Changes

"Male '''circumcision''' (from Latin ''circumcidere'', meaning "to cut around") is the surgical removal or [[amputation]] of the [[foreskin]] (prepuce) , a major part of the human [[penis]]. The foreskin comprises ''more than fifty percent'' of the epithelium of the [[penis]].<ref name="taylor1996">{{TaylorJR LockwoodAP TaylorAJ 1996}}</ref> When the "cutting around" is performed, the foreskin falls off, so [[amputation]] and [[mutilation]] is the result. The amputation destroys the [[Foreskin#Physiological_functions| many protective, immunological, sexual, and sensory physiological functions]] of the foreskin, so it is a very harmful and [[Pain| painfdulpainful]] surgery.<ref name="garrett2023-11-10">{{REFweb The procedure is most often an elective, non |url=https://intactamerica.org/pros-therapeutic surgery without [[medical indication]] performed on neonates and children for religious and cultural reasons in violation -cons-of the child's [[human rights]] to [[physical integrity]], but in older patients may be rarely indicated for therapeutic reasons. -circumcision/ It is a radical treatment option for pathological [[phimosis]], refractory [[Balanitis| balanoposthitis]] title=Pros and chronic [[urinary tract infection]]s Cons of Circumcision (UTIsSpoiler: You’ve Been Lied to); it is contraindicated in cases of certain genital structure abnormalities or poor general health. |last=Garrett |first=Connor |init= |author-link=Connor Judson Garrett |publisher=Intact America |date=2023-11-10 |accessdate=2024-06-02'''Posthectomy''' is a more accurate medical term that more accurately reflects the injury and loss of functional body tissue, but the Biblical [[euphemism]], ''circumcision'', is more commonly used. }}</ref>

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.<ref name="garrett2023-11-10" /> 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

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:

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]].

=== [[Medical indication]] ===There are no [[medical indication| medical indications ]] for circumcision of the newborn. The [[circumcision industry]] offers circumcision of the newborn to the public because of the [[financial incentive]].

The form of circumcision adopted by the medical community essentially was equivalent to the Jewish form with ''[[periah]]'', so it inflicted the maximum injury.

In a few cases with older patients, circumcision is legitimately indicated; a patient may be suffering recurring infections, and other methods of treatment have failed. In other cases, a patient may be suffering from a severe case of [[phimosis]]. Overall, the actual medical necessity for circumcision is extremely raresince many conditions respond to conservative treatment. All circumcisions injure the patient by amputating the [[foreskin]] its with many protective, immunological, sensory, and sexual [[Foreskin#Physiological_functions| functions]].

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

|url=httphttps://www.cirp.org/library/history/encyclopaediabritannica1876/

Initially, circumcision was adopted in the 19th century as a way to stop boys and men from masturbating, where when [[masturbation]] was seen as claimed to be the cause for many diseases. As the myth that circumcision prevented masturbation became debunked, advocates of circumcision began the great search to find the "medical benefits" of circumcision.

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

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

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.

|url=httphttps://www.cirp.org/library/complications/blalock1/

|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

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

|url=httphttps://www.cirp.org/library/general/laumann/

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

|url=httphttps://www.cirp.org/library/disease/UTI/mccracken/

}}</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

* 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

* It can be concluded that circumcision is ineffective as a preventive measure against UTIs[[UTI]].

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.

== Pain ==It is too dangerous to administer general anesthesia to newborn infants, so infant boys experience severe pain during circumcision.<ref name="garrett2024-01-09">{{REFweb |url=https://intactamerica.org/disadvantages-of-circumcision/ |title=10 Disadvantages of Circumcision & Horrifying Facts |last=Garrett |first=Connor |init= |author-link=Connor Judson Garrett |publisher= Risks and late effects Intact America |date=2024-01-09 |accessdate=3034-06-04}}</ref>Just like tonsil or appendix surgeryIn the past, advocates of circumcision is claimed that a surgical intervention newborn child's nerve system was not yet fully developed, and brings that as a result, the usual risks related to surgical operations, alongside several specific risks of complications and late effectschild felt no [[pain]] during the circumcision procedure. Uberoi et al[[Kanwaljeet J. Singh Anand| Anand]] & Hickey (20221987) report "some men are experiencing a complex negative constellation of psychological, physicalhave shown that newborn children do in fact feel [[pain]], and sexual associations that lead to significant emotional distress directed both internally and externallymore acutely than adults. The posts also reveal a discovery phenomenon wherein men discover the physical and psychological manifestations of the decisions made by others to modify their genitals."<ref name ="uberoi2022anand-hickey1987">{{REFjournal |last=UberoiAnand |first= |init=MKJS |author-link=Kanwaljeet J. Singh Anand |last2=AbdulcadirHickey |first2= |init2=JPR

|last3=Ohi |first3= |init3=DA |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=yesno |title=Potentially under-recognized late-stage physical Pain and psychosexual complications of non-therapeutic neonatal penile circumcision: a qualitative its effects in the human neonate and quantitative analysis of self-reports from an online community forumfetus

|journal=Int New Engl J Impot ResMed

|date=20221987-1011-2319 |volume=317 |issue= |article= |page=21 |pages=1321-9 |url=https://www.naturecirp.comorg/articleslibrary/pain/anand/s41443-022-00619-8 |archived= |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=362741893317037

|DOI=10.10381056/s41443-022-00619-8NEJM198711193172105 |accessdate=20232019-0111-08}}</ref>This has led American health associations to recommend doctors take measures to reduce the [[pain]] of circumcision in infants.

