus type 1 following circumcision with oral suctioning (metzitzah b’peh)<br />
|last=Blank<br />
|first=Susan<br />
|author-link=Susan Blank<br />
|last2=Schillinger<br />
|first2=Julia<br />
|website=https://web.archive.org/web/20071009055505/http://www.nyp-rpc.org/pdf/2005_health_alert46.pdf<br />
|publisher=The City of New York<br />
|date=2005-12-13<br />
|accessdate=2019-10-04<br />
|archived=yes<br />
}}</ref><br />
<br />
Susan Blank may have confused her ethnic views on circumcision with medical science. Her circumcision policy of 2012 received scathing critical comment.<ref name="frisch2013">{{REFjournal<br />
|last=Frisch<br />
|first=Morten<br />
|author-link=Morten Frisch<br />
|etal=yes<br />
|title=Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision<br />
|journal=Pediatrics<br />
|location=<br />
|date=2013-04-01<br />
|volume=131<br />
|issue=4<br />
|pages=<br />
|url=https://pediatrics.aappublications.org/content/131/4/796.long<br />
|quote=<br />
|pubmedID=23509170<br />
|pubmedCID=<br />
|DOI=10.1542/peds.2012-2896<br />
|accessdate=2020-02-07<br />
}}</ref> The statement failed to recognize that young boys are human persons with [[human rights]] independent of their parents. It expired in 2017 and has not been reaffirmed by the AAP.<br />
<br />
Susan Blank was the subject of a protest at her Queens, New York City home by the intactivist group [[Intaction]] for her involvement with the AAP 2012 [http://intaction.org Circumcision] Committee.<ref>https://qns.com/story/2013/11/24/queens-doctor-targeted-over-circumcisions/</ref><br />
<br />
{{SEEALSO}}<br />
<br />
* [[Bias]]<br />
* [https://www.youtube.com/watch?v=e61hWdKPNnw Youtube video by Intaction Protesters]<br />
<br />
{{REF}}<br />
<br />
{{DEFAULTSORT:Blank, Susan}}<br />
<br />
[[Category:Person]]<br />
[[Category:Female]]<br />
[[Category:Physician]]<br />
[[Category:American Academy of Pediatrics]]<br />
<br />
[[Category:From CircLeaks]]<br />
[[Category:From IntactWiki]]<br />
<br />
[[de:{{FULLPAGENAME}}]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Susan_Blank&diff=14303Susan Blank2020-05-03T19:48:44Z<p>WikiModEn4: </p>
<hr />
<div>{| class="infobox vcard" style="175px; font-size:90%" border="0" cellspacing="4" align="right" <br />
|- <br />
| [[Image:Blank_Susan.jpg|175px|center]]<br />
|-<br />
| align="center" | [[{{FULLPAGENAME}}]]<br />
|-<br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Colleagues & benefactors:'''<br />
|-<br />
| align="center" | [[Douglas Diekema]]<br>[[Andrew Freedman]] <br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Member of:'''<br />
|-<br />
| align="center" | [[AAP Circumcision Task Force 2012]]<br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Associates with:'''<br />
|-<br />
| align="center" | [[American Academy of Pediatrics]]<br />
|-<br />
|}<br />
<br />
'''Susan Blank''', MD, MPH, was the Chairwoman of the [[AAP Circumcision Task Force 2012]]. The Task force released a new policy statement on circumcision on 27 August 2012.<br />
<br />
She has worked at the New York City Department of Health and Mental Hygiene since 1992. She is affiliated with the CDC and works at the DOHMH as an assignee from the Division of Sexually Transmitted Disease Prevention at the CDC. Currently she is the Director and Assistant Commissioner of the Bureau of STD Control.<ref>{{REFweb<br />
|quote=<br />
|url=http://cdc.confex.com/cdc/std2010/webprogram/Person21221.html<br />
|title=Susan Blank, MD, MPH<br />
|last=<br />
|first=<br />
|publisher=<br />
|date=<br />
|accessdate=2019-10-04<br />
}}</ref> She appears to be convinced of the medical advantages of circumcision.<br />
<br />
{{Citation<br />
|Title=<br />
|Text="There's no argument that the trials that have been done are really compelling," says Susan Blank, chairwoman of the academy's task force on neonatal circumcision. "That is just one piece in the discussion of circumcision." The academy's panel also includes experts on urinary-tract infections, ethics and health-care finance among others, she says.<small>(119)</small><br />
|Author=<br />
|Source=Wall Street Journal<br />
|ref=<ref>{{REFweb |url=http://online.wsj.com/article/SB123802256715541879.html |title=Circumcision Decreases Risk of Contracting STDs, Study Says |website=Wall Street Journal |date=2009-03-26 |accessdate=2019-10-04}}</ref><br />
}}<br />
<br />
{{Citation<br />
|Title=<br />
|Text=This statement really is not neutral. There is clear evidence that supports the health benefits of male circumcision.<br />
|Author=<br />
|Source=Community Radio for Northern Colorado<br />
|ref=<ref>{{REFweb<br />
|url=http://kunc.org/post/pediatricians-decide-boys-are-better-circumcised-not<br />
|title=Pediatricians Decide Boys Are Better Off Circumcised Than Not<br />
|website=Community Radio for Northern Colorado<br />
|date=2012-08-31<br />
|accessdate=2019-10-04<br />
}}</ref><br />
}}<br />
<br />
Blank was an Assistant Commissioner at the New York City Department of Health and Mental Hygiene at the time that a ''mohel'' was believed to have infected three infants with [[herpes]] after performing mouth suction on their penis wounds.<ref>{{REFweb<br />
|quote=<br />
|url=http://cid.oxfordjournals.org/content/40/7/iii.full<br />
|title=New York Officials Bar Rabbi from Circumcision Ritual<br />
|last=<br />
|first=<br />
|publisher=<br />
|date=2005-02<br />
|accessdate=2019-10-04<br />
}}</ref> One of those infants died and another was believed to have brain damage. [[Thomas R. Frieden]] also worked at DOHMH at the time. It appears that Blank helped do research for the letter that Frieden later published as "An Open Letter to the Jewish Community", in response to these events.<ref>{{REFdocument<br />
|url=https://web.archive.org/web/20071009055505/http://www.nyp-rpc.org/pdf/2005_health_alert46.pdf<br />
|title=2005 Health Alert #46: Neonatal herpes infection with herpes simplex virus type 1 following circumcision with oral suctioning (metzitzah b’peh)<br />
|last=Blank<br />
|first=Susan<br />
|author-link=Susan Blank<br />
|last2=Schillinger<br />
|first2=Julia<br />
|website=https://web.archive.org/web/20071009055505/http://www.nyp-rpc.org/pdf/2005_health_alert46.pdf<br />
|publisher=The City of New York<br />
|date=2005-12-13<br />
|accessdate=2019-10-04<br />
|archived=yes<br />
}}</ref><br />
<br />
Susan Blank may have confused her ethnic views on circumcision with medical science. Her circumcision policy of 2012 received scathing critical comment.<ref name="frisch2013">{{REFjournal<br />
|last=Frisch<br />
|first=Morten<br />
|author-link=Morten Frisch<br />
|etal=yes<br />
|title=Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision<br />
|journal=Pediatrics<br />
|location=<br />
|date=2013-04-01<br />
|volume=131<br />
|issue=4<br />
|pages=<br />
|url=https://pediatrics.aappublications.org/content/131/4/796.long<br />
|quote=<br />
|pubmedID=23509170<br />
|pubmedCID=<br />
|DOI=10.1542/peds.2012-2896<br />
|accessdate=2020-02-07<br />
}}</ref> The statement failed to recognize that young boys are human persons with [[human rights]] independent of their parents. It expired in 2017 and has not been reaffirmed by the AAP.<br />
<br />
Susan Blank was the subject of a protest at her Queens, New York City home by the intactivist group [[Intaction]] for her involvement with the AAP 2012 Circumcision Committee.<ref>https://qns.com/story/2013/11/24/queens-doctor-targeted-over-circumcisions/</ref><br />
<br />
{{SEEALSO}}<br />
<br />
* [[Bias]]<br />
* [https://www.youtube.com/watch?v=e61hWdKPNnw Youtube video by Intaction Protesters]<br />
<br />
{{REF}}<br />
<br />
{{DEFAULTSORT:Blank, Susan}}<br />
<br />
[[Category:Person]]<br />
[[Category:Female]]<br />
[[Category:Physician]]<br />
[[Category:American Academy of Pediatrics]]<br />
<br />
[[Category:From CircLeaks]]<br />
[[Category:From IntactWiki]]<br />
<br />
[[de:{{FULLPAGENAME}}]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Susan_Blank&diff=14302Susan Blank2020-05-03T19:47:21Z<p>WikiModEn4: </p>
<hr />
<div>{| class="infobox vcard" style="175px; font-size:90%" border="0" cellspacing="4" align="right" <br />
|- <br />
| [[Image:Blank_Susan.jpg|175px|center]]<br />
|-<br />
| align="center" | [[{{FULLPAGENAME}}]]<br />
|-<br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Colleagues & benefactors:'''<br />
|-<br />
| align="center" | [[Douglas Diekema]]<br>[[Andrew Freedman]] <br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Member of:'''<br />
|-<br />
| align="center" | [[AAP Circumcision Task Force 2012]]<br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Associates with:'''<br />
|-<br />
| align="center" | [[American Academy of Pediatrics]]<br />
|-<br />
|}<br />
<br />
'''Susan Blank''', MD, MPH, was the Chairwoman of the [[AAP Circumcision Task Force 2012]]. The Task force released a new policy statement on circumcision on 27 August 2012.<br />
<br />
She has worked at the New York City Department of Health and Mental Hygiene since 1992. She is affiliated with the CDC and works at the DOHMH as an assignee from the Division of Sexually Transmitted Disease Prevention at the CDC. Currently she is the Director and Assistant Commissioner of the Bureau of STD Control.<ref>{{REFweb<br />
|quote=<br />
|url=http://cdc.confex.com/cdc/std2010/webprogram/Person21221.html<br />
|title=Susan Blank, MD, MPH<br />
|last=<br />
|first=<br />
|publisher=<br />
|date=<br />
|accessdate=2019-10-04<br />
}}</ref> She appears to be convinced of the medical advantages of circumcision.<br />
<br />
{{Citation<br />
|Title=<br />
|Text="There's no argument that the trials that have been done are really compelling," says Susan Blank, chairwoman of the academy's task force on neonatal circumcision. "That is just one piece in the discussion of circumcision." The academy's panel also includes experts on urinary-tract infections, ethics and health-care finance among others, she says.<small>(119)</small><br />
