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"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 is most often an elective, non-therapeutic surgery performed on neonates and children for religious and cultural reasons in violation of their [[human rights]], but in other cases may be indicated for both therapeutic and prophylactic reasons. It is a radical treatment option for pathological [[phimosis]], refractory [[Balanitis| balanoposthitis]] and chronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health.  '''Posthectomy''' is a the 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 circumcision of children, [[Child Genital Cutting (CGC)]] is a newer term that has been introduced to avoid issues associated with more traditional terms. Bollinger (2023) identifed CGC as an [[Adverse 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, And Circumcision. |journal=Kindred |date=2023-02-28 |volume= |issue= |pages= |accessdate=2023-03-01}}</ref>

With reference to involuntary, non-therapeutic circumcision of children, [[Child Genital Cutting (CGC)]] is a new term that has been introduced to avoid issues associated with more traditional terms. 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 choose to give or withhold [[informed consent ]] himself."<ref name="deacon2022">{{REFjournal

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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:

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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.

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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">{{FleissP HodgesF VanHoweRS 1998}}</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

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* Two studies that have been published in early 2007<ref>{{RCT Gray et al 2007}}</ref><ref>{{RCT Bailey et al 2007}}</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

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|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

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|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]].

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

|publishertitle=Spiegel OnlineAmerican Academy of Pediatrics: Circumcision Policy Statement; Task Force on Circumcision |websitejournal=Pediatrics |date=20121999-0803 |volume=103 |issue=3 |pages=686-1293 |accessdateurl=2019-10https://pediatrics.aappublications.org/content/103/3/686#sec-119 |formataccessdate=2019-11-26 |quotenote=Statement Reaffirmed Sept. 1, 2005}}</ref> The [[AAFP]] (2002) states quite simply in their [https://www. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operationcirp. Overallorg/library/statements/aafp2002/| position paper], their ''"Newborns experience pain threshold was lower and the risk of chronic pain increasedduring circumcision". Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice''<ref>{{REFjournal |last=Garry |init=TREFweb |title=Circumcision: a survey of fees and practicesPosition Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed |journalwebsite=OBG Management |date=1994 |volume=October |issue= |pages=34-36Official American Academy of Family Physicians Website |url=http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html |accessdate=2011-05-02}}</ref>This is not a debatable fact, and yet, it is not widely accepted, even by some doctors. It might be hard for some doctors to accept, as they may have been taught that the infant does not feel [[pain]], and may have performed countless circumcisions with this idea. Usage of anesthesia for infant circumcision is still by no means the rule. Penile injections of local anesthetic are now recommended by all of the major medical institutions if a circumcision is to be performed. In their [http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml Report 10 of the Council on Scientific Affairs], the AMA states ''"When the decision is made to proceed with circumcision, local anesthesia should be provided for the procedure. [[Ring block]] or [[dorsal penile nerve block]] [injections] are most effective. [[EMLA]] cream has limited utility"''. Alarmingly, ''"Despite the clear evidence that newborn males generate brisk pain responses during circumcision, a recent survey of residency training programs found that 26% of programs that taught circumcision provided no instruction on the use of local anesthesia". The AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, and 25% of obstetricians"''.<ref>{{REFjournal |last=Howard |init=CR |last2=Howard |init2=FM |last3=Garfunkel |init3=LC |last4=de Blieck |init4=EA |last5=Weitzman |init5=MREFweb |title=Report 10 of the Council on Scientific Affairs (I-99): Neonatal circumcision and pain relief: current training practicesCircumcision |journalwebsite=PediatricsAmerican Medical Association Official Website |dateurl=1998 |volume=101 |issue= |pages=423http://www.ama-assn.org/ama/no-index/about-428 |url=ama/13585.shtml |accessdate=2011-05-04}}</ref> The AAP's [http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx Heatlhy Children website] suggests ''"Your pediatrician (or your obstetrician) should discuss the forms of analgesia that are available"''.<ref>{{REFjournal |last=Stang |init=HJ |last2=Snellman |init2=LWREFweb |title=Where We Stand: Circumcision practice patterns in the United States |journalpublisher=Pediatrics[[AAP]] |date=19982011-03-23 |volumeurl=101 |issue=e5 |http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages= |url=/Where-We-Stand-Circumcision.aspx |accessdate= |note=Link to [[AAP]] website2019-10-12}}</ref>Be that as it may, few forms of analgesia are recommended. During procedures which take several minutesThere are basically two types of injections to choose from, babies tend to fall and the website does not go into the difference between a state 'dorsal nerve block' and a 'ring block' injection. Given what is known from aforementioned official documents, the AAP website may be more informative and effective if it would say ''"Make sure your doctor knows of the ineffectiveness of anything short of stuporlocal anesthesia, which in the past was falsely interpreted as peaceful sleepand make sure your baby is given an injection. This is your responsibility, nurturing because your doctor may or may not be up to date on the belief that babies felt no latest understandings of infant sensitivity to [[pain]] during circumcision. Measurements taken "'' The AAP may be holding back, however, perhaps because this would upset the doctor/parent power relationship, and may cause too much questioning of doctors in those cases revealed general. One may not expect to find this kind of advice on such a typically 3- to 4-fold increase in cortisol levelswebsite, and yet, which equals anything less than this is a state of severe shockdangerously weak statement. To control [[pain]], some physicians that circumcise use Tylenol, sugar,<ref>{{REFjournalREFweb |lastquote=GunnarTo calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, and soothing music is played in the room. |initurl=MRhttp://www.pollockclinics.com/circumcision/circumcision-guide.html |last2title=FischParents' Guide to Circumcision |init2last=RO |last3first=Korsvik |init3publisher=S |last4date=Donhowe |init4accessdate=JM2011-04-08}}</ref><ref>{{REFweb |titlequote=The effects of During the circumcision , your son will receive sugar pacifiers to suck on serum cortisol and behaviorwhich reduce his pain perceptions. |journalurl=Psychoneuroendocrinologyhttp://www.pollockclinics.com/circumcision/circumcision-before.html |datetitle=1981Before the Circumcision |volumelast=6 |issuefirst=3 |pagespublisher=269-275 |urldate=http://www.cirp.org/library/pain/gunnar/2011-04-08 |accessdate=20192011-1104-2608}}</ref>a topical cream,<ref>{{REFweb* Postoperative wound pain |quote=Then in our office, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesionshe will have topical anesthetic applied to his penis.* Postoperative pain from the exposure of the sensitive glans penis to clothing |url=http://www.pollockclinics. This pain will endure for several weeks or even longer in some casescom/circumcision/circumcision-before.html* Postoperative bleeding of |title=Before the wound. This can have severe consequences especially for very young infants, if they are not treated promptly. Their blood volume is only about 85 ml per kilogram of body weight, and even moderate blood loss can lead to hypovolaemia, hypovolaemic shock and even death.<ref>{{REFbookCircumcision