=== Possible operative and postoperative complications === The [https://www.cirp.org/library/statements/aap1999/|AAP Circumcision Policy Statement] (1999) states quite clearly that ''"There is surgery. Surgical complications of circumcision generally may be classified as considerable evidence that newborns who are [[Bleeding| hemorrhagecircumcised]]without analgesia experience pain and physiologic stress"''. Furthermore, [[infection]]the pain is quite severe, or surgical misadventure up to and including loss 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 penis and [[death]]phases associated with extensive tissue trauma such as...<ref name=tightening of the clamp"deacon2022" />''.<ref name="williams-kapilla1993">{{REFjournal |last=Williams |init=N |author-linkfirst= |last2=Kapilla |init2=L |author2-link= |etal=no |title=Complications American Academy of circumcision |trans-title= |language=Pediatrics: Circumcision Policy Statement; Task Force on Circumcision |journal=Brit J Surg |location=Pediatrics |date=19931999-1003 |volume=80103 |issue=103 |pages=1231686-693 |url=httphttps://wwwpediatrics.cirpaappublications.org/librarycontent/103/complications3/williams686#sec-kapila/9 |quoteaccessdate=2019-11-26 |pubmedID=8242285 |pubmedCIDnote= |DOI=10Statement Reaffirmed Sept.1002/bjs.1800801005 |accessdate=2019-11-271, 2005

* Intolerance or allergic reactions to the narcotics usedThe [[AAFP]] (2002) states quite simply in their [https://www.cirp.* Especially in newbornsorg/library/statements/aafp2002/| position paper], where the bodily ''"Newborns experience pain reduction mechanisms are during circumcision".''<ref>{{REFweb |title=Circumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed |website=Official 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 fully developed, local anaesthesia it is often insufficient not widely accepted, even by some doctors. It might be hard for some doctors to accept, as they may have been taught that the operation. Even in conjunction with regional anaesthesia of the dorsal nerve of the infant does not feel [[penispain]], the rate and may have performed countless circumcisions with this idea. Usage of failure to provide sufficient anaesthetic even anesthesia for experienced anaesthetists infant circumcision is still 5by 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%. The general anaesthesia that would be needed for newbornsof the Council on Scientific Affairs], however, poses significant risks for the child, and, therefore, AMA states ''"When the decision is only likely made to proceed with circumcision, local anesthesia should be used in emergenciesprovided for the procedure. [[Ring block]] or [[dorsal penile nerve block]] [injections] are most effective. A surgical operation without proper [[painEMLA]] control can lead to 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 development 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 a specific pain memoryobstetricians"''.<ref>{{REFweb |title=Report 10 of the Council on Scientific Affairs (I-99): Neonatal Circumcision |website=American Medical Association Official Website |url=http://www.spiegelama-assn.deorg/spiegelama/vorabno-index/experteabout-warntama/13585.shtml |accessdate=2011-rituelle05-beschneidung04}}</ref> The AAP's [http://www.healthychildren.org/English/ages-veraendertstages/prenatal/decisions-dasto-gehirnmake/pages/Where-derWe-kinderStand-a-849534Circumcision.html |title=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder |trans-title=aspx Heatlhy Childrenwebsite] suggests ''s pain expert warns: Ritual circumcision changes "Your pediatrician (or your obstetrician) should discuss the brain forms of children |language=German |last=Profanalgesia that are available"''. Dr. med. Boris Zernikow<ref>{{REFweb |firsttitle=Where We Stand: Circumcision |publisher=Spiegel Online[[AAP]] |websitedate=2011-03-23 |dateurl=2012http://www.healthychildren.org/English/ages-08stages/prenatal/decisions-to-make/pages/Where-We-Stand-12Circumcision.aspx |accessdate=2019-10-11 |format= |quote=12}}</ref>Be that as it may, few forms of analgesia are recommended. In unsedated 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 is known from aforementioned official documents, the AAP website may be more informative and partially sedated infants increased secretion effective if it would say ''"Make sure your doctor knows of the stress hormone cortisol could ineffectiveness of anything short of local anesthesia, and make sure your baby is given an injection. This is your responsibility, because your doctor may or may not be observed for months after up to date on the operationlatest understandings of infant sensitivity to [[pain]] during circumcision. Overall"'' The AAP may be holding back, however, perhaps because this would upset the doctor/parent power relationship, their pain threshold was lower and the risk may cause too much questioning of chronic pain increaseddoctors in general. Regardless One may not expect to find this kind of these findingsadvice on such a website, and yet, anything less than this is a dangerously weak statement. To control [[pain]], some physicians that circumcise use Tylenol, sugar, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFjournalREFweb |lastquote=GarryTo 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=Thttp://www.pollockclinics.com/circumcision/circumcision-guide.html |title=Parents' Guide to Circumcision: a survey of fees and practices |journallast=OBG Management |datefirst=1994 |volumepublisher=October |issuedate= |pagesaccessdate=342011-6 |url= |accessdate=04-08}}</ref><ref>{{REFjournalREFweb |lastquote=HowardDuring the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |initurl=CRhttp://www.pollockclinics.com/circumcision/circumcision-before.html |last2title=HowardBefore the Circumcision |init2last=FM |last3first=Garfunkel |init3publisher=LC |last4date=de Blieck2011-04-08 |init4accessdate=EA2011-04-08 |last5=Weitzman}}</ref> a topical cream,<ref>{{REFweb |init5quote=MThen in our office, he will have topical anesthetic applied to his penis. |titleurl=Neonatal http://www.pollockclinics.com/circumcision/circumcision and pain relief: current training practices-before.html |journaltitle=PediatricsBefore the Circumcision |datelast=1998 |volumefirst=101 |issuepublisher= |pagesdate=4232011-8 |url=04-08 |accessdate=2011-04-08}}</ref>and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFjournalREFweb |lastquote=StangWe use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection. |initurl=HJ |last2=Snellman |init2=LWhttp://www.pollockclinics.com/circumcision/circumcision-guide.html |title=Parents' Guide to Circumcision practice patterns in the United States |journallast=Pediatrics |datefirst=1998 |volumepublisher=101 |issue=e5 |pages= |urldate= |accessdate= |note=Link to [[AAP]] website2011-04-08}}</ref>. During procedures which take several minutes, babies tend Topical anaesthetic only serves to numb the area to fall into a state lessen the pain of stupor, which in the past was falsely interpreted as peaceful sleepinjection, nurturing the belief but studies have shown that babies felt no pain. Measurements taken in those cases revealed a typically 3- to 4-fold increase [[dorsal penile nerve block]] is only partially effective in cortisol levels, which equals a state of severe stopping the [[shockPain| pain of circumcision]].<refname="Journal of Perinatology April/May 2002">{{REFjournal |last=GunnarTaeusch |first=H. William |init=MRHW |last2=FischMartinez |first2=Alma M. |init2=ROAM |last3=KorsvikPartridge |first3=J. Colin |init3=SJC |last4=DonhoweSniderman |first4=Susan |init4=JMS |last5=Armstrong-Wells |titlefirst5=Jennifer |init5=J |last6=Fuentes-Afflick |first6=Elena |init6=The effects of circumcision on serum cortisol and behaviorE |journaltitle=PsychoneuroendocrinologyPain During Mogen or Plastibell Circumcision |datejournal=1981Journal of Perinatology |volume=622