|Author=<br />
|Source=Wall Street Journal<br />
|ref=<ref>{{REFweb |url=http://online.wsj.com/article/SB123802256715541879.html |title=Circumcision Decreases Risk of Contracting STDs, Study Says |website=Wall Street Journal |date=2009-03-26 |accessdate=2019-10-04}}</ref><br />
}}<br />
<br />
{{Citation<br />
|Title=<br />
|Text=This statement really is not neutral. There is clear evidence that supports the health benefits of male circumcision.<br />
|Author=<br />
|Source=Community Radio for Northern Colorado<br />
|ref=<ref>{{REFweb<br />
|url=http://kunc.org/post/pediatricians-decide-boys-are-better-circumcised-not<br />
|title=Pediatricians Decide Boys Are Better Off Circumcised Than Not<br />
|website=Community Radio for Northern Colorado<br />
|date=2012-08-31<br />
|accessdate=2019-10-04<br />
}}</ref><br />
}}<br />
<br />
Blank was an Assistant Commissioner at the New York City Department of Health and Mental Hygiene at the time that a ''mohel'' was believed to have infected three infants with [[herpes]] after performing mouth suction on their penis wounds.<ref>{{REFweb<br />
|quote=<br />
|url=http://cid.oxfordjournals.org/content/40/7/iii.full<br />
|title=New York Officials Bar Rabbi from Circumcision Ritual<br />
|last=<br />
|first=<br />
|publisher=<br />
|date=2005-02<br />
|accessdate=2019-10-04<br />
}}</ref> One of those infants died and another was believed to have brain damage. [[Thomas R. Frieden]] also worked at DOHMH at the time. It appears that Blank helped do research for the letter that Frieden later published as "An Open Letter to the Jewish Community", in response to these events.<ref>{{REFdocument<br />
|url=https://web.archive.org/web/20071009055505/http://www.nyp-rpc.org/pdf/2005_health_alert46.pdf<br />
|title=2005 Health Alert #46: Neonatal herpes infection with herpes simplex virus type 1 following circumcision with oral suctioning (metzitzah b’peh)<br />
|last=Blank<br />
|first=Susan<br />
|author-link=Susan Blank<br />
|last2=Schillinger<br />
|first2=Julia<br />
|website=https://web.archive.org/web/20071009055505/http://www.nyp-rpc.org/pdf/2005_health_alert46.pdf<br />
|publisher=The City of New York<br />
|date=2005-12-13<br />
|accessdate=2019-10-04<br />
|archived=yes<br />
}}</ref><br />
<br />
Susan Blank may have confused her ethnic views on circumcision with medical science. Her circumcision policy of 2012 received scathing critical comment.<ref name="frisch2013">{{REFjournal<br />
|last=Frisch<br />
|first=Morten<br />
|author-link=Morten Frisch<br />
|etal=yes<br />
|title=Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision<br />
|journal=Pediatrics<br />
|location=<br />
|date=2013-04-01<br />
|volume=131<br />
|issue=4<br />
|pages=<br />
|url=https://pediatrics.aappublications.org/content/131/4/796.long<br />
|quote=<br />
|pubmedID=23509170<br />
|pubmedCID=<br />
|DOI=10.1542/peds.2012-2896<br />
|accessdate=2020-02-07<br />
}}</ref> The statement failed to recognize that young boys are human persons with [[human rights]] independent of their parents. It expired in 2017 and has not been reaffirmed by the AAP.<br />
<br />
Susan Blank was the subject of a protest at her home by the intactivist group [[Intaction]] for her involvement with the AAP 2012 Circumcision Committee.<ref>https://qns.com/story/2013/11/24/queens-doctor-targeted-over-circumcisions/</ref><br />
<br />
{{SEEALSO}}<br />
<br />
* [[Bias]]<br />
* [https://www.youtube.com/watch?v=e61hWdKPNnw Youtube video by Intaction Protesters]<br />
<br />
{{REF}}<br />
<br />
{{DEFAULTSORT:Blank, Susan}}<br />
<br />
[[Category:Person]]<br />
[[Category:Female]]<br />
[[Category:Physician]]<br />
[[Category:American Academy of Pediatrics]]<br />
<br />
[[Category:From CircLeaks]]<br />
[[Category:From IntactWiki]]<br />
<br />
[[de:{{FULLPAGENAME}}]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Susan_Blank&diff=14301Susan Blank2020-05-03T19:44:38Z<p>WikiModEn4: </p>
<hr />
<div>{| class="infobox vcard" style="175px; font-size:90%" border="0" cellspacing="4" align="right" <br />
|- <br />
| [[Image:Blank_Susan.jpg|175px|center]]<br />
|-<br />
| align="center" | [[{{FULLPAGENAME}}]]<br />
|-<br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Colleagues & benefactors:'''<br />
|-<br />
| align="center" | [[Douglas Diekema]]<br>[[Andrew Freedman]] <br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Member of:'''<br />
|-<br />
| align="center" | [[AAP Circumcision Task Force 2012]]<br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Associates with:'''<br />
|-<br />
| align="center" | [[American Academy of Pediatrics]]<br />
|-<br />
|}<br />
<br />
'''Susan Blank''', MD, MPH, was the Chairwoman of the [[AAP Circumcision Task Force 2012]]. The Task force released a new policy statement on circumcision on 27 August 2012.<br />
<br />
She has worked at the New York City Department of Health and Mental Hygiene since 1992. She is affiliated with the CDC and works at the DOHMH as an assignee from the Division of Sexually Transmitted Disease Prevention at the CDC. Currently she is the Director and Assistant Commissioner of the Bureau of STD Control.<ref>{{REFweb<br />
|quote=<br />
|url=http://cdc.confex.com/cdc/std2010/webprogram/Person21221.html<br />
|title=Susan Blank, MD, MPH<br />
|last=<br />
|first=<br />
|publisher=<br />
|date=<br />
|accessdate=2019-10-04<br />
}}</ref> She appears to be convinced of the medical advantages of circumcision.<br />
<br />
{{Citation<br />
|Title=<br />
|Text="There's no argument that the trials that have been done are really compelling," says Susan Blank, chairwoman of the academy's task force on neonatal circumcision. "That is just one piece in the discussion of circumcision." The academy's panel also includes experts on urinary-tract infections, ethics and health-care finance among others, she says.<small>(119)</small><br />
|Author=<br />
|Source=Wall Street Journal<br />
|ref=<ref>{{REFweb |url=http://online.wsj.com/article/SB123802256715541879.html |title=Circumcision Decreases Risk of Contracting STDs, Study Says |website=Wall Street Journal |date=2009-03-26 |accessdate=2019-10-04}}</ref><br />
}}<br />
<br />
{{Citation<br />
|Title=<br />
|Text=This statement really is not neutral. There is clear evidence that supports the health benefits of male circumcision.<br />
|Author=<br />
|Source=Community Radio for Northern Colorado<br />
|ref=<ref>{{REFweb<br />
|url=http://kunc.org/post/pediatricians-decide-boys-are-better-circumcised-not<br />
|title=Pediatricians Decide Boys Are Better Off Circumcised Than Not<br />
|website=Community Radio for Northern Colorado<br />
|date=2012-08-31<br />
|accessdate=2019-10-04<br />
}}</ref><br />
}}<br />
<br />
Blank was an Assistant Commissioner at the New York City Department of Health and Mental Hygiene at the time that a ''mohel'' was believed to have infected three infants with [[herpes]] after performing mouth suction on their penis wounds.<ref>{{REFweb<br />
|quote=<br />
|url=http://cid.oxfordjournals.org/content/40/7/iii.full<br />
|title=New York Officials Bar Rabbi from Circumcision Ritual<br />
|last=<br />
|first=<br />
|publisher=<br />
|date=2005-02<br />
|accessdate=2019-10-04<br />
}}</ref> One of those infants died and another was believed to have brain damage. [[Thomas R. Frieden]] also worked at DOHMH at the time. It appears that Blank helped do research for the letter that Frieden later published as "An Open Letter to the Jewish Community", in response to these events.<ref>{{REFdocument<br />
|url=https://web.archive.org/web/20071009055505/http://www.nyp-rpc.org/pdf/2005_health_alert46.pdf<br />
|title=2005 Health Alert #46: Neonatal herpes infection with herpes simplex virus type 1 following circumcision with oral suctioning (metzitzah b’peh)<br />
|last=Blank<br />
|first=Susan<br />
|author-link=Susan Blank<br />
|last2=Schillinger<br />
|first2=Julia<br />
|website=https://web.archive.org/web/20071009055505/http://www.nyp-rpc.org/pdf/2005_health_alert46.pdf<br />
|publisher=The City of New York<br />
|date=2005-12-13<br />
|accessdate=2019-10-04<br />
|archived=yes<br />
}}</ref><br />
<br />
Susan Blank may have confused her ethnic views on circumcision with medical science. Her circumcision policy of 2012 received scathing critical comment.<ref name="frisch2013">{{REFjournal<br />
|last=Frisch<br />
|first=Morten<br />
|author-link=Morten Frisch<br />
|etal=yes<br />
|title=Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision<br />
|journal=Pediatrics<br />
|location=<br />
|date=2013-04-01<br />
|volume=131<br />
|issue=4<br />
|pages=<br />
|url=https://pediatrics.aappublications.org/content/131/4/796.long<br />
|quote=<br />
|pubmedID=23509170<br />
|pubmedCID=<br />
|DOI=10.1542/peds.2012-2896<br />
|accessdate=2020-02-07<br />
}}</ref> The statement failed to recognize that young boys are human persons with [[human rights]] independent of their parents. It expired in 2017 and has not been reaffirmed by the AAP.<br />
<br />
Susan Blank was the subject of a protest at her home by the intactivist group [[Intaction]] for her heading of the AAP 2012 Circumcision Committee.<ref>https://qns.com/story/2013/11/24/queens-doctor-targeted-over-circumcisions/</ref><br />
<br />
{{SEEALSO}}<br />
<br />
* [[Bias]]<br />
* [https://www.youtube.com/watch?v=e61hWdKPNnw Youtube video by Intaction Protesters]<br />
<br />
{{REF}}<br />
<br />
{{DEFAULTSORT:Blank, Susan}}<br />
<br />
[[Category:Person]]<br />
[[Category:Female]]<br />
[[Category:Physician]]<br />
[[Category:American Academy of Pediatrics]]<br />
<br />
[[Category:From CircLeaks]]<br />
[[Category:From IntactWiki]]<br />
<br />