|yearpublisher=2000 |titledate=Paediatric Handbook2011-04-08 |urlaccessdate=2011-04-08 |work=}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb |editorsquote=Smart JWe use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, Nolan Tand a local anesthetic injection. |editionurl=6http://www.pollockclinics.com/circumcision/circumcision-guide.html |volumetitle=Parents' Guide to Circumcision |chapterlast= |pages=82 |locationfirst=Victoria, Australia |publisher=Blackwell Science Asia |isbn= |quotedate= |accessdate= |note=2011-04-08}}</ref>Topical anaesthetic only serves to numb the area to lessen the pain of the injection, but studies have shown that a [[dorsal penile nerve block]] is only partially effective in stopping the [[Pain| pain of circumcision]].<refname="Journal of Perinatology April/May 2002">{{REFdocumentREFjournal |last=Taeusch |titlefirst=Autopsy of Demetrius MankerH. William |urlinit=HW |contributionlast2=Case 93-1711Martinez |lastfirst2=WetliAlma M. |firstinit2=CVAM |publisherlast3=Miami: Dade County Medical Examiner DepartmentPartridge |formatfirst3=J. Colin |dateinit3=1993-06-23JC |accessdatelast4=Sniderman}}</ref> <ref>{{REFjournal |first4=Susan |lastinit4=HissS |initlast5=JArmstrong-Wells |last2first5=HorowitzJennifer |init2init5=AJ |last3last6=KahanaFuentes-Afflick |init3first6=TElena |titleinit6=Fatal haemorrhage following male ritual circumcisionE |journaltitle=J Clin Forensic MedPain During Mogen or Plastibell Circumcision |datejournal=2000Journal of Perinatology |volume=722 |issue=3 |pages=32214-348 |url=http://www.cirpnature.orgcom/jp/journal/v22/libraryn3/deathfull/7210653a.html |quote=...more than half of the study group had what we considered excessive pain/hiss1discomfort over the course of the entire procedure. |pubmedID= |pubmedCID= |DOI= |note=April/May 2002 |date=2002-04 |accessdate=20192011-1104-0608}}</ref><refname="Clinical Pediatrics August 1986">{{REFdocumentREFjournal |last=Williamson |first=Paul S. |init=PS |last2=Evans |first2=Nolan Donovan |init2=ND |title=Judgement of inquiry into the death of McWillis, Ryleigh Roman BryanNeonatal Cortisol Response to Circumcision with Anesthesia |journal=Clinical Pediatrics |volume=25 |issue=8 |pages=412-6 |url=http://wwwcpj.circumstitionssagepub.com/death-exsangcontent/25/8/412.htmlabstract |contributionquote=The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine. |last=Newell |firstpubmedID=TEC |publisherpubmedCID=Burnaby, B.C.: B.C. Coroner's Service |formatDOI= |date=20041986-01-1908 |accessdate=20192011-1104-2608}}</ref>* Post operative [[lymphoedema]].* Postoperative [[Infection| infections]]. This includes both local infectionsDuring circumcision, which can be treated with local therapysomp physicians give children sugar pacifiers to "reduce the perception of pain", and systemic infections, requiring systemic antibiotic treatment.<ref>{{REFconferenceREFweb |lastquote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |url=Drhttp://www. medpollockclinics. Hartmanncom/circumcision/circumcision-before.html |firsttitle=WolfgangBefore the Circumcision |urllast= |placefirst=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German) |titlepublisher=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German) |date=20122011-1104-2608 |accessdate=2011-04-08}}</ref>* [[Wound dehiscence]]but in at least one study, meaning data shows that giving sugar to a child doesn't help to reduce the separation perception of pain in the edges of the wound or the tissue after suturingchild.* Adhesion between the surface or rim of the [[Glans penis|glans]] with the neighbouring [[penile skin]]<ref name="Lancet, causing [[skin]] pockets and bridges, as well as visually unpleasant results like uneven scars, which make a reThe 2010-circumcision necessary.* Postoperative [[phimosis]]: a phimotic ring can develop during scarring, which makes a re10-circumcision necessary. According to a study by Blalock et al.<ref09">{{REFjournal |last=BlalockSlater |first=Rebeccah |init=HJR |last2first2=VemulakondaLaura |init2=VL |last2=Cornelissen |last3first3=RitcheyLorenzo |init3=MLL |last3=Fabrizi |last4first4=RibbeckDebbie |init4=MD |last4=Patten |titlefirst5=Outpatient management of [[phimosis]] Following newborn circumcisionJan |journalinit5=J Urol |datelast5=Yoxen |first6=Alan |init6=A |last6=2003Worley |volumefirst7=169Stewart |issueinit7=6S |pageslast7=2332-2334Boyd |urlfirst8=http://www.cirp.org/library/complications/blalock1/Judith |accessdateinit8=2019-11-26J}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal |last8=Meek |lastfirst9=LeitchMaria |initinit9=IOWM |titlelast9=Circumcision - a continuing enigmaProf. Fitzgerald |journaltitle=Aust Paediatr JOral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial |datejournal=1970The Lancet |volume=6376 |issue=9748 |pages=591225-6532 |url=http://www.cirpthelancet.orgcom/journals/librarylancet/generalarticle/leitch1PIIS0140-6736%2810%2961303-7/fulltext |accessdatequote=2019-12-15}}</ref> 5.5%.* [[Sudden Infant Death Syndrome]] (SIDS).* Knot formation of the veins. If the dorsal vein, which originates Our data suggest that oral sucrose does not significantly affect activity in the tip of the [[foreskin]], is cut during circumcision without being clamped and sutured at its origin separately, it starts to develop new branches over timeneonatal brain or spinal cord nociceptive circuits, which can lead to the development of knots.* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro-penis) and induratio [[penis]] plastica (skewed penis).* Medical malpractice can also therefore might not be ruled out. Injuries, partly or entirely severing the [[Glans penis|glans]] or the [[penis]] can occur.* In rare cases, [[necrosis]], gangrene, ischaemia, keloid formation, and circulatory problems may also occuran effective analgesic drug.* When the circumcision is followed by the ultra-orthodox Jewish ritual The ability of Metzitzah B'Peh (which consists of sucking blood from the wound with the mouth), there is a risk of infection with [[herpes]] simplex type 1, which can lead sucrose to brain damage or [[death]].<ref>{{REFweb |url=http://www.nytimes.com/2012/03/08/nyregion/reduce clinical observational scores after noxious events in newborn infants-death-renews-debate-over-a-circumcision-ritualshould not be interpreted as pain relief.html?_r=0 |titlepubmedID=Baby’s Death Renews Debate Over a Circumcision Ritual |lastpubmedCID=Robbins |firstDOI=Liz |date=20122010-0310-0709 |accessdate=20192011-1004-1108}}</ref>Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals.

