Changes

"Male '''circumcision''' (from Latin ''circumcidere'', meaning "to cut around") is the surgical removal or [[amputation ]] of the [[foreskin]] (prepuce) , a major part of the human [[penis]]. The foreskin comprises ''more than fifty percent'' of the epithelium of the [[penis]].<ref name="taylor1996">{{TaylorJR LockwoodAP TaylorAJ 1996}}</ref> When the "cutting around" is performed, the foreskin falls off, so [[amputation]] and [[mutilation]] is the result...] The amputation destroys the [[Foreskin#Physiological_functions| many protective, immunological, sexual, and sensory physiological functions ]] of the foreskin, so it is considered to be a very harmfuland [[Pain| painful]] surgery.

The procedure '''Posthectomy''' is most often an elective, non-therapeutic surgery performed on neonates the more accurate medical term that more accurately reflects the injury and children for religious and cultural reasons in violation loss of their functional body tissue, but the Biblical [[human rightseuphemism]], but in other cases may be indicated for both ''circumcision'', is more commonly used.With reference to involuntary, non-therapeutic and prophylactic reasons. It is a radical treatment option for pathological circumcision of children, [[phimosisChild Genital Cutting (CGC)]], refractory is a newer term that has been introduced to avoid issues associated with more traditional terms. Bollinger (2023) identifed CGC as an [[BalanitisAdverse Childhood Experiences (ACEs)| balanoposthitisadverse childhood experience]] .<ref name="bollinger2023">{{REFjournal |last=Bollinger |init=D |author-link=Dan Bollinger |last2= |init2= |author2-link= |url=https://kindredmedia.org/2023/02/adverse-childhood-experiences-dysfunctional-households-and chronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health-circumcision/ |title=Adverse Childhood Experiences, Dysfunctional Households, And Circumcision. |journal=Kindred |date=2023-02-28 |volume= |issue= |pages= |accessdate=2023-03-01}}</ref>

'''Posthectomy''' Deacon & Muir (2022) have reviewed the evidence and concluded that "there is no medical justification for performing a more accurate medical term circumcision prior to an age that more accurately reflects he can assess the injury known risks and loss potential benefits, and choose to give or withhold [[informed consent]] himself."<ref name="deacon2022">{{REFjournal |last=Deacon |first=Matthew |init=M |author-link= |last2=Muir |first2=Gordon |init2=G |author2-link= |etal=no |title=What is the medical evidence on non-therapeutic child circumcision? |journal= Int J Impot Res |date=2022-01-08 |url=https://www.nature.com/articles/s41443-021-00502-y |pubmedID=34997197 |DOI=10.1038/s41443-021-00502-y |accessdate=2022-01-30}}</ref> Circumcision was popularized in English-speaking nationns in the nineteeth century. The practice of functional body tissuenon-therapeutic circumcision of boys now has greatly declined in [[Australia]], [[Canada]], but [[New Zealand]] and the [[United Kingdom]]. It has been gradually declining since 1985 in the Biblical [[euphemismUnited States]], . It has ''circumcisionnever'', is more commonly usedbeen a popular practice in other western nations.

With reference to involuntary, non-therapeutic circumcision Circumcision is classified as a form of children, [[Child Genital Cutting (CGC)genital mutilation]] is a new term that has been introduced to avoid issues associated with more traditional terms.

The [[amputation ]] of the [[foreskin]] is a very old ritual, whose exact origin cannot be verified beyond doubt. Circumcision is believed to have originated in east Africa near the Red Sea well before the dawn of recorded history.<ref name="demeo1997">{{REFbook |last=DeMeo |first= |author-link= |year=1997 |title=The geography of sexual mutilations |url=https://www.academia.edu/4212007/The_Geography_of_Male_and_Female_Genital_Mutilations |work=Sexual Mutilations: A Human Tragedy |editors=George C. Denniston, Marilyn Milos |edition= |volume= |chapter= |pages= |location=New York |publisher=Plenum |isbn=0-306-45589-7 |quote= |accessdate=2021-11-13 |note=}}</ref> 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.

[[Image:Circumcision Sakkara 3.jpg|200px|right]] For the [[Aborigines]], the [[Australia| 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

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.

In the Jewish religion[[Judaism]], the tradition of [[Brit Milah| circumcision ]] goes back to the [[Abrahamic covenant]] in a passage in the Book of Genesis (17, :10-14). It is was seen as a [[Abrahamic covenant| covenant between God and man]], dating back to the patriarch Abraham. The validity of this passage is increasingly being questioned.

According to the anthropologist and sociologist Rabbi Nissan Rubin, the [[Jewish circumcision| 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 almost 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 claimed that circumcision was necessary, as it diminished sexual desires and reduced the pleasure to a degree just sufficient for mere reproduction.

Jesus was born into a Jewish family in [[Israel]], where [[Judaism ]] was the prevailing religion, so He was [[circumcised ]] on the eighth day.<ref>{{REFweb

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

In Christianity, circumcision is practiced only in a few the Coptic churchesdenomination. There is no general belief that circumcision is a requirement of Christianity.<ref name="hill2004">{{REFweb |url=httphttps://www.cirp.org/pages/cultural/christian.htmlphp

Even the mere existence of a [[foreskin]] was falsoly 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:

|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.

|pagespage=107

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.

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]].

The circumcision of newborn boys is seen as a [[Abrahamic covenant| divine commandment]] in the [[Judaism| 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 [[Adolescent and adult circumcision| circumcision]], but it is not always required.

===Medical indication===In a few 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 There are no [[phimosismedical indication| medical indications]]. Overall, the actual medical necessity for circumcision is extremely rareof the newborn. All circumcisions injure the patient by amputating the The [[foreskincircumcision industry]] its with many protective, immunological, sensory, and sexual offers circumcision of the newborn to the public because of the [[Foreskin#Physiological_functions| functionsfinancial incentive]].

The form of circumcision adopted by the medical community essentially was equivalent to the Jewish form with ''[[periah]]'', so it inflicted the maximum injury. In a few cases with older patients, 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 since many conditions respond to conservative treatment. All circumcisions injure the patient by amputating the [[foreskin]] its with many protective, immunological, sensory, and sexual [[Foreskin#Physiological_functions| functions]].  # '''Deformed or malformed foreskin'''. A foreskin so deformed or malformed that it does not function properly may be removed by circumcision.

# '''Diseased foreskin.''' A foreskin that is diseased is a valid indication for cirumcision. Some diseases that qualify are malignancy, lichen sclerosis, [[Balanitis#Diabetic_males| yeast infection in men with diabetes]], and recurrent [[Balanitis| balanoposthitis]].

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. {''Potential'' means to exist in possibility, but not in actuality, so a "''potential'' benefit" is not a genuine proven benefit.) 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 |url=httphttps://www.cirp.org/library/history/encyclopaediabritannica1876/

Initially, circumcision was adopted in the 19th century as a way to stop boys and men from masturbating, where when [[masturbation ]] was seen as claimed to be 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.

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,"<!--{{Cold and Wiswell (1995)}} | [[Template:Cold and Wiswell (1995)|see more]]--> but this notion has no validity because the prepuce is ubiquitous in primates and because it provides functional advantages.<ref name="cold-mcgrath1995">{{REFbook

|url=httphttps://www.cirp.org/library/anatomy/cold-mcgrath/

|url=httphttps://www.cirp.org/library/history/ephron1/

|pages=222-23333

|publisher={{UNI|Yale University |Yale}} Press

In 1870 the promiment prominent Dr. [[Lewis Albert Sayre|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>

|pages=901-9033

[[Aaron J. Fink]] (1986), with no evidence whatsoever, claims that circumcision protects against [[AIDS ]] followed.<ref name="fink1986">{{REFjournal

|pagespage=1167

Retrospectively, circumcision was always advertised as a cure for whatever disease was in the public spotlight at the time. [[Doctors Opposing Circumcision(D.O.C.)]] (2016) statesstate:

|publisher=[[Doctors Opposing Circumcision(D.O.C.)]]

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 openin a [[subincision]], resulting in a partly or completely divided [[urethra]].

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".

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.

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.

* [[Phimosis]]: as mentioned earlier, true [[phimosis]] is rare and can be treated effectively without surgery. According to a study by Blalock et al. (2003)<refname="blalock2003">{{REFjournal

|pages=2332-23344 |url=httphttps://www.cirp.org/library/complications/blalock1/

}}</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]].

|pages=1052-10577 |url=httphttps://www.cirp.org/library/general/laumann/

}}</ref>, which found a higher rate of infection with bacterial venereal diseases in [[circumcised ]] than in [[intact ]] men.* The studies by Fleiss et al. (1998) support this.<ref name="fleiss-hodges-vanhowe1998">{{REFjournal |last=Fleiss |init=PM |last2=Hodges |init2=FM |last3=Van Howe |init3=RS |title=Immunological functions of the human prepuce |journal=Sex Transm Inf |date=FleissP HodgesF VanHoweRS 1998 |volume=74 |issue= |pages=364-367 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1758142/pdf/v074p00364.pdf |accessdate=2019-11-06}}</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

|url=httphttps://www.cirp.org/library/statements/aap1999/

* [[HIV ]] / [[AIDS]]: in the recent past, the argument that circumcision could help to contain the spread of [[HIV ]] has been stated numerous times.

*: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

|pages=378-38383

|pages=749-75454

|pages=1052-10577 |url=httphttps://www.cirp.org/library/general/laumann/

* Two studies that have been published in early 2007<ref>{{REFjournal |last=RCT Gray |init=RH |etal=yes |title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial |journal=Lancet |date=et al 2007 |volume=369 |issue= |pages=657-666 |url= |accessdate=}}</ref><ref>{{REFjournal |last=RCT Bailey |first=Robert C. |init=RC |author-link=Robert C. Bailey |etal=yes |title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial |journal=Lancet |date=et al 2007 |volume=369 |issue= |pages=643-656 |url= |accessdate=}}</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">{{BoyleGJ HillG 2011}}</ref>

The fact that the [[USA ]] has both the highest rate percentage 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

|pages=927-93434

|pages=1521-15288

* Urinary tract infections (UTI): a [[UTI ]] can be effectively treated with antibiotics, this was also proven by studies.<ref>{{REFjournal

|pages=552-5555 |url=httphttps://www.cirp.org/library/disease/UTI/mccracken/

|pages=1173-11755

|pages=549-55252

}}</ref> found that, during the first 6 years of life, the incidence of UTIs [[UTI]]s 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

|title=The incidence of genitourinary abnormalities in [[circumcised ]] and [[uncircumcised]] boys presenting with an initial urinary tract infection by 6 months of age

|pagespage=580

}}</ref> did not find a significant difference in UTI rates between [[circumcised ]] and [[intact ]] boys with normal urinary tract anatomy.* 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

|pages=45-488

|pages=322-3244

* It can be concluded that circumcision is ineffective as a preventive measure against UTIs[[UTI]].* 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.<ref>{{REFjournal |last=Wolbarst |init=A |title=Circumcision and penile cancer |journal=Lancet |date=1932 |volume=1 |issue=5655 |pages=150-153 |url= |accessdate=Wolbarst1932}}</ref> Today, it is known that sexually transmitted human papillomavirus (HPV) is a major risk factor<ref>{{REFjournal |last=McCance

|pages=55-599

|pages=375-3777

}}</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

Apart from the [[medical indication ]] of pathological phimosis, there also are other reasons for circumcision.