[[de:{{FULLPAGENAME}}]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Susan_Blank&diff=14300Susan Blank2020-05-03T19:44:17Z<p>WikiModEn4: </p>
<hr />
<div>{| class="infobox vcard" style="175px; font-size:90%" border="0" cellspacing="4" align="right" <br />
|- <br />
| [[Image:Blank_Susan.jpg|175px|center]]<br />
|-<br />
| align="center" | [[{{FULLPAGENAME}}]]<br />
|-<br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Colleagues & benefactors:'''<br />
|-<br />
| align="center" | [[Douglas Diekema]]<br>[[Andrew Freedman]] <br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Member of:'''<br />
|-<br />
| align="center" | [[AAP Circumcision Task Force 2012]]<br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Associates with:'''<br />
|-<br />
| align="center" | [[American Academy of Pediatrics]]<br />
|-<br />
|}<br />
<br />
'''Susan Blank''', MD, MPH, was the Chairwoman of the [[AAP Circumcision Task Force 2012]]. The Task force released a new policy statement on circumcision on 27 August 2012.<br />
<br />
She has worked at the New York City Department of Health and Mental Hygiene since 1992. She is affiliated with the CDC and works at the DOHMH as an assignee from the Division of Sexually Transmitted Disease Prevention at the CDC. Currently she is the Director and Assistant Commissioner of the Bureau of STD Control.<ref>{{REFweb<br />
|quote=<br />
|url=http://cdc.confex.com/cdc/std2010/webprogram/Person21221.html<br />
|title=Susan Blank, MD, MPH<br />
|last=<br />
|first=<br />
|publisher=<br />
|date=<br />
|accessdate=2019-10-04<br />
}}</ref> She appears to be convinced of the medical advantages of circumcision.<br />
<br />
{{Citation<br />
|Title=<br />
|Text="There's no argument that the trials that have been done are really compelling," says Susan Blank, chairwoman of the academy's task force on neonatal circumcision. "That is just one piece in the discussion of circumcision." The academy's panel also includes experts on urinary-tract infections, ethics and health-care finance among others, she says.<small>(119)</small><br />
|Author=<br />
|Source=Wall Street Journal<br />
|ref=<ref>{{REFweb |url=http://online.wsj.com/article/SB123802256715541879.html |title=Circumcision Decreases Risk of Contracting STDs, Study Says |website=Wall Street Journal |date=2009-03-26 |accessdate=2019-10-04}}</ref><br />
}}<br />
<br />
{{Citation<br />
|Title=<br />
|Text=This statement really is not neutral. There is clear evidence that supports the health benefits of male circumcision.<br />
|Author=<br />
|Source=Community Radio for Northern Colorado<br />
|ref=<ref>{{REFweb<br />
|url=http://kunc.org/post/pediatricians-decide-boys-are-better-circumcised-not<br />
|title=Pediatricians Decide Boys Are Better Off Circumcised Than Not<br />
|website=Community Radio for Northern Colorado<br />
|date=2012-08-31<br />
|accessdate=2019-10-04<br />
}}</ref><br />
}}<br />
<br />
Blank was an Assistant Commissioner at the New York City Department of Health and Mental Hygiene at the time that a ''mohel'' was believed to have infected three infants with [[herpes]] after performing mouth suction on their penis wounds.<ref>{{REFweb<br />
|quote=<br />
|url=http://cid.oxfordjournals.org/content/40/7/iii.full<br />
|title=New York Officials Bar Rabbi from Circumcision Ritual<br />
|last=<br />
|first=<br />
|publisher=<br />
|date=2005-02<br />
|accessdate=2019-10-04<br />
}}</ref> One of those infants died and another was believed to have brain damage. [[Thomas R. Frieden]] also worked at DOHMH at the time. It appears that Blank helped do research for the letter that Frieden later published as "An Open Letter to the Jewish Community", in response to these events.<ref>{{REFdocument<br />
|url=https://web.archive.org/web/20071009055505/http://www.nyp-rpc.org/pdf/2005_health_alert46.pdf<br />
|title=2005 Health Alert #46: Neonatal herpes infection with herpes simplex virus type 1 following circumcision with oral suctioning (metzitzah b’peh)<br />
|last=Blank<br />
|first=Susan<br />
|author-link=Susan Blank<br />
|last2=Schillinger<br />
|first2=Julia<br />
|website=https://web.archive.org/web/20071009055505/http://www.nyp-rpc.org/pdf/2005_health_alert46.pdf<br />
|publisher=The City of New York<br />
|date=2005-12-13<br />
|accessdate=2019-10-04<br />
|archived=yes<br />
}}</ref><br />
<br />
Susan Blank may have confused her ethnic views on circumcision with medical science. Her circumcision policy of 2012 received scathing critical comment.<ref name="frisch2013">{{REFjournal<br />
|last=Frisch<br />
|first=Morten<br />
|author-link=Morten Frisch<br />
|etal=yes<br />
|title=Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision<br />
|journal=Pediatrics<br />
|location=<br />
|date=2013-04-01<br />
|volume=131<br />
|issue=4<br />
|pages=<br />
|url=https://pediatrics.aappublications.org/content/131/4/796.long<br />
|quote=<br />
|pubmedID=23509170<br />
|pubmedCID=<br />
|DOI=10.1542/peds.2012-2896<br />
|accessdate=2020-02-07<br />
}}</ref> The statement failed to recognize that young boys are human persons with [[human rights]] independent of their parents. It expired in 2017 and has not been reaffirmed by the AAP.<br />
<br />
Susan Blank was the subject of a protest at her home by the intactivist group [[Intaction]] for her heading of the AAP 2012 Circumcision Committee.<ref>https://qns.com/story/2013/11/24/queens-doctor-targeted-over-circumcisions/</ref><br />
<br />
{{SEEALSO}}<br />
<br />
* [[Bias]]<br />
* [https://www.youtube.com/watch?v=e61hWdKPNnw Youtube Video by Intaction Protesters]<br />
<br />
{{REF}}<br />
<br />
{{DEFAULTSORT:Blank, Susan}}<br />
<br />
[[Category:Person]]<br />
[[Category:Female]]<br />
[[Category:Physician]]<br />
[[Category:American Academy of Pediatrics]]<br />
<br />
[[Category:From CircLeaks]]<br />
[[Category:From IntactWiki]]<br />
<br />
[[de:{{FULLPAGENAME}}]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Susan_Blank&diff=14299Susan Blank2020-05-03T19:43:42Z<p>WikiModEn4: </p>
<hr />
<div>{| class="infobox vcard" style="175px; font-size:90%" border="0" cellspacing="4" align="right" <br />
|- <br />
| [[Image:Blank_Susan.jpg|175px|center]]<br />
|-<br />
| align="center" | [[{{FULLPAGENAME}}]]<br />
|-<br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Colleagues & benefactors:'''<br />
|-<br />
| align="center" | [[Douglas Diekema]]<br>[[Andrew Freedman]] <br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Member of:'''<br />
|-<br />
| align="center" | [[AAP Circumcision Task Force 2012]]<br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Associates with:'''<br />
|-<br />
| align="center" | [[American Academy of Pediatrics]]<br />
|-<br />
|}<br />
<br />
'''Susan Blank''', MD, MPH, was the Chairwoman of the [[AAP Circumcision Task Force 2012]]. The Task force released a new policy statement on circumcision on 27 August 2012.<br />
<br />
She has worked at the New York City Department of Health and Mental Hygiene since 1992. She is affiliated with the CDC and works at the DOHMH as an assignee from the Division of Sexually Transmitted Disease Prevention at the CDC. Currently she is the Director and Assistant Commissioner of the Bureau of STD Control.<ref>{{REFweb<br />
|quote=<br />
|url=http://cdc.confex.com/cdc/std2010/webprogram/Person21221.html<br />
|title=Susan Blank, MD, MPH<br />
|last=<br />
|first=<br />
|publisher=<br />
|date=<br />
|accessdate=2019-10-04<br />
}}</ref> She appears to be convinced of the medical advantages of circumcision.<br />
<br />
{{Citation<br />
|Title=<br />
|Text="There's no argument that the trials that have been done are really compelling," says Susan Blank, chairwoman of the academy's task force on neonatal circumcision. "That is just one piece in the discussion of circumcision." The academy's panel also includes experts on urinary-tract infections, ethics and health-care finance among others, she says.<small>(119)</small><br />
|Author=<br />
|Source=Wall Street Journal<br />
|ref=<ref>{{REFweb |url=http://online.wsj.com/article/SB123802256715541879.html |title=Circumcision Decreases Risk of Contracting STDs, Study Says |website=Wall Street Journal |date=2009-03-26 |accessdate=2019-10-04}}</ref><br />
}}<br />
<br />
{{Citation<br />
|Title=<br />
|Text=This statement really is not neutral. There is clear evidence that supports the health benefits of male circumcision.<br />
|Author=<br />
|Source=Community Radio for Northern Colorado<br />
|ref=<ref>{{REFweb<br />
|url=http://kunc.org/post/pediatricians-decide-boys-are-better-circumcised-not<br />
|title=Pediatricians Decide Boys Are Better Off Circumcised Than Not<br />
|website=Community Radio for Northern Colorado<br />
|date=2012-08-31<br />
|accessdate=2019-10-04<br />
}}</ref><br />
}}<br />
<br />
Blank was an Assistant Commissioner at the New York City Department of Health and Mental Hygiene at the time that a ''mohel'' was believed to have infected three infants with [[herpes]] after performing mouth suction on their penis wounds.<ref>{{REFweb<br />
|quote=<br />
|url=http://cid.oxfordjournals.org/content/40/7/iii.full<br />
|title=New York Officials Bar Rabbi from Circumcision Ritual<br />
|last=<br />
|first=<br />
|publisher=<br />
|date=2005-02<br />
|accessdate=2019-10-04<br />
}}</ref> One of those infants died and another was believed to have brain damage. [[Thomas R. Frieden]] also worked at DOHMH at the time. It appears that Blank helped do research for the letter that Frieden later published as "An Open Letter to the Jewish Community", in response to these events.<ref>{{REFdocument<br />
|url=https://web.archive.org/web/20071009055505/http://www.nyp-rpc.org/pdf/2005_health_alert46.pdf<br />
|title=2005 Health Alert #46: Neonatal herpes infection with herpes simplex virus type 1 following circumcision with oral suctioning (metzitzah b’peh)<br />
|last=Blank<br />
|first=Susan<br />