* An unavoidable late effect {{Box|Boxtext=<big><b>However, none of the above three procedures totally eliminate pain. A baby boy will still experience some pain despite any circumcision is the permanent loss of sexual sensitivitythose analgesic procedures. This is partly due to the removal Prevention of sensory tissue. The [[foreskinpain]] contains very many nerve endings and touch receptors, which account for the major part of male sexual sensationrequires protecting a boy from elective neonatal non-therapeutic circumcision. If Only boys who are protected from the [[foreskin]] is removed, they can medically unnecessary circumcision surgery experience no longer provide sexual stimulation. It is also partly due to the fact that the surface of the [[Glans penis|glanspain]] reacts to the missing protection from friction and drying out by developing a callus layer. This reduces the sensitivity of the remaining nerves in the or [[Glans penis|glanstrauma]] gradually over the years. The study conducted by Sorrells et al.<ref/b>{{Sorrells etal 2007}}</refbig> found a significant reduction of sensitivity to touch for circumcised compared to intact [[penis]]es in adult males. Other studies revealed that circumcised men use condoms significantly less often than intact men, since they further limit the sexual sensitivity (see above).}}

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

|article= |page= |pages=291 |url=https://www.nature.com/articles/s41443-022-29500619-8 |archived= |quote= |pubmedID=36274189 |pubmedCID= |urlDOI=10.1038/s41443-022-00619-8 |accessdate=2023-01-08}}</ref> === Physical effects ===* [[Bodily harm]]* [[Circumcision scar]] is an invariable effect.* An unavoidable effect of any circumcision is the permanent loss of sexual sensitivity. This is partly due to the removal of sensory tissue. The [[foreskin]] contains very many nerve endings and touch receptors, which account for the major part of male sexual sensation. If the [[foreskin]] is removed, they can no longer provide sexual stimulation. It is also partly due to the fact that the surface of the [[Glans penis|glans]] reacts to the missing protection from friction and drying out by developing a callus layer. This reduces the sensitivity of the remaining nerves in the [[Glans penis|glans]] gradually over the years. The study conducted by Sorrells et al.<ref>{{Sorrells etal 2007}}</ref> found a significant reduction of sensitivity to touch for [[circumcised]] compared to [[intact]] [[penis]]es in adult males. Other studies revealed that [[circumcised]] men use condoms significantly less often than [[intact]] men, since they further limit the sexual sensitivity (see above). * Painful tension can occur when there is too little reserve [[skin]] left to support a full [[erection]]<ref name="taylor1996"/>. This risk is partly dependent on the anatomy of the [[penis]]. While some [[penis]]es already have the majority of their full size when flaccid ([[Flesh Penis]], or "[[shower]]"), others are rather short when flaccid and double or more their size during an [[erection]] ([[Blood Penis]], or "[[grower]]"). Especially in children's circumcision, where the [[penis]] is not yet fully developed, the amount of reserve [[skin]] needed in adulthood cannot be estimated. * 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

|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.

|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= |last3=Otero-Alén |first3= |init3=M |yearauthor3-link=2001 |titlelast4=García |first4= |init4=Understanding circumcision: A MultiH |author4-Disciplinary Approach to a Multilink= |last5=Suárez-Dimensional ProblemQuintanilla |first5= |urlinit5=https://J |author5-link.springer.com/chapter/10.1007/978= |last6=García-1Caballero |first6= |init6=T |author6-4757link= |last7=Gallego |first7= |init7=R |author7-3351link= |last8=García-8_14Caballero |workfirst8= |editorsinit8=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]R |editionauthor8-link= |volumeetal=no |chaptertitle=Ritual Immunohistological study of the density and medical circumcision among Filipino boysdistribution of human penile neural tissue: evidence of postgradient hypothesis |trans-traumatic stress disordertitle= |language= |journal= Int J Impot Res |location= |pagesdate=2532023-05-27002 |locationvolume=35 |issue=3 |article= |page= |pages=New York286-305 |publisherurl=Kluwer Academichttps://Plenum Publisherswww.nature.com/articles/s41443-022-00561-9 |isbnarchived=