The visual appearance of the [[penis]] is changed radically after circumcision. In this case, personal taste is decisive whether an [[intact ]] or a [[circumcised ]] [[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.

Since this modification and its possible late effects will It should be noted that every circumcision operation leaves a life-long [[circumcision scar]] that encircles the lifelong burden shaft of the person who undertakes an aesthetically motivated circumcision to suit his personal preferences[[penis]]. In addition, there frequently a valid decision to proceed can only be made by a color change at 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 reachedcircumcision scar which results in a two-tone appearance.

It should Since this modification and its possible late effects will be noted that every the lifelong burden of the person who undertakes an aesthetically motivated circumcision operation leaves to suit his personal preferences, a life-long valid decision to proceed can only be made by the person to be [[circumcision scarcircumcised]] that encircles himself, once he has reached the shaft necessary age and level of maturity to make that decision. This should normally be the peniscase when adulthood is reached.

In the United States, payment for non-therapeutic circumcision is made by most [[third-party payment| third-party payers]] without questionof necessity. 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]].

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]].

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 mental diseases, caused by the thinking of immoral thoughts! 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.

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

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 [[preputial sac]] underneath the [[foreskin]] is easy - — they are simply [[Preputial_sac#Washing| washed with warm water along with the rest of the body]], just like the areas between the toes.

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 of the foreskin| ballooning]]", where the [[foreskin]] inflates during urination, is not a serious problemconcern.

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.

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]].

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.

 == Risks and late effects Pain == Just like tonsil or appendix surgeryIn the past, advocates of circumcision is claimed that a surgical intervention and brings the usual risks related to surgical operationsnewborn child's nerve system was not yet fully developed, alongside several specific risks of complications and late effects. === Possible operative and postoperative complications === Circumcision is surgery. Surgical complications of circumcision generally may be classified that as hemorrhagea result, infection, or surgical misadventure up to and including loss of the penis and child felt no [[pain]] during the circumcision procedure. [[Kanwaljeet J. Singh Anand| Anand]] & Hickey (1987) have shown that newborn children do in fact feel [[deathpain]], and more acutely than adults.<ref name="williamsanand-kapilla1993hickey1987">{{REFjournal |last=WilliamsAnand |initfirst=NKJS |author-link=Kanwaljeet J. Singh Anand |last2=KapillaHickey |init2first2=LPR

|title=Complications of circumcisionPain and its effects in the human neonate and fetus

|journal=Brit New Engl J SurgMed

|date=19931987-1011-19 |volume=80317 |issue=1021 |pages=12311321-69 |url=httphttps://www.cirp.org/library/complicationspain/williams-kapilaanand/ |quote=However, in decisions about the use of these techniques, current knowledge suggests that humane considerations should apply as forcefully to the care of neonates and young, nonverbal infants as they do to children and adults in similar painful and stressful situations. |pubmedID=82422853317037

|DOI=10.10021056/bjs.1800801005NEJM198711193172105 |accessdate=2019-11-2708}}</ref>This has led American health associations to recommend doctors take measures to reduce the [[pain]] of circumcision in infants.

* Intolerance or allergic reactions to the narcotics usedThe [https://www.cirp.* Especially in org/library/statements/aap1999/|AAP Circumcision Policy Statement] (1999) states quite clearly that ''"There is considerable evidence that newborns, where the bodily pain reduction mechanisms who 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 [[peniscircumcised]]without analgesia experience pain and physiologic stress"''. Furthermore, the rate of failure to provide sufficient anaesthetic even for experienced anaesthetists pain is still 5-10%. The general anaesthesia that would be needed for newbornsquite severe, however, poses significant risks and requires injections for the child, proper pain management. Sucrose and, therefore, is only likely to Acetaminophen ''"cannot be used in emergenciesrecommended as the sole method of analgesia"''. A surgical operation without proper pain control can lead to Topical cream is no longer thought sufficient as ''"the analgesic effect is limited during the development phases associated with extensive tissue trauma such as...tightening of a specific pain memorythe clamp"''.<ref>{{REFweb |url=http://www.spiegel.de/spiegel/vorab/experte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-849534.html |title=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder |trans-title=Children's pain expert warns: Ritual circumcision changes the brain of children |language=GermanREFjournal |last=Prof. Dr. med. Boris Zernikow

|publishertitle=Spiegel OnlineAmerican Academy of Pediatrics: Circumcision Policy Statement; Task Force on Circumcision |websitejournal=Pediatrics |date=20121999-0803 |volume=103 |issue=3 |pages=686-1293 |accessdateurl=2019-10https://pediatrics.aappublications.org/content/103/3/686#sec-119 |formataccessdate=2019-11-26 |quotenote=Statement Reaffirmed Sept. 1, 2005}}</ref> The [[AAFP]] (2002) states quite simply in their [https://www. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operationcirp. Overallorg/library/statements/aafp2002/| position paper], their ''"Newborns experience pain threshold was lower and the risk of chronic pain increasedduring circumcision". Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice''<ref>{{REFjournal |last=Garry |init=TREFweb |title=Circumcision: a survey of fees and practicesPosition Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed |journalwebsite=OBG Management |date=1994 |volume=October |issue= |pages=34-36Official American Academy of Family Physicians Website |url=http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html |accessdate=2011-05-02}}</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. Penile injections of local anesthetic are now recommended by all of the major medical institutions if a circumcision is to be performed. 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 nerve block]] [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>{{REFjournal |last=Howard |init=CR |last2=Howard |init2=FM |last3=Garfunkel |init3=LC |last4=de Blieck |init4=EA |last5=Weitzman |init5=MREFweb |title=Report 10 of the Council on Scientific Affairs (I-99): Neonatal circumcision and pain relief: current training practicesCircumcision |journalwebsite=PediatricsAmerican Medical Association Official Website |dateurl=1998 |volume=101 |issue= |pages=423http://www.ama-assn.org/ama/no-index/about-428 |url=ama/13585.shtml |accessdate=2011-05-04}}</ref> 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>{{REFjournal |last=Stang |init=HJ |last2=Snellman |init2=LWREFweb |title=Where We Stand: Circumcision practice patterns in the United States |journalpublisher=Pediatrics[[AAP]] |date=19982011-03-23 |volumeurl=101 |issue=e5 |http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages= |url=/Where-We-Stand-Circumcision.aspx |accessdate= |note=Link to [[AAP]] website2019-10-12}}</ref>Be that as it may, few forms of analgesia are recommended. During procedures which take several minutesThere are basically two types of injections to choose from, babies tend to fall and the website does not go into the difference between a state 'dorsal nerve block' and a 'ring block' injection. 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 stuporlocal anesthesia, which in the past was falsely interpreted as peaceful sleepand make sure your baby is given an injection. This is your responsibility, nurturing because your doctor may or may not be up to date on the belief that babies felt no latest understandings of infant sensitivity to [[pain]] during circumcision. Measurements taken "'' 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 those cases revealed general. One may not expect to find this kind of advice on such a typically 3- to 4-fold increase in cortisol levelswebsite, and yet, which equals anything less than this is a state of severe shockdangerously weak statement. To control [[pain]], some physicians that circumcise use Tylenol, sugar,<ref>{{REFjournalREFweb |lastquote=GunnarTo 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. |initurl=MRhttp://www.pollockclinics.com/circumcision/circumcision-guide.html |last2title=FischParents' Guide to Circumcision |init2last=RO |last3first=Korsvik |init3publisher=S |last4date=Donhowe |init4accessdate=JM2011-04-08}}</ref><ref>{{REFweb |titlequote=The effects of During the circumcision , your son will receive sugar pacifiers to suck on serum cortisol and behaviorwhich reduce his pain perceptions. |journalurl=Psychoneuroendocrinologyhttp://www.pollockclinics.com/circumcision/circumcision-before.html |datetitle=1981Before the Circumcision |volumelast=6 |issuefirst=3 |pagespublisher=269-275 |urldate=http://www.cirp.org/library/pain/gunnar/2011-04-08 |accessdate=20192011-1104-2608}}</ref>a topical cream,<ref>{{REFweb* Postoperative wound pain |quote=Then in our office, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesionshe will have topical anesthetic applied to his penis.* Postoperative pain from the exposure of the sensitive glans penis to clothing |url=http://www.pollockclinics. This pain will endure for several weeks or even longer in some casescom/circumcision/circumcision-before.html* Postoperative bleeding of |title=Before 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>{{REFbookCircumcision