|pages=269214-758 |url=http://www.cirpnature.orgcom/libraryjp/journal/v22/n3/full/7210653a.html |quote=...more than half of the study group had what we considered excessive pain/gunnardiscomfort over the course of the entire procedure. |pubmedID= |pubmedCID= |DOI= |note=April/May 2002 |date=2002-04 |accessdate=20192011-1104-2608}}</ref>* Postoperative wound pain, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions.* 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.* 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.<refname="Clinical Pediatrics August 1986">{{REFbookREFjournal |last=Williamson |first=Paul S. |yearinit=2000PS |titlelast2=Paediatric HandbookEvans |urlfirst2=Nolan Donovan |workinit2=ND |editorstitle=Smart J, Nolan T.Neonatal Cortisol Response to Circumcision with Anesthesia |editionjournal=6Clinical Pediatrics |volume=25 |chapterissue=8 |pagepages=82412-6 |locationurl={{AUSChttp://cpj.sagepub.com/content/25/8/412.abstract |VIC}}, Australiaquote=The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine. |publisherpubmedID=Blackwell Science Asia |isbnpubmedCID= |quoteDOI= |accessdatedate=1986-08 |noteaccessdate=2011-04-08}}</ref>During circumcision, somp physicians give children sugar pacifiers to "reduce the perception of pain",<ref>{{REFdocumentREFweb |titlequote=Autopsy of Demetrius MankerDuring the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |url=http://www.pollockclinics.com/circumcision/circumcision-before.html |contributiontitle=Case 93-1711Before the Circumcision |last=Wetli |first=CV |publisher=Miami: Dade County Medical Examiner Department |format= |date=19932011-0604-2308 |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.<refname="Lancet, The 2010-10-09">{{REFjournal |last=HissSlater |first=Rebeccah |init=JR |first2=Laura |init2=L |last2=HorowitzCornelissen |init2first3=Lorenzo |init3=AL |last3=KahanaFabrizi |init3first4=Debbie |init4=D |last4=TPatten |titlefirst5=Fatal haemorrhage following male ritual circumcisionJan |journalinit5=J Clin Forensic Med |datelast5=2000Yoxen |volumefirst6=7Alan |issueinit6=A |pageslast6=32-4Worley |urlfirst7=http://www.cirp.org/library/death/hiss1/Stewart |accessdateinit7=2019-11-06S}}</ref><ref>{{REFdocument |last7=Boyd |titlefirst8=Judgement of inquiry into the death of McWillis, Ryleigh Roman BryanJudith |urlinit8=http://www.circumstitions.com/death-exsang.htmlJ |contributionlast8=Meek |lastfirst9=NewellMaria |firstinit9=TECM |publisherlast9=Burnaby, B.CProf.Fitzgerald |title=Oral sucrose as an analgesic drug for procedural pain in newborn infants: B.C. Coroner's Servicea randomised controlled trial |formatjournal=The Lancet |datevolume=2004-01-19376 |accessdateissue=2019-11-269748}}</ref>* Post operative [[lymphoedema]].* Postoperative [[Infection | infections]]. This includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.<ref>{{REFconferencepages=1225-32 |lasturl=Drhttp://www. medthelancet. Hartmanncom/journals/lancet/article/PIIS0140-6736%2810%2961303-7/fulltext |firstquote=WolfgangOur data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuits, and therefore might not be an effective analgesic drug. The ability of sucrose to reduce clinical observational scores after noxious events in newborn infants should not be interpreted as pain relief. |urlpubmedID= |placepubmedCID=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German) |titleDOI=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German) |date=20122010-1110-2609 |accessdate=2011-04-08}}</ref>Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals. * It has been shown that an infant's response to [[Wound dehiscencepain]]can be altered for years as a consequence of circumcision.<ref>{{TaddioA etal 1995}}</ref><ref>{{TaddioA KatzJ IlersichAL KorenG 1997}}</ref> {{Box|Boxtext=<big><b>However, meaning the separation none of the edges above three procedures totally eliminate pain. A baby boy will still experience some pain despite any of the wound or the tissue after suturingthose analgesic procedures.* Adhesion between the surface or rim Prevention of the [[Glans penis|glanspain]] with requires protecting a boy from elective neonatal non-therapeutic circumcision. Only boys who are protected from the neighbouring medically unnecessary circumcision surgery experience no [[penile skinpain]], causing or [[skintrauma]] pockets .</b></big>}} == Risks and bridges, as well as visually unpleasant results effects ==Just like uneven scarstonsil or appendix surgery, which make circumcision is a resurgical intervention and brings the usual risks related to surgical operations, alongside several specific risks of complications and late effects.<ref name="garrett2024-01-circumcision necessary09" /> Uberoi et al.* Postoperative [[phimosis]]: (2022) report "some men are experiencing a phimotic ring can develop during scarringcomplex negative constellation of psychological, physical, which makes a re-circumcision necessaryand sexual associations that lead to significant emotional distress directed both internally and externally. According to The posts also reveal a study discovery phenomenon wherein men discover the physical and psychological manifestations of the decisions made by Blalock et alothers to modify their genitals."<refname ="uberoi2022">{{REFjournal |last=BlalockUberoi |first= |init=HJM |author-link= |last2=VemulakondaAbdulcadir |first2= |init2=VJ |author2-link= |last3=RitcheyOhi |first3= |init3=MLDA |author3-link= |last4=RibbeckSantiago |first4= |init4=MJE |author4-link= |last5= |titlefirst5=Outpatient management of [[phimosis]] Following newborn circumcision |journalinit5=J Urol |dateauthor5-link=2003 |volumelast6=169 |issuefirst6=6 |pagesinit6=2332 |author6-4link= |urllast7=http://www.cirp.org/library/complications/blalock1/ |accessdatefirst7=2019-11-26}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal |init7= |lastauthor7-link=Leitch |initlast8=IOW |titlefirst8=Circumcision - a continuing enigma |journalinit8=Aust Paediatr J |dateauthor8-link=1970 |volumelast9=6 |issuefirst9= |pagesinit9=59 |author9-65link= |urletal=http://www.cirp.org/library/general/leitch1/yes |accessdatetitle=2019Potentially under-12recognized late-15}}</ref> 5.5%.* [[Sudden Infant Death Syndrome]] (SIDS).* Knot formation stage physical and psychosexual complications of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], is cut during non-therapeutic neonatal penile circumcision without being clamped : a qualitative and sutured at its origin separately, it starts to develop new branches over time, which can lead to the development quantitative analysis of knots.self-reports from an online community forum* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro |trans-penis) and induratio [[penis]] plastica (skewed penis).title= |language=* Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis |glans]] or the [[penis]] can occur.journal=Int J Impot Res* In rare cases, [[necrosis]], gangrene, ischaemia, keloid formation, and circulatory problems may also occur. |location=* When the circumcision is followed by the ultra |date=2022-10-orthodox Jewish ritual of Metzitzah B'Peh (which consists of sucking blood from the wound with the mouth), there is a risk of infection with [[herpes]] simplex type 1, which can lead to brain damage or [[death]].<ref>{{REFweb23 |volume= |issue= |article= |page= |pages= |url=httphttps://www.nytimesnature.com/2012articles/03/08/nyregion/infantss41443-death022-renews00619-debate-over-a-circumcision-ritual.html?_r8 |archived=0 |titlequote=Baby’s Death Renews Debate Over a Circumcision Ritual |lastpubmedID=Robbins36274189 |firstpubmedCID=Liz |dateDOI=201210.1038/s41443-022-0300619-078 |accessdate=20192023-1001-1108}}</ref> === Physical late effects ===* [[Bodily harm]]* [[Circumcision scar]] is an invariable effect.* An unavoidable late effect of any circumcision is the permanent loss of sexual sensitivity. <ref name="garrett2024-01-09" /> 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).

