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| painful]] surgery.<ref name="garrett2023-11-10">{{REFweb The un |url=https://intactamerica.org/pros-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, noncons-therapeutic surgery without [[medical indication]] performed on neonates and children for religious and cultural reasons in violation 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 [[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'''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. |accessdate=2024-06-02}}</ref>

Circumcision was popularized in English-speaking nations in the nineteenth century. The practice of non-therapeutic circumcision of boys now has greatly declined in [[Australia]], [[Canada]], [[New Zealand]] and the [[United Kingdom]]. It has been gradually declining since 1985 in the [[United States]]. It has ''never'' been a popular practice in other western nations. Circumcision is classified as a form of [[genital mutilation]].

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 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.

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]] 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:

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]].

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]].

|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 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 |trans-title=

|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 a specific pain memorylocal anesthesia". The AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, and 25% of obstetricians"''.<ref>{{REFweb |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.aspx Heatlhy Children website] suggests ''"Your pediatrician (or your obstetrician) should discuss the forms of analgesia that are available"''.html<ref>{{REFweb |title=KinderschmerzWhere We Stand: Circumcision |publisher=[[AAP]] |date=2011-03-Experte warnt23 |url=http: Rituelle Beschneidung verändert das Gehirn der Kinder//www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx |transaccessdate=2019-10-title=Children12}}</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 is known from aforementioned official documents, the AAP website may be more informative and effective if it would say ''s "Make sure your doctor knows of the ineffectiveness of anything short of local anesthesia, and make sure your baby is given an injection. This is your responsibility, because your doctor may or may not be up to date on the latest understandings of infant sensitivity to [[pain expert warns: Ritual ]] during circumcision changes ."'' The AAP may be holding back, however, perhaps because this would upset the brain doctor/parent power relationship, and may cause too much questioning of childrendoctors in general. One may not expect to find this kind of advice on such a website, and yet, anything less than this is a dangerously weak statement. To control [[pain]], some physicians that circumcise use Tylenol, sugar,<ref>{{REFweb |languagequote=GermanTo 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. |lasturl=Profhttp://www. Drpollockclinics. medcom/circumcision/circumcision-guide. Boris Zernikowhtml |title=Parents' Guide to Circumcision |last=

|publisher=Spiegel Online |website= |date=2012-08-12 |accessdate=20192011-1004-11 |format= |quote=08}}</ref>. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation. Overall, their pain threshold was lower and the risk of chronic pain increased. Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFjournalREFweb |lastquote=GarryDuring the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |initurl=Thttp://www.pollockclinics.com/circumcision/circumcision-before.html |title=Before the Circumcision: a survey of fees and practices |journallast=OBG Management |datefirst=1994 |volumepublisher=October |issuedate= |pages=342011-04-6 |url=08 |accessdate=2011-04-08}}</ref>a topical cream,<ref>{{REFjournalREFweb |lastquote=HowardThen in our office, he will have topical anesthetic applied to his penis. |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> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb |init5quote=MWe use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection. |titleurl=Neonatal http://www.pollockclinics.com/circumcision/circumcision and pain relief: current training practices-guide.html |journaltitle=PediatricsParents' Guide to Circumcision |datelast=1998 |volumefirst=101 |issuepublisher= |pages=423-8 |urldate= |accessdate=2011-04-08}}</ref>Topical anaesthetic only serves to numb the area to lessen the pain of the injection, but studies have shown that a [[dorsal penile nerve block]] is only partially effective in stopping the [[Pain| pain of circumcision]].<refname="Journal of Perinatology April/May 2002">{{REFjournal |last=StangTaeusch |initfirst=HJH. William |last2init=SnellmanHW |init2last2=LWMartinez |titlefirst2=Circumcision practice patterns in the United StatesAlma M. |journalinit2=PediatricsAM |datelast3=1998Partridge |volumefirst3=101J. Colin |issueinit3=e5JC |pageslast4=Sniderman |urlfirst4=Susan |accessdateinit4=S |notelast5=Link to [[AAP]] website}}</ref>. During procedures which take several minutes, babies tend to fall into a state of stupor, which in the past was falsely interpreted as peaceful sleep, nurturing the belief that babies felt no pain. Measurements taken in those cases revealed a typically 3Armstrong- to 4-fold increase in cortisol levels, which equals a state of severe [[shock]].<ref>{{REFjournalWells |lastfirst5=GunnarJennifer |initinit5=MRJ |last2last6=FischFuentes-Afflick |init2first6=ROElena |last3=Korsvik |init3init6=S |last4=Donhowe |init4=JME |title=The effects of circumcision on serum cortisol and behaviorPain During Mogen or Plastibell Circumcision |journal=Psychoneuroendocrinology |date=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><ref name="Clinical Pediatrics August 1986">{{REFjournal |last=Williamson* Postoperative wound pain, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions |first=Paul S.* Postoperative pain from the exposure of the sensitive glans penis |init=PS |last2=Evans |first2=Nolan Donovan |init2=ND |title=Neonatal Cortisol Response to clothingCircumcision with Anesthesia |journal=Clinical Pediatrics |volume=25 |issue=8 |pages=412-6 |url=http://cpj. This pain will endure for several weeks or even longer in some casessagepub.com/content/25/8/412.abstract* Postoperative [[bleeding]] |quote=The adrenal cortisol response to surgery was not significantly reduced by the administration of the woundlidocaine. This can have severe consequences especially for very young infants |pubmedID= |pubmedCID= |DOI= |date=1986-08 |accessdate=2011-04-08}}</ref> During circumcision, if they are not treated promptly. Their blood volume is only about 85 ml per kilogram somp physicians give children sugar pacifiers to "reduce the perception of body weight, and even moderate blood loss can lead to hypovolaemiapain", hypovolaemic [[shock]] and even death.<ref>{{REFbookREFweb |quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |url=http://www.pollockclinics.com/circumcision/circumcision-before.html |title=Before the Circumcision