|yearpublisher=2000 |titledate=Paediatric Handbook2011-04-08 |urlaccessdate=2011-04-08 |work=}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb |editorsquote=Smart JWe use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, Nolan Tand a local anesthetic injection. |editionurl=6http://www.pollockclinics.com/circumcision/circumcision-guide.html |volumetitle=Parents' Guide to Circumcision |chapterlast= |pagesfirst=82 |location=Victoria, Australia |publisher=Blackwell Science Asia |isbn= |quotedate= |accessdate= |note=2011-04-08}}</ref>Topical anaesthetic only serves to numb the area to lessen the pain of the injection, but studies have shown that a [[dorsal penile nerve block]] is only partially effective in stopping the [[Pain| pain of circumcision]].<refname="Journal of Perinatology April/May 2002">{{REFdocumentREFjournal |titlelast=Taeusch |first=Autopsy of Demetrius MankerH. William |urlinit=HW |contributionlast2=Case 93-1711Martinez |lastfirst2=WetliAlma M. |firstinit2=CVAM |publisherlast3=Miami: Dade County Medical Examiner DepartmentPartridge |formatfirst3=J. Colin |dateinit3=1993-06-23JC |accessdatelast4=Sniderman}}</ref> <ref>{{REFjournal |first4=Susan |lastinit4=HissS |initlast5=JArmstrong-Wells |last2first5=HorowitzJennifer |init2init5=AJ |last3last6=KahanaFuentes-Afflick |init3first6=TElena |titleinit6=Fatal haemorrhage following male ritual circumcisionE |journaltitle=J Clin Forensic MedPain During Mogen or Plastibell Circumcision |datejournal=2000Journal of Perinatology |volume=722 |issue=3 |pages=32214-348 |url=http://www.cirpnature.orgcom/jp/journal/libraryv22/deathn3/hiss1full/7210653a.html |quote=...more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure. |pubmedID= |pubmedCID= |DOI= |note=April/May 2002 |date=2002-04 |accessdate=20192011-1104-0608}}</ref><refname="Clinical Pediatrics August 1986">{{REFdocumentREFjournal |last=Williamson |first=Paul S. |init=PS |last2=Evans |first2=Nolan Donovan |init2=ND |title=Judgement of inquiry into the death of McWillis, Ryleigh Roman BryanNeonatal Cortisol Response to Circumcision with Anesthesia |journal=Clinical Pediatrics |volume=25 |issue=8 |pages=412-6 |url=http://wwwcpj.circumstitionssagepub.com/death-exsangcontent/25/8/412.htmlabstract |contributionquote=The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine. |lastpubmedID=Newell |firstpubmedCID=TEC |publisher=Burnaby, B.C.: B.C. Coroner's Service |formatDOI= |date=20041986-01-1908 |accessdate=20192011-1104-2608}}</ref>* Post operative [[lymphoedema]].* Postoperative infections. This includes both local infectionsDuring circumcision, which can be treated with local therapy, and systemic infectionssomp physicians give children sugar pacifiers to "reduce the perception of pain", requiring systemic antibiotic treatment.<ref>{{REFconferenceREFweb |quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |lasturl=Drhttp://www. medpollockclinics.com/circumcision/circumcision-before. Hartmannhtml |firsttitle=WolfgangBefore the Circumcision |urllast= |placefirst=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German) |titlepublisher=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German) |date=20122011-1104-2608 |accessdate=2011-04-08}}</ref>* [[Wound dehiscence]]but in at least one study, meaning data shows that giving sugar to a child doesn't help to reduce the separation perception of pain in the edges of the wound or the tissue after suturingchild.* Adhesion between the surface or rim of the [[Glans penis|glans]] with the neighbouring penile skin<ref name="Lancet, causing skin pockets and bridges, as well as visually unpleasant results like uneven scars, which make a reThe 2010-circumcision necessary.* Postoperative [[phimosis]]: a phimotic ring can develop during scarring, which makes a re10-circumcision necessary. According to a study by Blalock et al.<ref09">{{REFjournal |last=BlalockSlater |first=Rebeccah |init=HJR |last2first2=VemulakondaLaura |init2=VL |last2=Cornelissen |last3first3=RitcheyLorenzo |init3=MLL |last4last3=Fabrizi |first4=RibbeckDebbie |init4=MD |last4=Patten |titlefirst5=Outpatient management of [[phimosis]] Following newborn circumcisionJan |journalinit5=J Urol |datelast5=Yoxen |first6=Alan |init6=A |last6=2003Worley |volumefirst7=169Stewart |issueinit7=6S |pageslast7=2332-2334Boyd |urlfirst8=http://www.cirp.org/library/complications/blalock1/Judith |accessdateinit8=2019-11-26J}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal |last8=Meek |lastfirst9=LeitchMaria |initinit9=IOWM |titlelast9=Circumcision - a continuing enigmaProf. Fitzgerald |journaltitle=Aust Paediatr JOral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial |datejournal=1970The Lancet |volume=6376 |issue=9748 |pages=591225-6532 |url=http://www.cirpthelancet.orgcom/libraryjournals/generallancet/leitch1article/PIIS0140-6736%2810%2961303-7/fulltext |accessdatequote=2019-12-15}}</ref> 5.5%.* [[Sudden Infant Death Syndrome]] (SIDS).* Knot formation of the veins. If the dorsal vein, which originates Our data suggest that oral sucrose does not significantly affect activity in the tip of the [[foreskin]]neonatal brain or spinal cord nociceptive circuits, 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.* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro-penis) and induratio [[penis]] plastica (skewed penis).* Medical malpractice can also therefore might not be ruled out. Injuries, partly or entirely severing the [[Glans penis|glans]] or the [[penis]] can occur.* In rare cases, necrosis, gangrene, ischaemia, keloid formation and circulatory problems may also occuran effective analgesic drug.* When the circumcision is followed by the ultra-orthodox Jewish ritual The ability 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 sucrose to brain damage or death.<ref>{{REFweb |url=http://www.nytimes.com/2012/03/08/nyregion/reduce clinical observational scores after noxious events in newborn infants-death-renews-debate-over-a-circumcision-ritualshould not be interpreted as pain relief.html?_r=0 |titlepubmedID=Baby’s Death Renews Debate Over a Circumcision Ritual |lastpubmedCID=Robbins |firstDOI=Liz |date=20122010-0310-0709 |accessdate=20192011-1004-1108}}</ref>Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals.

* An unavoidable late effect {{Box|Boxtext=<big><b>However, none of the above three procedures totally eliminate pain. A baby boy will still experience some pain despite any circumcision is the permanent loss of sexual sensitivitythose analgesic procedures. This is partly due to the removal Prevention of sensory tissue. The [[foreskinpain]] contains very many nerve endings and touch receptors, which account for the major part of male sexual sensationrequires protecting a boy from elective neonatal non-therapeutic circumcision. If Only boys who are protected from the [[foreskin]] is removed, they can medically unnecessary circumcision surgery experience no longer provide sexual stimulation. It is also partly due to the fact that the surface of the [[Glans penis|glanspain]] 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 or [[Glans penis|glanstrauma]] gradually over the years. The study conducted by Sorrells et al.<ref/b>{{Sorrells etal 2007}}</refbig> 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).}}

* Painful tension can occur when there == Risks and effects ==Just like tonsil or appendix surgery, circumcision is too little reserve skin left a surgical intervention and brings the usual risks related to surgical operations, alongside several specific risks of complications and late effects. Uberoi et al. (2022) report "some men are experiencing a complex negative constellation of psychological, physical, and sexual associations that lead to support significant emotional distress directed both internally and externally. The posts also reveal a full erectiondiscovery phenomenon wherein men discover the physical and psychological manifestations of the decisions made by others to modify their genitals."<refname ="uberoi2022">{{REFjournal |last=TaylorUberoi |first= |init=JRM |author-link= |last2=LockwoodAbdulcadir |first2= |init2=APJ |author2-link= |last3=TaylorOhi |first3= |init3=AJDA |author3-link= |last4=Santiago |first4= |init4=JE |author4-link= |last5= |first5= |init5= |author5-link= |last6= |first6= |init6= |author6-link= |last7= |first7= |init7= |author7-link= |last8= |first8= |init8= |author8-link= |last9= |first9= |init9= |author9-link= |etal=yes |title=The prepucePotentially under-recognized late-stage physical and psychosexual complications of non-therapeutic neonatal penile circumcision: <q>Specialized mucosa a qualitative and quantitative analysis of the [[penis]] and its loss to circumcision</q>self-reports from an online community forum |trans-title= |language= |journal=British Journal of UrologyInt J Impot Res |location= |date=19962022-10-23 |volume=77

|article= |page= |pages=291 |url=https://www.nature.com/articles/s41443-022-29500619-8 |archived= |urlquote= |pubmedID=36274189 |pubmedCID= |DOI=10.1038/s41443-022-00619-8 |accessdate=2023-01-08}}</ref> === Physical effects ===* [[Bodily harm]]* [[Circumcision scar]] is an invariable effect.* An unavoidable 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>{{Sorrells etal 2007}}</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). * Painful tension can occur when there is too little reserve [[skin]] left to support a full [[erection]]<ref name="taylor1996"/>. 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.

|pages=289-29292

* 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.* Vaginal dryness: Due to the loss of the natural [[gliding action]], which comes from the mobility of the fore- [[foreskin]] 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>{{FrischM LindholmM GroenbaekM 2011}}</ref><ref>{{REFjournal

|pagespage=227

}}</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 name="ColdCJ TaylorJR 1999">{{ColdCJ TaylorJR 1999}}</ref><ref>{{REFjournal

|pages=2113-21166

* [[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

|pagespage=89

=== Psychological late effects === [[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effects]] are also possible after a circumcision, especially if the operation * Shorter adult penile length was carried out in childhoodreported by Park et al. On this occasion (2016) as a variety result of trauma may occurNMC (newborn male circumcision).{{Citation |Title= |Text=In conclusion, which dependsecond to fourth digit ratio, among othersflaccid penile length, on and age and circumstances of the circumcisionwere significant predictive factors for erectile penile length. For exampleFurthermore, whether the circumcision took place with or without sufficient anaesthesia, if penile lengths of the individual has been informed about NMC group were shorter than those of 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 ownnon-NMC group. 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 |Author=Park et al. |Source=* It was observed that infants, following circumcision without pain control, had a disturbed bond with their mother |ref=<ref>{{REFjournal |last=MarshallPark |first= |init=REJK |author-link= |last2=PorterDoo |first2= |init2=FLAR |author2-link= |last3=RogersKim |first3= |init3=AGJH |author3-link= |last4=Park |first4= |init4=HS |author4-link= |etal=yes |title=Circumcision: II effects upon motherProspective investigation of penile length with newborn male circumcision and second to fourth digit ratio. |trans-infant interactiontitle= |language= |journal=Early Hum DevCan Urol Assoc J |location= |date=19822016-09 |season= |volume=710 |issue=49-10 |article= |page= |pages=367-374 |url=httphttps://www.cirpncbi.nlm.nih.orggov/librarypmc/birtharticles/marshall2PMC5028213/ |archived= |quote= |pubmedID=27695583 |pubmedCID=5028213 |DOI=10.5489/cuaj.3590 |accessdate=20202022-0209-0104}}</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.}}

