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]] The and [[amputationmutilation]] 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 electivethe more accurate medical term that more accurately reflects the injury and loss of functional body tissue, but the Biblical [[euphemism]], ''circumcision'', is more commonly used.With reference to involuntary, non-therapeutic surgery performed on neonates and circumcision of children for religious and cultural reasons in violation of their , [[human rightsChild Genital Cutting (CGC)]], but in other cases may be indicated for both therapeutic and prophylactic reasons. It is a radical treatment option for pathological newer term that has been introduced to avoid issues associated with more traditional terms. Bollinger (2023) identifed CGC as an [[phimosisAdverse Childhood Experiences (ACEs)| adverse 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-circumcision/ |title=Adverse Childhood Experiences, Dysfunctional Households, refractory [[BalanitisAnd Circumcision. |journal=Kindred |date=2023-02-28 |volume= |issue= |pages= | balanoposthitis]] accessdate=2023-03-01}}</ref> Deacon & Muir (2022) have reviewed the evidence and concluded that "there is no medical justification for performing a circumcision prior to an age that he can assess the known risks and potential benefits, and chronic choose to give or withhold [[urinary tract infectioninformed consent]]s (UTIs); it 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 contraindicated in cases of certain genital structure abnormalities or poor general healththe 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>

'''Posthectomy''' is a more accurate medical term that more accurately reflects Circumcision was popularized in English-speaking nationns in the injury and loss nineteeth century. The practice of non-therapeutic circumcision of functional body tissueboys now has greatly declined in [[Australia]], but [[Canada]], [[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.

In [[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 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:

|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===There are no [[medical indication| medical indications ]] for circumcsion circumcision of the newborn. The [[circumcision industry]] offers circumcision of the newbornto the public because of the [[financial 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 raresince 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]].

# '''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]].

|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.

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

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

|pages=222-23333

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|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.)]]

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/

|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

|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 the penismaturity to make that decision. In addition, there frequently a a color change at This should normally be the circumcision scar which results in a two-tone appearancecase 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.

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

|publisher=Spiegel Online |website= |date=2012-08-12 |accessdate=2019-10-11 |format= |quote=}}</ref>. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation. Overall, their pain threshold was lower and the risk of chronic pain increased. Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFjournal |last=Garry |init=T |title=Circumcision: a survey American Academy of fees and practices |journal=OBG Management |date=1994 |volume=October |issue= |pages=34-36 |url= |accessdate=}}</ref><ref>{{REFjournal |last=Howard |init=CR |last2=Howard |init2=FM |last3=Garfunkel |init3=LC |last4=de Blieck |init4=EA |last5=Weitzman |init5=M |title=Neonatal circumcision and pain reliefPediatrics: current training practicesCircumcision Policy Statement; Task Force on Circumcision

|date=19981999-03 |volume=101103 |issue=3 |pages=423686-42893 |url=https://pediatrics.aappublications.org/content/103/3/686#sec-9 |accessdate=2019-11-26 |note=Statement Reaffirmed Sept. 1, 2005}}</ref> The [[AAFP]] (2002) states quite simply in their [https://www.cirp.org/library/statements/aafp2002/| position paper], ''"Newborns experience pain during circumcision".''<ref>{{REFjournal |last=Stang |init=HJ |last2=Snellman |init2=LWREFweb |title=Circumcision practice patterns in the United States: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed |journal=Pediatrics |date=1998 |volume=101 |issue=e5 |pageswebsite=Official American Academy of Family Physicians Website |url=http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html |accessdate=2011-05-02 |note=Link }}</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 [[AAPpain]] website, 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/ref>13585. During procedures which take several minutesshtml Report 10 of the Council on Scientific Affairs], babies tend the AMA states ''"When the decision is made to fall into a state of stuporproceed with circumcision, which in local anesthesia should be provided for the past was falsely interpreted as peaceful sleepprocedure. [[Ring block]] or [[dorsal penile nerve block]] [injections] are most effective. [[EMLA]] cream has limited utility"''. Alarmingly, nurturing ''"Despite the belief clear evidence that newborn males generate brisk pain responses during circumcision, a recent survey of residency training programs found that 26% of programs that babies felt taught circumcision provided no paininstruction on the use of local anesthesia". Measurements taken in those cases revealed a typically 3- to 4-fold increase in cortisol levelsThe AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, which equals a state and 25% of severe shockobstetricians"''.<ref>{{REFjournal |last=Gunnar |init=MR |last2=Fisch |init2=RO |last3=Korsvik |init3=S |last4=Donhowe |init4=JMREFweb |title=The effects Report 10 of circumcision the Council on serum cortisol and behaviorScientific Affairs (I-99): Neonatal Circumcision |journal=Psychoneuroendocrinology |date=1981 |volume=6 |issue=3 |pageswebsite=269-275American Medical Association Official Website |url=http://www.cirpama-assn.org/libraryama/painno-index/gunnarabout-ama/13585.shtml |accessdate=20192011-1105-2604

* Postoperative wound pain, in 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 case forms of childrenanalgesia that are available"'s circumcisions conceivably worsened by '.<ref>{{REFweb |title=Where We Stand: Circumcision |publisher=[[AAP]] |date=2011-03-23 |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 forceful breaking of website does not go into the preputial adhesionsdifference between a 'dorsal nerve block' and a 'ring block' injection.* Postoperative pain Given what is known from aforementioned official documents, the exposure AAP website may be more informative and effective if it would say ''"Make sure your doctor knows of the sensitive glans penis to clothingineffectiveness of anything short of local anesthesia, and make sure your baby is given an injection. This is your responsibility, because your doctor may or may not be up to date on the latest understandings of infant sensitivity to [[pain will endure for several weeks or even longer in some cases]] during circumcision.* Postoperative bleeding "'' The AAP may be holding back, however, perhaps because this would upset the doctor/parent power relationship, and may cause too much questioning of the wounddoctors in general. This can have severe consequences especially for very young infants, if they are One may not treated promptly. Their blood volume is only about 85 ml per kilogram expect to find this kind of body weightadvice on such a website, and even moderate blood loss can lead to hypovolaemiayet, anything less than this is a dangerously weak statement. To control [[pain]], some physicians that circumcise use Tylenol, sugar,<ref>{{REFweb |quote=To calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, hypovolaemic shock and even deathsoothing music is played in the room. |url=http://www.pollockclinics.com/circumcision/circumcision-guide.html |title=Parents' Guide to Circumcision |last= |first= |publisher= |date= |accessdate=2011-04-08}}</ref><ref>{{REFbookREFweb |quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |url=http://www.pollockclinics.com/circumcision/circumcision-before.html |title=Before the Circumcision