|author-link=Susan Blank<br />
|last2=Schillinger<br />
|first2=Julia<br />
|website=https://web.archive.org/web/20071009055505/http://www.nyp-rpc.org/pdf/2005_health_alert46.pdf<br />
|publisher=The City of New York<br />
|date=2005-12-13<br />
|accessdate=2019-10-04<br />
|archived=yes<br />
}}</ref><br />
<br />
Susan Blank may have confused her ethnic views on circumcision with medical science. Her circumcision policy of 2012 received scathing critical comment.<ref name="frisch2013">{{REFjournal<br />
|last=Frisch<br />
|first=Morten<br />
|author-link=Morten Frisch<br />
|etal=yes<br />
|title=Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision<br />
|journal=Pediatrics<br />
|location=<br />
|date=2013-04-01<br />
|volume=131<br />
|issue=4<br />
|pages=<br />
|url=https://pediatrics.aappublications.org/content/131/4/796.long<br />
|quote=<br />
|pubmedID=23509170<br />
|pubmedCID=<br />
|DOI=10.1542/peds.2012-2896<br />
|accessdate=2020-02-07<br />
}}</ref> The statement failed to recognize that young boys are human persons with [[human rights]] independent of their parents. It expired in 2017 and has not been reaffirmed by the AAP.<br />
<br />
Susan Blank was the subject of a protest at her home by the intactivist group [[Intaction]] for her heading of the AAP 2012 Circumcision Committee.<ref>https://qns.com/story/2013/11/24/queens-doctor-targeted-over-circumcisions/</ref><br />
<br />
{{SEEALSO}}<br />
<br />
* [[Bias]]<br />
* [[https://www.youtube.com/watch?v=e61hWdKPNnw | Youtube Video by Intaction Protesters]]<br />
<br />
{{REF}}<br />
<br />
{{DEFAULTSORT:Blank, Susan}}<br />
<br />
[[Category:Person]]<br />
[[Category:Female]]<br />
[[Category:Physician]]<br />
[[Category:American Academy of Pediatrics]]<br />
<br />
[[Category:From CircLeaks]]<br />
[[Category:From IntactWiki]]<br />
<br />
[[de:{{FULLPAGENAME}}]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Susan_Blank&diff=14298Susan Blank2020-05-03T19:42:49Z<p>WikiModEn4: </p>
<hr />
<div>{| class="infobox vcard" style="175px; font-size:90%" border="0" cellspacing="4" align="right" <br />
|- <br />
| [[Image:Blank_Susan.jpg|175px|center]]<br />
|-<br />
| align="center" | [[{{FULLPAGENAME}}]]<br />
|-<br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Colleagues & benefactors:'''<br />
|-<br />
| align="center" | [[Douglas Diekema]]<br>[[Andrew Freedman]] <br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Member of:'''<br />
|-<br />
| align="center" | [[AAP Circumcision Task Force 2012]]<br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Associates with:'''<br />
|-<br />
| align="center" | [[American Academy of Pediatrics]]<br />
|-<br />
|}<br />
<br />
'''Susan Blank''', MD, MPH, was the Chairwoman of the [[AAP Circumcision Task Force 2012]]. The Task force released a new policy statement on circumcision on 27 August 2012.<br />
<br />
She has worked at the New York City Department of Health and Mental Hygiene since 1992. She is affiliated with the CDC and works at the DOHMH as an assignee from the Division of Sexually Transmitted Disease Prevention at the CDC. Currently she is the Director and Assistant Commissioner of the Bureau of STD Control.<ref>{{REFweb<br />
|quote=<br />
|url=http://cdc.confex.com/cdc/std2010/webprogram/Person21221.html<br />
|title=Susan Blank, MD, MPH<br />
|last=<br />
|first=<br />
|publisher=<br />
|date=<br />
|accessdate=2019-10-04<br />
}}</ref> She appears to be convinced of the medical advantages of circumcision.<br />
<br />
{{Citation<br />
|Title=<br />
|Text="There's no argument that the trials that have been done are really compelling," says Susan Blank, chairwoman of the academy's task force on neonatal circumcision. "That is just one piece in the discussion of circumcision." The academy's panel also includes experts on urinary-tract infections, ethics and health-care finance among others, she says.<small>(119)</small><br />
|Author=<br />
|Source=Wall Street Journal<br />
|ref=<ref>{{REFweb |url=http://online.wsj.com/article/SB123802256715541879.html |title=Circumcision Decreases Risk of Contracting STDs, Study Says |website=Wall Street Journal |date=2009-03-26 |accessdate=2019-10-04}}</ref><br />
}}<br />
<br />
{{Citation<br />
|Title=<br />
|Text=This statement really is not neutral. There is clear evidence that supports the health benefits of male circumcision.<br />
|Author=<br />
|Source=Community Radio for Northern Colorado<br />
|ref=<ref>{{REFweb<br />
|url=http://kunc.org/post/pediatricians-decide-boys-are-better-circumcised-not<br />
|title=Pediatricians Decide Boys Are Better Off Circumcised Than Not<br />
|website=Community Radio for Northern Colorado<br />
|date=2012-08-31<br />
|accessdate=2019-10-04<br />
}}</ref><br />
}}<br />
<br />
Blank was an Assistant Commissioner at the New York City Department of Health and Mental Hygiene at the time that a ''mohel'' was believed to have infected three infants with [[herpes]] after performing mouth suction on their penis wounds.<ref>{{REFweb<br />
|quote=<br />
|url=http://cid.oxfordjournals.org/content/40/7/iii.full<br />
|title=New York Officials Bar Rabbi from Circumcision Ritual<br />
|last=<br />
|first=<br />
|publisher=<br />
|date=2005-02<br />
|accessdate=2019-10-04<br />
}}</ref> One of those infants died and another was believed to have brain damage. [[Thomas R. Frieden]] also worked at DOHMH at the time. It appears that Blank helped do research for the letter that Frieden later published as "An Open Letter to the Jewish Community", in response to these events.<ref>{{REFdocument<br />
|url=https://web.archive.org/web/20071009055505/http://www.nyp-rpc.org/pdf/2005_health_alert46.pdf<br />
|title=2005 Health Alert #46: Neonatal herpes infection with herpes simplex virus type 1 following circumcision with oral suctioning (metzitzah b’peh)<br />
|last=Blank<br />
|first=Susan<br />
|author-link=Susan Blank<br />
|last2=Schillinger<br />
|first2=Julia<br />
|website=https://web.archive.org/web/20071009055505/http://www.nyp-rpc.org/pdf/2005_health_alert46.pdf<br />
|publisher=The City of New York<br />
|date=2005-12-13<br />
|accessdate=2019-10-04<br />
|archived=yes<br />
}}</ref><br />
<br />
Susan Blank may have confused her ethnic views on circumcision with medical science. Her circumcision policy of 2012 received scathing critical comment.<ref name="frisch2013">{{REFjournal<br />
|last=Frisch<br />
|first=Morten<br />
|author-link=Morten Frisch<br />
|etal=yes<br />
|title=Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision<br />
|journal=Pediatrics<br />
|location=<br />
|date=2013-04-01<br />
|volume=131<br />
|issue=4<br />
|pages=<br />
|url=https://pediatrics.aappublications.org/content/131/4/796.long<br />
|quote=<br />
|pubmedID=23509170<br />
|pubmedCID=<br />
|DOI=10.1542/peds.2012-2896<br />
|accessdate=2020-02-07<br />
}}</ref> The statement failed to recognize that young boys are human persons with [[human rights]] independent of their parents. It expired in 2017 and has not been reaffirmed by the AAP.<br />
<br />
Susan Blank was the subject of a protest at her home by the intactivist group [[Intaction]] for her heading of the AAP 2012 Circumcision Committee.<ref>https://qns.com/story/2013/11/24/queens-doctor-targeted-over-circumcisions/</ref><br />
<br />
{{SEEALSO}}<br />
<br />
* [[Bias]]<br />
* [[https://www.youtube.com/watch?v=e61hWdKPNnw]]<br />
<br />
{{REF}}<br />
<br />
{{DEFAULTSORT:Blank, Susan}}<br />
<br />
[[Category:Person]]<br />
[[Category:Female]]<br />
[[Category:Physician]]<br />
[[Category:American Academy of Pediatrics]]<br />
<br />
[[Category:From CircLeaks]]<br />
[[Category:From IntactWiki]]<br />
<br />
[[de:{{FULLPAGENAME}}]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Susan_Blank&diff=14297Susan Blank2020-05-03T19:39:19Z<p>WikiModEn4: </p>
<hr />
<div>{| class="infobox vcard" style="175px; font-size:90%" border="0" cellspacing="4" align="right" <br />
|- <br />
| [[Image:Blank_Susan.jpg|175px|center]]<br />
|-<br />
| align="center" | [[{{FULLPAGENAME}}]]<br />
|-<br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Colleagues & benefactors:'''<br />
|-<br />
| align="center" | [[Douglas Diekema]]<br>[[Andrew Freedman]] <br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Member of:'''<br />
|-<br />
| align="center" | [[AAP Circumcision Task Force 2012]]<br />
|- style="background: #DCDCDC"<br />
| align="center" | '''Associates with:'''<br />
|-<br />
| align="center" | [[American Academy of Pediatrics]]<br />
|-<br />
|}<br />
<br />
'''Susan Blank''', MD, MPH, was the Chairwoman of the [[AAP Circumcision Task Force 2012]]. The Task force released a new policy statement on circumcision on 27 August 2012.<br />
<br />
She has worked at the New York City Department of Health and Mental Hygiene since 1992. She is affiliated with the CDC and works at the DOHMH as an assignee from the Division of Sexually Transmitted Disease Prevention at the CDC. Currently she is the Director and Assistant Commissioner of the Bureau of STD Control.<ref>{{REFweb<br />
|quote=<br />
|url=http://cdc.confex.com/cdc/std2010/webprogram/Person21221.html<br />
|title=Susan Blank, MD, MPH<br />
|last=<br />
|first=<br />
|publisher=<br />
|date=<br />
|accessdate=2019-10-04<br />
}}</ref> She appears to be convinced of the medical advantages of circumcision.<br />
<br />
{{Citation<br />
|Title=<br />
|Text="There's no argument that the trials that have been done are really compelling," says Susan Blank, chairwoman of the academy's task force on neonatal circumcision. "That is just one piece in the discussion of circumcision." The academy's panel also includes experts on urinary-tract infections, ethics and health-care finance among others, she says.<small>(119)</small><br />
|Author=<br />
|Source=Wall Street Journal<br />