* In boys circumcised === Sexual effects ===Cepeda-Emiliani et al (2023) cited six reports in childhoodthe literature of detrimental effects of circumcision, including erectile function, sensation, masturbatory pleasure, orgasm, and sexual satisfaction. The authors also cited three studies of severe distress in [[posttraumatic stress disordercircumcised]] (men, due to their infant circumcision, with complaints of [[PTSDglans]]) could be diagnosed. In a study on Philippine boysinsensitivity, in whom no delayed [[PTSDejaculation]] 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 operationunpleasant sensation.<refname="cepeda2023">{{REFbookREFjournal |last=RamosCepe da-Emiliani |first=S |init=A |author-link=Alfonso Cepeda-Emiliani |last2=BoyleGándara-Cortés |first2=GJ |yearinit2=M |author2-link= |last3=Otero-Alén |first3= |init3=M |author3-link=2001 |titlelast4=García |first4= |init4=Understanding circumcision: A MultiH |author4-Disciplinary Approach to a Multilink= |last5=Suárez-Dimensional ProblemQuintanilla |first5= |urlinit5=https://J |author5-link.springer.com/chapter/10.1007/978= |last6=García-1Caballero |first6= |init6=T |author6-4757link= |last7=Gallego |first7= |init7=R |author7-3351link= |last8=García-8_14Caballero |workfirst8= |editorsinit8=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]R |editionauthor8-link= |volumeetal=no |chaptertitle=Ritual Immunohistological study of the density and medical circumcision among Filipino boysdistribution of human penile neural tissue: evidence of postgradient hypothesis |trans-traumatic stress disordertitle= |language= |journal= Int J Impot Res |location= |pagesdate=2532023-05-27002 |locationvolume=35 |issue=3 |article= |page= |pages=New York286-305 |publisherurl=Kluwer Academichttps://Plenum Publisherswww.nature.com/articles/s41443-022-00561-9 |isbnarchived=

|accessdatepubmedID=35501394 |pubmedCID= |DOI=10.1038/s41443-022-00561-9 |noteaccessdate=2023-11-26

* CircumcisionsCircumcision and frenectomy remove tissues with heightened erogenous sensitivity.<ref name="cepeda2023" /> <ref name="winkleman1959">{{WinkelmannRK 1959}}</ref> They concluded, especially those "Evidence has also started to accumulate that happen without consentmale circumcision may result in lifelong physical, sexual, can spark feelings of helplessness and alienation, which can persist sometimes psychological harm as traumawell. These feeling can also be triggered later" The [[amputation]] of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the [[penis]], when someone circumcised as an infant becomes aware leaving only the uninhibited protopathic sensibility of his circumcisionthe artificially externalized [[glans penis]]. In an online study, interviewed men stated they felt betrayed - 55% The imbalance caused by not having the mother, 50% by input from the father, and 58% by now ablated fine-touch receptors may be a leading cause of the doctor, and 73% felt that their changes in sexual behavior noted in [[circumcised]] human rights had been violatedmales.<ref name="GSoCH">{{REFwebREFjournal |last=Van Howe |init=RS |author-link=Robert S. Van Howe |last2=Cold |init2=CJ |title=Advantages and Disadvantages of Neonatal Circumcision |journal=The Journal of the American Medical Association |volume=277 |issue=13 |pages=1052-7 |url=http://www.circumcisionharmncbi.orgnlm.nih.gov/pubmed/9218663 |titlequote= |pubmedID=9218663 |pubmedCID= |DOI=Global Survey of Circumcision Harm |accessdatedate=20191997-1004-1202 |accessdate=

* It can frequently be found that Histology of the loss is deniedmale circumcision scar shows [[amputation]] neuromas, much as happens with Schwann cell proliferation and the loss bulbous collection of other body partsvariably sized neurites. [[Amputation]] neuromas do not mediate normal sensation and are notorious for generating pain.<ref name="ColdCJ TaylorJR 1999"/> Cepeda-Emiliani et al. This denial can lead (2023) commented:<blockquote> Taking the sleve technique as an example of surgical flexibility during circumcision, to fathers having their sons circumcised in order not the extent that this technique is of such versatility that it allows highly variable quantities of cutaneous and subcutaneous tissue to be reminded excised directly from the penile body, and to the extent that the prepuce is still conceived by segments of their own loss. In this processthe medical community as "just a small piece of skin", we are concerned that aggressive circumcisions are intentionally or unintentionally being performed in pediatric and adult patients in the belief that "redundant" or " extra" tissue is being excised, their own body or in the belief that "excesive sensitivity" is defined as being reduced to augment ejaculatory latency time.<ref name="normalcepeda2023" /></blockquote>The un-anesthetized and un-sedated newborn infant is restrained by being strapped to a special plastic board called the [[circumstraint]]. The procedure is most often an elective, non-therapeutic surgery without [[medical indication]] performed on neonates and children for religious and cultural reasons in violation of the child's [[foreskinhuman rights]] redefined as to [[physical integrity]], but in older patients may be rarely indicated for therapeutic reasons. It is a foreign objectradical treatment option for pathological [[phimosis]], refractory [[balanoposthitis]] and chronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health. Their own parents  See [[Sexual effects of circumcision]] for more information. === Psychological effects ===[[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effects]] are seen as "good"also possible after a circumcision, so that this image is projected onto especially if the circumcision their parents operation was carried out as well, in order to keep the positive emotion intactchildhood. The father wants to be On this occasion a "good" father later in life as wellvariety of [[trauma]] may occur, which depend, among others, on age and so, following an idealised image circumstances of his own parentsthe circumcision. For example, whether the circumcisiontook place with or without sufficient anaesthesia, which if the individual has been redefined as a "good thing"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. The psychological late effects of circumcision are not yet fully researched, is passed and many studies took place on rather a small scale. This situation needs to his son by having him circumcised be rectified, because the available studies, as wellas the histories of negatively affected men, suggest that these late effects may have more impact than previously assumed. * It was observed that infants, following circumcision without [[pain]] control, had a disturbed bond with their mother<ref>{{REFjournal |last=van der KolkMarshall |init=BARE |urllast2=http://www.cirp.org/library/psych/vanderkolk/Porter |titleinit2=The compulsion to repeat the trauma: re-enactment, revictimization, and masochismFL |journallast3=Psychiatr Clin North AmRogers |dateinit3=1989AG |volumeetal=12yes |issuetitle=2Circumcision: II effects upon mother-infant interaction |pagesjournal=389-411Early Hum Dev |accessdatedate=2019-10-12}}</ref><ref>{{REFjournal1982 |lastvolume=Goldman7 |initissue=R4 |authorpages=367-link=Ronald Goldman74 |url=httphttps://www.cirp.org/library/psychbirth/goldman1marshall2/ |title=The psychological impact of circumcision |journal=BJU Int |date=1999 |volume=83 |issue=Suppl. 1 |pages=93-103 |accessdate=20192020-1002-1201}}</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. * If the In boys [[circumcised male feels incomplete]] in childhood, [[post-traumatic stress disorder]] ([[PTSD]]) could be diagnosed. In a study on Philippine boys, or due in whom no [[PTSD]] was found prior to the missing operation, 69% of the boys [[foreskincircumcised]] disadvantaged compared to intact males, an inferiority complex in the traditional ritual and depression may occur. This can be accompanied 51% of those [[circumcised]] by conscious recognition of his own incompleteness, or standard medical procedures (including anaesthesia) fulfilled the DSM-IV criteria for PTSD following the deficiency may remain completely subconsciousoperation.<ref>{{REFjournalREFbook |last=RhinehartRamos |init=J |url=http://www.cirp.org/library/psych/rhinehart1/S |titlelast2=Neonatal circumcision reconsideredBoyle |journalinit2=Transactional Analysis JGJ |dateyear=19992001 |volumetitle=29Understanding circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem |issueurl=3https://link.springer.com/chapter/10.1007/978-1-4757-3351-8_14 |pageswork=215-221 |accessdateeditors=2019-10-12}}</ref>[[George C. In an online studyDenniston]], 75% of those interviewed stated that they felt incomplete, and 66% said they felt inferior compared with intact males[[Frederick M.<ref name="GSoCH"/>* 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 yearsHodges]], who had previously been prepared for their impending circumcision, that the children experienced the operation as an aggressive assault on their bodies.<ref>{{REFjournal[[Marilyn Fayre Milos]] |lastedition=Cansever |initvolume=G |datechapter=1965Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder |urlpages=http://www.cirp.org/library/psych/cansever/253-70 |titlelocation=Psychological effects of circumcisionNew York |journalpublisher=Brit. J. Med. PsycholKluwer Academic/Plenum Publishers |volumeisbn=38 |pagesquote=321-331 |accessdate=2019-10-12 |note=

* Fear Circumcisions, especially those that happen without consent, can spark feelings of being alone or darknesshelplessness 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="Levy1945GSoCH">{{REFjournal |last=Levy |first=David M. |init=DMREFweb |url=http://www.cirpcircumcisionharm.org/library/psych/levy1/ |title=Psychic trauma Global Survey of operations in children; and a note on combat neurosis |journal=American Journal of Diseases of Children |volume=69 |date=1945 |pages=7-25Circumcision Harm

* 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>{{VanderKolkBA 1989}}</ref><ref>{{REFjournal |last=Goldman |init=R |author-link=Ronald Goldman |url=https://www.cirp.org/library/psych/goldman1/ |title=The psychological impact of circumcision |journal=BJU Int |date=1999 |volume=83 |issue=Suppl. 1 |pages=93-103 |accessdate=2019-10-12}}</ref>* 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 |last=Rhinehart |init=J |url=https://www.cirp.org/library/psych/rhinehart1/ |title=Neonatal circumcision reconsidered |journal=Transactional Analysis J |date=1999 |volume=29 |issue=3 |pages=215-21 |accessdate=2019-10-12}}</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"/>* 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 |last=Cansever |init=G |date=1965 |url=https://www.cirp.org/library/psych/cansever/ |title=Psychological effects of circumcision |journal=Brit. J. Med. Psychol |volume=38 |pages=321-31 |accessdate=2019-10-12}}</ref>* Fear of being alone or darkness.<ref name="Levy1945">{{REFjournal |last=Levy |first=David M. |init=DM |url=https://www.cirp.org/library/psych/levy1/ |title=Psychic trauma of operations in children; and a note on combat neurosis |journal=American Journal of Diseases of Children |volume=69 |date=1945 |pages=7-25 |accessdate=2019-10-12}}</ref>* Fear of doctors, clinics and also closed rooms.<ref name="Levy1945"/>* Relapse into the state of bed-wetting, even if the child was already dry before.<ref name="Levy1945"/>* [[Circumcised ]] males who become fathers frequently manifest [[adamant father syndrome]]. [[Intact America]] (2019) called circumcision as an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]],<ref name-"bollinger2019">{{REFdocument |title=Child genital cutting as an adverse childhood experience |url=http://adversechildhoodexperiences.net/CGC_as_an_ACE.pdf |last=Bollinger |first=Dan |author-link=Dan Bollinger |last2=Chapin |first2=Georganne |author2-link=Georganne Chapin |publisher=Intact America |location=Tarrytown |format=PDF |date=2019-08 |accessdate=2021-11-02