|yearpublisher=2000 |titledate=Paediatric Handbook2011-04-08 |urlaccessdate=2011-04-08}}</ref> a topical cream,<ref>{{REFweb |workquote=Then in our office, he will have topical anesthetic applied to his penis. |editorsurl=Smart J, Nolan Thttp://www.pollockclinics.com/circumcision/circumcision-before.html |editiontitle=6Before the Circumcision |volumelast= |chapter= |pagesfirst=82 |location=Victoria, Australia |publisher=Blackwell Science Asia |isbn= |quotedate=2011-04-08 |accessdate= |note=2011-04-08}}</ref>and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFdocumentREFweb |title=Autopsy of Demetrius Manker |urlquote=We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection. |contributionurl=Case 93http://www.pollockclinics.com/circumcision/circumcision-1711guide.html |lasttitle=WetliParents' Guide to Circumcision |firstlast=CV |publisherfirst=Miami: Dade County Medical Examiner Department |formatpublisher= |date=1993-06-23 |accessdate=2011-04-08}}</ref> <ref>{{REFjournal 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|lastpain of circumcision]].<ref name=Hiss"Journal of Perinatology April/May 2002">{{REFjournal |initlast=JTaeusch |last2first=HorowitzH. William |init2init=AHW |last3last2=KahanaMartinez |init3first2=TAlma M. |titleinit2=Fatal haemorrhage following male ritual circumcisionAM |journallast3=J Clin Forensic MedPartridge |datefirst3=2000J. Colin |volumeinit3=7JC |issuelast4=Sniderman |pagesfirst4=32-34Susan |urlinit4=http://www.cirp.org/library/death/hiss1/S |accessdatelast5=2019-11Armstrong-06Wells}}</ref><ref>{{REFdocument |first5=Jennifer |titleinit5=Judgement of inquiry into the death of McWillis, Ryleigh Roman BryanJ |urllast6=http://www.circumstitions.com/death-exsang.htmlFuentes-Afflick |first6=Elena |contributioninit6=E |lasttitle=NewellPain During Mogen or Plastibell Circumcision |firstjournal=TECJournal of Perinatology |publishervolume=Burnaby, B.C.: B.C. Coroner's Service 22 |formatissue=3 |datepages=2004214-01-198 |accessdateurl=2019-11-26}}<http://ref>www.nature.com/jp/journal/v22/n3/full/7210653a.html* Post operative [[lymphoedema]] |quote=.* Postoperative infections. This includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.<ref>{{REFconferencemore than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure. |lastpubmedID=Dr. med. Hartmann |firstpubmedCID=Wolfgang |urlDOI= |placenote=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German)April/May 2002 |titledate=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German)2002-04 |dateaccessdate=20122011-1104-26 |accessdate=08}}</ref><ref name="Clinical Pediatrics August 1986">{{REFjournal* [[Wound dehiscence]], meaning the separation of the edges of the wound or the tissue after suturing |last=Williamson |first=Paul S.* Adhesion between the surface or rim of the [[Glans penis |glans]] init=PS |last2=Evans |first2=Nolan Donovan |init2=ND |title=Neonatal Cortisol Response to Circumcision 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.Anesthesia |journal=Clinical Pediatrics* Postoperative [[phimosis]] |volume=25 |issue=8 |pages=412-6 |url=http: a phimotic ring can develop during scarring, which makes a re-circumcision necessary//cpj.sagepub. According to a study by Blalock et alcom/content/25/8/412.<ref>{{REFjournalabstract |lastquote=BlalockThe adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine. |initpubmedID=HJ |last2pubmedCID=Vemulakonda |init2DOI=V |last3date=Ritchey1986-08 |init3accessdate=ML2011-04-08 |last4=Ribbeck}}</ref> During circumcision, somp physicians give children sugar pacifiers to "reduce the perception of pain",<ref>{{REFweb |init4quote=M During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |titleurl=Outpatient management of [[phimosis]] Following newborn http://www.pollockclinics.com/circumcision/circumcision-before.html |journaltitle=J UrolBefore the Circumcision |datelast=2003 |volumefirst=169 |issuepublisher=6 |pagesdate=23322011-233404-08 |urlaccessdate=http://www.cirp.org/library/complications/blalock1/ |accessdate=2019-11-26}}<2011-04-08}}</ref>but in at least one study, the prevalence is 2data shows that giving sugar to a child doesn't help to reduce the perception of pain in the child.9%, according to Leitch<refname="Lancet, The 2010-10-09">{{REFjournal |last=LeitchSlater |initfirst=IOWRebeccah |titleinit=Circumcision - a continuing enigmaR |journalfirst2=Aust Paediatr JLaura |dateinit2=1970L |volumelast2=6Cornelissen |issuefirst3=Lorenzo |pagesinit3=59-65L |urllast3=http://www.cirp.org/library/general/leitch1/Fabrizi |accessdatefirst4=2019-12-15Debbie}}</ref> 5.5%. |init4=D* [[Sudden Infant Death Syndrome]] (SIDS). |last4=Patten* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], is cut during circumcision without being clamped and sutured at its origin separately, it starts to develop new branches over time, which can lead to the development of knots. |first5=Jan |init5=J |last5=Yoxen |first6=Alan* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro-penis) and induratio [[penis]] plastica (skewed penis). |init6=A* Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis |last6=Worley |first7=Stewart |glans]] or the [[penis]] can occur.init7=S |last7=Boyd* In rare cases, necrosis, gangrene, ischaemia, keloid formation and circulatory problems may also occur. |first8=Judith* 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 |init8=J |last8=Meek |first9=Maria |init9=M |last9=Prof. Fitzgerald |title=Oral sucrose as an analgesic drug for procedural pain in newborn infants: a risk of infection with [[herpes]] simplex type 1, which can lead to brain damage or [[death]].<ref>{{REFwebrandomised controlled trial |journal=The Lancet |volume=376 |issue=9748 |pages=1225-32 |url=http://www.nytimesthelancet.com/2012journals/03lancet/08article/nyregion/infantsPIIS0140-death6736%2810%2961303-renews-debate-over-a-circumcision-ritual.html?_r=07/fulltext |titlequote=Baby’s Death Renews Debate Over a Circumcision Ritual |last=RobbinsOur 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. |firstpubmedID= |pubmedCID= |DOI=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. === Physical late effects === * An unavoidable late effect It has been shown that an infant's response to [[pain]] can be altered for years as a consequence 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 <ref>{{TaddioA etal 1995}}</ref><ref>{{TaddioA KatzJ IlersichAL KorenG 1997}}</ref> {{Box|Boxtext=<big><b>However, none of the major part above three procedures totally eliminate pain. A baby boy will still experience some pain despite any of male sexual sensationthose analgesic procedures. If the Prevention of [[foreskinpain]] is removed, they can no longer provide sexual stimulationrequires protecting a boy from elective neonatal non-therapeutic circumcision. It is also partly due to the fact that the surface of Only boys who are protected from the medically unnecessary circumcision surgery experience no [[Glans penis|glanspain]] or [[trauma]] reacts to the missing protection from friction and drying out by developing a callus layer. This reduces </b></big>}} == Risks and effects ==Just like tonsil or appendix surgery, circumcision is a surgical intervention and brings the sensitivity usual risks related to surgical operations, alongside several specific risks of the remaining nerves in the [[Glans penis|glans]] gradually over the yearscomplications and late effects. The study conducted by Sorrells Uberoi et al.<ref>{{Sorrells etal 2007}}</ref> found (2022) report "some men are experiencing a significant reduction complex negative constellation of sensitivity psychological, physical, and sexual associations that lead to touch for circumcised compared to intact [[penis]]es in adult malessignificant emotional distress directed both internally and externally. Other studies revealed that circumcised The posts also reveal a discovery phenomenon wherein men use condoms significantly less often than intact men, since they further limit discover the physical and psychological manifestations of the sexual sensitivity (see above)decisions made by others to modify their genitals. * Painful tension can occur when there is too little reserve [[skin]] left to support a full erection<"<refname ="uberoi2022">{{REFjournal |last=TaylorUberoi |first= |init=JRM |author-link= |last2=LockwoodAbdulcadir |first2= |init2=APJ |author2-link= |last3=TaylorOhi |first3= |init3=AJDA |titleauthor3-link=The prepuce: <q>Specialized [[mucosa]] of the [[penis]] and its loss to circumcision</q> |journallast4=British Journal of UrologySantiago |datefirst4=1996 |volumeinit4=JE |author4-link= |last5=77 |issuefirst5= |pagesinit5=291 |author5-295link= |urllast6= |first6= |accessdateinit6=}}</ref>. This risk is partly dependent on the anatomy of the [[penis]]. While some [[penis]]es already have the majority of their full size when flaccid ([[ |author6-link= |last7= |first7= |init7= |author7-link= |last8= |first8= |init8= |author8-link= |last9= |first9= |init9= |author9-link= |etal=yes |title=Potentially under-recognized late-stage physical and psychosexual complications of non-therapeutic neonatal penile circumcision: a qualitative and quantitative analysis of self-reports from an online community forum |trans-title= |language= |journal=Int J Impot Res |location= |date=2022-10-23 |volume= |issue= |article= |page= |pages= |url=https://www.nature.com/articles/s41443-022-00619-8 |archived= |quote= |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 "[[showerPenis]], or "[[shower]]"), others are rather short when flaccid and double or more their size during an [[erection]]"), 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. * Erectile dysfunction: Both the damage inflicted to the blood vessels in the [[foreskin]] and the reduced sexual sensitivity can be causes for reduced erectile function with advancing age.<ref>{{REFjournal |last=Money |init=J |last2=Davison