|yearpublisher=2000 |titledate=Paediatric Handbook2011-04-08 |urlaccessdate=2011-04-08}}</ref> 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 |worklast=Slater |editorsfirst=Smart J, Nolan T.Rebeccah |editioninit=6R |volumefirst2=Laura |chapterinit2=L |pagelast2=82Cornelissen |locationfirst3={{AUSC|VIC}}, AustraliaLorenzo |publisherinit3=Blackwell Science AsiaL |isbnlast3=Fabrizi |quotefirst4=Debbie |accessdateinit4=D |notelast4=}}</ref><ref>{{REFdocumentPatten |titlefirst5=Autopsy of Demetrius MankerJan |urlinit5=J |contributionlast5=Case 93-1711Yoxen |lastfirst6=WetliAlan |firstinit6=CVA |publisherlast6=Miami: Dade County Medical Examiner DepartmentWorley |formatfirst7=Stewart |dateinit7=1993-06-23S |accessdatelast7=}}</ref> <ref>{{REFjournalBoyd |lastfirst8=HissJudith |initinit8=J |last2last8=HorowitzMeek |init2first9=AMaria |last3init9=KahanaM |init3last9=TProf. Fitzgerald |title=Fatal haemorrhage following male ritual circumcisionOral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial |journal=J Clin Forensic Med |date=2000The Lancet |volume=7376 |issue=9748 |pages=1225-32-4 |url=http://www.cirpthelancet.orgcom/libraryjournals/deathlancet/hiss1article/ |accessdate=2019PIIS0140-116736%2810%2961303-06}}<7/ref><ref>{{REFdocumentfulltext |titlequote=Judgement of inquiry into the death of McWillisOur data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuits, Ryleigh Roman Bryan |url=http://wwwand therefore might not be an effective analgesic drug.circumstitions.com/death-exsangThe ability of sucrose to reduce clinical observational scores after noxious events in newborn infants should not be interpreted as pain relief.html |contribution= |lastpubmedID=Newell |firstpubmedCID=TEC |publisher=Burnaby, B.C.: B.C. Coroner's Service |formatDOI= |date=20042010-0110-1909 |accessdate=20192011-1104-2608}}</ref>* Post -operative [[lymphoedema]]pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals.* Postoperative It has been shown that an infant's response to [[Infection| infectionspain]]. This includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatmentaltered for years as a consequence of circumcision.<ref>{{REFconference |last=Dr. med. Hartmann |first=Wolfgang |url= |place=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German) |title=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German) |date=2012-11-26 |accessdate=TaddioA etal 1995}}</ref><ref>{{TaddioA KatzJ IlersichAL KorenG 1997}}</ref>* [[Wound dehiscence]]{{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-circumcision necessary01-09" /> 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= |first7=http://www.cirp.org/library/complications/blalock1/ |accessdateinit7=2019 |author7-11link= |last8= |first8= |init8= |author8-26link=}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal |last9= |first9= |init9= |lastauthor9-link=Leitch |initetal=IOWyes |title=Circumcision Potentially under- recognized late-stage physical and psychosexual complications of non-therapeutic neonatal penile circumcision: a continuing enigmaqualitative and quantitative analysis of self-reports from an online community forum |trans-title= |language= |journal=Aust Paediatr Int JImpot Res |location= |date=19702022-10-23 |volume=6