== Rights Complications ===== Possible operative and ethics postoperative complications === The [[Rights situation on circumcision|rights situation]] Circumcision is discussed in a separate articlesurgery. ----- {{FromIntactWiki |URL=http://intactwiki.org/wiki/Circumcision |Title=Circumcision}} Surgical complications of circumcision generally may be classified as [[Image:Intact vs circumcised.JPG |thumbnail|right|300pxBleeding| The intact and circumcised human penis, side by side.hemorrhage]] 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 [[foreskininfection]] 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 surgical misadventure up to be unethical and a human rights violation, unless there is concrete medical indication. Proponents including loss of circumcision consider the circumcision of non-consenting minors to be a "religious freedom" penis and a "parental right." == Complications ===== Pain ===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 [[paindeath]] during the circumcision procedure. Anand & Hickey (1987) have shown that newborn children do in fact feel [[pain]], and more acutely than adults.<ref name="ananddeacon2022" /><ref name="williams-hickey1987kapilla1993">{{REFjournal |last=AnandWilliams |firstinit=N |author-link= |last2=HickeyKapilla |first2init2=L |author2-link= |etal=no |title=Pain and its effects in the human neonate and fetusComplications of circumcision |trans-title= |language= |journal=New Engl Brit J MedSurg |location= |date=19871993-11-1910 |volume=31780 |issue=2110 |pages=13211231-96 |url=httphttps://www.cirp.org/library/paincomplications/anandwilliams-kapila/ |quote= |pubmedID=33170378242285 |pubmedCID= |DOI= |accessdate=2019-11-08}}</ref> This has led American health associations to recommend doctors take measures to reduce the pain of circumcision in infants. The [http://www10.cirp.org/library1002/statements/aap1999/|AAP Circumcision Policy Statement] (1999) 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 asbjs...tightening of the clamp"''.<ref>{{REFjournal |last= |first= |title=American Academy of Pediatrics: Circumcision Policy Statement; Task Force on Circumcision |journal=Pediatrics |date=1999-03 |volume=103 |issue=3 |pages=686-693 |url=https://pediatrics.aappublications.org/content/103/3/686#sec-91800801005 |accessdate=2019-11-26 |note=Statement Reaffirmed Sept. 1, 200527

The * Intolerance or allergic reactions to the narcotics used.* 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 [[AAFPpenis]] (2002) states quite simply in their [http://www.cirp.org/library/statements/aafp2002/| position paper], ''"Newborns experience pain during circumcision"the rate of failure to provide sufficient anaesthetic even for experienced anaesthetists is still 5-10%.''<ref>{{REFweb |title=Circumcision: Position Paper on Neonatal CircumcisionThe 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. Board Approved: August 2007 Reaffirmed |website=Official American Academy A surgical operation without proper [[pain]] control can lead to the development of Family Physicians Websitea specific pain memory<ref>{{REFweb |url=http://www.aafpspiegel.orgde/onlinespiegel/envorab/home/clinical/clinicalrecs/children/circumcisionexperte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-849534.html |accessdatetitle=2011Kinderschmerz-05Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder |trans-02title=Children's pain expert warns: Ritual circumcision changes the brain of children}}</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 |language=German |last=Prof. Dr. med.Boris Zernikow |first= |publisher=Spiegel Online |website= |date=2012-08-12Penile injections of anesthetic are now recommended by all of the major medical institutions. In their [http://www.ama |accessdate=2019-assn.org/ama/no10-index/about-ama11 |format= |quote=}}</13585ref>.shtml Report 10 In unsedated and partially sedated infants increased secretion of the Council on Scientific Affairs]stress hormone cortisol could be observed for months after the operation. Overall, their pain threshold was lower and the AMA states ''"When the decision is made to proceed risk of chronic pain increased. Regardless of these findings, infant circumcisions with circumcision, local anesthesia should be provided for the procedure. Ring block insufficient or dorsal penile blocks [injections] no anaesthetic are most effective. EMLA cream has limited utility"''. Alarmingly, ''"Despite the clear evidence that newborn males generate brisk pain responses during circumcision, still common practice<ref>{{REFjournal |last=Garry |init=T |title=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"''.fees and practices |journal=OBG Management |date=1994 |volume=October |issue= |pages=34-6 |url= |accessdate=}}</ref><ref>{{REFwebREFjournal |last=Howard |titleinit=Report 10 of the Council on Scientific Affairs (I-99): Neonatal CircumcisionCR |websitelast2=American Medical Association Official WebsiteHoward |urlinit2=http://www.ama-assn.org/ama/no-index/about-ama/13585.shtmlFM |accessdatelast3=2011-05-04Garfunkel}}</ref> |init3=LC 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 |last4=de Blieck |init4=EA |last5=Weitzman |init5=M |title=Neonatal circumcision and pain relief: current training practices |titlejournal=Where We Stand: CircumcisionPediatrics |date=1998 |volume=101 |publisherissue=[[AAP]] |datepages=2011423-03-238 |url=http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx |accessdate=2019-10-12}}}</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.<ref>{{REFjournal |last=Stang |init=HJ |last2=SnellmanGiven what is known from aforementioned official documents, |init2=LW |title=Circumcision practice patterns in 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 United States |journal=Pediatrics |date on the latest understandings of infant sensitivity =1998 |volume=101 |issue=e5 |pages= |url= |accessdate= |note=Link to pain during circumcision."'' The [[AAP may be holding back, however, perhaps because this would upset the doctor]] website}}</parent power relationshipref>. During procedures which take several minutes, and may cause too much questioning of doctors in general. One may not expect babies tend to find this kind fall into a state of advice on such a websitestupor, and yetwhich in the past was falsely interpreted as peaceful sleep, anything less than this is nurturing the belief that babies felt no pain. Measurements taken in those cases revealed a dangerously weak statementtypically 3- to 4-fold increase in cortisol levels, which equals a state of severe [[shock]]. To control pain, some physicians that circumcise use Tylenol, sugar,<ref>{{REFwebREFjournal |quotelast=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.Gunnar |init=MR |last2=Fisch |urlinit2=http://www.pollockclinics.com/circumcision/circumcision-guide.htmlRO |titlelast3=Parents' Guide to CircumcisionKorsvik |lastinit3=S |firstlast4=Donhowe |publisherinit4=JM |datetitle= The effects of circumcision on serum cortisol and behavior |accessdatejournal=2011-04-08Psychoneuroendocrinology}}</ref><ref>{{REFweb |date=1981 |quotevolume=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.6 |issue=3 |pages=269-75 |url=httphttps://www.pollockclinicscirp.comorg/circumcisionlibrary/pain/gunnar/circumcision-before.html |titleaccessdate=Before the Circumcision2019-11-26 |last=}}</ref> |first=* Postoperative wound pain, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions. |publisher= |date=2011-04-08* 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. |accessdate=2011-04-08}}</ref> a topical cream* Postoperative [[bleeding]] of the wound. This can have severe consequences especially for very young infants,<ref>{{REFweb |quote=Then in our officeif they are not treated promptly. Their blood volume is only about 85 ml per kilogram of body weight, he will have topical anesthetic applied and even moderate blood loss can lead to his penishypovolaemia, hypovolaemic [[shock]] and even death.<ref>{{REFbook |urllast= |first=http://www.pollockclinics.com/circumcision/circumcision-before.html |titleyear=Before the Circumcision2000 |lasttitle=Paediatric Handbook |firsturl= |publisherwork= |dateeditors=Smart J, Nolan T. |edition=6 |volume= |chapter=2011-04-08 |accessdatepage=2011-04-0882 |location={{AUSC|VIC}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb, Australia |publisher=Blackwell Science Asia |isbn= |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. |urlaccessdate= |note=http:}}<//www.pollockclinics.com/circumcision/circumcision-guide.htmlref><ref>{{REFdocument |title=Parents' Guide to CircumcisionAutopsy of Demetrius Manker |lasturl= |firstcontribution=Case 93-1711 |publisherlast=Wetli |datefirst=CV |accessdatepublisher=Miami: Dade County Medical Examiner Department |format= |date=20111993-0406-0823 |accessdate=}}</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<ref>{{REFjournal |last="Journal of Perinatology April/May 2002">{{REFjournalHiss |lastinit=TaeuschJ |firstlast2=H. WilliamHorowitz |initinit2=HWA |last2last3=MartinezKahana |first2init3=Alma M.T |init2title=AMFatal haemorrhage following male ritual circumcision |last3journal=PartridgeJ Clin Forensic Med |first3date=J. Colin2000 |init3volume=JC7 |last4issue=Sniderman |first4pages=Susan32-4 |init4url=Shttps://www.cirp.org/library/death/hiss1/ |last5accessdate=Armstrong2019-Wells11-06 |first5=Jennifer}}</ref><ref>{{REFdocument |init5title=JJudgement of inquiry into the death of McWillis, Ryleigh Roman Bryan |last6url=Fuentes-Afflick |first6=Elenahttp://www.circumstitions.com/death-exsang.html |init6contribution=E |titlelast=Pain During Mogen or Plastibell CircumcisionNewell |journalfirst=Journal of PerinatologyTEC |volumepublisher=22 |issueBurnaby, B.C.: B.C. Coroner's Service |format=3 |pagesdate=2142004-21801-19 |urlaccessdate=http:2019-11-26}}<//www.natureref>* Post operative [[lymphoedema]].com/jp/journal/v22/n3/full/7210653a.html * Postoperative [[Infection|quote=.infections]].This includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure.<ref>{{REFconference |pubmedIDlast=Dr. med. Hartmann |pubmedCIDfirst=Wolfgang |DOIurl= |noteplace=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German) |title=April/May 2002Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German) |date=20022012-0411-26 |accessdate=2011-04-08}}</ref><ref name="Clinical Pediatrics August 1986">{{REFjournal |last=Williamson |first=Paul S* [[Wound dehiscence]], meaning the separation of the edges of the wound or the tissue after suturing. * Adhesion between the surface or rim of the [[Glans penis|init=PS |last2=Evans |first2=Nolan Donovanglans]] 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.* 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 |init2last=NDBlalock |titleinit=Neonatal Cortisol Response to Circumcision with AnesthesiaHJ |last2=Vemulakonda |journalinit2=Clinical PediatricsV |volumelast3=25Ritchey |issueinit3=8ML |pageslast4=412-416Ribbeck |urlinit4=http://cpj.sagepub.com/content/25/8/412.abstract |quoteM |title=The adrenal cortisol response to surgery was not significantly reduced by the administration Outpatient management of lidocaine.[[phimosis]] Following newborn circumcision |pubmedIDjournal=J Urol |pubmedCIDdate=2003 |volume=169 |DOIissue=6 |datepages=19862332-084 |url=https://www.cirp.org/library/complications/blalock1/ |accessdate=20112019-0411-0826}}</ref> During circumcision, somp physicians give children sugar pacifiers to "reduce the perception of pain"prevalence is 2.9%,according to Leitch<ref>{{REFwebREFjournal |quotelast=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.Leitch |urlinit=http://www.pollockclinics.com/circumcision/circumcision-before.htmlIOW |title=Before the Circumcision- a continuing enigma |lastjournal=Aust Paediatr J |firstdate=1970 |publishervolume=6 |dateissue=2011 |pages=59-04-0865 |url=https://www.cirp.org/library/general/leitch1/ |accessdate=20112019-0412-0815}}</ref> but in at least one study, data shows that giving sugar to a child doesn't help to reduce the perception 5.5%.* [[Sudden Infant Death Syndrome]] (SIDS).* Knot formation of pain in the childveins.<ref name="LancetIf the dorsal vein, which originates in the tip of the [[foreskin]], The 2010-10-09">{{REFjournal |last=Slateris 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. |first=Rebeccah |init=R* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro-penis) and induratio [[penis]] plastica (skewed penis). |first2=Laura * Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis|init2=Lglans]] or the [[penis]] can occur. |last2=Cornelissen* In rare cases, [[necrosis]], gangrene, ischaemia, keloid formation, and circulatory problems may also occur. |first3=Lorenzo |init3=L |last3=Fabrizi |first4=Debbie |init4=D |last4=Patten* 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 |first5url=Jan |init5http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritual.html?_r=J0 |last5title=YoxenBaby’s Death Renews Debate Over a Circumcision Ritual |first6last=AlanRobbins |init6first=ALiz |last6date=Worley2012-03-07 |first7accessdate=Stewart2019-10-11 |init7=S}}</ref> |last7=Boyd |first8=Judith |init8=J |last8Death =Meek |first9=Maria |init9=M A study in 2010 estimated approximately 117 neonatal circumcision-related [[Death|last9=Prof. Fitzgerald |title=Oral sucrose as an analgesic drug for procedural pain deaths]] occur annually in newborn infants: a randomised controlled trial |journal=The Lancetthe [[United States]], about one out of every 77 male neonatal deaths, more than suffocation, auto accidents, or even [[SIDS]].<ref name="Bollinger 2010">{{REFjournal |volumelast=376Bollinger |issuefirst=9748Dan |pagesinit=1225D |author-1232link=Dan Bollinger |urllast2=Boy's Health Advisory |title=httpLost Boys://wwwAn Estimate of U.thelancetS.com/journals/lancet/article/PIIS0140Circumcision-6736%2810%2961303-7/fulltextRelated Infant Deaths |journal=Thymos: Journal of Boyhood Studies |volume=4 |quoteissue=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. 1 |pubmedIDpages=78-90 |pubmedCIDurl= |DOI= |date=2010-10-09 |accessdate=2011-04-08}}<http://www.mensstudies.com/content/ref> Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals. It has been shown that an infant's response to [[pain]] can be altered for years as a consequence of circumcision.<ref>{{REFjournal |last=Taddio |first=Anna |init=A |first2=Morton |init2=M |last2=Goldbach |first3=Moshe |init3=M |last3=Ipp |first4=Bonnie |init4=B |last4=Stevens |first5=Gideon |init5=G |last5=Koren |title=Effect of neonatal circumcision on pain responses during vaccination in boys |journal=The Lancet |volume=345 |issueb64n267w47m333x0/?p=8945 |pages7ebbd6b446d940cbbd4274c095754b12π=291-2 |url=http://www.cirp.org/library/pain/taddio/5