=== Psychological late Sexual effects === [[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late Cepeda-Emiliani et al (2023) cited six reports in the literature of detrimental effects]] are also possible after a of circumcision, especially if the operation was carried out in childhoodincluding erectile function, sensation, masturbatory pleasure, orgasm, and sexual satisfaction. On this occasion a variety The authors also cited three studies of severe distress in [[traumacircumcised]] may occurmen, which depend, among others, on age and circumstances of the due to their infant circumcision. For example, whether the circumcision took place with or without sufficient anaesthesia, if the individual has been informed about the operation beforehandcomplaints of [[glans]] insensitivity, if he was delayed [[circumcisedejaculation]] 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 ownunpleasant sensation. 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. * It was observed that infants, following circumcision without pain control, had a disturbed bond with their mother<refname="cepeda2023">{{REFjournal |last=MarshallCepe da-Emiliani |first= |init=REA |author-link=Alfonso Cepeda-Emiliani |last2=PorterGándara-Cortés |first2= |init2=FLM |author2-link= |last3=RogersOtero-Alén |first3= |init3=AGM |etalauthor3-link= |last4=García |first4=yes |titleinit4=Circumcision: II effects upon motherH |author4-infant interactionlink= |journallast5=Early Hum DevSuárez-Quintanilla |datefirst5=1982 |volumeinit5=7J |issueauthor5-link=4 |pageslast6=367García-74Caballero |urlfirst6=http://www.cirp.org/library/birth/marshall2/ |accessdateinit6=2020T |author6-02-01link= |last7=Gallego}}</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. |first7= |init7=R* In boys [[circumcised]] in childhood, [[posttraumatic stress disorder]] ([[PTSD]]) could be diagnosed. In a study on Philippine boys, in whom no [[PTSD]] was found prior to the operation, 69% of the boys [[circumcised]] in the traditional ritual and 51% of those [[circumcised]] by standard medical procedures (including anaesthesia) fulfilled the DSM |author7-IV criteria for PTSD following the operation.<ref>{{REFbooklink= |lastlast8=RamosGarcía-Caballero |initfirst8=S |last2init8=BoyleR |init2author8-link=GJ |yearetal=2001no |title=Understanding circumcisionImmunohistological study of the density and distribution of human penile neural tissue: A Multigradient hypothesis |trans-Disciplinary Approach to a Multi-Dimensional Problemtitle= |urllanguage=https://link.springer.com/chapter/10.1007/978-1-4757-3351-8_14 |workjournal=Int J Impot Res |editorslocation=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |editiondate=2023-05-02 |volume=35 |chapterissue=3 |article=Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder |pagespage=253-70 |locationpages=New York286-305 |publisherurl=Kluwer Academichttps:/Plenum Publishers/www.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="garrett2024-01-09" /><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 well." The [[amputation]] of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the [[traumapenis]]. These feeling can also be triggered later, when someone leaving only the uninhibited protopathic sensibility of the artificially externalized [[circumcisedglans penis]] as an infant becomes aware of his circumcision. 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 [[human rightscircumcised]] had been violatedhuman males.<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 |quote= |pubmedID=9218663 |pubmedCID= |titleDOI=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. This denial can lead to fathers having their sons [[circumcisedAmputation]] in order neuromas do not mediate normal sensation and are notorious for generating pain.<ref name="ColdCJ TaylorJR 1999"/> Cepeda-Emiliani et al. (2023) commented:<blockquote> Taking the sleve technique as an example of surgical flexibility during circumcision, to 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 a <ref name="goodgarrett2024-01-09" father later in life as well/> On this occasion a variety 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, is passed on to his son by having him 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, and many studies took place on rather a small scale. This situation needs to 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.<ref>{{VanderKolkBA 1989}}</ref> * It was observed that infants, following circumcision without [[pain]] control, had a disturbed bond with their mother<ref>{{REFjournal |last=GoldmanMarshall |init=RRE |author-linklast2=Porter |init2=FL |last3=Rogers |init3=Ronald GoldmanAG |urletal=http://www.cirp.org/library/psych/goldman1/yes |title=The psychological impact of circumcisionCircumcision: II effects upon mother-infant interaction |journal=BJU IntEarly Hum Dev |date=19991982 |volume=837 |issue=Suppl. 14 |pages=93367-10374 |url=https://www.cirp.org/library/birth/marshall2/ |accessdate=20192020-1002-1201}}</ref>, as well as problems with nurturing, up to the point of refusal to be fed. The sleeping habits of these babies were also disturbed, with prolonged non-REM sleep and increased waking. * If the In boys [[circumcised]] male feels incompletein 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 in the traditional ritual and 51% of those [[intactcircumcised]] males, an inferiority complex and depression may occur. This can be accompanied 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=215-21 |accessdateeditors=2019-10-12}}</ref>[[George C. In an online studyDenniston]], 75% of those interviewed stated that they felt incomplete[[Frederick M. Hodges]], and 66% said they felt inferior compared with [[intactMarilyn Fayre Milos]] males.<ref name |edition="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 |lastvolume=Cansever |initchapter=GRitual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder |datepages=1965253-70 |urllocation=http://www.cirp.org/library/psych/cansever/New York |titlepublisher=Psychological effects of circumcisionKluwer Academic/Plenum Publishers |journalisbn=Brit. J. Med. Psychol |volumequote=38 |pagesaccessdate=321-31 |accessdatenote=2019-10-12