|pagesarticle=59-65 |urlpage=http://www.cirp.org/library/general/leitch1/ |accessdatepages=2019-12-15}}</ref> 5.5%.* [[Sudden Infant Death Syndrome]] (SIDS).* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], is cut during circumcision without being clamped and sutured at its origin separately, it starts to develop new branches over time, which can lead to the development of knots.* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro-penis) and induratio [[penis]] plastica (skewed penis).* Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis|glans]] or the [[penis]] can occur.* In rare cases, [[necrosis]], gangrene, ischaemia, keloid formation, and circulatory problems may also occur.* When the circumcision is followed by the ultra-orthodox Jewish ritual of Metzitzah B'Peh (which consists of sucking blood from the wound with the mouth), there is a risk of infection with [[herpes]] simplex type 1, which can lead to brain damage or [[death]].<ref>{{REFweb |url=httphttps://www.nytimesnature.com/2012/03/08/nyregionarticles/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/s41443-03022-0700619-8 |accessdate=20192023-1001-1108

=== 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.<ref name="cepeda2023">{{REFjournal |last=Cepe da-Emiliani |first= |init=A |author-link=Alfonso Cepeda-Emiliani |last2=Gándara-Cortés |first2= |init2=M |author2-link= |last3=Otero-Alén |first3= |init3=M |author3-link= |last4=García |first4= |init4=H |author4-link= |last5=Suárez-Quintanilla |first5= |init5=JThe psychological late effects |author5-link= |last6=García-Caballero |first6= |init6=T |author6-link= |last7=Gallego |first7= |init7=R |author7-link= |last8=García-Caballero |first8= |init8=R |author8-link= |etal=no |title=Immunohistological study of circumcision are not yet fully researched, the density and many studies took place on rather a small scaledistribution of human penile neural tissue: gradient hypothesis |trans-title= |language= |journal= Int J Impot Res |location= |date=2023-05-02 |volume=35 |issue=3 |article= |page= |pages=286-305 |url=https://www.nature. 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 assumedcom/articles/s41443-022-00561-9 |archived= |quote= |pubmedID=35501394 |pubmedCID= |DOI=10.1038/s41443-022-00561-9 |accessdate=2023-11-26}}</ref>

Circumcision and frenectomy remove tissues with heightened erogenous sensitivity.<ref name="garrett2024-01-09" /><ref name="cepeda2023" /> <ref name="winkleman1959">{{WinkelmannRK 1959}}</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 [[amputation]] neuromas, Schwann cell proliferation and the bulbous collection of variably sized neurites. [[Amputation]] neuromas do not mediate normal sensation and are notorious for generating pain.<ref name="ColdCJ TaylorJR 1999"/> 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 excised directly from the penile body, and to the extent that the prepuce is still conceived by segments of the 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, or in the belief that "excesive sensitivity" is being reduced to augment ejaculatory latency time.<ref name="cepeda2023" /></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 [[human rights]] to [[physical integrity]], but in older patients may be rarely indicated for therapeutic reasons. It is a radical 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.  See [[Sexual effects of circumcision]] for more information. === Psychological effects ===[[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effects]] are also possible after a circumcision, especially if the operation was carried out in childhood.<ref name="garrett2024-01-09" /> On this occasion a variety of [[trauma]] may occur, which depend, among others, on age and circumstances of the circumcision. For example, whether the circumcision took place with or without sufficient anaesthesia, if the individual has been informed about the operation beforehand, if he was [[circumcised]] against his will or without his consent, and also, in the case of infant circumcision, if he was told about it during childhood or had to find it out coincidentally on his own. 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<ref>{{REFjournal |last=Marshall

|url=httphttps://www.cirp.org/library/birth/marshall2/

|url=httphttps://www.cirp.org/library/psych/goldman1/

* If the [[circumcised]] male feels incomplete, or due to the missing [[foreskin]] disadvantaged compared to [[intact]] males, an inferiority complex and [[depression ]] may occur. This can be accompanied by conscious recognition of his own incompleteness, or the deficiency may remain completely subconscious<ref>{{REFjournal

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

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

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

* [[Circumcised ]] males who become fathers frequently manifest [[adamant father syndrome]].

[[Intact America]] (2019) called circumcision as an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]],<ref name-"bollinger2019">{{REFdocument