|ref=<ref>{{REFweb |url=http://online.wsj.com/article/SB123802256715541879.html |title=Circumcision Decreases Risk of Contracting STDs, Study Says |website=Wall Street Journal |date=2009-03-26 |accessdate=2019-10-04}}</ref><br />
}}<br />
<br />
{{Citation<br />
|Title=<br />
|Text=This statement really is not neutral. There is clear evidence that supports the health benefits of male circumcision.<br />
|Author=<br />
|Source=Community Radio for Northern Colorado<br />
|ref=<ref>{{REFweb<br />
|url=http://kunc.org/post/pediatricians-decide-boys-are-better-circumcised-not<br />
|title=Pediatricians Decide Boys Are Better Off Circumcised Than Not<br />
|website=Community Radio for Northern Colorado<br />
|date=2012-08-31<br />
|accessdate=2019-10-04<br />
}}</ref><br />
}}<br />
<br />
Blank was an Assistant Commissioner at the New York City Department of Health and Mental Hygiene at the time that a ''mohel'' was believed to have infected three infants with [[herpes]] after performing mouth suction on their penis wounds.<ref>{{REFweb<br />
|quote=<br />
|url=http://cid.oxfordjournals.org/content/40/7/iii.full<br />
|title=New York Officials Bar Rabbi from Circumcision Ritual<br />
|last=<br />
|first=<br />
|publisher=<br />
|date=2005-02<br />
|accessdate=2019-10-04<br />
}}</ref> One of those infants died and another was believed to have brain damage. [[Thomas R. Frieden]] also worked at DOHMH at the time. It appears that Blank helped do research for the letter that Frieden later published as "An Open Letter to the Jewish Community", in response to these events.<ref>{{REFdocument<br />
|url=https://web.archive.org/web/20071009055505/http://www.nyp-rpc.org/pdf/2005_health_alert46.pdf<br />
|title=2005 Health Alert #46: Neonatal herpes infection with herpes simplex virus type 1 following circumcision with oral suctioning (metzitzah b’peh)<br />
|last=Blank<br />
|first=Susan<br />
|author-link=Susan Blank<br />
|last2=Schillinger<br />
|first2=Julia<br />
|website=https://web.archive.org/web/20071009055505/http://www.nyp-rpc.org/pdf/2005_health_alert46.pdf<br />
|publisher=The City of New York<br />
|date=2005-12-13<br />
|accessdate=2019-10-04<br />
|archived=yes<br />
}}</ref><br />
<br />
Susan Blank may have confused her ethnic views on circumcision with medical science. Her circumcision policy of 2012 received scathing critical comment.<ref name="frisch2013">{{REFjournal<br />
|last=Frisch<br />
|first=Morten<br />
|author-link=Morten Frisch<br />
|etal=yes<br />
|title=Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision<br />
|journal=Pediatrics<br />
|location=<br />
|date=2013-04-01<br />
|volume=131<br />
|issue=4<br />
|pages=<br />
|url=https://pediatrics.aappublications.org/content/131/4/796.long<br />
|quote=<br />
|pubmedID=23509170<br />
|pubmedCID=<br />
|DOI=10.1542/peds.2012-2896<br />
|accessdate=2020-02-07<br />
}}</ref> The statement failed to recognize that young boys are human persons with [[human rights]] independent of their parents. It expired in 2017 and has not been reaffirmed by the AAP.<br />
<br />
Susan Blank was the subject of a protest at her home by the intactivist group [[Intaction]] for her heading of the AAP 2012 Circumcision Committee.<ref>https://qns.com/story/2013/11/24/queens-doctor-targeted-over-circumcisions/</ref><br />
<br />
{{SEEALSO}}<br />
<br />
* [[Bias]]<br />
<br />
{{REF}}<br />
<br />
{{DEFAULTSORT:Blank, Susan}}<br />
<br />
[[Category:Person]]<br />
[[Category:Female]]<br />
[[Category:Physician]]<br />
[[Category:American Academy of Pediatrics]]<br />
<br />
[[Category:From CircLeaks]]<br />
[[Category:From IntactWiki]]<br />
<br />
[[de:{{FULLPAGENAME}}]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Michael_Winnel&diff=14290Michael Winnel2020-05-03T17:36:17Z<p>WikiModEn4: </p>
<hr />
<div>Michael Winnel is the leader of the [[Foreskin Revolution]] and an [[intactivist]].<br />
<br />
Michael Winnel was formerly a pharmaceutical representative and his work took him to New York where he first became involved in the fight against [http://foreskinrevolution.org circumcision]. Michael is now occupied full-time as the leader of the Foreskin Revolution which focuses on the continuing practice of the circumcision of children in the three Western countries with the most significant numbers, namely the USA, Canada and Australia. He is based in Sydney Australia. <br />
<br />
He advocates for the rights of children and the adults they become. Winnel has stated he believes all people should feel empowered to celebrate their body, and that the foreskin is valuable, purposeful tissue that is better enjoyed, embraced and explored, rather than forcibly amputated in childhood.</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Michael_Winnel&diff=14289Michael Winnel2020-05-03T17:32:46Z<p>WikiModEn4: Created page with "Michael Winnel is the leader of the Foreskin Revolution. Michael Winnel was formerly a pharmaceutical representative and his work took him to New York where he first beca..."</p>
<hr />
<div>Michael Winnel is the leader of the [[Foreskin Revolution]].<br />
<br />
Michael Winnel was formerly a pharmaceutical representative and his work took him to New York where he first became involved in the fight against circumcision. Michael is now occupied full-time as the leader of the Foreskin Revolution which focuses on the continuing practice of the circumcision of children in the three Western countries with the most significant numbers, namely the USA, Canada and Australia.</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Foreskin_Revolution&diff=14286Foreskin Revolution2020-05-03T15:27:28Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Foreskin Revolution<br />
|titlestyle = color:black;<br />
|image = [[File:FSR.png|175px]]<br />
|imagestyle = <br />
|caption = Foreskin Revolution logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2018<br />
|header3 = Founder:<br />
|data4 = [[Michael Winnel]]<br />
|header5 = Founding location:<br />
|data6 = Sydney<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Sydney Australia<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|http://foreskinrevolution.org}}<br />
}}<br />
'''Foreskin Revolution''' is a anti-[[circumcision]] advocacy organization based in Australia. Foreskin Revolution supports the [[WWDOGA]].<br />
The founder and Director is [[Michael Winnel]].<br />
<br />
Foreskin Revolution is a human rights movement that uses art, politics and popular culture to spread the core messages - that the normal, whole body is awesome with the foreskin being the most enjoyable part of the body, and that [http://foreskinrevolution.org circumcision] of a healthy child is an assault on that body that needs to end. We wrap all of this in a revolutionary spirit that holds a place for everyone - cut men and their partners who resent it, intact men who are sick of the body shaming or anyone who understands that our society needs to move beyond this harmful practice. <ref>https://www.sbs.com.au/news/the-feed/the-movement-to-save-men-s-foreskins-has-come-to-australia</ref><br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://foreskinrevolution.org/|2020-05-03}}<br />
* [https://www.youtube.com/channel/UCL55XSqdCcZJW5vtx6eEW0g/ YouTube Channel]<br />
* [https://www.sbs.com.au/news/the-feed/the-movement-to-save-men-s-foreskins-has-come-to-australia The movement to save men's foreskins has come to Australia]<br />
<br />
{{REF}}<br />
<br />
[[Category: Intactivism organization]]<br />
[[Category: Australia]]<br />
<br />
[[de: Foreskin Revolution]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Foreskin_Revolution&diff=14285Foreskin Revolution2020-05-03T15:16:16Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Foreskin Revolution<br />
|titlestyle = color:black;<br />
|image = [[File:FSR.png|175px]]<br />
|imagestyle = <br />
|caption = Foreskin Revolution logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2018<br />
|header3 = Founder:<br />
|data4 = [[Michael Winnel]]<br />
|header5 = Founding location:<br />
|data6 = Sydney<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Sydney Australia<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|http://foreskinrevolution.org}}<br />
}}<br />
'''Foreskin Revolution''' is a anti-[[circumcision]] advocacy organization based in Australia. Foreskin Revolution supports the [[WWDOGA]].<br />
The founder and Director is [[Michael Winnel]].<br />
<br />
Foreskin Revolution is a human rights movement that uses art, politics and popular culture to spread the core messages - that the normal, whole body is awesome with the foreskin being the most enjoyable part of the body, and that circumcision of a healthy child is an assault on that body that needs to end. We wrap all of this in a revolutionary spirit that holds a place for everyone - cut men and their partners who resent it, intact men who are sick of the body shaming or anyone who understands that our society needs to move beyond this harmful practice. <ref>https://www.sbs.com.au/news/the-feed/the-movement-to-save-men-s-foreskins-has-come-to-australia</ref><br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://foreskinrevolution.org/|2020-05-03}}<br />
* [https://www.youtube.com/channel/UCL55XSqdCcZJW5vtx6eEW0g/ YouTube Channel]<br />
* [https://www.sbs.com.au/news/the-feed/the-movement-to-save-men-s-foreskins-has-come-to-australia The movement to save men's foreskins has come to Australia]<br />
<br />
{{REF}}<br />
<br />
[[Category: Intactivism organization]]<br />
[[Category: Australia]]<br />
<br />
[[de: Foreskin Revolution]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Intaction&diff=14284Intaction2020-05-03T15:13:51Z<p>WikiModEn4: /* Board of Directors */</p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Intaction<br />
|titlestyle = color:black;<br />
|image = [[File:Intaction logonewcropped.png|175px]]<br />