|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 [[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=

|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= |init=SA |author-link=Alfonso Cepeda-Emiliani |last2=BoyleGándara-Cortés |first2= |init2=GJM |author2-link= |yearlast3=2001Otero-Alén |first3= |init3=M |author3-link= |last4=García |first4= |init4=H |author4-link= |last5=Suárez-Quintanilla |first5= |init5=J |author5-link= |last6=García-Caballero |first6= |init6=T |author6-link= |last7=Gallego |first7= |init7=R |author7-link= |last8=García-Caballero |first8= |init8=R |author8-link= |etal=no |title=Understanding circumcisionImmunohistological study of the density and distribution of human penile neural tissue: A Multigradient hypothesis |trans-title= |language= |journal= Int J Impot Res |location= |date=2023-05-Disciplinary Approach to a Multi02 |volume=35 |issue=3 |article= |page= |pages=286-Dimensional Problem305 |url=https://linkwww.springernature.com/chapterarticles/s41443-022-00561-9 |archived= |quote= |pubmedID=35501394 |pubmedCID= |DOI=10.10071038/978-1s41443-4757022-335100561-8_149 |workaccessdate=2023-11-26}}</ref> Circumcision and frenectomy remove tissues with heightened erogenous sensitivity.<ref name="cepeda2023" /> <ref name="winkleman1959">{{WinkelmannRK 1959}}</ref> |editors=They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well." The [[amputation]] of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the [[George C. Dennistonpenis]], leaving only the uninhibited protopathic sensibility of the artificially externalized [[Frederick M. Hodgesglans penis]], . The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of the changes in sexual behavior noted in [[Marilyn Fayre Miloscircumcised]]human males.<ref>{{REFjournal |editionlast=Van Howe |volumeinit=RS |author-link=Robert S. Van Howe |last2=Cold |init2=CJ |chaptertitle=Ritual Advantages and medical circumcision among Filipino boys: evidence Disadvantages of Neonatal Circumcision |journal=The Journal of post-traumatic stress disorderthe American Medical Association |pagesvolume=253-270277 |locationissue=New York13 |publisherpages=Kluwer Academic/Plenum Publishers1052-7 |isbnurl=http://www.ncbi.nlm.nih.gov/pubmed/9218663

* CircumcisionsHistology of the male circumcision scar shows [[amputation]] neuromas, especially those that happen without consent, can spark feelings Schwann cell proliferation and the bulbous collection of helplessness variably sized neurites. [[Amputation]] neuromas do not mediate normal sensation and alienation, which can persist as traumaare notorious for generating pain.<ref name="ColdCJ TaylorJR 1999"/> Cepeda-Emiliani et al. These feeling can also be triggered later, when someone circumcised (2023) commented:<blockquote> Taking the sleve technique as an infant becomes aware example of his surgical flexibility during circumcision. In an online study, interviewed men stated they felt betrayed - 55% by to the extent that this technique is of such versatility that it allows highly variable quantities of cutaneous and subcutaneous tissue to be excised directly from the motherpenile body, 50% and to the extent that the prepuce is still conceived by segments of the fathermedical community as "just a small piece of skin", we are concerned that aggressive circumcisions are intentionally or unintentionally being performed in pediatric and 58% by adult patients in the doctorbelief that "redundant" or " extra" tissue is being excised, and 73% felt or in the belief that their human rights had been violated"excesive sensitivity" is being reduced to augment ejaculatory latency time.<ref name="GSoCHcepeda2023"/>{{REFweb |url=http://www.circumcisionharm.org</blockquote> |title=Global Survey of Circumcision Harm |accessdate=2019The un-10anesthetized and un-12}}</ref>* It can frequently be found that sedated newborn infant is restrained by being strapped to a special plastic board called the loss [[circumstraint]]. The procedure is deniedmost often an elective, much as happens with non-therapeutic surgery without [[medical indication]] performed on neonates and children for religious and cultural reasons in violation of the loss of other body parts. This denial can lead child's [[human rights]] to fathers having their sons circumcised [[physical integrity]], but in order not to older patients may be reminded of their own lossrarely indicated for therapeutic reasons. In this process It is a radical treatment option for pathological [[phimosis]], their own body refractory [[balanoposthitis]] and chronic [[urinary tract infection]]s (UTIs); it is defined as "normal" and the contraindicated in cases of certain genital structure abnormalities or poor general health.  See [[foreskinSexual effects of circumcision]] redefined as a foreign objectfor more information. Their own parents  === 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=Porter |init2=FL |last3=Rogers |init3=AG |etal=http://www.cirp.org/library/psych/vanderkolk/yes |title=The compulsion to repeat the traumaCircumcision: reII effects upon mother-enactment, revictimization, and masochisminfant interaction |journal=Psychiatr Clin North AmEarly Hum Dev |date=19891982 |volume=127 |issue=24 |pages=389367-41174 |url=https://www.cirp.org/library/birth/marshall2/ |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. * In boys [[circumcised]] in childhood, [[post-traumatic stress disorder]] ([[PTSD]]) could be diagnosed. In a study on Philippine boys, in whom no [[PTSD]] was found prior to the operation, 69% of the boys [[circumcised]] in the traditional ritual and 51% of those [[circumcised]] by standard medical procedures (including anaesthesia) fulfilled the DSM-IV criteria for PTSD following the operation.<ref>{{REFjournalREFbook |last=GoldmanRamos |init=RS |last2=Boyle |init2=GJ |year=2001 |authortitle=Understanding circumcision: A Multi-link=Ronald GoldmanDisciplinary Approach to a Multi-Dimensional Problem |url=httphttps://wwwlink.cirpspringer.orgcom/librarychapter/psych/goldman110.1007/978-1-4757-3351-8_14 |titlework=The psychological impact of circumcision |journaleditors=BJU Int[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |dateedition=1999 |volume=83 |issuechapter=Suppl. 1Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder |pages=93253-10370 |location=New York |publisher=Kluwer Academic/Plenum Publishers |isbn= |quote= |accessdate= |note=}}</ref>* Circumcisions, especially those that happen without consent, can spark feelings of helplessness and alienation, which can persist as [[trauma]]. These feeling can also be triggered later, when someone [[circumcised]] as an infant becomes aware of his circumcision. In an online study, interviewed men stated they felt betrayed - 55% by the mother, 50% by the father, and 58% by the doctor, and 73% felt that their [[human rights]] had been violated.<ref name="GSoCH">{{REFweb |url=http://www.circumcisionharm.org/ |title=Global Survey of Circumcision 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