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

|last2=HickeyKapilla |first2init2=L

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

|journal=New Engl Brit J MedSurg

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

|pubmedID=33170378242285

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

The [http://www* Intolerance or allergic reactions to the narcotics used.cirp.org/library/statements/aap1999/|AAP Circumcision Policy Statement] (1999) states quite clearly that ''"There is considerable evidence that * Especially in newborns who , where the bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is often insufficient for the operation. Even in conjunction with regional anaesthesia of the dorsal nerve of the [[circumcisedpenis]] without analgesia experience pain and physiologic stress"''. Furthermore, the pain rate of failure to provide sufficient anaesthetic even for experienced anaesthetists is quite severestill 5-10%. The general anaesthesia that would be needed for newborns, however, and requires injections poses significant risks for proper pain management. Sucrose the child, and Acetaminophen ''"cannot , therefore, is only likely to be recommended as the sole method of analgesia"''used in emergencies. Topical cream is no longer thought sufficient as ''"A surgical operation without proper [[pain]] control can lead to the analgesic effect is limited during the phases associated with extensive tissue trauma such as...tightening development of the clamp"''.a specific pain memory<ref>{{REFjournalREFweb |lasturl=http://www.spiegel.de/spiegel/vorab/experte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-849534.html |firsttitle=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder |trans-title=American Academy Children's pain expert warns: Ritual circumcision changes the brain of Pediatrics: Circumcision Policy Statement; Task Force on Circumcisionchildren |journallanguage=PediatricsGerman |datelast=1999-03Prof. Dr. med. Boris Zernikow |volumefirst=103 |issuepublisher=3Spiegel Online |pageswebsite=686-93 |urldate=https://pediatrics.aappublications.org/content/103/3/686#sec2012-08-912 |accessdate=2019-10-11-26 |noteformat= |quote=Statement Reaffirmed Sept. 1, 2005}}</ref> The [[AAFP]] (2002) states quite simply in their [http://www.cirpIn unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation.org/library/statements/aafp2002/| position paper]Overall, ''"Newborns experience their pain threshold was lower and the risk of chronic pain during circumcision"increased.''Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFwebREFjournal |last=Garry |init=T |title=Circumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmeda survey of fees and practices |websitejournal=Official American Academy of Family Physicians WebsiteOBG Management |urldate=http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html1994 |accessdatevolume=2011-05-02}}</ref> This is not a debatable fact, and yet, it is not widely accepted, even by some doctors. It might be hard for some doctors to accept, as they may have been taught that the infant does not feel [[pain]], and may have performed countless circumcisions with this idea. Usage of anesthesia for infant circumcision is still by no means the rule. Penile injections of anesthetic are now recommended by all of the major medical institutions. In their [http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml Report 10 of the Council on Scientific Affairs], the AMA states ''"When the decision is made to proceed with circumcision, local anesthesia should be provided for the procedure. Ring block or dorsal penile blocks [injections] are most effective. [[EMLA]] cream has limited utility"''. Alarmingly, ''"Despite the clear evidence that newborn males generate brisk pain responses during circumcision, a recent survey of residency training programs found that 26% of programs that taught circumcision provided no instruction on the use of local anesthesia". The AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, and 25% of obstetricians"''.<ref>{{REFwebOctober |titleissue=Report 10 of the Council on Scientific Affairs (I-99): Neonatal Circumcision |websitepages=American Medical Association Official Website34-6 |url=http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml |accessdate=2011-05-04}}</ref> The AAP's [http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx Heatlhy Children website] suggests ''"Your pediatrician (or your obstetrician) should discuss the forms of analgesia that are available"''.<ref>{{REFwebREFjournal |titlelast=Where We Stand: CircumcisionHoward |publisherinit=[[AAP]]CR |datelast2=2011-03-23Howard |urlinit2=http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspxFM |accessdatelast3=2019-10-12Garfunkel}}</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. |init3=LC |last4=de BlieckGiven what is known from aforementioned official documents, the AAP website may be more informative and effective if it would say ''"Make sure your doctor knows of the ineffectiveness of anything short of local anesthesia, and make sure your baby is given an injection. This is your responsibility, because your doctor may or may not be up to date on the latest understandings of infant sensitivity to pain during circumcision."'' The AAP may be holding back, however, perhaps because this would upset the doctor/parent power relationship, and may cause too much questioning of doctors in general. One may not expect to find this kind of advice on such a website, and yet, anything less than this is a dangerously weak statement. |init4=EA |last5=WeitzmanTo control [[pain]], some physicians that circumcise use Tylenol, sugar,<ref>{{REFweb |init5=M |quotetitle=To calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, Neonatal circumcision and soothing music is played in the room.pain relief: current training practices |urljournal=http://www.pollockclinics.com/circumcision/circumcision-guide.htmlPediatrics |titledate=Parents' Guide to Circumcision1998 |lastvolume=101 |firstissue= |publisherpages=423-8 |dateurl= |accessdate=2011-04-08}}</ref><ref>{{REFwebREFjournal |last=Stang |init=HJ |quotelast2=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.Snellman |urlinit2=http://www.pollockclinics.com/circumcision/circumcision-before.htmlLW |title=Before Circumcision practice patterns in the CircumcisionUnited States |journal=Pediatrics |date=1998 |lastvolume=101 |firstissue=e5 |publisherpages= |dateurl=2011-04-08 |accessdate=2011-04-08 |note=Link to [[AAP]] website}}</ref> . During procedures which take several minutes, babies tend to fall into a state of stupor, which in the past was falsely interpreted as peaceful sleep, nurturing the belief that babies felt no pain. Measurements taken in those cases revealed a topical creamtypically 3- to 4-fold increase in cortisol levels,which equals a state of severe [[shock]].<ref>{{REFwebREFjournal |last=Gunnar |init=MR |last2=Fisch |init2=RO |quotelast3=Then in our office, he will have topical anesthetic applied to his penis.Korsvik |urlinit3=http://www.pollockclinics.com/circumcision/circumcision-before.htmlS |titlelast4=Before the CircumcisionDonhowe |lastinit4=JM |firsttitle=The effects of circumcision on serum cortisol and behavior |publisherjournal=Psychoneuroendocrinology |date=2011-04-081981 |accessdatevolume=2011-04-086}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb |issue=3 |quotepages=We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection.269-75 |url=httphttps://www.pollockclinicscirp.comorg/circumcisionlibrary/pain/gunnar/circumcision-guide.html |titleaccessdate=Parents2019-11-26}}</ref>* Postoperative wound pain, in the case of children' Guide s circumcisions conceivably worsened by the forceful breaking of the preputial adhesions.* Postoperative pain from the exposure of the sensitive glans penis to Circumcisionclothing. 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.<ref>{{REFbook