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

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

* It can frequently be found that Histology of the loss is deniedmale circumcision scar shows [[amputation]] neuromas, much as happens with Schwann cell proliferation and the loss bulbous collection of other body partsvariably sized neurites. [[Amputation]] neuromas do not mediate normal sensation and are notorious for generating pain.<ref name="ColdCJ TaylorJR 1999"/> Cepeda-Emiliani et al. This denial can lead (2023) commented:<blockquote> Taking the sleve technique as an example of surgical flexibility during circumcision, to fathers having their sons circumcised in order not the extent that this technique is of such versatility that it allows highly variable quantities of cutaneous and subcutaneous tissue to be reminded excised directly from the penile body, and to the extent that the prepuce is still conceived by segments of their own loss. In this processthe medical community as "just a small piece of skin", we are concerned that aggressive circumcisions are intentionally or unintentionally being performed in pediatric and adult patients in the belief that "redundant" or " extra" tissue is being excised, their own body or in the belief that "excesive sensitivity" is defined as being reduced to augment ejaculatory latency time.<ref name="normalcepeda2023" /></blockquote>The un-anesthetized and un-sedated newborn infant is restrained by being strapped to a special plastic board called the [[circumstraint]]. The procedure is most often an elective, non-therapeutic surgery without [[medical indication]] performed on neonates and children for religious and cultural reasons in violation of the child's [[foreskinhuman rights]] redefined as to [[physical integrity]], but in older patients may be rarely indicated for therapeutic reasons. It is a foreign objectradical treatment option for pathological [[phimosis]], refractory [[balanoposthitis]] and chronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health. Their own parents  See [[Sexual effects of circumcision]] for more information. === Psychological effects ===[[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effects]] are seen as "good"also possible after a circumcision, so that this image is projected onto especially if the circumcision their parents operation was carried out as well, in order to keep the positive emotion intactchildhood. The father wants to be On this occasion a "good" father later in life as wellvariety of [[trauma]] may occur, which depend, among others, on age and so, following an idealised image circumstances of his own parentsthe circumcision. For example, whether the circumcisiontook place with or without sufficient anaesthesia, which if the individual has been redefined as a "good thing"informed about the operation beforehand, if he was [[circumcised]] against his will or without his consent, and also, in the case of infant circumcision, if he was told about it during childhood or had to find it out coincidentally on his own. The psychological late effects of circumcision are not yet fully researched, is passed and many studies took place on rather a small scale. This situation needs to his son by having him circumcised be rectified, because the available studies, as wellas the histories of negatively affected men, suggest that these late effects may have more impact than previously assumed. * It was observed that infants, following circumcision without [[pain]] control, had a disturbed bond with their mother<ref>{{REFjournal |last=van der KolkMarshall |init=BARE |urllast2=http://www.cirp.org/library/psych/vanderkolk/Porter |titleinit2=The compulsion to repeat the trauma: re-enactment, revictimization, and masochismFL |journallast3=Psychiatr Clin North AmRogers |dateinit3=1989AG |volumeetal=12yes |issuetitle=2Circumcision: II effects upon mother-infant interaction |pagesjournal=389-411Early Hum Dev |accessdatedate=2019-10-12}}</ref><ref>{{REFjournal1982 |lastvolume=Goldman7 |initissue=R4 |authorpages=367-link=Ronald Goldman74 |url=httphttps://www.cirp.org/library/psychbirth/goldman1marshall2/ |title=The psychological impact of circumcision |journal=BJU Int |date=1999 |volume=83 |issue=Suppl. 1 |pages=93-103 |accessdate=20192020-1002-1201}}</ref>, as well as problems with nurturing, up to the point of refusal to be fed. The sleeping habits of these babies were also disturbed, with prolonged non-REM sleep and increased waking. * If the In boys [[circumcised male feels incomplete]] in childhood, [[post-traumatic stress disorder]] ([[PTSD]]) could be diagnosed. In a study on Philippine boys, or due in whom no [[PTSD]] was found prior to the missing operation, 69% of the boys [[foreskincircumcised]] disadvantaged compared to intact males, an inferiority complex in the traditional ritual and depression may occur. This can be accompanied 51% of those [[circumcised]] by conscious recognition of his own incompleteness, or standard medical procedures (including anaesthesia) fulfilled the DSM-IV criteria for PTSD following the deficiency may remain completely subconsciousoperation.<ref>{{REFjournalREFbook |last=RhinehartRamos |init=J |url=http://www.cirp.org/library/psych/rhinehart1/S |titlelast2=Neonatal circumcision reconsideredBoyle |journalinit2=Transactional Analysis JGJ |dateyear=19992001 |volumetitle=29Understanding circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem |issueurl=3https://link.springer.com/chapter/10.1007/978-1-4757-3351-8_14 |pageswork=215-221 |accessdateeditors=2019-10-12}}</ref>[[George C. In an online studyDenniston]], 75% of those interviewed stated that they felt incomplete, and 66% said they felt inferior compared with intact males[[Frederick M.<ref name="GSoCH"/>* Cases in which children felt ill treated or punished have been documented as well. G. Cansever found in her study on 12 boys aged between 4 and 7 yearsHodges]], who had previously been prepared for their impending circumcision, that the children experienced the operation as an aggressive assault on their bodies.<ref>{{REFjournal[[Marilyn Fayre Milos]] |lastedition=Cansever |initvolume=G |datechapter=1965Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder |urlpages=http://www.cirp.org/library/psych/cansever/253-70 |titlelocation=Psychological effects of circumcisionNew York |journalpublisher=Brit. J. Med. PsycholKluwer Academic/Plenum Publishers |volumeisbn=38 |pagesquote=321-331 |accessdate=2019-10-12 |note=

* Fear Circumcisions, especially those that happen without consent, can spark feelings of being alone or darknesshelplessness and alienation, which can persist as [[trauma]]. These feeling can also be triggered later, when someone [[circumcised]] as an infant becomes aware of his circumcision. In an online study, interviewed men stated they felt betrayed - 55% by the mother, 50% by the father, and 58% by the doctor, and 73% felt that their [[human rights]] had been violated.<ref name="Levy1945GSoCH">{{REFjournal |last=Levy |first=David M. |init=DMREFweb |url=http://www.cirpcircumcisionharm.org/library/psych/levy1/ |title=Psychic trauma Global Survey of operations in children; and a note on combat neurosis |journal=American Journal of Diseases of Children |volume=69 |date=1945 |pages=7-25Circumcision Harm

* Fear It can frequently be found that the loss is denied, much as happens with the loss of doctorsother 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, clinics their own body is defined as "normal" and also closed roomsthe [[foreskin]] redefined as a foreign object.<ref name=Their own parents are seen as "Levy1945good"/>* Relapse into , so that this image is projected onto the state of bed-wettingcircumcision their parents carried out as well, even if in order to keep the child was already dry beforepositive emotion intact.<ref name=The father wants to be a "Levy1945good"/>* Circumcised males who become fathers frequently manifest [[adamant father syndrome]]. 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 [[Intact Americacircumcised]] (2019) called circumcision as an adverse childhood experience,well.<ref name-"bollinger2019">{{REFdocument |title=Child genital cutting as an adverse childhood experience |url=http:VanderKolkBA 1989}}<//adversechildhoodexperiences.net/CGC_as_an_ACE.pdfref><ref>{{REFjournal |last=BollingerGoldman |firstinit=DanR |author-link=Dan BollingerRonald Goldman |last2url=Chapinhttps://www.cirp.org/library/psych/goldman1/ |first2title=GeorganneThe psychological impact of circumcision |author2-linkjournal=Georganne ChapinBJU Int |publisherdate=Intact America1999 |locationvolume=Tarrytown83 |formatissue=PDFSuppl. 1 |datepages=201993-08103 |accessdate=20212019-1110-0212

== Complications ===== Pain ===In * If the past, advocates of circumcision claimed that a newborn child's nerve system was not yet fully developed, and that as a result[[circumcised]] male feels incomplete, or due to the child felt no missing [[painforeskin]] during the circumcision procedure. Anand & Hickey (1987) have shown that newborn children do in fact feel disadvantaged compared to [[painintact]]males, an inferiority complex and more acutely than adults[[depression]] may occur.This can be accompanied by conscious recognition of his own incompleteness, or the deficiency may remain completely subconscious<ref name="anand-hickey1987">{{REFjournal |last=Anand |first= |author-link= |last2=Hickey |first2= |author2-link= |etal=no |title=Pain and its effects in the human neonate and fetus |trans-title= |language=Rhinehart |journalinit=New Engl J Med |location= |date=1987-11-19 |volume=317 |issue=21 |pages=1321-9 |url=httphttps://www.cirp.org/library/painpsych/anandrhinehart1/ |quote= |pubmedID=3317037 |pubmedCID= |DOI= |accessdatetitle=2019-11-08}}</ref> This has led American health associations to recommend doctors take measures to reduce the pain of Neonatal circumcision in infants. The [http://www.cirp.org/library/statements/aap1999/|AAP Circumcision Policy Statement] (1999) states quite clearly that ''"There is considerable evidence that newborns who are circumcised without analgesia experience pain and physiologic stress"''. Furthermore, the pain is quite severe, and requires injections for proper pain management. Sucrose and Acetaminophen ''"cannot be recommended as the sole method of analgesia"''. Topical cream is no longer thought sufficient as ''"the analgesic effect is limited during the phases associated with extensive tissue trauma such as...tightening of the clamp"''.<ref>{{REFjournal |last= |first= |title=American Academy of Pediatrics: Circumcision Policy Statement; Task Force on Circumcisionreconsidered |journal=PediatricsTransactional Analysis J |date=1999-03 |volume=10329