|url=httphttps://www.cirp.org/library/psych/rhinehart1/

|pages=215-22121

}}</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"/>

|url=httphttps://www.cirp.org/library/psych/cansever/

|pages=321-33131

|url=httphttps://www.cirp.org/library/psych/levy1/

* [[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

=== Pain Possible operative and postoperative complications ===In the past, advocates Circumcision is surgery. Surgical complications of circumcision claimed that a newborn child's nerve system was not yet fully developed, and that generally may be classified as a result[[Bleeding| hemorrhage]], the child felt no [[paininfection]] during , or surgical misadventure up to and including loss of the circumcision procedure. Anand & Hickey (1987) have shown that newborn children do in fact feel penis and [[paindeath]], and more acutely than adults.<ref name="ananddeacon2022" /><ref name="williams-hickey1987kapilla1993">{{REFjournal |last=AnandWilliams |firstinit=N

|last2=HickeyKapilla |first2init2=L

|title=Pain and its effects in the human neonate and fetusComplications of circumcision

|journal=New Engl Brit J MedSurg

|date=19871993-11-1910 |volume=31780 |issue=2110 |pages=13211231-96 |url=httphttps://www.cirp.org/library/paincomplications/anandwilliams-kapila/

|pubmedID=33170378242285

|DOI=10.1002/bjs.1800801005 |accessdate=2019-11-0827}}</ref> This has led American health associations to recommend doctors take measures to reduce the pain of circumcision in infants.

The [http://www* Intolerance or allergic reactions to the narcotics used.cirp.org/library/statements/aap1999/|AAP Circumcision Policy Statement] (1999) states quite clearly that ''"There is considerable evidence that * Especially in newborns who are circumcised without analgesia experience pain and physiologic stress"''. Furthermore, where the bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is quite severe, and requires injections often insufficient for proper pain managementthe operation. Sucrose and Acetaminophen ''"cannot be recommended as Even in conjunction with regional anaesthesia of the dorsal nerve of the [[penis]], the sole method rate of analgesia"''failure to provide sufficient anaesthetic even for experienced anaesthetists is still 5-10%. Topical cream is no longer thought sufficient as ''"The general anaesthesia that would be needed for newborns, however, poses significant risks for the analgesic effect child, and, therefore, is limited during only likely to be used in emergencies. A surgical operation without proper [[pain]] control can lead to the phases associated with extensive tissue trauma such as...tightening development of the clamp"''.a specific pain memory<ref>{{REFjournalREFweb |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=German |last=Prof. Dr. med. Boris Zernikow

|titlepublisher=American Academy of Pediatrics: Circumcision Policy Statement; Task Force on CircumcisionSpiegel Online |journalwebsite=Pediatrics |date=19992012-0308-12 |volumeaccessdate=103 |issue=3 |pages=6862019-693 |url=https://pediatrics.aappublications.org/content/103/3/686#sec10-911 |accessdateformat=2019-11-26 |notequote=Statement Reaffirmed Sept. 1, 2005}}</ref> The [[AAFP]] (2002) states quite simply in their [http://www.cirpIn unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation.org/library/statements/aafp2002/| position paper]Overall, ''"Newborns experience their pain threshold was lower and the risk of chronic pain during circumcision"increased.''Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFwebREFjournal |last=Garry |init=T |title=Circumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmeda survey of fees and practices |journal=OBG Management |date=1994 |volume=October |issue= |websitepages=Official American Academy of Family Physicians Website34-6 |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 anesthetic are now recommended by all of the major medical institutions. In their [http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml Report 10 of the Council on Scientific Affairs], the AMA states ''"When the decision is made to proceed with circumcision, local anesthesia should be provided for the procedure. Ring block or dorsal penile blocks [injections] are most effective. EMLA cream has limited utility"''. Alarmingly, ''"Despite the clear evidence that newborn males generate brisk pain responses during circumcision, a recent survey of residency training programs found that 26% of programs that taught circumcision provided no instruction on the use of local anesthesia". The AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, and 25% of obstetricians"''.<ref>{{REFwebREFjournal |last=Howard |init=CR |last2=Howard |init2=FM |last3=Garfunkel |init3=LC |last4=de Blieck |init4=EA |last5=Weitzman |init5=M |title=Report 10 of the Council on Scientific Affairs (I-99)Neonatal circumcision and pain relief: Neonatal Circumcisioncurrent training practices |journal=Pediatrics |date=1998 |volume=101 |issue= |websitepages=American Medical Association Official Website423-8 |url=http://www.ama-assn.org/ama/no-index/about-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>{{REFwebREFjournal |last=Stang |init=HJ |last2=Snellman |init2=LW |title=Where We Stand: Circumcisionpractice patterns in the United States |publisherjournal=[[AAP]]Pediatrics |date=2011-03-231998 |volume=101 |issue=e5 |pages= |url=http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx |accessdate=2019-10-12 |note=Link to [[AAP]] website}}</ref> Be that as it may. During procedures which take several minutes, few forms of analgesia are recommended. There are basically two types of injections babies tend to choose from, and the website does not go fall into the difference between a 'dorsal nerve block' and a 'ring block' injection. Given what is known from aforementioned official documentsstate of stupor, which 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 anesthesiapast was falsely interpreted as peaceful sleep, and make sure your baby is given an injection. This is your responsibility, because your doctor may or may not be up to date on nurturing the latest understandings of infant sensitivity to belief that babies felt no pain during circumcision."'' The AAP may be holding back, however, perhaps because this would upset the doctor/parent power relationship, and may cause too much questioning of doctors Measurements taken in general. One may not expect those cases revealed a typically 3- to find this kind of advice on such a website4-fold increase in cortisol levels, and yet, anything less than this is which equals a dangerously weak statementstate 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 |urlinit=http://www.pollockclinics.com/circumcision/circumcision-guide.htmlMR |titlelast2=Parents' Guide to CircumcisionFisch |lastinit2=RO |firstlast3=Korsvik |publisherinit3=S |datelast4=Donhowe |accessdateinit4=2011-04-08}}</ref><ref>{{REFwebJM |quotetitle=During the The effects of circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.serum cortisol and behavior |urljournal=http://www.pollockclinics.com/circumcision/circumcision-before.htmlPsychoneuroendocrinology |titledate=Before the Circumcision1981 |lastvolume=6 |firstissue=3 |publisherpages=269-75 |dateurl=2011-04-08https://www.cirp.org/library/pain/gunnar/ |accessdate=20112019-0411-0826}}</ref> a topical cream* Postoperative wound pain,<ref>{{REFwebin the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions. |quote=Then * Postoperative pain from the exposure of the sensitive glans penis to clothing. This pain will endure for several weeks or even longer in our office, he will have topical anesthetic applied to his penissome cases. |url=http://www* Postoperative [[bleeding]] of the wound.pollockclinicsThis can have severe consequences especially for very young infants, if they are not treated promptly.com/circumcision/circumcision-beforeTheir 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.html |title=Before the Circumcision<ref>{{REFbook