|publisheryear=2000 |title=Paediatric Handbook |dateurl= |accessdatework=2011-04-08}}</ref> Topical anaesthetic only serves to numb the area to lessen the pain of the injection |editors=Smart J, but studies have shown that a dorsal penile ring block is not always effective in stopping the pain of circumcisionNolan T.<ref name |edition=6 |volume= |chapter= |page=82 |location="Journal of Perinatology April/May 2002">{{REFjournalAUSC|VIC}}, Australia |lastpublisher=TaeuschBlackwell Science Asia |firstisbn=H. William |initquote=HW |last2accessdate=Martinez |first2note=Alma M.}}</ref><ref>{{REFdocument |init2title=AMAutopsy of Demetrius Manker |last3url=Partridge |first3contribution=J. ColinCase 93-1711 |init3last=JCWetli |last4first=SnidermanCV |first4publisher=SusanMiami: Dade County Medical Examiner Department |init4format=S |last5date=Armstrong1993-06-Wells23 |first5accessdate=Jennifer}}</ref> <ref>{{REFjournal |last=Hiss |init5init=J |last6last2=Horowitz |init2=Fuentes-AfflickA |first6last3=ElenaKahana |init6init3=ET |title=Pain During Mogen or Plastibell CircumcisionFatal haemorrhage following male ritual circumcision |journal=Journal of PerinatologyJ Clin Forensic Med |date=2000 |volume=227 |issue=3 |pages=21432-84 |url=httphttps://www.naturecirp.comorg/jplibrary/journaldeath/v22hiss1/n3 |accessdate=2019-11-06}}</full/7210653a.htmlref><ref>{{REFdocument |title=Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan |quoteurl=http://www.circumstitions..more than half of the study group had what we considered excessive paincom/discomfort over the course of the entire proceduredeath-exsang.html |pubmedIDcontribution= |pubmedCIDlast=Newell |DOIfirst=TEC |notepublisher=Burnaby, B.C.: B.C. Coroner's Service |format=April/May 2002 |date=20022004-01-0419 |accessdate=20112019-0411-0826}}</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 name="Clinical Pediatrics August 1986">{{REFjournalREFconference |last=WilliamsonDr. med. Hartmann |first=Paul SWolfgang |url= |place=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German) |title=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German) |date=2012-11-26 |accessdate=}}</ref>* [[Wound dehiscence]], meaning the separation of the edges of the wound or the tissue after suturing.* Adhesion between the surface or rim of the [[Glans penis|glans]] with the neighbouring [[penile skin]], causing [[skin]] pockets and bridges, as well as visually unpleasant results like uneven scars, which make a re-circumcision necessary.* Postoperative [[phimosis]]: a phimotic ring can develop during scarring, which makes a re-circumcision necessary. According to a study by Blalock et al.<ref>{{REFjournal |last=Blalock |init=PSHJ |last2=EvansVemulakonda |init2=V |last3=Ritchey |init3=ML |first2last4=Nolan DonovanRibbeck |init2init4=NDM |title=Neonatal Cortisol Response to Circumcision with AnesthesiaOutpatient management of [[phimosis]] Following newborn circumcision |journal=Clinical PediatricsJ Urol |date=2003 |volume=25169 |issue=86 |pages=4122332-64 |url=httphttps://cpjwww.sagepubcirp.comorg/contentlibrary/25complications/8blalock1/412.abstract |quoteaccessdate=The adrenal cortisol response to surgery was not significantly reduced by 2019-11-26}}</ref>, the administration of lidocaineprevalence is 2.9%, according to Leitch<ref>{{REFjournal |pubmedIDlast=Leitch |pubmedCIDinit=IOW |DOItitle=Circumcision - a continuing enigma |journal=Aust Paediatr J |date=19861970 |volume=6 |issue= |pages=59-0865 |url=https://www.cirp.org/library/general/leitch1/ |accessdate=20112019-0412-0815}}</ref> During 5.5%.