|pages=686215-69321 |accessdate=2019-10-12}}</ref>. In an online study, 75% of those interviewed stated that they felt incomplete, and 66% said they felt inferior compared with [[intact]] males.<ref name="GSoCH"/>* Cases in which children felt ill treated or punished have been documented as well. G. Cansever found in her study on 12 boys aged between 4 and 7 years, who had previously been prepared for their impending circumcision, that the children experienced the operation as an aggressive assault on their bodies.<ref>{{REFjournal |last=Cansever |init=G |date=1965 |url=https://pediatricswww.aappublicationscirp.org/contentlibrary/103psych/3cansever/686#sec |title=Psychological effects of circumcision |journal=Brit. J. Med. Psychol |volume=38 |pages=321-931 |accessdate=2019-1110-2612}}</ref>* Fear of being alone or darkness.<ref name="Levy1945">{{REFjournal |last=Levy |first=David M. |init=DM |url=https://www.cirp.org/library/psych/levy1/ |title=Psychic trauma of operations in children; and a noteon combat neurosis |journal=American Journal of Diseases of Children |volume=69 |date=1945 |pages=7-25 |accessdate=Statement Reaffirmed Sept. 1, 20052019-10-12

The [[AAFPIntact America]] (20022019) states quite simply in their called circumcision an [http://www.cirp.org/library/statements/aafp2002/[Adverse Childhood Experiences (ACEs)| position paperadverse childhood experience]], ''<ref name-"Newborns experience pain during circumcisionbollinger2019".''<ref>{{REFwebREFdocument |title=Circumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed |website=Official American Academy of Family Physicians WebsiteChild genital cutting as an adverse childhood experience |url=http://wwwadversechildhoodexperiences.aafp.orgnet/online/en/home/clinical/clinicalrecs/children/circumcisionCGC_as_an_ACE.htmlpdf |last=Bollinger |accessdatefirst=2011Dan |author-05-02link=Dan Bollinger}}</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. |last2=Chapin |first2=GeorgannePenile injections of anesthetic are now recommended by all of the major medical institutions. In their [http://www.ama |author2-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>{{REFweblink=Georganne Chapin |publisher=Intact America |titlelocation=Report 10 of the Council on Scientific Affairs (I-99): Neonatal CircumcisionTarrytown |websiteformat=American Medical Association Official WebsitePDF |urldate=http://www.ama2019-assn.org/ama/no-index/about-ama/13585.shtml08 |accessdate=20112021-0511-0402

The AAP's [http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-== Complications ===== Possible operative and postoperative complications ===Circumcisionis surgery.aspx Heatlhy Children website Surgical complications of circumcision generally may be classified as [[Bleeding| hemorrhage] suggests ''"Your pediatrician (], [[infection]], or your obstetrician) should discuss surgical misadventure up to and including loss of the forms of analgesia that are availablepenis and [[death]].<ref name="deacon2022"''./><refname="williams-kapilla1993">{{REFwebREFjournal |last=Williams |init=N |author-link= |last2=Kapilla |init2=L |author2-link= |etal=no |title=Where We Stand: CircumcisionComplications of circumcision |trans-title= |language= |journal=Brit J Surg |publisherlocation=[[AAP]] |date=20111993-0310 |volume=80 |issue=10 |pages=1231-236 |url=httphttps://www.healthychildrencirp.org/English/ages-stageslibrary/prenatalcomplications/decisionswilliams-to-makekapila/pages |quote= |pubmedID=8242285 |pubmedCID= |DOI=10.1002/Where-We-Stand-Circumcisionbjs.aspx1800801005 |accessdate=2019-1011-1227}}</ref> Be that as it may, few forms of analgesia are recommended. There are basically two types of injections to choose from, and the website does not go into the difference between a 'dorsal nerve block' and a 'ring block' injection.

Given what * Intolerance or allergic reactions to the narcotics used.* Especially in newborns, where the bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is known from aforementioned official documents, often insufficient for the AAP website may be more informative and effective if it would say ''"Make sure your doctor knows operation. Even in conjunction with regional anaesthesia of the ineffectiveness dorsal nerve of anything short of local anesthesia, and make sure your baby is given an injection. This is your responsibilitythe [[penis]], because your doctor may or may not be up to date on the latest understandings rate of infant sensitivity failure to pain during circumcisionprovide sufficient anaesthetic even for experienced anaesthetists is still 5-10%."'' The AAP may general anaesthesia that would be holding backneeded for newborns, however, perhaps because this would upset poses significant risks for the doctor/parent power relationshipchild, and may cause too much questioning of doctors , therefore, is only likely to be used in generalemergencies. One may not expect A surgical operation without proper [[pain]] control can lead to find this kind the development of advice on such a website, and yet, anything less than this is a dangerously weak statement. To control specific pain, some physicians that circumcise use Tylenol, sugar,memory<ref>{{REFweb |quote=To calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, and soothing music is played in the room. |url=http://www.pollockclinicsspiegel.comde/circumcisionspiegel/vorab/circumcisionexperte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-guide849534.html |title=ParentsKinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder |trans-title=Children' Guide to Circumcisions pain expert warns: Ritual circumcision changes the brain of children |language=German |last=Prof. Dr. med. Boris Zernikow