|imagestyle = <br />
|caption = Intaction logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2010<br />
|header3 = Founder:<br />
|data4 = [[Anthony Losquadro]]<br />
|header5 = Founding location:<br />
|data6 = New York City<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Brooklyn, New York City<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|http://intaction.org}}<br />
}}<br />
'''Intaction Inc.''' is a anti-[[circumcision]] advocacy organization based in Brooklyn, N.Y., USA. Intaction is a 501 (c)(3) organization and a registered corporation under the Not-For-Profit Laws of New York State, and formed in 2010. Intaction Inc. supports the [[WWDOGA]].<br />
The founder and Director is [[Anthony Losquadro]].<br />
Intaction's name is derived from the words "Intact" and "Action." Members of the organization refer to themselves as "Intactivists," and the anti-circumcision movement as "Intactivism."<br />
<br />
==Advocacy==<br />
Intaction also has a large full-time mobile education truck, which they use to display photo campaigns such as "Circumcision - I Did Not Consent" and "Foreskin - A Girl Can Hope.<ref>{{REFweb<br />
|url=https://www.vice.com/en_us/article/wd4ggx/intaction-is-fighting-for-your-babys-foreskin<br />
|title=The Fight for Baby Foreskin Hits the Streets<br />
|last=Euse<br />
|first=Erica<br />
|date=2014-05-12<br />
|publisher=Vice<br />
|accessdate=2020-04-11<br />
}}</ref> In addition to public education events held mostly in New York City, the group marches in parades advocating for the intact body and foreskin.<ref>{{REFweb<br />
|url=https://www.sheknows.com/parenting/articles/1140294/anti-circumcision-intactivist-movement-parents-2/<br />
|title=Inside the Anti-Circumcision Movement: These Blood-Soaked Activists Want You to Cut Them Some Slack<br />
|last=O'Connor<br />
|first=A.M.<br />
|date=2018-07-12<br />
|publisher=She Knows<br />
|accessdate=2020-04-11<br />
}}</ref><br />
<br />
The group is also frequently present at New York City's Union Square Park.<ref>{{REFweb<br />
|url=https://www.independent.co.uk/life-style/new-york-city-circumcision-america-protest-infant-sons-foreskin-a8500026.html<br />
|title=An advocacy group in New York City wants people to stop circumcising their infant sons<br />
|last=Ritschel<br />
|first=Chelsea<br />
|date=2018-08-20<br />
|publisher=The Independent<br />
|accessdate=2020-04-11<br />
}}</ref><ref>{{REFweb<br />
|url=https://melmagazine.com/en-us/story/why-foreskin-activists-are-taking-to-the-streets<br />
|title=Why Foreskin Activists Are Taking to the Streets<br />
|last=Myers<br />
|first=Quinn<br />
|date=<br />
|publisher=Mel Magazine<br />
|accessdate=2020-04-11<br />
}}</ref><br />
<br />
[[File:20180412 170459croppedWeb.jpg|thumb | Intaction's Mobile Unit with "Foreskin A Girl Can Hope" campaign (2018-Present)]]<br />
[[File:Intaction 1323correctedsmall.jpg|thumb | Mobile Unit with "Circumcision I Did Not Consent campaign (2014-2017)]]<br />
They are "fighting against [http://intaction.org circumcision] through education, advocacy, and activism".<ref>https://intaction.org/about-us/</ref>.<br />
<br />
== Board of Directors ==<br />
* [[Craig Adams]]<br />
* [[Aura Bobadilla]], Latino coordinator<br />
* [[Jonathan Friedman]]<br />
* [[David Grant]]<br />
* [[William Kaye]]<br />
* [[Everett Leiter]]<br />
* [[Anthony Losquadro]]<br />
* [[Michael Winnel]], (Sydney, AU) Australian Liaison<br />
* [[Adam Zeldis]]<br />
<br />
== Address ==<br />
Intaction Inc.<br><br />
PO Box 370599<br><br />
Brooklyn, NY, 11237, USA<br><br />
1-866-6-FORESKIN (1-866-636-7375)<br />
<br />
{{SEEALSO}}<br />
* {{REFweb<br />
|url=https://splinternews.com/inside-the-anti-circumcision-movement-these-blood-soak-1793861318<br />
|title=Inside the Anti-Circumcision Movement: These Blood-Soaked Activists Want You to Cut Them Some Slack<br />
|first=Charlotte<br />
|last=Shane<br />
|publisher=Splinter<br />
|date=2016-08-22<br />
|accessdate=2020-01-25<br />
}}<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|https://intaction.org/|2019-09-15}}<br />
* [https://www.youtube.com/intaction1/ YouTube Channel]<br />
* [https://circumcisionchronicles.libsyn.com/ Circumcision Chronicles UNCUT Podcast]<br />
<br />
{{REF}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:USA]]<br />
<br />
[[de:Intaction]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Foreskin_Revolution&diff=14283Foreskin Revolution2020-05-03T15:12:02Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Foreskin Revolution<br />
|titlestyle = color:black;<br />
|image = [[File:FSR.png|175px]]<br />
|imagestyle = <br />
|caption = Foreskin Revolution logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2018<br />
|header3 = Founder:<br />
|data4 = [[Michael Winnel]]<br />
|header5 = Founding location:<br />
|data6 = Sydney<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Sydney Australia<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|http://foreskinrevolution.org}}<br />
}}<br />
'''Foreskin Revolution''' is a anti-[[circumcision]] advocacy organization based in Australia. Foreskin Revolution. supports the [[WWDOGA]].<br />
The founder and Director is [[Michael Winnel]].<br />
<br />
Foreskin Revolution is a human rights movement that uses art, politics and popular culture to spread the core messages - that the normal, whole body is awesome with the foreskin being the most enjoyable part of the body, and that circumcision of a healthy child is an assault on that body that needs to end. We wrap all of this in a revolutionary spirit that holds a place for everyone - cut men and their partners who resent it, intact men who are sick of the body shaming or anyone who understands that our society needs to move beyond this harmful practice. <ref>https://www.sbs.com.au/news/the-feed/the-movement-to-save-men-s-foreskins-has-come-to-australia</ref><br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://foreskinrevolution.org/|2020-05-03}}<br />
* [https://www.youtube.com/channel/UCL55XSqdCcZJW5vtx6eEW0g/ YouTube Channel]<br />
* [https://www.sbs.com.au/news/the-feed/the-movement-to-save-men-s-foreskins-has-come-to-australia The movement to save men's foreskins has come to Australia]<br />
<br />
{{REF}}<br />
<br />
[[Category: Intactivism organization]]<br />
[[Category: Australia]]<br />
<br />
[[de: Foreskin Revolution]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Foreskin_Revolution&diff=14282Foreskin Revolution2020-05-03T15:11:31Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Foreskin Revolution<br />
|titlestyle = color:black;<br />
|image = [[File:FSR.png|175px]]<br />
|imagestyle = <br />
|caption = Foreskin Revolution logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2018<br />
|header3 = Founder:<br />
|data4 = [[Michael Winnel]]<br />
|header5 = Founding location:<br />
|data6 = Sydney<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Sydney Australia<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|http://foreskinrevolution.org}}<br />
}}<br />
'''Foreskin Revolution''' is a anti-[[circumcision]] advocacy organization based in Australia. Foreskin Revolution. supports the [[WWDOGA]].<br />
The founder and Director is [[Michael Winnel]].<br />
<br />
Foreskin Revolution is a human rights movement that uses art, politics and popular culture to spread the core messages - that the normal, whole body is awesome with the foreskin being the most enjoyable part of the body, and that circumcision of a healthy child is an assault on that body that needs to end. We wrap all of this in a revolutionary spirit that holds a place for everyone - cut men and their partners who resent it, intact men who are sick of the body shaming or anyone who understands that our society needs to move beyond this harmful practice. <ref>https://www.sbs.com.au/news/the-feed/the-movement-to-save-men-s-foreskins-has-come-to-australia</ref><br />
<br />
{{LINKS}}<br />
* {{URLwebsite|https://foreskinrevolution.org/|2020-05-03}}<br />
* [https://www.youtube.com/channel/UCL55XSqdCcZJW5vtx6eEW0g/ YouTube Channel]<br />
* [https://www.sbs.com.au/news/the-feed/the-movement-to-save-men-s-foreskins-has-come-to-australia The movement to save men's foreskins has come to Australia]<br />
<br />
{{REF}}<br />
<br />
[[Category: Intactivism organization]]<br />
[[Category: Australia]]<br />
<br />
[[de: Foreskin Revolution]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Foreskin_Revolution&diff=14281Foreskin Revolution2020-05-03T15:10:32Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Foreskin Revolution<br />
|titlestyle = color:black;<br />
|image = [[File:FSR.png|175px]]<br />
|imagestyle = <br />
|caption = Foreskin Revolution logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2018<br />
|header3 = Founder:<br />
|data4 = [[Michael Winnel]]<br />
|header5 = Founding location:<br />
|data6 = Sydney<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Sydney Australia<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|http://foreskinrevolution.org}}<br />
}}<br />
'''Foreskin Revolution''' is a anti-[[circumcision]] advocacy organization based in Australia. Foreskin Revolution. supports the [[WWDOGA]].<br />
The founder and Director is [[Michael Winnel]].<br />
<br />
Foreskin Revolution is a human rights movement that uses art, politics and popular culture to spread the core messages - that the normal, whole body is awesome with the foreskin being the most enjoyable part of the body, and that circumcision of a healthy child is an assault on that body that needs to end. We wrap all of this in a revolutionary spirit that holds a place for everyone - cut men and their partners who resent it, intact men who are sick of the body shaming or anyone who understands that our society needs to move beyond this harmful practice. <ref>https://www.sbs.com.au/news/the-feed/the-movement-to-save-men-s-foreskins-has-come-to-australia</ref><br />