* [[Sudden Infant Death Syndrome]] (SIDS).* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], is cut during circumcisionwithout being clamped and sutured at its origin separately, it starts to develop new branches over time, somp physicians give children sugar pacifiers which can lead to the development of knots.* Possible deformities due to "reduce circumcision include hypoplasia of the [[penis]] (micro-penis) and induratio [[penis]] plastica (skewed penis).* Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis|glans]] or the [[penis]] can occur.* In rare cases, [[necrosis]], gangrene, ischaemia, keloid formation, and circulatory problems may also occur.* When the circumcision is followed by the ultra-orthodox Jewish ritual of Metzitzah B'Peh (which consists of sucking blood from the wound with the perception mouth), there is a risk of pain"infection with [[herpes]] simplex type 1,which can lead to brain damage or [[death]].<ref>{{REFweb |quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |url=http://www.pollockclinicsnytimes.com/circumcision2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-beforeritual.html?_r=0 |title=Before the Baby’s Death Renews Debate Over a CircumcisionRitual |last=Robbins |first= |publisher=Liz |date=20112012-0403-0807 |accessdate=20112019-0410-0811}}</ref> but in at least one study=== Death ===There is indeed a risk of [[death]] from non-therapeutic neonatal circumcision, data shows that giving sugar <ref name="garrett2024-01-09" /> although the [[circumcision industry]] takes care to a child doesn't help to reduce not reveal it.A study in 2010 estimated approximately 117 neonatal circumcision-related [[Death| deaths]] occur annually in the perception [[United States]], about one out of pain in the childevery 77 male neonatal deaths, more than suffocation, auto accidents, or even [[SIDS]].<ref name="Lancet, The Bollinger 2010-10-09">{{REFjournal |last=SlaterBollinger |first=RebeccahDan |init=RD |first2author-link=Laura |init2=LDan Bollinger |last2=CornelissenBoy's Health Advisory |first3=Lorenzo |init3=L |last3=Fabrizi |first4=Debbie |init4=D |last4=Patten |first5=Jan |init5=J |last5=Yoxen |first6=Alan |init6=A |last6=Worley |first7=Stewart |init7title=Lost Boys: An Estimate of U.S |last7=Boyd |first8=Judith |init8=J |last8=Meek |first9=Maria |init9=M |last9=Prof. FitzgeraldCircumcision-Related Infant Deaths |titlejournal=Oral sucrose as an analgesic drug for procedural pain in newborn infantsThymos: a randomised controlled trial |journal=The LancetJournal of Boyhood Studies |volume=3764 |issue=97481 |pages=122578-3290 |url=http://www.thelancetmensstudies.com/journalscontent/lancetb64n267w47m333x0/article/PIIS0140-6736%2810%2961303-7/fulltext?p=7ebbd6b446d940cbbd4274c095754b12π=5 |quote=Our data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuits, and therefore might not be an effective analgesic drug. The ability of sucrose to reduce clinical observational scores after noxious events in newborn infants should not be interpreted as pain relief.