|publisher=Spiegel Online |website= |date=2012-08-12 |accessdate=20112019-0410-0811 |format= |quote=}}</ref><ref>{{REFweb |quote=During . In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the circumcisionoperation. Overall, your son will receive sugar pacifiers to suck on which reduce his their pain threshold was lower and the risk of chronic pain perceptionsincreased. |urlRegardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFjournal |last=Garry |init=http://www.pollockclinics.com/circumcision/circumcision-before.htmlT |title=Before the Circumcision: a survey of fees and practices |lastjournal=OBG Management |firstdate=1994 |publishervolume=October |dateissue= |pages=34-6 |url=2011-04-08 |accessdate=2011-04-08}}</ref> a topical cream,<ref>{{REFwebREFjournal |quotelast=Then in our office, he will have topical anesthetic applied to his penis.Howard |urlinit=http://www.pollockclinics.com/circumcision/circumcision-before.htmlCR |titlelast2=Before the CircumcisionHoward |lastinit2=FM |firstlast3=Garfunkel |publisherinit3=LC |datelast4=2011-04-08de Blieck |init4=EA |last5=Weitzman |accessdateinit5=2011-04-08M}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb |title=Neonatal circumcision and pain relief: current training practices |quotejournal=We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection.Pediatrics |date=1998 |volume=101 |urlissue=http://www.pollockclinics.com/circumcision/circumcision-guide.html |titlepages=Parents' Guide to Circumcision423-8 |lasturl= |firstaccessdate= |publisher}}</ref><ref>{{REFjournal |last=Stang |dateinit=HJ |accessdatelast2=2011-04-08Snellman}}</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 |init2=LW |title=Circumcision practice patterns in stopping the pain of circumcision.<ref name="Journal of Perinatology April/May 2002">{{REFjournalUnited States |lastjournal=TaeuschPediatrics |firstdate=H. William1998 |initvolume=HW101 |last2issue=Martineze5 |first2pages=Alma M. |init2url=AM |last3accessdate=Partridge |first3note=JLink to [[AAP]] website}}</ref>. Colin |init3=JC |last4=Sniderman |first4=Susan |init4=S |last5=ArmstrongDuring procedures which take several minutes, babies tend to fall into a state of stupor, which in the past was falsely interpreted as peaceful sleep, nurturing the belief that babies felt no pain. Measurements taken in those cases revealed a typically 3- to 4-Wellsfold increase in cortisol levels, which equals a state of severe [[shock]].<ref>{{REFjournal |first5last=JenniferGunnar |init5init=JMR |last6last2=Fuentes-AfflickFisch |first6init2=ElenaRO |init6last3=EKorsvik |titleinit3=Pain During Mogen or Plastibell CircumcisionS |journallast4=Journal of PerinatologyDonhowe |volumeinit4=22JM |issuetitle=3 The effects of circumcision on serum cortisol and behavior |journal=Psychoneuroendocrinology |date=1981 |volume=6 |issue=3 |pages=214269-21875 |url=httphttps://www.naturecirp.comorg/jplibrary/journal/v22/n3pain/fullgunnar/7210653a.html |quoteaccessdate=...more than half of the study group had what we considered excessive pain2019-11-26}}</discomfort over the course ref>* Postoperative wound pain, in the case of children's circumcisions conceivably worsened by the forceful breaking of the entire procedurepreputial adhesions. |pubmedID= |pubmedCID= |DOI=* Postoperative pain from the exposure of the sensitive glans penis to clothing. This pain will endure for several weeks or even longer in some cases. |note=April/May 2002 |date=2002-04 |accessdate=2011-04-08}}</ref>* Postoperative [[bleeding]] of the wound. This can have severe consequences especially for very young infants, if they are not treated promptly. Their blood volume is only about 85 ml per kilogram of body weight, and even moderate blood loss can lead to hypovolaemia, hypovolaemic [[shock]] and even death.<ref name="Clinical Pediatrics August 1986">{{REFjournalREFbook |last=Williamson |first=Paul S. |inityear=PS2000 |last2title=EvansPaediatric Handbook |first2url=Nolan Donovan |init2work=ND |titleeditors=Neonatal Cortisol Response to Circumcision with AnesthesiaSmart J, Nolan T. |journaledition=Clinical Pediatrics6 |volume=25 |issuechapter=8 |pagespage=412-41682 |urllocation=http://cpj.sagepub.com/content/25/8/412.abstract {{AUSC|VIC}}, Australia |quotepublisher=The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine.Blackwell Science Asia |pubmedIDisbn= |pubmedCIDquote= |DOIaccessdate= |datenote=1986-08 |accessdate=2011-04-08}}}}</ref> During circumcision, somp physicians give children sugar pacifiers to "reduce the perception of pain",<ref>{{REFwebREFdocument |quotetitle=Autopsy of Demetrius Manker |url=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |urlcontribution=http://www.pollockclinics.com/circumcision/circumcisionCase 93-before.html1711 |titlelast=Before the CircumcisionWetli |lastfirst=CV |firstpublisher=Miami: Dade County Medical Examiner Department |publisherformat= |date=20111993-0406-0823 |accessdate=2011-04-08}}</ref> but in at least one study, data shows that giving sugar to a child doesn't help to reduce the perception of pain in the child.<ref name="Lancet, The 2010-10-09">>{{REFjournal |last=SlaterHiss |firstinit=RebeccahJ |initlast2=RHorowitz |first2init2=LauraA |init2last3=LKahana |last2init3=CornelissenT |first3title=LorenzoFatal haemorrhage following male ritual circumcision |init3journal=LJ Clin Forensic Med |last3date=Fabrizi2000 |first4volume=Debbie7 |init4issue=D |last4pages=Patten32-4 |first5url=Janhttps://www.cirp.org/library/death/hiss1/ |init5accessdate=J2019-11-06 |last5=Yoxen}}</ref><ref>{{REFdocument |first6title=AlanJudgement of inquiry into the death of McWillis, Ryleigh Roman Bryan |init6url=A |last6=Worleyhttp://www.circumstitions.com/death-exsang.html |first7contribution=Stewart |init7last=SNewell |last7first=BoydTEC |first8publisher=JudithBurnaby, B.C.: B.C. Coroner's Service |init8format=J |last8date=Meek2004-01-19 |first9accessdate=Maria2019-11-26 |init9=M}}</ref> |last9=Prof* Post operative [[lymphoedema]]. Fitzgerald * Postoperative [[Infection|title=Oral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trialinfections]]. This includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.<ref>{{REFconference |journallast=The LancetDr. med. Hartmann |volumefirst=376Wolfgang |issueurl=9748 |pagesplace=1225-1232Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German) |urltitle=http://wwwStellungnahme zur Anhörung am 26.thelancet.com/journals/lancet/article/PIIS0140November 2012 [Opinion on the hearing on 26 November 2012] (German) |date=2012-6736%2810%296130311-7/fulltext26 |quoteaccessdate=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 }}</ref>* [[Wound dehiscence]], meaning the separation of the edges of sucrose to reduce clinical observational scores the wound or the tissue after noxious events in newborn infants should not be interpreted as pain reliefsuturing. * Adhesion between the surface or rim of the [[Glans penis|pubmedID= |pubmedCID= |DOI= |date=2010glans]] with the neighbouring [[penile skin]], causing [[skin]] pockets and bridges, as well as visually unpleasant results like uneven scars, which make a re-10-09circumcision necessary. |accessdate=2011* Postoperative [[phimosis]]: a phimotic ring can develop during scarring, which makes a re-04-08}}circumcision necessary. According to a study by Blalock et al.</ref> Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals.{{REFjournal |last=BlalockIt has been shown that an infant's response to [[pain]] can be altered for years as a consequence of circumcision.<ref>{{REFjournal |init=HJ |lastlast2=TaddioVemulakonda |firstinit2=AnnaV |initlast3=ARitchey |first2init3=MortonML |init2last4=MRibbeck |last2init4=GoldbachM |first3title=MosheOutpatient management of [[phimosis]] Following newborn circumcision |init3journal=MJ Urol |last3date=Ipp2003 |first4volume=Bonnie169 |init4issue=B6 |last4pages=Stevens2332-4 |first5url=Gideonhttps://www.cirp.org/library/complications/blalock1/ |init5accessdate=G |last5=Koren2019-11-26}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal |titlelast=Effect of neonatal circumcision on pain responses during vaccination in boysLeitch |journalinit=The LancetIOW |title=Circumcision - a continuing enigma |journal=Aust Paediatr J |date=1970 |volume=3456 |issue=8945 |pages=29159-265 |url=httphttps://www.cirp.org/library/paingeneral/taddioleitch1/ |quoteaccessdate=2019-12-15 |pubmedID=7837863 |pubmedCID= |DOI= |date=1995 |accessdate=}}}}</ref><ref>{{REFjournal5.5%. |last=Taddio* [[Sudden Infant Death Syndrome]] (SIDS). |first=Anna |init=A |last2=Katz |init2=J* 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. |last3=Ilersich |init3=AL* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro-penis) and induratio [[penis]] plastica (skewed penis). |last4=Koren * Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis|init4=Gglans]] or the [[penis]] can occur. |title=Effects * 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 neonatal circumcision on pain response during subsequent routine vaccination |journal=The Lancet |volume=349 |issue=9052 |pages=599-603Metzitzah 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 |url=http://www.thelancetnytimes.com/journals2012/lancet03/article08/PIIS0140nyregion/infants-death-renews-debate-over-a-6736(96)10316circumcision-ritual.html?_r=0/fulltext |quotetitle=Baby’s Death Renews Debate Over a Circumcision Ritual |pubmedIDlast=9057731Robbins |pubmedCIDfirst=Liz |DOIdate=10.1016/S01402012-6736(96)1031603-007 |dateaccessdate=19972019-10-03 |accessdate=11}}</ref>=== Death ==={{Box|Boxtext=<big><b>However, none of the above three procedures totally eliminate pain. A baby boy will still experience some pain despite any of those analgesic procedures. Prevention of pain requires protecting a boy from elective A study in 2010 estimated approximately 117 neonatal noncircumcision-therapeutic circumcision. Only boys who are protected from the medically unnecessary circumcision surgery experience no pain or trauma.</b></big>}} === Sexual effects === Circumcision and frenectomy remove tissues with heightened erogenous sensitivity. Boyle et al. (2002) wrote, "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings&mdash;many of which are lost to circumcision."<ref>{{REFjournal |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=http://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." The [[amputation]] of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the penis, leaving only the uninhibited protopathic sensibility of the artificially externalized glans penis. The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of the changes in sexual behavior noted in circumcised human males.<ref>{{REFjournal |last=Van Howe |init=RS |author-link=Robert S. Van Howe |last2=Cold |init2=CJ |title=Advantages and Disadvantages of Neonatal Circumcision |journal=The Journal of the American Medical Association |volume=277 |issue=13 |pages=1052-7 |url=http://www.ncbi.nlm.nih.gov/pubmed/9218663 |quote= |pubmedID=9218663 |pubmedCID= |DOI= |date=1997-04-02 |accessdate=}}</ref> Histology of the male circumcision scar shows related [[amputation]] neuromas, Schwann cell proliferation and the bulbous collection of variably sized neurites. [[AmputationDeath| deaths]] neuromas do not mediate normal sensation and are notorious for generating pain.<ref name="ColdCJ TaylorJR 1999"/> === Death ===A study in 2010 estimated approximately 117 neonatal circumcision-related deaths occur annually in the [[United States]], about one out of every 77 male neonatal deaths, more than suffocation, auto accidents, or even [[SIDS]].<ref name="Bollinger 2010">{{REFjournal |last=Bollinger