<br />
{{LINKS}}<br />
* {{URLwebsite|https://foreskinrevolution/|2020-05-03}}<br />
* [https://www.youtube.com/channel/UCL55XSqdCcZJW5vtx6eEW0g/ YouTube Channel]<br />
* [https://www.sbs.com.au/news/the-feed/the-movement-to-save-men-s-foreskins-has-come-to-australia The movement to save men's foreskins has come to Australia]<br />
<br />
{{REF}}<br />
<br />
[[Category: Intactivism organization]]<br />
[[Category: Australia]]<br />
<br />
[[de: Foreskin Revolution]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Foreskin_Revolution&diff=14280Foreskin Revolution2020-05-03T15:08:19Z<p>WikiModEn4: Created page with "{{Infobox |bodystyle = float:right; valign:top; |title = Foreskin Revolution |titlestyle = color:black; |image = 175px |imagestyle =..."</p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Foreskin Revolution<br />
|titlestyle = color:black;<br />
|image = [[File:FSR.png|175px]]<br />
|imagestyle = <br />
|caption = Foreskin Revolution logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2018<br />
|header3 = Founder:<br />
|data4 = [[Michael Winnel]]<br />
|header5 = Founding location:<br />
|data6 = Sydney<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Sydney Australia<br />
|header11 = Website:<br />
|data12 = {{URLwebsite|http://foreskinrevolution.org}}<br />
}}<br />
'''Foreskin Revolution''' is a anti-[[circumcision]] advocacy organization based in Australia. Foreskin Revolution. supports the [[WWDOGA]].<br />
The founder and Director is [[Michael Winnel]].<br />
<br />
Foreskin Revolution is a human rights movement that uses art, politics and popular culture to spread the core messages - that the normal, whole body is awesome with the foreskin being the most enjoyable part of the body, and that circumcision of a healthy child is an assault on that body that needs to end. We wrap all of this in a revolutionary spirit that holds a place for everyone - cut men and their partners who resent it, intact men who are sick of the body shaming or anyone who understands that our society needs to move beyond this harmful practice. <br />
<br />
{{LINKS}}<br />
* {{URLwebsite|https://foreskinrevolution/|2020-05-03}}<br />
* [https://www.youtube.com/channel/UCL55XSqdCcZJW5vtx6eEW0g/ YouTube Channel]<br />
<br />
{{REF}}<br />
<br />
[[Category: Intactivism organization]]<br />
[[Category: Australia]]<br />
<br />
[[de: Foreskin Revolution]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Your_Whole_Baby&diff=14279Your Whole Baby2020-05-03T14:59:28Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Your Whole Baby<br />
|titlestyle = color:black;<br />
|image = [[File:Yourwholebabylogo.png|175px]]<br />
|imagestyle = <br />
|caption = Your Whole Baby logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2014<br />
|header3 = Founder:<br />
|data4 = [[Jen Williams]]<br />
|header5 = Founding location:<br />
|data6 = Leander<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Leander, Texas <br />
|header11 = Website:<br />
|data12 = {{URLwebsite|http://yourwholebaby.org}}<br />
}}The organization '''Your Whole Baby''' offers a website with a great variety of information about [[circumcision]], mainly focusing on medically unnecessary, non-therapeutic [[Routine Infant Circumcision]] ([[RIC]]).<br />
The organization exhibits at various expecting parent and baby shows across the United States. The organization as also places billboards exhorting parents to keep their baby whole and intact. <ref>https://www.wlwt.com/article/anti-male-circumcision-group-erects-billboard-in-kentucky/14516141#</ref> <ref>https://jewishchronicle.timesofisrael.com/oakland-billboard-decries-infant-circumcision/</ref><br />
<br />
There are links to academic studies and personal perspectives, information for how to talk to your spouse about [[circumcision]], how to protect your son from ill informed American doctors and how to be active in promoting the end to Routine Infant Circumcision ([[RIC]]).<br />
<br />
Your Whole Baby was founded by Jen Williams, a animal rights campaigner, who said, "We need everyone's voices, quiet and loud, to bring this practice ( [http://yourwholebaby.org circumcision] )to an end as soon as possible." <ref>https://www.yourwholebaby.org/board-of-directors</ref><br />
<br />
== Board of Directors ==<br />
* [[Alexandre Rotta]], MD<br />
* [[Kenneth Zatz]], MD<br />
* [[John V. Geisheker]], JD, LL.M<br />
* [[Ryan McAllister]], PhD<br />
* [[Jen Williams]]<br />
<br />
== Advisory Board ==<br />
* Dr. [[Raja Abusharr]], MD, FAAFP<br />
* Dr. [[Cammy Benton]], MD, ABIHM IFMCP<br />
* Dr. [[Gregory Boyle]], PhD, DSc, FAPS<br />
* Dr. [[Teri M. Mitchell]], APRN, CNM, IBCLC<br />
* Dr. [[Jórunn Vidar Valgardsdottir]], MD, FM<br />
* Dr. [[Adrienne Carmack]], Urologist<br />
* [[Amy Wright Glenn]], Author & Doula<br />
* [[Gloria Lemay]], Midwifery Educator<br />
* [[David J. Llewellyn]], BA, JD<br />
* [[Marilyn Fayre Milos]], RN<br />
* [[Lisa Braver Moss]], Author<br />
* Dr. [[Darcia Narvaez]], Psychology Professor<br />
* [[Angela Saltalamacchia]], BSN, RN<br />
* [[Travis Wisdom]], BA, MA, LLM<br />
* [[Sylvia Joy Zakusilov]], RN, MSN, NP-C<br />
<br />
<br />
== Address ==<br />
* PO Box 854<br />
* Leander, TX 78646<br />
* info@yourwholebaby.org<br />
<br />
== Facebook groups/pages for US states ==<br />
* [[Your Whole Baby of Alabama, Georgia, Kentucky & Tennessee]]<br />
* [[Your Whole Baby of Arizona, Colorado & New Mexico]]<br />
* [[Your Whole Baby of Arkansas, Louisiana, Mississippi & Oklahoma]]<br />
* [[Your Whole Baby of California]]<br />
* [[Your Whole Baby of Delaware, Maryland & New Jersey]]<br />
* [[Your Whole Baby of Florida]]<br />
* [[Your Whole Baby of Hawaii]]<br />
* [[Your Whole Baby of Idaho, Montana & Wyoming]]<br />
* [[Your Whole Baby of Indiana & Ohio]]<br />
* [[Your Whole Baby of Iowa, Illinois & Wisconsin]]<br />
* [[Your Whole Baby of Kansas, Missouri & Nebraska]]<br />
* [[Your Whole Baby of ME]]<br />
* [[Your Whole Baby of Michigan]]<br />
* [[Your Whole Baby of Minnesota, North Dakota & South Dakota]]<br />
* [[Your Whole Baby of Nevada & Utah]]<br />
* [[Your Whole Baby of New England]]<br />
* [[Your Whole Baby of New York]]<br />
* [[Your Whole Baby of North Carolina, South Carolina, Virginia & West Virginia]]<br />
* [[Your Whole Baby of Oregon, Washington & Alaska]]<br />
* [[Your Whole Baby of Pennsylvania]]<br />
* [[Your Whole Baby of Texas]]<br />
<br />
== International ==<br />
* [[Your Whole Baby: Español]]<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.yourwholebaby.org/|2019-09-15}}<br />
* {{URL-FBpage|yourwholebaby|2019-09-15}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:Memes]]<br />
[[Category:USA]]<br />
[[Category:Your Whole Baby]]<br />
<br />
[[de:Your Whole Baby]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Your_Whole_Baby&diff=14278Your Whole Baby2020-05-03T14:56:52Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Your Whole Baby<br />
|titlestyle = color:black;<br />
|image = [[File:Yourwholebabylogo.png|175px]]<br />
|imagestyle = <br />
|caption = Your Whole Baby logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2014<br />
|header3 = Founder:<br />
|data4 = [[Jen Williams]]<br />
|header5 = Founding location:<br />
|data6 = Leander<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Leander, Texas <br />
|header11 = Website:<br />
|data12 = {{URLwebsite|http://yourwholebaby.org}}<br />
}}The organization '''Your Whole Baby''' offers a website with a great variety of information about [[circumcision]], mainly focusing on medically unnecessary, non-therapeutic [[Routine Infant Circumcision]] ([[RIC]]).<br />
The organization exhibits at various expecting parent and baby shows across the United States. The organization as also places billboards exhorting parents to keep their baby whole and intact. <ref>https://www.wlwt.com/article/anti-male-circumcision-group-erects-billboard-in-kentucky/14516141#</ref> <ref>https://jewishchronicle.timesofisrael.com/oakland-billboard-decries-infant-circumcision/</ref><br />
<br />
There are links to academic studies and personal perspectives, information for how to talk to your spouse about [[circumcision]], how to protect your son from ill informed American doctors and how to be active in promoting the end to Routine Infant Circumcision ([[RIC]]).<br />
<br />
Your Whole Baby was founded by Jen Williams, a animal rights campaigner, who said, "We need everyone's voices, quiet and loud, to bring this practice ( [http://yourwholebaby.org circumcision] )to an end as soon as possible." <ref>https://www.yourwholebaby.org/board-of-directors</ref><br />
<br />
== Board of Directors ==<br />
* [[Alexandre Rotta]], MD<br />
* [[Kenneth Zatz]], MD<br />
* [[John V. Geisheker]], JD, LL.M<br />
* [[Ryan McAllister]], PhD<br />
* [[Jen Williams]]<br />
<br />
== Advisory Board ==<br />
* Dr. [[Raja Abusharr]], MD, FAAFP<br />
* Dr. [[Cammy Benton]], MD, ABIHM IFMCP<br />
* Dr. [[Gregory Boyle]], PhD, DSc, FAPS<br />
* Dr. [[Teri M. Mitchell]], APRN, CNM, IBCLC<br />
* Dr. [[Jórunn Vidar Valgardsdottir]], MD, FM<br />
* Dr. [[Adrienne Carmack]], Urologist<br />
* [[Amy Wright Glenn]], Author & Doula<br />
* [[Gloria Lemay]], Midwifery Educator<br />
* [[David J. Llewellyn]], BA, JD<br />
* [[Marilyn Fayre Milos]], RN<br />
* [[Lisa Braver Moss]], Author<br />
* Dr. [[Darcia Narvaez]], Psychology Professor<br />
* [[Angela Saltalamacchia]], BSN, RN<br />
* [[Travis Wisdom]], BA, MA, LLM<br />
* [[Sylvia Joy Zakusilov]], RN, MSN, NP-C<br />
<br />
== Facebook groups/pages for US states ==<br />
* [[Your Whole Baby of Alabama, Georgia, Kentucky & Tennessee]]<br />
* [[Your Whole Baby of Arizona, Colorado & New Mexico]]<br />
* [[Your Whole Baby of Arkansas, Louisiana, Mississippi & Oklahoma]]<br />