* 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=AnandRhinehart |firstinit= |author-link= |last2=Hickey |first2= |author2-link= |etal=no |title=Pain and its effects in the human neonate and fetus |trans-title= |language= |journal=New Engl J Med |location= |date=1987-11-19 |volume=317 |issue=21 |pages=1321-9 |url=httphttps://www.cirp.org/library/painpsych/anandrhinehart1/ |quotetitle= |pubmedID=3317037 |pubmedCID= |DOI= |accessdate=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=686215-9321 |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.Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFjournal |urllast=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=2011-04 |pages=34-086 |url= |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 |init=CR |urllast2=http://www.pollockclinics.com/circumcision/circumcision-before.htmlHoward |titleinit2=Before the CircumcisionFM |last3=Garfunkel |lastinit3=LC |firstlast4=de Blieck |publisherinit4=EA |datelast5=2011-04-08Weitzman |accessdateinit5=2011-04-08M}}</ref> |title=Neonatal circumcision and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFwebpain relief: current training practices |journal=Pediatrics |quotedate=We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection.1998 |urlvolume=http://www.pollockclinics.com/circumcision/circumcision-guide.html101 |titleissue=Parents' Guide to Circumcision |lastpages=423-8 |firsturl= |publisheraccessdate=}}</ref><ref>{{REFjournal |datelast=Stang |accessdateinit=2011-04-08HJ}}</ref> Topical anaesthetic only serves to numb |last2=Snellman |init2=LW |title=Circumcision practice patterns in the area to lessen the pain of the injection, but studies have shown that a dorsal penile ring block is not always effective in stopping the pain of circumcision.<ref nameUnited States |journal="Journal of Perinatology April/May 2002">{{REFjournal Pediatrics |lastdate=Taeusch1998 |firstvolume=H. William101 |initissue=HWe5 |last2pages=Martinez |first2url=Alma M. |init2accessdate=AM |last3note=Partridge |first3=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-Wells |first5=Jennifer |init5=J |last6=Fuentesto 4-Afflickfold increase in cortisol levels, which equals a state of severe [[shock]].<ref>{{REFjournal |first6last=ElenaGunnar |init6init=EMR |titlelast2=Pain During Mogen or Plastibell CircumcisionFisch |journalinit2=Journal of PerinatologyRO |volumelast3=22Korsvik |issueinit3=S |last4=3Donhowe |pagesinit4=214-8JM |urltitle=http://www.nature.com/jp/The effects of circumcision on serum cortisol and behavior |journal/v22/n3/full/7210653a.html=Psychoneuroendocrinology |quotedate=...more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure. |pubmedID1981 |volume=6 |pubmedCIDissue=3 |DOIpages=269-75 |noteurl=Aprilhttps://www.cirp.org/library/pain/gunnar/May 2002 |date=2002-04 |accessdate=20112019-0411-0826}}</ref><ref name="Clinical Pediatrics August 1986">{{REFjournal |last=Williamson |first=Paul S* Postoperative wound pain, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions. |init=PS* 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. |last2=Evans |first2=Nolan Donovan |init2=ND |title=Neonatal Cortisol Response * 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 Circumcision with Anesthesiahypovolaemia, hypovolaemic [[shock]] and even death.<ref>{{REFbook |journallast=Clinical Pediatrics |volumefirst=25 |issueyear=82000 |pagestitle=412-6Paediatric Handbook |url=http://cpj.sagepub.com/content/25/8/412.abstract |quotework=The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine |editors=Smart J, Nolan T. |pubmedIDedition=6 |pubmedCIDvolume= |DOIchapter= |datepage=1986-0882 |accessdatelocation=2011-04-08{{AUSC|VIC}}</ref> During circumcision, somp physicians give children sugar pacifiers to "reduce the perception of pain",<ref>{{REFweb, Australia |publisher=Blackwell Science Asia |isbn= |quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |urlaccessdate= |note=http:}}<//www.pollockclinics.com/circumcision/circumcision-before.htmlref><ref>{{REFdocument |title=Before the CircumcisionAutopsy of Demetrius Manker |lasturl= |firstcontribution=Case 93-1711 |publisherlast=Wetli |datefirst=2011CV |publisher=Miami: Dade County Medical Examiner Department |format= |date=1993-0406-0823 |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"><ref>{{REFjournal |last=SlaterHiss |firstinit=RebeccahJ |initlast2=R |first2=LauraHorowitz |init2=LA |last2last3=CornelissenKahana |first3init3=LorenzoT |init3title=LFatal haemorrhage following male ritual circumcision |last3journal=FabriziJ Clin Forensic Med |first4date=Debbie2000 |init4volume=D7 |last4issue=Patten |first5pages=Jan32-4 |init5url=Jhttps://www.cirp.org/library/death/hiss1/ |last5accessdate=Yoxen2019-11-06 |first6=Alan |init6=A}}</ref><ref>{{REFdocument |last6title=WorleyJudgement of inquiry into the death of McWillis, Ryleigh Roman Bryan |first7url=Stewart |init7=Shttp://www.circumstitions.com/death-exsang.html |last7contribution=Boyd |first8last=JudithNewell |init8first=JTEC |last8publisher=MeekBurnaby, B.C.: B.C. Coroner's Service |first9format=Maria |init9date=M2004-01-19 |last9accessdate=Prof2019-11-26}}</ref>* 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=1225-32Rechtsausschuss 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}}</ref>* [[Wound dehiscence]], and therefore might not be an effective analgesic drug. The ability 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 relief. suturing.* Adhesion between the surface or rim of the [[Glans penis|pubmedID= |pubmedCID=glans]] with the neighbouring [[penile skin]], causing [[skin]] pockets and bridges, as well as visually unpleasant results like uneven scars, which make a re-circumcision necessary. |DOI= |date=2010* Postoperative [[phimosis]]: a phimotic ring can develop during scarring, which makes a re-10-09 |accessdate=2011-04-08}}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=Blalock |init=HJ |last2=VemulakondaIt has been shown that an infant's response to [[pain]] can be altered for years as a consequence of circumcision.<ref>{{TaddioA etal 1995}}</ref><ref>{{TaddioA KatzJ IlersichAL KorenG 1997}}</ref> |init2=V |last3=Ritchey |init3=ML |last4=Ribbeck{{Box |init4=M |Boxtexttitle=<big><b>However, none Outpatient management 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 neonatal non[[phimosis]] Following newborn circumcision |journal=J Urol |date=2003 |volume=169 |issue=6 |pages=2332-therapeutic circumcision. Only boys who are protected from the medically unnecessary circumcision surgery experience no pain or [[trauma]]4 |url=https://www.cirp.<org/library/complications/b><blalock1/big>}}  |accessdate=== Sexual effects ===2019-11-26 Circumcision and frenectomy remove tissues with heightened erogenous sensitivity}}</ref>, the prevalence is 2. Boyle et al. (2002) wrote9%, "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings&mdash;many of which are lost according to circumcision."Leitch<ref>{{REFjournal |last=BoyleLeitch |firstinit=Gregory J.IOW |inittitle=GJCircumcision - a continuing enigma |author-linkjournal=Gregory BoyleAust Paediatr J |first2date=Gillian A.1970 |init2volume=GA6 |last2issue=Bensley |titlepages=Adverse Sexual and Psychological Effects of Male Infant Circumcision59-65 |journalurl=Psychological reports |volume=88 |issue=3, Part 2 |pages=1105–6 |url=http://www.https://www.cirp.org/library/psychgeneral/boyle5leitch1/ |quoteaccessdate=2019-12-15 |pubmedID=11597060 |pubmedCID= |DOI=10.1046}}</jref> 5.1464-410x.19995%.0830s1085.x |date=July 2001* [[Sudden Infant Death Syndrome]] (SIDS). |accessdate=}}</ref> They concluded* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], "Evidence has also started to accumulate that male is cut during circumcision may result in lifelong physicalwithout being clamped and sutured at its origin separately, sexualit starts to develop new branches over time, and sometimes psychological harm as wellwhich can lead to the development of knots." The [[amputation]] * Possible deformities due to circumcision include hypoplasia 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 (micro-penis) and induratio [[glans penis]]plastica (skewed penis). The imbalance caused by * Medical malpractice can also not having be ruled out. Injuries, partly or entirely severing the input from the now ablated fine-touch receptors may be a leading cause of [[Glans penis|glans]] or the changes in sexual behavior noted in [[circumcisedpenis]] human malescan occur.<ref>{{REFjournal |last=Van Howe |init=RS |author-link=Robert S* In rare cases, [[necrosis]], gangrene, ischaemia, keloid formation, and circulatory problems may also occur. Van Howe |last2=Cold |init2=CJ |title=Advantages and Disadvantages * When the circumcision is followed by the ultra-orthodox Jewish ritual of Metzitzah B'Peh (which consists of Neonatal Circumcision |journal=The Journal sucking blood from the wound with the mouth), there is a risk of the American Medical Association |volume=277 |issue=13 |pages=1052-7infection with [[herpes]] simplex type 1, which can lead to brain damage or [[death]].<ref>{{REFweb |url=http://www.ncbinytimes.nlm.nih.govcom/2012/03/08/pubmednyregion/9218663infants-death-renews-debate-over-a-circumcision-ritual.html?_r=0 |title=Baby’s Death Renews Debate Over a Circumcision Ritual |quote= |pubmedID=9218663 |pubmedCID= |DOI= |date=1997|last=Robbins |first=Liz |date=2012-03-07 |accessdate=2019-10-04-02 |accessdate=11