|year=2000 |title=Paediatric Handbook |url= |work= |editors=Smart J, Nolan T. |edition=6 |volume= |chapter= |page=82 |location={{AUSC|VIC}}, Australia |publisher=Blackwell Science Asia |dateisbn= |quote=2011-04-08 |accessdate=2011-04-08 |note=}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFwebREFdocument |quotetitle=We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection.Autopsy of Demetrius Manker |url=http://www.pollockclinics.com/circumcision/circumcision-guide.html |titlecontribution=Parents' Guide to CircumcisionCase 93-1711 |last=Wetli |first=CV |publisher=Miami: Dade County Medical Examiner Department |format= |date=1993-06-23 |accessdate=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 ring block is not always effective in stopping the pain of circumcision.<ref name="Journal of Perinatology April/May 2002">{{REFjournal |last=TaeuschHiss |firstinit=H. WilliamJ |initlast2=HWHorowitz |last2init2=MartinezA |first2last3=Alma M.Kahana |init2init3=AMT |last3title=PartridgeFatal haemorrhage following male ritual circumcision |first3journal=J. ColinClin Forensic Med |init3date=JC2000 |last4volume=Sniderman7 |first4issue=Susan |init4pages=S32-4 |last5url=Armstrong-Wellshttps://www.cirp.org/library/death/hiss1/ |first5accessdate=Jennifer2019-11-06}}</ref><ref>{{REFdocument |init5title=JJudgement of inquiry into the death of McWillis, Ryleigh Roman Bryan |last6url=Fuenteshttp://www.circumstitions.com/death-Afflickexsang.html |first6contribution=Elena |init6last=ENewell |titlefirst=Pain During Mogen or Plastibell CircumcisionTEC |journalpublisher=Journal of PerinatologyBurnaby, B.C.: B.C. Coroner's Service |volumeformat=22 |issuedate=32004-01-19 |pagesaccessdate=2142019-21811-26 |url=http:}}<//wwwref>* Post operative [[lymphoedema]].nature* Postoperative [[Infection| infections]].com/jp/journal/v22/n3/full/7210653aThis includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.html<ref>{{REFconference |quotelast=Dr.med..more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure.Hartmann |pubmedIDfirst=Wolfgang |pubmedCIDurl= |DOIplace=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German) |notetitle=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>* [[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|glans]] with the neighbouring [[penile skin]], causing [[skin]] pockets and bridges, as well as visually unpleasant results like uneven scars, which make a re-circumcision necessary.* Postoperative [[phimosis]]: a phimotic ring can develop during scarring, which makes a re-circumcision necessary. According to a study by Blalock et al.<ref name="Clinical Pediatrics August 1986">{{REFjournal |last=WilliamsonBlalock |firstinit=HJ |last2=Vemulakonda |init2=Paul S.V |initlast3=PSRitchey |last2init3=EvansML |first2last4=Nolan DonovanRibbeck |init2init4=NDM |title=Neonatal Cortisol Response to Circumcision with AnesthesiaOutpatient management of [[phimosis]] Following newborn circumcision |journal=Clinical PediatricsJ Urol |date=2003 |volume=25169 |issue=86 |pages=4122332-4164 |url=httphttps://cpjwww.sagepubcirp.comorg/contentlibrary/25complications/8blalock1/412.abstract |quoteaccessdate=The adrenal cortisol response to surgery was not significantly reduced by 2019-11-26}}</ref>, the administration of lidocaineprevalence is 2.9%, according to Leitch<ref>{{REFjournal |pubmedIDlast=Leitch |pubmedCIDinit=IOW |DOItitle=Circumcision - a continuing enigma |journal=Aust Paediatr J |date=19861970 |volume=6 |issue= |pages=59-0865 |url=https://www.cirp.org/library/general/leitch1/ |accessdate=20112019-0412-0815}}</ref> During 5.5%.* [[Sudden Infant Death Syndrome]] (SIDS).* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], is cut during circumcisionwithout being clamped and sutured at its origin separately, it starts to develop new branches over time, somp physicians give children sugar pacifiers which can lead to "reduce the perception 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 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 occur.* When the circumcision is followed by the ultra-orthodox Jewish ritual of pain"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 |quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |url=http://www.pollockclinicsnytimes.com/circumcision2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-beforeritual.html?_r=0 |title=Before the Baby’s Death Renews Debate Over a CircumcisionRitual |last=Robbins |first= |publisher=Liz |date=20112012-0403-0807 |accessdate=20112019-0410-0811}}</ref> but === Death ===A study in 2010 estimated approximately 117 neonatal circumcision-related [[Death| deaths]] occur annually in at least the [[United States]], about one studyout of every 77 male neonatal deaths, more than suffocation, auto accidents, data shows that giving sugar to a child doesn't help to reduce the perception of pain in the childor even [[SIDS]].<ref name="Lancet, The Bollinger 2010-10-09">{{REFjournal |last=SlaterBollinger |first=RebeccahDan |init=RD |first2author-link=Laura |init2=LDan Bollinger |last2=CornelissenBoy's Health Advisory |first3=Lorenzo |init3=L |last3=Fabrizi |first4=Debbie |init4=D |last4=Patten |first5=Jan |init5=J |last5=Yoxen |first6=Alan |init6=A |last6=Worley |first7=Stewart |init7title=Lost Boys: An Estimate of U.S |last7=Boyd |first8=Judith |init8=J |last8=Meek |first9=Maria |init9=M |last9=Prof. FitzgeraldCircumcision-Related Infant Deaths |titlejournal=Oral sucrose as an analgesic drug for procedural pain in newborn infantsThymos: a randomised controlled trial |journal=The LancetJournal of Boyhood Studies |volume=3764 |issue=97481 |pages=122578-123290 |url=http://www.thelancetmensstudies.com/journalscontent/lancetb64n267w47m333x0/article/PIIS0140-6736%2810%2961303-7/fulltext?p=7ebbd6b446d940cbbd4274c095754b12π=5 |quote=Our data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuits, and therefore might not be an effective analgesic drug. The ability of sucrose to reduce clinical observational scores after noxious events in newborn infants should not be interpreted as pain relief.

|DOI=10.3149/thy.0401.78 |date=2010-04-26 |accessdate=2019-10-0912}}</ref><ref>{{REFweb |accessdateurl=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=20112010-04-0826 |accessdate=}}</ref> Post-operative pain and the pain See also the child must endure during recovery is hardly, if ever, addressed by professionalslist of [[fatalities]].