|DOI=10.3149/thy.0401.78 |date=2010-1004-0926 |accessdate=20112019-0410-0812}}</ref> Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals. It has been shown that an infant's response to [[pain]] can be altered for years as a consequence of circumcision.<ref>{{TaddioA etal 1995}}</ref><ref>{{TaddioA KatzJ IlersichAL KorenG 1997}}</ref> {{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 neonatal non-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=1105–6REFweb |url=http://www.cirpicgi.org/library2010/psych/boyle504/infant-circumcision-causes-100-deaths-each-year-in-us |title=Infant circumcision causes 100 deaths each year in US |quotelast= |pubmedIDfirst=11597060 |pubmedCIDpublisher=ICGI |DOIwebsite=10.1046/j.1464-410x.1999.0830s1085.x[[International Coalition for Genital Integrity]] |date=July 20012010-04-26

}}</ref> They concluded, "Evidence has See also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as wellthe list of [[fatalities]]."

The [[amputation]] of the prepuce results in the loss of the majority of fine== Forced circumcision ==<!--touch neuroreceptors found === United States military ===American soldiers serving in the [[penis]], leaving only the uninhibited protopathic sensibility World War II were subjected to regular inspections of the artificially externalized [[glans penis]]their genitals. The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of If intact, the changes in sexual behavior noted in [[circumcised]] human malessoldiers risked being ordered to undergo immediate circumcision.<ref>{{REFjournalREFbook |last=Van HoweSchoen |first=Ed |init=RSE |author-link=Robert SEdgar J. Van HoweSchoen |last2year=Cold2005 |init2title=CJOn Circumcision |titleurl=https://books.google.de/books?id=Advantages and Disadvantages of Neonatal Circumcision-zUhdvSt7cgC |journalwork=The Journal of the American Medical Association |volumeeditor=277Dianne Yeakey |issueedition=13 |pagesvolume=1052-7 |urlchapter=http://www.ncbi.nlm.nih.gov/pubmed/9218663 |quotepages=72-3 |pubmedIDlocation=9218663Georgetown, Canada |pubmedCIDpublisher=RDR Books |DOIisbn=1-157143-123-3 |datequote=1997-04-02For a critical view, see Sorrells, "The History of Circumcision," p. 333

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

Histology Human babies, because they are not yet in possession of language, are incapable of the male circumcision scar shows giving or refusing consent to be [[amputationcircumcised]] neuromas. The element of force has led some scholars to view the circumcision of baby boys as a category of forced circumcision.<ref>For example, Schwann cell proliferation and 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 bulbous collection forced circumcision of variably sized neuritesAmerican children sprang up nationwide." F. Hodges, "A Short History," p. 31; see also [[AmputationLeonard B. Glick|Glick]] neuromas do not mediate normal sensation and are notorious for generating pain, ''Marked in Your Flesh'', pp. 273-281.</ref name="ColdCJ TaylorJR 1999"/> === Death ===A study in 2010 estimated approximately 117 neonatal circumcision-related deaths occur annually There are, however, physicians in the United States, about one out who argue strongly for non-therapeutic circumcision of every 77 male neonatal deaths, more than suffocation, auto accidents, or even [[SIDS]]newborn babies; and circumcision is widely accepted as a postnatal procedure in American hospitals.<ref name="Bollinger 2010">{{REFjournalREFbook |last=BollingerFletcher |first=DanChristopher R. |init=DCR |author-linkyear=Dan Bollinger1999 |last2title=Boy's Health AdvisoryCircumcision in America in 1998: Attitudes, Beliefs, and Charges of American Physicians |titleurl=Lost Boyshttp: An Estimate of U//www.Sspringerlink. com/content/h2150v731233m177/ |work=Male and Female Circumcision-Related Infant Deaths |journaleditors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |edition=Thymos: Journal of Boyhood Studies |volume=4 |issuechapter=1Section 5 |pages=78259-9071 |urllocation=New York |publisher=http:Kluwer Academic//www.mensstudies.com/content/b64n267w47m333x0/?pPlenum Publishers |isbn=7ebbd6b446d940cbbd4274c095754b12π=5

|note=ID 10.1007/978-0-585-39937-9_19}}</ref>Parental consent is required.<ref>{{REFweb |url=http:See, e.g., Shephard and Shephard, ''The Complete Guide'', p. 125.<//wwwref> A statement published by the [[American Academy of Pediatrics]] in 1999 claimed that "parents should determine what is in the best interest of the child... It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in additions to the medical factors, when making a decision."<ref>Lannon and Bailey, "Circumcision Policy Statement," p.icgi691.org</2010/04/infantref> however surrogate consent for non-therapeutic circumcisionis now viewed as unethical. In the [[United Kingdom]], where non-causes-100-deaths-each-year-therapeutic circumcision has now become far less prevalent than inthe [[United States]], the written consent of both parents is required, if a physician is to perform a non-us |title=Infant therapeutic circumcision causes 100 deaths each year in USof a child.<ref>{{REFjournal

|publishertitle=ICGIRe J (child's religious upbringing and circumcision) |websitejournal=[[International Coalition for Genital Integrity]]Family Court Reports |date=20102000 |volume=1 |issue= |pages=307-04-2614 |url=https://www.cirp.org/library/legal/Re_J/2000.html |accessdate=2019-10-12}}</ref> See also the list of [[fatalities]](The National Health Service does not provide non-therapeutic circumcision.)