There is indeed a risk of [[death]] from non-therapeutic neonatal circumcision,<ref name="garrett2024-01-09" /> although the [[circumcision industry]] takes care to not reveal it.A study in 2010 estimated approximately 117 neonatal circumcision-related [[Death| 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

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

}}</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

|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=== {{UNI|Stanford University|SU}} has published a video of an actual non-therapeutic plastibell circumcision. The infant has received two injections of local anesthesia to deaden the dorsal nerves. The ventral nerves were not deadened so the infant still feels pain. One can his cries on the soundtrack.* [https://med.stanford.edu/newborns/professional-education/circumcision/plastibell-technique.html Plastibell Technique] ===Gomco clamp circumcision=== '''Not for the squeamish:''' This is a video of an actual circumcision with a Gomco clamp. The infant boy received two dorsal penile nerve block (DPNB) analgesic injections but they did not seem to work. * [https://www.reddit.com/r/Intactivism/comments/qbpzqr/trained_medical_professionals_restrain_infant_to/ Circumcision video] ==Recommendations of medical authorities==* [[George Hill| Hill]] (2007) said:

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]]. === Consent by surrogates ===Two ethicists, Myers & Earp (2020), have conducted a detailed review and analysis of the claimed medical benefits of non-therapeutic [[circumcision]]. They have determined that the alleged benefits are not material, so they do not support granting of consent by a surrogate. 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 Medical ethics has long recognized limitations on the individual reaches the age power of consent. Consent by a surrogate for a non-therapeutic circumcision is an unethical practicesurrogates.<ref name="myers2020">{{REFjournal |last=Myers |first= |init=A |author-link= |last2=Earp |first2= |init2=BD |author2-link=Brian D. EarpCommittee on Bioethics, American Academy of Pediatrics |etal=no |title=What is the best age to circumcise? A medical Informed consent, parental permission, and ethical analysisassent in pediatric practice |trans-title=

|journal=J Biosoc SciPediatrics

|date=2020-091995 |volume=3495 |issue=72 |article= |page= |pages=560314-7217 |url=https://onlinelibrarywww.wileycirp.comorg/doilibrary/absethics/10.1111AAP/bioe.12714

|pubmedID=320688987478854

|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-LRbKRzgaRQ |archived= |quote= |pubmedID=27456510 |pubmedCID= |DOI=10.11111542/bioepeds.127142016-1485 |format=PDF |accessdate=2023-05-1821}}</ref> <ref>{{SEEALSO}}REFjournal* [[Adolescent and adult circumcision]] |last=Committee on Bioethics* [[Breastfeeding]] ||etal=no* [[Case Histories]] |title=Informed Consent in Decision-Making in Pediatric Practice* [[Circumcision maps]] |trans-title=* [[Circumcision methods]] |language=* [[Circumcision scar]] |journal=Pediatrics* [[Circumpendium]] |location=* [[Circumstraint]] |date=2016-08* [[Documented severe complications of circumcision]] |volume=138* [[Ethics of non-therapeutic child circumcision]] |issue=2* [[FGM]] |article=* [[Human rights]] |page=e20161484* [[Lymphoedema]] |pages=* [[MGM]] |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* [[Pain]] |archived=* [[Psychological issues of male circumcision]] |quote=* [[Rights situation on circumcision]] |pubmedID=27456514* [[Risks and complications]] |pubmedCID=* [[Sexual effects of circumcision]] |DOI=10.1542/peds.2016-1484* [[Sudden Infant Death Syndrome]] (SIDS) |format=PDF* [[Trauma]] |accessdate=2023-05-21{{LINKS}}</ref>