|pages=72-733

Human babies, because they are not yet in possession of language, are incapable of giving or refusing consent for being 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>{{REFbook

|pages=259-27171

}}</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 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]], a the written consent of both parents is required, if a physician is to perform a non-therapeutic circumcision of a child.<ref>{{REFjournal

|pages=307-31414 |url=httphttps://www.cirp.org/library/legal/Re_J/2000.html

In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<ref>See, e.g., [[Margaret A. Somerville|Somerville]], "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; [[Abbie Chessler|Chessler]], "Justifying the Unjustifiable"; Smith, "Male Circumcision."</ref> For example, critics have pointed out that, in the [[United States]], more than 1.3% of male neonatal deaths are attributable to the complications of non-therapeutic circumcision surgery.<ref name="Bollinger 2010"/>==Video=====Is circumcision healthy?===The video ''Is Circumcision Healthy'' is recommended for parental viewing.<br><br> <youtube>D_3LQjZgdbQ</youtube> ===Dr. Christopher Guest discusses circumcision===<br><youtube>v=TQIp9f4krVQ</youtube> ===Plastibel circumcision===

'''Not for the squeamish:'''

Male circumcision is harmful because it excises healthy tissue and permanently impairs beneficial physiological functions. Male circumcision also causes psychological problems that tend to perpetuate the cycle of abuse. Male circumcision is a costly diversion of medical resources away from beneficial services. Male circumcision violates legal rights, [[human rights]], and ethical standards. Finally, we must remember that males are the more vulnerable and sensitive of the two genders and, therefore, deserve the greater degree of protection from traumatic, invasive, injurious,and unnecessary surgery. For all of these reasons the non-therapeutic circumcision of boys should not be performed and the [[genital integrity]] of all children should be respected and protected.<ref name="hill2007">{{REFjournal

|pages=318-32323

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>{{REFdocument

Ethical and [[human rights ]] concerns have been raised regarding elective infant male