It has been shown that an infant's response == Forced circumcision ==<!--=== United States military ===American soldiers serving in World War II were subjected to [[pain]] can be altered for years as a consequence regular inspections of their genitals. If intact, the soldiers risked being ordered to undergo immediate circumcision.<ref>{{REFjournalREFbook |last=TaddioSchoen |first=AnnaEd |init=AE |first2author-link=MortonEdgar J. Schoen |init2year=M2005 |last2title=GoldbachOn Circumcision |first3url=Moshe |init3https://books.google.de/books?id=M |last3=Ipp |first4=Bonnie |init4=B |last4=Stevens-zUhdvSt7cgC |first5work=Gideon |init5editor=GDianne Yeakey |last5edition=Koren |title=Effect of neonatal circumcision on pain responses during vaccination in boys |journal=The Lancet |volume=345 |issuechapter=8945 |pages=29172-23 |urllocation=http://www.cirp.org/library/pain/taddio/Georgetown, Canada |quotepublisher=RDR Books |pubmedIDisbn=78378631-157143-123-3 |pubmedCIDquote= |DOI= |date=1995For 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 === Human babies, because they are not yet in possession of language, are incapable of giving or refusing consent to be [[circumcised]]. The element of force has led some scholars to view the circumcision of baby boys as a category of forced circumcision.<ref>For example, Frederick M. Hodges, a medical historian, writes: "In the late 1970s, as the Americans were growing increasingly aware of the abuses of power rampant throughout the nation's social institutions, influential grass-roots movements protesting the forced circumcision of American children sprang up nationwide." F. Hodges, "A Short History," p. 31; see also [[Leonard B. Glick|Glick]], ''Marked in Your Flesh'', pp. 273-281.</ref> There are, however, physicians in the United States who argue strongly for non-therapeutic circumcision of newborn babies; and circumcision is widely accepted as a postnatal procedure in American hospitals.<ref>{{REFjournalREFbook |last=TaddioFletcher |first=AnnaChristopher R. |init=ACR |last2year=Katz1999 |init2title=JCircumcision in America in 1998: Attitudes, Beliefs, and Charges of American Physicians |last3url=Ilersichhttp://www.springerlink.com/content/h2150v731233m177/ |init3work=ALMale and Female Circumcision |last4editors=Koren[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |init4edition=G |titlevolume=Effects of neonatal circumcision on pain response during subsequent routine vaccination |journalchapter=The LancetSection 5 |volumepages=349259-71 |issuelocation=9052New York |pagespublisher=599-603Kluwer Academic/Plenum Publishers |urlisbn=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)10316-0/fulltext

|pubmedID=9057731 |pubmedCIDaccessdate=2019-10-12 |DOInote=ID 10.10161007/S0140978-0-6736(96)10316585-0 |date=199739937-03 |accessdate=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 claimed 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> however surrogate consent for non-therapeutic circumcision is now viewed as unethical.

In the [[United Kingdom]], where non-therapeutic circumcision has now become far less prevalent than in the [[United States]], the written consent of both parents is required, if a physician is to perform a non-therapeutic circumcision of a child.<ref>{{BoxREFjournal |Boxtextlast= |first= |title=Re J (child's religious upbringing and circumcision) |journal=Family Court Reports |date=2000 |volume=1 |issue= |pages=307-14 |url=https://www.cirp.org/library/legal/Re_J/2000.html |accessdate=2019-10-12}}<big/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.<bref>HoweverSee, none of e.g., [[Margaret A. Somerville|Somerville]], "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; [[Abbie Chessler|Chessler]], "Justifying the above three procedures totally eliminate painUnjustifiable"; Smith, "Male Circumcision. A baby boy will still experience some pain despite any of those analgesic procedures"</ref> For example, critics have pointed out that, in the [[United States]], more than 1. Prevention 3% of pain requires protecting a boy from elective male neonatal deaths are attributable to the complications of non-therapeutic circumcisionsurgery. Only boys who are protected from the medically unnecessary <ref name="Bollinger 2010"/>==Video=====Is circumcision surgery experience no pain or traumahealthy?===The video ''Is Circumcision Healthy'' is recommended for parental viewing.<br><br> <youtube>D_3LQjZgdbQ</byoutube> ===Dr. Christopher Guest discusses circumcision===<br><youtube>v=TQIp9f4krVQ</bigyoutube> ===Plastibel circumcision=== {{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] === Sexual effects Gomco clamp circumcision===

Circumcision and frenectomy remove tissues with heightened erogenous sensitivity. Boyle et al. (2002) wrote, "'''Not for the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings&mdash;many of which are lost to circumcision."<ref>{{REFjournal |last=Boyle |first=Gregory J. |init=GJ |author-link=Gregory Boyle |first2=Gillian A. |init2=GA |last2=Bensley |title=Adverse Sexual and Psychological Effects of Male Infant Circumcision |journal=Psychological reports |volume=88 |issue=3, Part 2 |pages=1105–1106 |url=httpsqueamish://www.cirp.org/library/psych/boyle5/ |quote= |pubmedID=11597060 |pubmedCID= |DOI=10.1046/j.1464-410x.1999.0830s1085.x |date=July 2001 |accessdate=}}</ref> They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well."'''

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==* [[amputationGeorge 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 the prepuce results in the loss 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 majority more vulnerable and sensitive of fine-touch neuroreceptors found in the penistwo genders and, leaving only therefore, deserve the uninhibited protopathic sensibility greater degree of the artificially externalized glans penisprotection from traumatic, invasive, injurious,and unnecessary surgery. The imbalance caused by not having the input from For all of these reasons the now ablated finenon-touch receptors may therapeutic circumcision of boys should not be a leading cause performed and the [[genital integrity]] of the changes in sexual behavior noted in circumcised human malesall children should be respected and protected.<refname="hill2007">{{REFjournal |last=Van HoweHill |first=George |init=RSG |author-link=Robert Van HoweGeorge Hill |last2title=ColdThe case against circumcision |init2journal=CJ |title=Advantages Journal of Men's Health and Disadvantages of Neonatal CircumcisionGender |journaldate=The Journal of the American Medical Association2007 |volume=2774 |issue=133 |pages=1052318-723 |url=httphttps://www.ncbi.nlm.nihacademia.govedu/pubmed8367383/9218663The_Case_Against_Circumcision

|pubmedID=9218663

|dateaccessdate=19972021-0405-02 |accessdate=30

</blockquote>* Andrew E. MacNeiiy, Head, Division of Pediatric Urology, Department of Urological Sciences, {{UNI|University of British Columbia|UBC}}, Vancouver, BC, (2008) said:<blockquote>Histology 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 male incidence of such illness is so low that circumcision scar shows cannot be justified as prophylaxis. The role of the foreskin in [[amputationHIV]] neuromastransmission in developed countries is unclear, Schwann cell proliferation and safe sexual practice remains the bulbous collection cornerstone of variably sized neuritesprevention. [[Amputation]] neuromas do not mediate There remains a lack of knowledge regarding what constitutes the normal sensation foreskin both among parents and are notorious for generating painamong primary care providers.<ref name="ColdCJ TaylorJR 1999"/> === Death ===A study This lack of knowledge results in 2010 estimated approximately 117 neonatal circumcision-related deaths occur annually a burden of costs to our health care system in the United Statesform of unnecessary urological referrals, about one out expansion of wait times and circumcisions. Routine circumcision of every 77 male neonatal deaths, more than suffocation, auto accidents, all infants is not justified from a health or even [[SIDS]]cost-benefit perspective.<ref name="Bollinger 2010">{{REFjournal |last=BollingerMacNeily |first=DanAndrew |init=D |author-link=Dan Bollinger |last2etal=Boy's Health Advisoryno |title=Lost BoysRoutine circumcision: An Estimate of U.S. Circumcisionthe opposing view |trans-Related Infant Deathstitle= |language= |journal=Thymos: Journal of Boyhood StudiesCan Urol Assoc J |location= |date=2007-11 |volume=1 |issue=4 |issuearticle= |page=1 |pages=78395-907 |url=http://www.mensstudieseuropepmc.comorg/contentarticle/b64n267w47m333x0PMC/?p=7ebbd6b446d940cbbd4274c095754b12π=5 |quote=2422979 |pubmedID=18542825

|DOI=10.31495489/thycuaj.0401.78 |date=2010-04-26455 |accessdate=20192021-1011-1208}}</ref></blockquote> * The [[Royal Dutch Medical Association]] (KNMG) (2010) said: <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 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 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>{{REFwebREFdocument |title=Non-therapeutic circumcision of male minors |url=httphttps://www.icgidoctorsopposingcircumcision.org/2010wp-content/uploads/2016/0409/infantknmg-non-therapeutic-circumcision-causesof-100male-deathsminors-each27-year05-in-us2010.pdf |titlecontribution=Infant circumcision causes 100 deaths each year in US

|publisher=ICGIRoyal Dutch Medical Association |websiteformat=[[International Coalition for Genital Integrity]]PDF |date=2010-04-26 |accessdate=2021-11-08}}</ref> See also the list of [[fatalities]].</blockquote>

<!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--=== United States military ===therapeutic and the infant is unable to consent.