|pubmedID=7837863

|DOI=10.3149/thy.0401.78 |date=19952010-04-26 |accessdate=2019-10-12}}</ref><ref>{{REFweb |url=http://www.icgi.org/2010/04/infant-circumcision-causes-100-deaths-each-year-in-us |title=Infant circumcision causes 100 deaths each year in US |last= |first= |publisher=ICGI |website=[[International Coalition for Genital Integrity]] |date=2010-04-26

}}</ref>See also the list of [[fatalities]]. == Forced circumcision ==<!--=== United States military ===American soldiers serving in World War II were subjected to regular inspections of their genitals. If intact, the soldiers risked being ordered to undergo immediate circumcision.<ref>{{REFjournalREFbook |last=TaddioSchoen |first=AnnaEd |init=AE |last2author-link=KatzEdgar J. Schoen |init2year=J2005 |last3title=IlersichOn Circumcision |init3url=AL |last4https://books.google.de/books?id=Koren-zUhdvSt7cgC |init4work=G |titleeditor=Effects of neonatal circumcision on pain response during subsequent routine vaccinationDianne Yeakey |journaledition=The Lancet |volume=349 |issuechapter=9052 |pages=59972-6033 |urllocation=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)10316-0/fulltextGeorgetown, Canada |quotepublisher=RDR Books |pubmedIDisbn=9057731 |pubmedCID= |DOI=10.1016/S01401-157143-6736(96)10316123-03 |datequote=1997-03For a critical view, see Sorrells, "The History of Circumcision," p. 333

|note=}}</ref>This practice was discontinued at least six decades ago.-->=== Non-therapeutic circumcision of male children ===

{{Box|Boxtext=<big><b>HoweverHuman babies, because they are not yet in possession of language, none are incapable of giving or refusing consent to be [[circumcised]]. The element of force has led some scholars to view the above three procedures totally eliminate pain. A circumcision of baby boy will still experience some pain despite any boys as a category of those analgesic proceduresforced circumcision.<ref>For example, Frederick M. Prevention Hodges, a medical historian, writes: "In the late 1970s, as the Americans were growing increasingly aware of pain requires protecting a boy from elective neonatal nonthe abuses of power rampant throughout the nation's social institutions, influential grass-therapeutic roots movements protesting the forced circumcisionof American children sprang up nationwide." F. Hodges, "A Short History," p. Only boys who are protected from the medically unnecessary circumcision surgery experience no pain or trauma31; see also [[Leonard B. Glick|Glick]], ''Marked in Your Flesh'', pp. 273-281.</bref></big>}} === Sexual effects === Circumcision and frenectomy remove tissues with heightened erogenous sensitivity. Boyle et al. (2002) wroteThere are, however, "physicians in the genitally intact male has thousands United States who argue strongly for non-therapeutic circumcision of fine touch receptors newborn babies; and other highly erogenous nerve endings&mdash;many of which are lost to circumcisionis widely accepted as a postnatal procedure in American hospitals."<ref>{{REFjournalREFbook |last=BoyleFletcher |first=Gregory JChristopher R. |init=GJCR |author-linkyear=Gregory Boyle1999 |first2title=Gillian A.Circumcision in America in 1998: Attitudes, Beliefs, and Charges of American Physicians |init2url=GAhttp://www.springerlink.com/content/h2150v731233m177/ |last2work=BensleyMale and Female Circumcision |titleeditors=Adverse Sexual and Psychological Effects of Male Infant Circumcision[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |journaledition=Psychological reports |volume=88 |issuechapter=3, Part 2Section 5 |pages=1105–1106259-71 |urllocation=New York |publisher=http://www.cirp.org/library/psych/boyle5Kluwer Academic/Plenum Publishers |isbn=

|pubmedID=11597060 |pubmedCIDaccessdate=2019-10-12 |DOInote=ID 10.10461007/j.1464978-0-585-39937-410x.1999.0830s1085.x |date=July 2001 |accessdate=9_19}}</ref> They concludedParental 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 claimed that "Evidence has also started parents should determine what is in the best interest of the child... It is legitimate for parents to accumulate that male circumcision may result take into account cultural, religious, and ethnic traditions, in lifelong physicaladditions to the medical factors, sexualwhen making a decision."<ref>Lannon and Bailey, and sometimes psychological harm "Circumcision Policy Statement," p. 691.</ref> however surrogate consent for non-therapeutic circumcision is now viewed as wellunethical."

The amputation of In the prepuce results in the loss of the majority of fine[[United Kingdom]], where non-touch neuroreceptors found therapeutic circumcision has now become far less prevalent than in the penis[[United States]], leaving only the uninhibited protopathic sensibility written consent of the artificially externalized glans penis. The imbalance caused by not having the input from the now ablated fineboth parents is required, if a physician is to perform a non-touch receptors may be therapeutic circumcision of a leading cause of the changes in sexual behavior noted in circumcised human maleschild.<ref>{{REFjournal |last=Van Howe |initfirst=RS |author-linktitle=Robert Van HoweRe J (child's religious upbringing and circumcision) |last2journal=ColdFamily Court Reports |init2=CJ |titledate=Advantages and Disadvantages of Neonatal Circumcision |journal=The Journal of the American Medical Association2000 |volume=2771 |issue=13 |pages=1052307-714 |url=httphttps://www.ncbicirp.nlm.nih.govorg/library/legal/pubmedRe_J/92186632000.html |quoteaccessdate=2019-10-12}}</ref> (The National Health Service does not provide non-therapeutic circumcision.)  In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<ref>See, e.g., [[Margaret A. Somerville|Somerville]], "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; [[Abbie Chessler|pubmedIDChessler]], "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=9218663"Bollinger 2010"/> |pubmedCID==Video== |DOI===Is circumcision healthy?===The video ''Is Circumcision Healthy'' is recommended for parental viewing.<br><br> |date<youtube>D_3LQjZgdbQ</youtube> ===Dr. Christopher Guest discusses circumcision===1997-04-02 |accessdate<br><youtube>v=}}TQIp9f4krVQ</refyoutube>

Histology of the male ===Plastibel 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 name="ColdCJ TaylorJR 1999"/>==