* Medical historian [[Robert Darby]] (2014) wrote simply:<blockquote>"To avoid circumcision complications, avoid circumcision."<ref>{{REFjournal |last=Darby |first= |init=R |author-link=Robert Darby |etal=no |title=To avoid circumcision complications, avoid circumcision |trans-title= |language= |journal=Can Urol Assoc J |location= |date=2014-08-14 |volume=8 |issue=7-8 |article= |page=231 |pages= |url=https://cuaj.ca/index.php/journal/article/view/1709/1823 |archived= |quote= |pubmedID= |pubmedCID= |DOI=10.5489/cuaj.1709 |accessdate=2022-12-16}}</ref></blockquote>* The [[Canadian Paediatric Society]] (CPS) (2015) said: <blockquote>In most jurisdictions, authority is limited only to interventions deemed to be medically necessary. In cases in which medical necessity is 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=Sorokin |first=S. Todd

The term "circumcision" without a gender qualifier refers specifically to male circumcision. It means "to cut around," and it refers to the [[excision]] of the [[foreskin]] from the penis. The 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 [[Religion and Culture|religious or cultural]] reasons. The procedure may be performed on consenting adults, but it is most often performed on non-consenting minors, particularly newborn children, which is why the ritual is so controversial. Opponents of circumcision consider the circumcision of non-consenting minors to be unethical and a [[human rights ]] violation, unless there is concrete [[medical indication]]. Proponents === Consent by surrogates ===Medical ethics has long recognized limitations on the power of circumcision consider the circumcision consent by surrogates.<ref>{{REFjournal |last=Committee on Bioethics, American Academy of nonPediatrics |etal=no |title= Informed consent, parental permission, and assent in pediatric practice |trans-title= |language= |journal=Pediatrics |location= |date=1995 |volume=95 |issue=2 |article= |page= |pages=314-17 |url=https://www.cirp.org/library/ethics/AAP/ |archived= |quote= |pubmedID=7478854 |pubmedCID= |DOI= |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=2016-08 |volume=138 |issue=2 |article= |page=e20161485 |pages= |url=https://watermark.silverchair.com/peds_20161485.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQM8zYHFd0Ylu9Annq_AgEQgIICT24ikc839aJMYOiypqC2G9f7_yKGAGkAekzzbCtck5TElALWVCGNoVSOaA6rDA_dOkQ_LyJnxYlZ88J9-uk15tvlIBbE82_aNyYfq5e9xmEfqD2vh374q3Naz57dxZaUbgxUkKX4PqsiLmYHLvVrr7bQK2MZuuUOKiQU8JZy7lLjkp-PjJO1U9cyIplTAgs_EdvgK8MWWoIsj-X-ZUDImAG63-rlj_qLsy5dYwytmxfCuVa47RdZseLSr2_bdDpwKAKGhq_Ly9rlHZeW_f7fYktVfF_sFTgcJziAlvEQmdyWIw0qf-hlO31Qb3sH6kDdcvHAbm7llY5xa34XLYIt8QR0YFIimgDGFliN4-ce2vjvvrwS85WeeNFhpn-Ywn4Qjpy06hPuLDL-MtI2Z3BZbBsKq4dp8qGu1q9GlXaKw193riTFG9G5bF5GCKmxmt0nCQTthrb_CcK2UhKjZwPekC9zkIUHPZ9BXJt0SM03F_g-GgqbE0hTYKMqNdJ3sHDQu2luFrJ9JEiMzxtP28gJoYh20d2APA0xrRbXBYsFdAlr50gb1BSAbNJhTyx-Kh3geoSHsAYMjPaG7cIbh0jd42pWCUx30vjlAGK8zXTuf7-31oi81CLbHTAJLuzK3NT4Whi17jVq1SbXsIXlWpKc_d-HujCvlb74rkZQ6RG9wkxW7gAKaDqtKv5zTOTMBD9vLVxgp8lDmVA8PFB59Bqd6w-fi86tW132oWQM-mTfwdIBXFbUFXkeTUC5RYyqJQIXAEwLJSRm1RX-consenting minors to be a "religious freedom" and a "parental rightLRbKRzgaRQ |archived= |quote= |pubmedID=27456510 |pubmedCID= |DOI=10.1542/peds."2016-1485 |format=PDF |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=British family court opinion |date=2016-08 |volume=138The |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=2023-05-21}}</ref> Two ethicists, Myers & Earp (2020), have conducted a detailed review and analysis of the claimed medical benefits of ''non-therapeutic '' [[circumcision ]]. They have determined than the alleged benefits are not material, so they do not support granting of male children came before consent by a surrogate. In other words, ''Non-therapeutic'' circumcision is not truly healthcare. Moreover, they comment that even the most perfectly executed surgery produces [[trauma]] and harm to the patient. Circumcision also produces tissue loss and loss of function, therefore, circumcision should be performed only after the court in individual reaches the case age of consent. <u>Consent by a surrogate for a ''non-therapeutic'' circumcision of a minor child is an unethical practice.</u><ref name="myers2020">{{REFjournal |last=Myers |first= |init=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 ==[[Re B and G (children) (No 2) EWFC 3Intact America]] (20152024)'' . In that case, Judge Sir James Munby ruled argues that public opinion regarding non-therapeutic [[circumcision ]] of male children caused ''significant harm''is approaching or at a "tipping point" at which [[intact]] genitals would be preferred over the [[circumcised]] variety. <ref>{{REFweb |url=https://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=2024-03-23 |accessdate=2024-04-09}}</ref>{{SEEALSO}}* [[Adolescent and adult circumcision]]* [[Bodily harm]]* [[Breastfeeding]]* [[Case Histories]]* [[Circumcision maps]]* [[Circumcision methods]]* [[Circumcision scar]]* [[Circumpendium]]* [[Circumstraint]]* [[Documented severe complications of circumcision]]* [[Ethics of non-therapeutic child circumcision]]* [[FGM]]* [[Human rights]]* [[Lymphoedema]]* [[MGM]]* [[Pain]]* [[Psychological issues of male circumcision]]* [[Rights situation on circumcision]]* [[Risks and complications]]* [[Sexual effects of circumcision]]* [[Sudden Infant Death Syndrome]] (SIDS).* [[Trauma]]{{LINKS}}

|url=httphttps://www.cirp.org/library/anatomy/garcia/ |title=What exactly is circumcision and what is it not? |last=Garcia |first=Francisco |date=1995-12-11 |accessdate=2020-09-08}}* {{REFjournal |last=Fleiss |first=Paul |init=P |author-link=Paul M. Fleiss |title=The foreskin is necessary |journal=Mothering |date=1997-01 |volume= |issue= |pages=36-45 |url=http://www.noharmm.org/mothering.htm |accessdate=2020-06-29}}*{{REFweb |url=https://15square.org.uk/losses-from-circumcision/ |title=Losses from Circumcision |last=Ball |first=Peter |publisher=15 Square |date=2003-08-09 |accessdate=2023-02-23}}* {{REFweb

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