American soldiers serving After reviewing the currently available evidence, the RACP believes that the frequency of diseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision in World War II were subjected Australia and New Zealand. However it is reasonable for parents to regular inspections weigh the benefits and risks of their genitals. If intact, circumcision and to make the soldiers risked being ordered decision whether or not to undergo immediate circumcisioncircumcise their sons.<refname="racp2010">{{REFbook |last=Schoen |first=Ed |init=E |author-link=Edgar J. Schoen |year=2005REFdocument |title=On Circumcisionof Infant Males |url=https://bookswww.googleracp.deedu.au//docs/default-source/advocacy-library/books?id=circumcision-of-infant-zUhdvSt7cgCmales.pdf |workcontribution= |editorlast=Dianne Yeakey |editionfirst= |volumepublisher=The Royal Australasian College of Physicians |chapterformat=PDF |pagesdate=722010-09-7301 |location=Georgetown, Canada |publisheraccessdate=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>

=== Non* The [[American Academy of Pediatrics]] (AAP) has not re-therapeutic affirmed its disastrous, failed 2012 Circumcision Policy Statement, which expired in 2017, so currently has no position on child circumcision of male children ===.

Human babies, because they are not yet in possession of language, are incapable of giving or refusing consent for being circumcised. The element of force has led some scholars to view the circumcision of baby boys as a category of forced circumcision.<ref>For example, Frederick M. Hodges, a medical * Medical historian, writes: "In the late 1970s, as the Americans were growing increasingly aware of the abuses of power rampant throughout the nation's social institutions, influential grass-roots movements protesting the forced circumcision of American children sprang up nationwide." F. Hodges, "A Short History," p. 31; see also [[Leonard B. Glick|GlickRobert Darby]], ''Marked in Your Flesh'', pp. 273-281.(2014) wrote simply:</refblockquote> There are"To avoid circumcision complications, however, physicians in the United States who argue strongly for non-therapeutic circumcision of newborn babies; and avoid circumcision is widely accepted as a postnatal procedure in American hospitals."<ref>{{REFbookREFjournal |last=FletcherDarby |first=Christopher |init=R. |initauthor-link=CRRobert Darby |yearetal=1999no |title=Circumcision in America in 1998: AttitudesTo avoid circumcision complications, Beliefs, and Charges of American Physiciansavoid circumcision |trans-title= |urllanguage=http://www.springerlink.com/content/h2150v731233m177/ |workjournal=Male and Female CircumcisionCan Urol Assoc J |editorslocation=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |editiondate=2014-08-14 |volume=8 |chapterissue=Section 57-8 |pagesarticle= |page=259-271231 |locationpages=New York |publisherurl=Kluwer Academichttps://cuaj.ca/index.php/journal/article/view/1709/Plenum Publishers1823 |isbnarchived=

|accessdatepubmedID=2019-10-12 |notepubmedCID=ID 10.1007/978-0-585-39937-9_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 non-therapeutic circumcision of a child.<ref>{{REFjournal |lastDOI= |first= |title=Re J (child's religious upbringing and circumcision) |journal=Family Court Reports |date=2000 |volume=1 |issue= |pages=307-314 |url=http://www.cirp10.org/library5489/legal/Re_J/2000cuaj.html1709 |accessdate=20192022-1012-1216}}</ref> </blockquote>* The [[Canadian Paediatric Society]] (The National Health Service does not provide non-therapeutic circumcision.CPS) (2015)said:

<blockquote>In recent yearsmost jurisdictions, legal writers in several English-speaking countries have been questioning the practice of acceding authority is limited only to interventions deemed to parental wishesbe medically necessary.<ref>See, e.g., [[Margaret A. Somerville|Somerville]]In cases in which medical necessity is not established or a proposed treatment is based on personal preference, "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; Chessler, "Justifying interventions should be deferred until 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 individual concerned is able to the complications of non-therapeutic circumcision surgerymake their own choices.<ref name="Bollinger 2010CPS2015"/>{{REFjournal |last=Sorokin |first=S. Todd |init=ST |author-link= |last2=Finlay |first2=VideoJC |author2-link= |last3=Jeffries{{UNI |Stanford Universityfirst3=AL |SU}} has published a video of an actual nonauthor3-therapeutic plastibell link= |etal=yes |title=Newborn male 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.* [ |journal=Paediatr Child Health |location= |date=2015-08 |volume=20 |issue=6 |pages=311-20 |url=https://medwww.stanfordncbi.edunlm.nih.gov/newbornspmc/professional-educationarticles/PMC4578472/ |quote= |pubmedID=26435672 |pubmedCID=4578472 |DOI=10.1093/circumcisionpch/plastibell-technique20.6.html Plastibell Technique]311 |accessdate=2019-10-27}}Not for the squeamish:</ref></blockquote> This is a video * The [[Canadian Urological Association]] (CUA) considered the matter of an actual circumcision with and issued a Gomco clampstatement in February 2018. The infant boy received two dorsal penile nerve block (DPNB) analgesic injections but they did not seem to work. * [httpsCUA concluded://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 "Given the cycle of abuse. Male circumcision is a costly diversion of medical resources away from beneficial services. Male circumcision violates legal rightssocioeconomic, human rightseducational status, and ethical standards. Finally, we must remember that males are the more vulnerable and sensitive of the two genders and, therefore, deserve the greater degree health demographics of protection from traumaticour population, invasive, injurious,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, {{UNI|University male children came before the court in the case of British Columbia|UBC}}, 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>The [[Rights situation on circumcision|rights situation]] is discussed in a separate article. Newborn circumcision remains an area of controversy[[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 adults comprises about fifteen square inches of highly functional erogenous tissue.  Circumcision is most often performed in healthy males for [[HIVReligion and Culture|religious or cultural]] transmission in developed countries reasons. The procedure may be performed on consenting adults, but it is unclearmost often performed on non-consenting minors, and safe sexual practice remains particularly newborn children, 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/PMCethics/2422979AAP/ |archived= |quote= |pubmedID=185428257478854

|DOI=10.5489/cuaj.455 |accessdate=20212023-1105-0821}}</ref></blockquoteref>{{REFjournal |last=Committee on Bioethics |etal=no |title=Informed Consent in Decision-Making in Pediatric Practice |trans-title=* The [[Royal Dutch Medical Association]] (KNMG) (2010) said: |language= |journal=Pediatrics<blockquote> |location=The official viewpoint of KNMG and other related medical/scientific organisations is that non |date=2016-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, [[urethra]]l 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>{{REFdocument08 |volume=138 |issue=2 |article= |page=e20161485 |titlepages=Non-therapeutic circumcision of male minors |url=https://wwwwatermark.doctorsopposingcircumcisionsilverchair.orgcom/wppeds_20161485.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQM8zYHFd0Ylu9Annq_AgEQgIICT24ikc839aJMYOiypqC2G9f7_yKGAGkAekzzbCtck5TElALWVCGNoVSOaA6rDA_dOkQ_LyJnxYlZ88J9-uk15tvlIBbE82_aNyYfq5e9xmEfqD2vh374q3Naz57dxZaUbgxUkKX4PqsiLmYHLvVrr7bQK2MZuuUOKiQU8JZy7lLjkp-PjJO1U9cyIplTAgs_EdvgK8MWWoIsj-content/uploads/2016/09/knmgX-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