{{UNI|Stanford University|SU}} has published a video of an actual non-therapeutic plastibell circumcision. The infant has received two injections of local anesthesia to deaden the dorsal nerves. The ventral nerves were not deadened so the infant still feels pain. One can his cries on the soundtrack.* [https://med.stanford.edu/newborns/professional-education/circumcision/plastibell-technique.html Plastibell Technique] === Death Gomco clamp circumcision===A study in 2010 estimated approximately 117 neonatal '''Not for the squeamish:''' This is a video of an actual circumcision-related deaths occur annually in with a Gomco clamp. The infant boy received two dorsal penile nerve block (DPNB) analgesic injections but they did not seem to work. * [https://www.reddit.com/r/Intactivism/comments/qbpzqr/trained_medical_professionals_restrain_infant_to/ Circumcision video] ==Recommendations of medical authorities==* [[George Hill| Hill]] (2007) said:<blockquote>Male circumcision is harmful because it excises healthy tissue and permanently impairs beneficial physiological functions. Male circumcision also causes psychological problems that tend to perpetuate the cycle of abuse. Male circumcision is a costly diversion of medical resources away from beneficial services. Male circumcision violates legal rights, [[human rights]], and ethical standards. Finally, we must remember that males are the more vulnerable and sensitive of the United Statestwo genders and, therefore, about one out deserve the greater degree of every 77 male neonatal deathsprotection from traumatic, more than suffocationinvasive, auto accidentsinjurious, or even and unnecessary surgery. For all of these reasons the non-therapeutic circumcision of boys should not be performed and the [[SIDSgenital integrity]]of all children should be respected and protected.<ref name="Bollinger 2010hill2007">{{REFjournal |last=BollingerHill |first=DanGeorge |init=DG |author-link=Dan BollingerGeorge Hill |last2title=Boy's Health AdvisoryThe case against circumcision |titlejournal=Lost Boys: An Estimate Journal of U.S. Circumcision-Related Infant DeathsMen's Health and Gender |journaldate=Thymos: Journal of Boyhood Studies2007

|issue=13 |pages=78318-9023 |url=httphttps://www.mensstudiesacademia.comedu/content8367383/b64n267w47m333x0/?p=7ebbd6b446d940cbbd4274c095754b12π=5The_Case_Against_Circumcision

|DOI=10.3149/thy.0401.78 |date=2010-04-26 |accessdate=20192021-1005-1230}}</ref><ref/blockquote>* Andrew E. MacNeiiy, Head, Division of Pediatric Urology, Department of Urological Sciences, {{REFweb UNI|University of British Columbia|url=httpUBC}}, Vancouver, BC, (2008) said://www<blockquote>Newborn circumcision remains an area of controversy. Social, cultural, aesthetic and religious pressures form the most common reasons for non-therapeutic circumcision. Although penile cancer and UTIs are reduced compared with uncircumcised males, the incidence of such illness is so low that circumcision cannot be justified as prophylaxis. The role of the foreskin in [[HIV]] transmission in developed countries is unclear, and safe sexual practice remains the cornerstone of prevention. There remains a lack of knowledge regarding what constitutes the normal foreskin both among parents and among primary care providers.icgiThis lack of knowledge results in a burden of costs to our health care system in the form of unnecessary urological referrals, expansion of wait times and circumcisions.org/2010/04/infant-Routine circumcisionof all infants is not justified from a health or cost-causesbenefit perspective.<ref>{{REFjournal |last=MacNeily |first=Andrew |init= |author-100-deaths-each-year-in-uslink= |etal=no |title=Infant Routine circumcision causes 100 deaths each year in US: the opposing view |lasttrans-title= |firstlanguage= |publisherjournal=ICGICan Urol Assoc J |websitelocation=International Coalition for Genital Integrity |date=20102007-0411 |volume=1 |issue=4 |article= |page= |pages=395-267 |url=http://europepmc.org/article/PMC/2422979 |pubmedID=18542825 |pubmedCID= |DOI=10.5489/cuaj.455 |accessdate=2021-11-08}}</ref> See also the list of [[fatalities]]. == Forced circumcision ==</blockquote>

American soldiers serving in World War II were subjected <blockquote>The official viewpoint of KNMG and other related medical/scientific organisations is that non-therapeutic circumcision of male minors is a violation of children’s rights to regular inspections autonomy and physical integrity. Contrary to popular belief, circumcision can cause complications – [[bleeding]], infection, [[urethra]]l stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of their genitalsdeterrence. If intact, KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the soldiers risked being ordered to undergo immediate circumcisiondanger of complications.<ref>{{REFbookREFdocument |last=Schoen |firsttitle=Ed |authorNon-link=Edgar J. Schoen |year=2005 |title=On Circumcisiontherapeutic circumcision of male minors |url=https://bookswww.googledoctorsopposingcircumcision.deorg/wp-content/uploads/books?id=2016/09/knmg-non-therapeutic-circumcision-of-male-minors-27-05-zUhdvSt7cgC2010.pdf |workcontribution= |editorlast=Dianne Yeakey |editionfirst= |volumepublisher=Royal Dutch Medical Association |chapterformat=PDF |pagesdate=72-732010 |locationaccessdate=Georgetown, Canada |publisher=RDR Books |isbn=12021-15714311-123-3 |quote=For a critical view, see Sorrells, "The History of Circumcision," p. 333 |accessdate= |note=08}}</ref> This practice was discontinued at least six decades ago.--</blockquote> * The [[Royal Australasian College of Physicians]] (2010) said:

=== Non<blockquote>Ethical and [[human rights]] concerns have been raised regarding elective infant male circumcision because it is recognised that the foreskin has a functional role, the operation is non-therapeutic circumcision of male children ===and the infant is unable to consent.

Human babiesAfter reviewing the currently available evidence, 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 RACP believes that the frequency of baby boys as a category of forced diseases modifiable by circumcision.<ref>For example, Frederick M. Hodges, a medical historian, writes: "In the late 1970s, as the Americans were growing increasingly aware level of protection offered by circumcision and the abuses complication rates 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 do not warrant routine infant circumcision in Your Flesh'', ppAustralia and New Zealand. 273-281.</ref> There are, however, physicians in However it is reasonable for parents to weigh the United States who argue strongly for non-therapeutic benefits and risks of circumcision of newborn babies; and circumcision is widely accepted as a postnatal procedure in American hospitalsto make the decision whether or not to circumcise their sons.<refname="racp2010">{{REFbook |last=Fletcher |first=Christopher R. |year=1999REFdocument |title=Circumcision in America in 1998: Attitudes, Beliefs, and Charges of American PhysiciansInfant Males |url=httphttps://www.springerlinkracp.edu.comau/content/h2150v731233m177docs/ |work=Male and Female Circumcision |editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |edition= |volume= |chapter=Section 5 |pages=259default-271 |location=New York |publisher=Kluwer Academicsource/Plenum Publishers |isbn= |quote= |accessdate=2019-10advocacy-12 |note=ID 10.1007library/978-0-585-39937circumcision-9_19}}</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 noninfant-therapeutic circumcision of a childmales.<ref>{{REFjournalpdf |contribution=

|titlepublisher=Re J (child's religious upbringing and circumcision)The Royal Australasian College of Physicians |journalformat=Family Court ReportsPDF |date=2000 |volume=1 |issue= |pages=3072010-09-314 |url=http://www.cirp.org/library/legal/Re_J/2000.html01 |accessdate=20192021-1011-1208}}</ref> (The National Health Service does not provide non-therapeutic circumcision.)</blockquote>

In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<ref>See, e.g., * The [[Margaret A. Somerville|SomervilleAmerican Academy of Pediatrics]], "Therapeutic and Non(AAP) has not re-Therapeutic Medical Procedures"; Poulteraffirmed its disastrous, ''English Criminal Law''; Chessler, "Justifying the Unjustifiable"; Smith, "Male failed 2012 Circumcision."</ref> For example, critics have pointed out thatPolicy Statement, which expired in the United States2017, more than 1.3% of male neonatal deaths are attributable to the complications of non-therapeutic so currently has no position on child circumcision surgery.<ref name="Bollinger 2010"/>

* Medical historian [[Robert Darby]] (2014) wrote simply:<blockquote>"To avoid circumcision complications, avoid circumcision."<ref>{{REFjournal |last=Darby |first=Video |init=R |author-link=Robert DarbyStanford University has published a video of an actual non |etal=no |title=To avoid circumcision complications, avoid circumcision |trans-therapeutic plastibell circumcision. The infant has received two injections of local anesthesia to deaden the dorsal nerves. The ventral nerves were not deadened so the infant still feels pain. One can his cries on the soundtrack.title= |language= |journal=Can Urol Assoc J |location= |date=2014-08-14 |volume=8 |issue=7-8 |article= |page=231 |pages=* [ |url=https://medcuaj.stanfordca/index.eduphp/journal/article/view/newborns1709/professional1823 |archived= |quote= |pubmedID= |pubmedCID= |DOI=10.5489/cuaj.1709 |accessdate=2022-education12-16}}</circumcisionref></plastibell-technique.html Plastibell Techniqueblockquote>* The [[Canadian Paediatric Society]](CPS) (2015) said:

Not for * The [[Canadian Urological Association]] (CUA) considered the squeamishmatter of circumcision and issued a statement in February 2018. The CUA concluded:

This is a video of an actual circumcision with a Gomco clamp. The infant boy received two dorsal penile nerve block (DPNB) analgesic injections but they did not seem to work. * [https://www.reddit.com/r/Intactivism/comments/qbpzqr/trained_medical_professionals_restrain_infant_to/ Circumcision video] ==Recommendations of medical authorities==* Hill (2007) said:<blockquote>Male circumcision is harmful because it excises healthy tissue and permanently impairs beneficial physiological functions. Male circumcision also causes psychological problems that tend to perpetuate "Given the cycle of abuse. Male circumcision is a costly diversion of medical resources away from beneficial services. Male circumcision violates legal rights, human rightssocioeconomic, and ethical standards. Finallyeducational status, we must remember that males are the more vulnerable and sensitive health demographics of the two genders and, therefore, deserve the greater degree of protection from traumatic, invasive, injuriousour population,and unnecessary surgery. For all of these reasons the non-therapeutic universal neonatal circumcision of boys should not cannot be performed and justified based on the genital integrity of all children should be respected and protectedcurrent evidence available.<ref name="hill2007cua2018">{{REFjournal |last=HillDave |first=GeorgeSumit |init=GS |author-link=George Hill |etal=yes |title=The case against Canadian Urological Association guideline on the care of the normal foreskin and neonatal circumcisionin Canadian infants (abridged version) |journal=Journal of Men's Health and GenderCan Urol Assoc J |location= |date=20072018-02 |volume=412 |issue=32 |pages=31818-32328 |url=https://wwwcuaj.academiaca/index.eduphp/journal/article/view/83673835034/The_Case_Against_Circumcision3470