* [[Your Whole Baby of California]]<br />
* [[Your Whole Baby of Delaware, Maryland & New Jersey]]<br />
* [[Your Whole Baby of Florida]]<br />
* [[Your Whole Baby of Hawaii]]<br />
* [[Your Whole Baby of Idaho, Montana & Wyoming]]<br />
* [[Your Whole Baby of Indiana & Ohio]]<br />
* [[Your Whole Baby of Iowa, Illinois & Wisconsin]]<br />
* [[Your Whole Baby of Kansas, Missouri & Nebraska]]<br />
* [[Your Whole Baby of ME]]<br />
* [[Your Whole Baby of Michigan]]<br />
* [[Your Whole Baby of Minnesota, North Dakota & South Dakota]]<br />
* [[Your Whole Baby of Nevada & Utah]]<br />
* [[Your Whole Baby of New England]]<br />
* [[Your Whole Baby of New York]]<br />
* [[Your Whole Baby of North Carolina, South Carolina, Virginia & West Virginia]]<br />
* [[Your Whole Baby of Oregon, Washington & Alaska]]<br />
* [[Your Whole Baby of Pennsylvania]]<br />
* [[Your Whole Baby of Texas]]<br />
<br />
== International ==<br />
* [[Your Whole Baby: Español]]<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.yourwholebaby.org/|2019-09-15}}<br />
* {{URL-FBpage|yourwholebaby|2019-09-15}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:Memes]]<br />
[[Category:USA]]<br />
[[Category:Your Whole Baby]]<br />
<br />
[[de:Your Whole Baby]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Your_Whole_Baby&diff=14277Your Whole Baby2020-05-03T14:55:45Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Your Whole Baby<br />
|titlestyle = color:black;<br />
|image = [[File:Yourwholebabylogo.png|175px]]<br />
|imagestyle = <br />
|caption = Your Whole Baby logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2014<br />
|header3 = Founder:<br />
|data4 = [[Jen Williams]]<br />
|header5 = Founding location:<br />
|data6 = Leander<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Leander, Texas <br />
|header11 = Website:<br />
|data12 = {{URLwebsite|http://yourwholebaby.org}}<br />
}}The organization '''Your Whole Baby''' offers a website with a great variety of information about [[circumcision]], mainly focusing on medically unnecessary, non-therapeutic [[Routine Infant Circumcision]] ([[RIC]]).<br />
The organization exhibits at various expecting parent and baby shows across the United States. The organization as also places billboards exhorting parents to keep their baby whole and intact. <ref>https://www.wlwt.com/article/anti-male-circumcision-group-erects-billboard-in-kentucky/14516141#</ref> <ref>https://jewishchronicle.timesofisrael.com/oakland-billboard-decries-infant-circumcision/</ref><br />
<br />
There are links to academic studies and personal perspectives, information for how to talk to your spouse about [[circumcision]], how to protect your son from ill informed American doctors and how to be active in promoting the end to Routine Infant Circumcision ([[RIC]]).<br />
<br />
Your Whole Baby was founded by Jen Williams, a animal rights campaigner, who said, "We need everyone's voices, quiet and loud, to bring this practice to an end as soon as possible." <ref>https://www.yourwholebaby.org/board-of-directors</ref><br />
<br />
== Board of Directors ==<br />
* [[Alexandre Rotta]], MD<br />
* [[Kenneth Zatz]], MD<br />
* [[John V. Geisheker]], JD, LL.M<br />
* [[Ryan McAllister]], PhD<br />
* [[Jen Williams]]<br />
<br />
== Advisory Board ==<br />
* Dr. [[Raja Abusharr]], MD, FAAFP<br />
* Dr. [[Cammy Benton]], MD, ABIHM IFMCP<br />
* Dr. [[Gregory Boyle]], PhD, DSc, FAPS<br />
* Dr. [[Teri M. Mitchell]], APRN, CNM, IBCLC<br />
* Dr. [[Jórunn Vidar Valgardsdottir]], MD, FM<br />
* Dr. [[Adrienne Carmack]], Urologist<br />
* [[Amy Wright Glenn]], Author & Doula<br />
* [[Gloria Lemay]], Midwifery Educator<br />
* [[David J. Llewellyn]], BA, JD<br />
* [[Marilyn Fayre Milos]], RN<br />
* [[Lisa Braver Moss]], Author<br />
* Dr. [[Darcia Narvaez]], Psychology Professor<br />
* [[Angela Saltalamacchia]], BSN, RN<br />
* [[Travis Wisdom]], BA, MA, LLM<br />
* [[Sylvia Joy Zakusilov]], RN, MSN, NP-C<br />
<br />
== Facebook groups/pages for US states ==<br />
* [[Your Whole Baby of Alabama, Georgia, Kentucky & Tennessee]]<br />
* [[Your Whole Baby of Arizona, Colorado & New Mexico]]<br />
* [[Your Whole Baby of Arkansas, Louisiana, Mississippi & Oklahoma]]<br />
* [[Your Whole Baby of California]]<br />
* [[Your Whole Baby of Delaware, Maryland & New Jersey]]<br />
* [[Your Whole Baby of Florida]]<br />
* [[Your Whole Baby of Hawaii]]<br />
* [[Your Whole Baby of Idaho, Montana & Wyoming]]<br />
* [[Your Whole Baby of Indiana & Ohio]]<br />
* [[Your Whole Baby of Iowa, Illinois & Wisconsin]]<br />
* [[Your Whole Baby of Kansas, Missouri & Nebraska]]<br />
* [[Your Whole Baby of ME]]<br />
* [[Your Whole Baby of Michigan]]<br />
* [[Your Whole Baby of Minnesota, North Dakota & South Dakota]]<br />
* [[Your Whole Baby of Nevada & Utah]]<br />
* [[Your Whole Baby of New England]]<br />
* [[Your Whole Baby of New York]]<br />
* [[Your Whole Baby of North Carolina, South Carolina, Virginia & West Virginia]]<br />
* [[Your Whole Baby of Oregon, Washington & Alaska]]<br />
* [[Your Whole Baby of Pennsylvania]]<br />
* [[Your Whole Baby of Texas]]<br />
<br />
== International ==<br />
* [[Your Whole Baby: Español]]<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.yourwholebaby.org/|2019-09-15}}<br />
* {{URL-FBpage|yourwholebaby|2019-09-15}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:Memes]]<br />
[[Category:USA]]<br />
[[Category:Your Whole Baby]]<br />
<br />
[[de:Your Whole Baby]]</div>WikiModEn4https://en.intactiwiki.org/w/index.php?title=Your_Whole_Baby&diff=14276Your Whole Baby2020-05-03T14:54:41Z<p>WikiModEn4: </p>
<hr />
<div>{{Infobox<br />
|bodystyle = float:right; valign:top;<br />
|title = Your Whole Baby<br />
|titlestyle = color:black;<br />
|image = [[File:Yourwholebabylogo.png|175px]]<br />
|imagestyle = <br />
|caption = Your Whole Baby logo<br />
|captionstyle = <br />
|headerstyle = background:#d2d2d2;<br />
|labelstyle = background:#d2d2d2;<br />
|datastyle = <br />
|header1 = Formation:<br />
|data2 = 2014<br />
|header3 = Founder:<br />
|data4 = [[Jen Williams]]<br />
|header5 = Founding location:<br />
|data6 = Leander<br />
|header7 = Type:<br />
|data8 = Non-profit corporation<br />
|header9 = Location:<br />
|data10 = Leander, Texas <br />
|header11 = Website:<br />
|data12 = {{URLwebsite|http://yourwholebaby.org}}<br />
}}The organization '''Your Whole Baby''' offers a website with a great variety of information about [[circumcision]], mainly focusing on medically unnecessary, non-therapeutic [[Routine Infant Circumcision]] ([[RIC]]).<br />
The organization exhibits at various expecting parent and baby shows across the United States. The organization as also places billboards exhorting parents to keep their baby whole and intact. <ref>https://www.wlwt.com/article/anti-male-circumcision-group-erects-billboard-in-kentucky/14516141#</ref><br />
<br />
There are links to academic studies and personal perspectives, information for how to talk to your spouse about [[circumcision]], how to protect your son from ill informed American doctors and how to be active in promoting the end to Routine Infant Circumcision ([[RIC]]).<br />
<br />
Your Whole Baby was founded by Jen Williams, a animal rights campaigner, who said, "We need everyone's voices, quiet and loud, to bring this practice to an end as soon as possible." <ref>https://www.yourwholebaby.org/board-of-directors</ref><br />
<br />
== Board of Directors ==<br />
* [[Alexandre Rotta]], MD<br />
* [[Kenneth Zatz]], MD<br />
* [[John V. Geisheker]], JD, LL.M<br />
* [[Ryan McAllister]], PhD<br />
* [[Jen Williams]]<br />
<br />
== Advisory Board ==<br />
* Dr. [[Raja Abusharr]], MD, FAAFP<br />
* Dr. [[Cammy Benton]], MD, ABIHM IFMCP<br />
* Dr. [[Gregory Boyle]], PhD, DSc, FAPS<br />
* Dr. [[Teri M. Mitchell]], APRN, CNM, IBCLC<br />
* Dr. [[Jórunn Vidar Valgardsdottir]], MD, FM<br />
* Dr. [[Adrienne Carmack]], Urologist<br />
* [[Amy Wright Glenn]], Author & Doula<br />
* [[Gloria Lemay]], Midwifery Educator<br />
* [[David J. Llewellyn]], BA, JD<br />
* [[Marilyn Fayre Milos]], RN<br />
* [[Lisa Braver Moss]], Author<br />
* Dr. [[Darcia Narvaez]], Psychology Professor<br />
* [[Angela Saltalamacchia]], BSN, RN<br />
* [[Travis Wisdom]], BA, MA, LLM<br />
* [[Sylvia Joy Zakusilov]], RN, MSN, NP-C<br />
<br />
== Facebook groups/pages for US states ==<br />
* [[Your Whole Baby of Alabama, Georgia, Kentucky & Tennessee]]<br />
* [[Your Whole Baby of Arizona, Colorado & New Mexico]]<br />
* [[Your Whole Baby of Arkansas, Louisiana, Mississippi & Oklahoma]]<br />
* [[Your Whole Baby of California]]<br />
* [[Your Whole Baby of Delaware, Maryland & New Jersey]]<br />
* [[Your Whole Baby of Florida]]<br />
* [[Your Whole Baby of Hawaii]]<br />
* [[Your Whole Baby of Idaho, Montana & Wyoming]]<br />
* [[Your Whole Baby of Indiana & Ohio]]<br />
* [[Your Whole Baby of Iowa, Illinois & Wisconsin]]<br />
* [[Your Whole Baby of Kansas, Missouri & Nebraska]]<br />
* [[Your Whole Baby of ME]]<br />
* [[Your Whole Baby of Michigan]]<br />
* [[Your Whole Baby of Minnesota, North Dakota & South Dakota]]<br />
* [[Your Whole Baby of Nevada & Utah]]<br />
* [[Your Whole Baby of New England]]<br />
* [[Your Whole Baby of New York]]<br />
* [[Your Whole Baby of North Carolina, South Carolina, Virginia & West Virginia]]<br />
* [[Your Whole Baby of Oregon, Washington & Alaska]]<br />
* [[Your Whole Baby of Pennsylvania]]<br />
* [[Your Whole Baby of Texas]]<br />
<br />
== International ==<br />
* [[Your Whole Baby: Español]]<br />
<br />
{{LINKS}}<br />
* {{URLwebsite|http://www.yourwholebaby.org/|2019-09-15}}<br />
* {{URL-FBpage|yourwholebaby|2019-09-15}}<br />
<br />
[[Category:Intactivism organization]]<br />
[[Category:Memes]]<br />
[[Category:USA]]<br />
[[Category:Your Whole Baby]]<br />
<br />
[[de:Your Whole Baby]]</div>WikiModEn4