After reviewing the currently available evidenceTwo ethicists, Myers & Earp (2020), have conducted a detailed review and analysis of the RACP believes that the frequency claimed medical benefits of diseases modifiable by ''non-therapeutic'' [[circumcision]]. They have determined than the alleged benefits are not material, the level so they do not support granting of protection offered consent by a surrogate. In other words, ''Non-therapeutic'' circumcision and is not truly healthcare. Moreover, they comment that even the complication rates of circumcision do not warrant routine infant circumcision in Australia most perfectly executed surgery produces [[trauma]] and New Zealand. However it is reasonable for parents harm to weigh the benefits patient. Circumcision also produces tissue loss and risks loss of function, therefore, circumcision and to make should be performed only after the individual reaches the decision whether or not to circumcise their sonsage of consent. <u>Consent by a surrogate for a ''non-therapeutic'' circumcision of a minor child is an unethical practice.</u><ref name="racp2010myers2020">{{REFdocument |title=Circumcision of Infant Males |url=https://www.racp.edu.au//docs/default-source/advocacy-library/circumcision-of-infant-males.pdf |contribution=REFjournal |last=Myers

|publisherinit=A |author-link= |last2=Earp |first2= |init2=BD |author2-link=Brian D. Earp |etal=no |title=What is the best age to circumcise? A medical and ethical analysis |trans-title= |language= |journal=J Biosoc Sci |location= |date=2020-09 |volume=34 |issue=7 |pages=560-72 |url=https://onlinelibrary.wiley.com/doi/abs/10.1111/bioe.12714 |archived= |quote= |pubmedID=32068898 |pubmedCID= |DOI=10.1111/bioe.12714 |accessdate=2023-05-18}}</ref> == Tipping point ==The Royal Australasian College [[Intact America]] (2024) argues that public opinion regarding non-therapeutic [[circumcision]] of Physicianschildren is approaching or at a "tipping point" at which [[intact]] genitals would be preferred over the [[circumcised]] variety.<ref>{{REFweb |formaturl=PDFhttps://intactamerica.org/public-opinion-on-circumcision/ |title=Public Opinion on Circumcision: Can Intactivists Hit A Tipping Point? |last=Anonymous |first= |init= |publisher=Intact America |date=20102024-0903-0123 |accessdate=20212024-1104-0809

* The [[American Academy of Pediatrics]] (AAP) has not re-affirmed its disastrous, failed 2012 Circumcision Policy Statement, which expired in 2017, so currently has no position on child circumcision.{{REFweb * The [[Canadian Paediatric Society]] (CPS) (2015) said |url=https://www.cirp.org/library/anatomy/garcia/ <blockquote>In most jurisdictions, authority |title=What exactly is limited only to interventions deemed to be medically necessary. In cases in which medical necessity circumcision and what is it not established or a proposed treatment is based on personal preference, interventions should be deferred until the individual concerned is able to make their own choices.<ref name="CPS2015">{{REFjournal? |last=SorokinGarcia |first=S. ToddFrancisco |initdate=ST1995-12-11 |authoraccessdate=2020-09-link=08 |last2=Finlay}} |first2=JC* {{REFjournal |author2-linklast=Fleiss |last3first=JeffriesPaul |first3init=ALP |author3author-link= |etal=yesPaul M. Fleiss |title=Newborn male circumcisionThe foreskin is necessary |journal=Paediatr Child Health |location=Mothering |date=20151997-0801 |volume=20 |issue=6 |pages=31136-2045 |url=httpshttp://www.ncbinoharmm.nlmorg/mothering.nih.govhtm |accessdate=2020-06-29}}*{{REFweb |url=https:/pmc/articles15square.org.uk/PMC4578472losses-from-circumcision/ |quotetitle=Losses from Circumcision |pubmedIDlast=Ball |first=26435672Peter |pubmedCIDpublisher=457847215 Square |DOIdate=10.1093/pch/20.6.3112003-08-09 |accessdate=20192023-1002-2723

<* {{REFweb |url=http://members.tranquility.net/~rwinkel/ref><MGM/blockquote>primer.html * The [[Canadian Urological Association]] (CUA) considered |title=Male Circumcision in the matter of circumcision and issued a statement in February 2018. The CUA concludedUSA:A Human Rights Primer |last=Winkel |first=Rich |author-link=Rich Winkel |date=2005-05-12<blockquote>"Given the socioeconomic, educational status, and health demographics of our population, universal neonatal circumcision cannot be justified based on the current evidence available.<ref name |accessdate="cua2018">2021-01-27}} * {{REFjournal |last=DaveTesta |first=SumitPatrick |init=S

|last2=Block |first2=Walter E. |init2= |author2-link= |etal=yesno |title=Canadian Urological Association guideline on the care of the normal foreskin Libertarianism and neonatal circumcision in Canadian infants (abridged version) |trans-title= |language= |journal=Can Urol Assoc Int JHealth Poiicy Manag

|date=20182014-0205-26 |volume=123 |issue=2 |article= |page= |pages=1833-2840 |url=https://cuajwww.ca/indexacademia.phpedu/journal/article7587653/Libertarianism_and_Circumcision?email_work_card=view/5034/3470 |quote=-paper |pubmedID=24987720 |pubmedCID=4075101 |DOI= |accessdate=2021-11-09}}</ref><10.15171/blockquote> == Rights and ethics == The [[Rights situation on circumcision|rights situation]] is discussed in a separate articleijhpm. ----- {{FromIntactWiki |URL=http://intactwiki2014.org/wiki/Circumcision51 |Titleaccessdate=Circumcision

|url=httphttps://www.cirpintaction.org/librarywhat-is-circumcision/ |title=What is circumcision? |last=Simone |first=Judy |author-link= |publisher=Intaction |website=https:/anatomy/garciaintaction.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 exactly 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=34997197 |pubmedCID= |DOI=10.1038/s41443-021-00502-y |accessdate=2023-04-30}}* {{REFweb |url=https://intactamerica.org/pros-and-cons-of-circumcision / |title=Pros and what is it not?Cons of Circumcision (Spoiler: You’ve Been Lied to) |last=GarciaGarrett |first=Francisco |init=CJ |publisher=Intact America |date=19952023-1211-1110 |accessdate=20202024-0903-0822

* {{REFjournalREFweb |lasturl=Fleisshttps://intactamerica.org/groups-who-pressure-you-to-circumcise/ |firsttitle=PaulThe 4 Authority Figures and Groups Who Will Pressure You to Circumcise (and What You Can Do) |initlast=PAnonymous |author-linkfirst=Paul M. Fleiss |titleinit=The foreskin is necessary |journalpublisher=MotheringIntact America |date=19972024-01 |volume= |issue= |pages=36-45 |url=http://www.noharmm.org/mothering.htm24 |accessdate=20202024-0601-2927

|url=httphttps://membersintactamerica.tranquility.netorg/~rwinkelkeeping-your-sons-penis-intact/MGM |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:/primer/intactamerica.htmlorg/timeline-of-circumcision-suffering/ |title=Male A Timeline of Circumcision in the USASuffering: A Human Rights Primer Detailed Look |last=WinkelAnonymous |first=Rich |init= |publisher=Intact America |date=20052024-0502-1202 |accessdate=20212024-0102-2709

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