|accessdate=2021-0511-3009}}</ref></blockquote>* Andrew E. MacNeiiy, Head, Division ==British family court opinion==The issue of Pediatric Urology, Department non-therapeutic circumcision of Urological Sciences, University male children came before the court in the case of British Columbia, Vancouver, BC, ''[[Re B and G (children) (No 2) EWFC 3]] (20082015) said:'' . In that case, Judge Sir James Munby ruled that circumcision of male children caused ''significant harm''. == Rights and ethics ==<blockquote>Newborn The [[Rights situation on circumcision remains an area of controversy|rights situation]] is discussed in a separate article. [[Image:Intact vs circumcised. SocialJPG |thumbnail|right|300px| The intact and circumcised human penis, cultural, aesthetic and religious pressures form the most common reasons for non-therapeutic side by side.]] The term "circumcision" without a gender qualifier refers specifically to male circumcision. Although penile cancer It means "to cut around," and UTIs are reduced compared with uncircumcised males, it refers to the incidence [[excision]] of such illness is so low that circumcision cannot be justified as prophylaxisthe [[foreskin]] from the penis. The role of term is inaccurate and a euphemism because the operation actually cuts off or [[amputation| amputates]] the [[foreskin ]], which in HIV transmission adults comprises about fifteen square inches of highly functional erogenous tissue.  Circumcision is most often performed in developed countries healthy males for [[Religion and Culture|religious or cultural]] reasons. The procedure may be performed on consenting adults, but it is unclearmost often performed on non-consenting minors, particularly newborn children, and safe sexual practice remains which is why the cornerstone of preventionritual is so controversial. There remains a lack Opponents of knowledge regarding what constitutes circumcision consider the normal foreskin both among parents circumcision of non-consenting minors to be unethical and among primary care providers. This lack of knowledge results in a burden of costs to our health care system in the form of unnecessary urological referrals[[human rights]] violation, expansion of wait times and circumcisionsunless there is concrete [[medical indication]]. Routine circumcision === Consent by surrogates ===Medical ethics has long recognized limitations on the power of all infants is not justified from a health or cost-benefit perspectiveconsent by surrogates.<ref>{{REFjournal |last=MacNeily |first=Andrew |init= |author-link=Committee on Bioethics, American Academy of Pediatrics

|title=Routine circumcision: the opposing viewInformed consent, parental permission, and assent in pediatric practice

|journal=Can Urol Assoc JPediatrics

|date=2007-111995 |volume=195 |issue=42

|pages=395314-717 |url=httphttps://europepmcwww.cirp.org/articlelibrary/ethics/PMCAAP/2422979

|pubmedID=185428257478854

|DOI=10.5489/cuaj.455 |accessdate=20212023-1105-0821}}</ref></blockquoteref>{{REFjournal |last=Committee on Bioethics* The Royal Dutch Medical Association (KNMG) (2010) said: |etal=no<blockquote> |title=Informed Consent in Decision-Making in Pediatric Practice The official viewpoint of KNMG and other related medical/scientific organisations is that non |trans-therapeutic circumcision of male minors is a violation of children’s rights to autonomy and physical integrity. Contrary to popular belief, circumcision can cause complications – bleeding, infection, urethral stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications.<ref>{{REFdocumenttitle= |language= |journal=Pediatrics |location= |titledate=Non2016-therapeutic circumcision of male minors08 |volume=138 |issue=2 |article= |page=e20161485 |pages= |url=https://wwwwatermark.doctorsopposingcircumcisionsilverchair.orgcom/wppeds_20161485.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQM8zYHFd0Ylu9Annq_AgEQgIICT24ikc839aJMYOiypqC2G9f7_yKGAGkAekzzbCtck5TElALWVCGNoVSOaA6rDA_dOkQ_LyJnxYlZ88J9-content/uploads/2016/09/knmguk15tvlIBbE82_aNyYfq5e9xmEfqD2vh374q3Naz57dxZaUbgxUkKX4PqsiLmYHLvVrr7bQK2MZuuUOKiQU8JZy7lLjkp-PjJO1U9cyIplTAgs_EdvgK8MWWoIsj-X-ZUDImAG63-rlj_qLsy5dYwytmxfCuVa47RdZseLSr2_bdDpwKAKGhq_Ly9rlHZeW_f7fYktVfF_sFTgcJziAlvEQmdyWIw0qf-hlO31Qb3sH6kDdcvHAbm7llY5xa34XLYIt8QR0YFIimgDGFliN4-ce2vjvvrwS85WeeNFhpn-nonYwn4Qjpy06hPuLDL-therapeuticMtI2Z3BZbBsKq4dp8qGu1q9GlXaKw193riTFG9G5bF5GCKmxmt0nCQTthrb_CcK2UhKjZwPekC9zkIUHPZ9BXJt0SM03F_g-circumcisionGgqbE0hTYKMqNdJ3sHDQu2luFrJ9JEiMzxtP28gJoYh20d2APA0xrRbXBYsFdAlr50gb1BSAbNJhTyx-ofKh3geoSHsAYMjPaG7cIbh0jd42pWCUx30vjlAGK8zXTuf7-male31oi81CLbHTAJLuzK3NT4Whi17jVq1SbXsIXlWpKc_d-minorsHujCvlb74rkZQ6RG9wkxW7gAKaDqtKv5zTOTMBD9vLVxgp8lDmVA8PFB59Bqd6w-27fi86tW132oWQM-05mTfwdIBXFbUFXkeTUC5RYyqJQIXAEwLJSRm1RX-2010.pdfLRbKRzgaRQ |archived= |contributionquote= |lastpubmedID=27456510 |firstpubmedCID= |publisherDOI=Royal Dutch Medical Association10.1542/peds.2016-1485

|accessdate=2023-05-21}}</ref> <ref>{{REFjournal |last=Committee on Bioethics ||etal=no |title=Informed Consent in Decision-Making in Pediatric Practice |trans-title= |language= |journal=Pediatrics |location= |date=20102016-08 |volume=138 |issue=2 |article= |page=e20161484 |pages= |url=https://watermark.silverchair.com/peds_20161484.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMYv3coRY-UCYMgTaqAgEQgIICT4di03qn2Hbho3i8Li_78lod0lNMunch25nx1rKvaM_aeFerz5eN6_k8VVeNv-DLocZp28whQr1x4WYDVwSs4uF73vZpYZYuDphYQkwxV1HHgMbZAbHBFuE8QyCHyDvSY-fhQcUl-JrYxa3TbhYgd4bKiU9zfIyXUsCnItroCc9iNrMicPg0v_A0AJJlhxioOlAU-im6OPI06OcCBj78yqkPO0J4nMTN1FLochsOyvZZdtFQQzLhrnM_Gey8K75lFYIBJHA7uzMmP2o5KZ-FTGUkEA_eSpEIpwv2WI4SbtrA8WYk3cQqXOmLIWjkSs9CTELD7CQP29xarr1ANrF_id4CiCX7zIomC2Ciz9lHBEgz8EH2i9Woke_YuZeLax52_6JpdhH1qdMQyF1bByjP8mU98V5_B4BPPiBpKt4pVA_UgtaABRHL8oPv6SwOUQZ2Bc-0_E2tod0VIF1FJBwZRZJm2ZkJPgBSKUo8VBe5Pz_6Vpt2DqLzwqVUYscPsIJMvxl09mMtvJrsBa8yVoTRWj4Rd0OBTMV7zhZskDnYYyrAZ6sHMk0MzvbHilPNbNgU5o7mXmcbFGDgGgWbqrIdT6sVSSfPJm4TnR0HSWbc_EnHhhyye7tVlFGjAsR0R46_DSwEMz8M5DkSln8xfKtX_so9rjCvYeq45wqn09g8DqtV-WHEA9PIrcw5kTcz5I0JkNuW4-vKVU1Xz9XHiYi4Zqbq0vx9NWLdNSYHQSOGMZ1MCAxT152evQdipQB5wokR8Q4rICoJYII5bsmRMYd7JQ |archived= |quote= |pubmedID=27456514 |pubmedCID= |DOI=10.1542/peds.2016-1484 |format=PDF |accessdate=20212023-1105-0821

* [[Sudden Infant Death Syndrome]] (SIDS).* [[Trauma]]

|url=httphttps://www.cirp.org/library/anatomy/garcia/

|article= |page= |pages=33-40 |url=https://www.academia.edu/7587653/Libertarianism_and_Circumcision?email_work_card=view-paper |pubmedID=24987720 |pubmedCID=4075101 |DOI=10.15171/ijhpm.2014.51 |accessdate=}} * {{REFweb |url=https://intaction.org/what-is-circumcision/ |title=What is circumcision? |last=Simone |first=Judy |author-link= |publisher=Intaction |website=https://intaction.org/ |date=2020-07-26 |accessdate=2020-10-04 |format= |quote=}}* {{REFjournal |last=Deacon |first= |init=M |author-link= |last2=Muir |first2= |init2=G |author2-link= |etal=no |title=What is the medical evidence on non-therapeutic child circumcision? |trans-title= |language= |journal= Int J Impot Res |location= |date=2022-01-08 |volume= |issue= |article= |page= |pages= |url=https://www.nature.com/articles/s41443-021-00502-y |archived= |quote= |pubmedID=2498772034997197 |pubmedCID=4075101 |DOI=10.151711038/s41443-021-00502-y |accessdate=2023-04-30}}* {{REFweb |url=https://intactamerica.org/pros-and-cons-of-circumcision/ |title=Pros and Cons of Circumcision (Spoiler: You’ve Been Lied to) |last=Garrett |first= |init=CJ |publisher=Intact America |date=2023-11-10 |accessdate=2024-03-22}}* {{REFweb |url=https://intactamerica.org/groups-who-pressure-you-to-circumcise/ |title=The 4 Authority Figures and Groups Who Will Pressure You to Circumcise (and What You Can Do) |last=Anonymous |first= |init= |publisher=Intact America |date=2024-01-24 |accessdate=2024-01-27}}* {{REFweb |url=https://ijhpmintactamerica.2014org/keeping-your-sons-penis-intact/ |title=Keeping Your Son’s Penis Intact: A Guide for Parents |last=Anonymous |first= |init= |publisher=Intact America |date=2024-01-24 |accessdate=2024-01-29}}* {{REFweb |url=https://intactamerica.51org/timeline-of-circumcision-suffering/ |title=A Timeline of Circumcision Suffering: A Detailed Look |last=Anonymous |first= |init= |publisher=Intact America |date=2024-02-02 |accessdate=2024-02-09}}{{REF}}

[[Category:TermPenile surgery]][[Category:Medical term]][[Category:Male genital mutilation]]