* {{REFweb |url=http://wwwTwo ethicists, Myers & Earp (2020), have conducted a detailed review and analysis of the claimed medical benefits of ''non-therapeutic'' [[circumcision]].cirpThey have determined than the alleged benefits are not material, so they do not support granting of consent by a surrogate.org/library/anatomy/garcia/ |title=What exactly 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 and what should be performed only after the individual reaches the age of consent. <u>Consent by a surrogate for a ''non-therapeutic'' circumcision of a minor child is it not?an unethical practice.</u><ref name="myers2020">{{REFjournal |last=GarciaMyers |first=Francisco |dateinit=1995-12-11A |accessdateauthor-link=2020-09-08}}* {{REFjournal |lastlast2=FleissEarp |firstfirst2=Paul |initinit2=PBD |authorauthor2-link=Paul MBrian D. FleissEarp |etal=no |title=The foreskin What is necessarythe best age to circumcise? A medical and ethical analysis |journaltrans-title=Mothering |datelanguage=1997-01 |volumejournal=J Biosoc Sci |issuelocation= |pagesdate=362020-4509 |volume=34 |urlissue=http://www.noharmm.org/mothering.htm7 |accessdatepages=2020-06560-29}}*{{REFweb72 |url=https://15squareonlinelibrary.orgwiley.ukcom/losses-from-circumcisiondoi/abs/10.1111/bioe.12714 |titlearchived=Losses from Circumcision |lastquote=Ball |firstpubmedID=Peter32068898 |publisherpubmedCID=15 Square |dateDOI=2003-08-0910.1111/bioe.12714 |accessdate=2023-0205-2318}}</ref> * == Tipping point ==[[Intact America]] (2024) argues that public opinion regarding non-therapeutic [[circumcision]] of children is approaching or at a "tipping point" at which [[intact]] genitals would be preferred over the [[circumcised]] variety.<ref>{{REFweb |url=httphttps://membersintactamerica.tranquility.netorg/~rwinkelpublic-opinion-on-circumcision/MGM/primer.html |title=Male Public Opinion on Circumcision in the USA: Can Intactivists Hit A Human Rights Primer Tipping Point? |last=WinkelAnonymous |first=Rich |init= |publisher=Intact America |date=20052024-0503-1223 |accessdate=20212024-0104-2709}}</ref>

* ==Financial and other costs==Infant male circumcision is an extra-cost option after birth. There are no medical indications for it. It is a medically-unnecessary, non-therapeutic, non-beneficial irreversible amputation of a functional body part, so medical insurance may or may not pay for it. There are several financial costs associated with infant circumcision. There is a hospital fee, a set-up fee, pharmaceutical fees, a separate fee for the medical doctor who performs the amputation, and various possible additional costs for the treatment of complications.<ref name="garrett2023-12-21">{{REFjournalREFweb |url=https://intactamerica.org/economics-of-circumcision/ |title=The Economics of Circumcision: A Full Breakdown of This Penis Business |last=TestaGarrett |first=PatrickConnor

|author-link=Connor Judson Garrett |last2publisher=BlockIntact America |first2=Walter E. |init2date= |author22023-link= |etal=no |title=Libertarianism and circumcision |trans12-title=21 |languageaccessdate= |journal=Int J Health Poiicy Manag |location= |date=20142024-05-26 |volume=3 |issue= |article= |page= |pages=33-40 |url=https://www.academia.edu/7587653/Libertarianism_and_Circumcision?email_work_card=view-paper |pubmedID=24987720 |pubmedCID=4075101 |DOI=10.15171/ijhpm.2014.51 |accessdate=15}}</ref>

There also are additional non-financial costs, which include sexual and sensory losses that adversely impact on the sexual experience in adult life, and psychological losses such as [[PTSD]], and grieving of losses.==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> === Dr. Eric discusses circumcision ===<br><youtube>v=iZ64pqWZRW8</youtube>Dr. Eric understates the numerous functions of the foreskin.===Plastibel circumcision=== {{UNI|Stanford University|SU}} has published a video of an actual non-therapeutic plastibell circumcision. The infant has received two injections of local anesthesia to deaden the dorsal nerves. The ventral nerves were not deadened so the infant still feels pain. One can his cries on the soundtrack.* [https://med.stanford.edu/newborns/professional-education/circumcision/plastibell-technique.html Plastibell Technique] ===Gomco clamp circumcision=== '''Not for the squeamish:''' This is a video of an actual circumcision with a Gomco clamp. The infant boy received two dorsal penile nerve block (DPNB) analgesic injections but they did not seem to work. * [https://www.reddit.com/r/Intactivism/comments/qbpzqr/trained_medical_professionals_restrain_infant_to/ Circumcision video] {{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}} * {{REFweb |url=https://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 |url=http://members.tranquility.net/~rwinkel/MGM/primer.html |title=Male Circumcision in the USA: A Human Rights Primer |last=Winkel |first=Rich |author-link=Rich Winkel |date=2005-05-12 |accessdate=2021-01-27}} * {{REFjournal |last=Testa |first=Patrick |init= |author-link= |last2=Block |first2=Walter E. |init2= |author2-link= |etal=no |title=Libertarianism and circumcision |trans-title= |language= |journal=Int J Health Poiicy Manag |location= |date=2014-05-26 |volume=3 |issue= |article= |page= |pages=33-40 |url=https://www.academia.edu/7587653/Libertarianism_and_Circumcision?email_work_card=view-paper |pubmedID=24987720 |pubmedCID=4075101 |DOI=10.15171/ijhpm.2014.51 |accessdate=}} * {{REFweb |url=https://intaction.org/what-is-circumcision/ |title=What is circumcision? |last=Simone |first=Judy |author-link= |publisher=Intaction |website=https://intaction.org/ |date=2020-07-26 |accessdate=2020-10-04 |format= |quote=}}* {{REFjournal |last=Deacon |first= |init=M |author-link= |last2=Muir |first2= |init2=G

|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]]