== Forced circumcision == In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<!ref>See, e.g., [[Margaret A. Somerville|Somerville]], "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; [[Abbie Chessler|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"/>== United States military =Recommendations of medical authorities==* [[George Hill| Hill]] (2007) said:<blockquote>American soldiers serving in World War II were subjected Male circumcision is harmful because it excises healthy tissue and permanently impairs beneficial physiological functions. Male circumcision also causes psychological problems that tend to regular inspections perpetuate the cycle of their genitalsabuse. If intactMale 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 soldiers risked being ordered to undergo immediate greater degree of protection from traumatic, invasive, injurious,and unnecessary surgery. For all of these reasons the non-therapeutic circumcisionof boys should not be performed and the [[genital integrity]] of all children should be respected and protected.<refname="hill2007">{{REFbookREFjournal |last=SchoenHill |first=EdGeorge |init=EG |author-link=Edgar J. Schoen |year=2005George Hill |title=On CircumcisionThe case against circumcision |urljournal=https://books.google.de/books?id=-zUhdvSt7cgC |work= |editor=Dianne YeakeyJournal of Men's Health and Gender |editiondate=2007 |volume=4 |chapterissue=3 |pages=72318-323 |locationurl=Georgetown, Canadahttps://www.academia.edu/8367383/The_Case_Against_Circumcision |publisherquote=RDR Books |isbnpubmedID=1-157143-123-3 |quotepubmedCID=For a critical view, see Sorrells, "The History of Circumcision," p. 333 |accessdateDOI= |noteaccessdate=2021-05-30}}</ref> This practice was discontinued at least six decades ago.--</blockquote> === Non-therapeutic circumcision * Andrew E. MacNeiiy, Head, Division of male children === Human babiesPediatric Urology, because they are not yet in possession Department of languageUrological Sciences, are incapable {{UNI|University of giving or refusing consent for being circumcised. The element of force has led some scholars to view the British Columbia|UBC}}, Vancouver, BC, (2008) said:<blockquote>Newborn circumcision remains an area of baby boys as a category of forced circumcisioncontroversy.<ref>For exampleSocial, Frederick M. Hodgescultural, a medical historian, writes: "In aesthetic and religious pressures form the late 1970smost common reasons for non-therapeutic circumcision. Although penile cancer and UTIs are reduced compared with uncircumcised males, as the Americans were growing increasingly aware incidence of the abuses such illness is so low that circumcision cannot be justified as prophylaxis. The role 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 foreskin in [[Leonard B. Glick|GlickHIV]], ''Marked transmission in Your Flesh''developed countries is unclear, ppand safe sexual practice remains the cornerstone of prevention. 273-281There remains a lack of knowledge regarding what constitutes the normal foreskin both among parents and among primary care providers.</ref> There are, however, physicians This lack of knowledge results in a burden of costs to our health care system in the United States who argue strongly for non-therapeutic circumcision form of unnecessary urological referrals, expansion of newborn babies; wait times and circumcisions. Routine circumcision of all infants is widely accepted as not justified from a postnatal procedure in American hospitalshealth or cost-benefit perspective.<ref>{{REFbookREFjournal |last=FletcherMacNeily |first=Christopher R.Andrew |init=CR |yearauthor-link= |etal=1999no |title=Circumcision in America in 1998Routine circumcision: Attitudes, Beliefs, and Charges of American Physiciansthe opposing view |trans-title= |urllanguage=http://www.springerlink.com/content/h2150v731233m177/ |workjournal=Male and Female CircumcisionCan Urol Assoc J |editorslocation=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |editiondate=2007-11 |volume=1 |chapterissue=Section 54 |pagesarticle=259-71 |locationpage=New York |publisherpages=Kluwer Academic/Plenum Publishers395-7 |isbnurl=http://europepmc.org/article/PMC/2422979 |quotepubmedID=18542825 |accessdatepubmedCID=2019-10-12 |noteDOI=ID 10.10075489/978-0-585cuaj.455 |accessdate=2021-3993711-9_1908}}</ref> Parental consent is required.<ref/blockquote>See, e.g., Shephard and Shephard, '' * The Complete Guide'', p. 125.[[Royal Dutch Medical Association]] (KNMG) (2010) said: </refblockquote> A statement published by the American Academy The official viewpoint of Pediatrics in 1999 declares KNMG and other related medical/scientific organisations is that "parents should determine what non-therapeutic circumcision of male minors is in the best interest a violation of the childchildren’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. It KNMG is legitimate for parents calling upon doctors to take into account cultural, religious, actively and ethnic traditions, in additions to insistently inform parents who are considering the procedure of the absence of medical factors, when making a decision."<ref>Lannon benefits and Bailey, "Circumcision Policy Statement," p. 691the danger of complications.</ref> In the United Kingdom, where non{{REFdocument |title=Non-therapeutic circumcision has now become far less prevalent than in the United States, a written consent of both parents is required, if a physician is to perform a male minors |url=https://www.doctorsopposingcircumcision.org/wp-content/uploads/2016/09/knmg-non-therapeutic -circumcision -of a child-male-minors-27-05-2010.<ref>{{REFjournalpdf |contribution=

|titlepublisher=Re J (child's religious upbringing and circumcision)Royal Dutch Medical Association |journalformat=Family Court ReportsPDF |date=2000 |volume=1 |issue= |pages=307-14 |url=http://www.cirp.org/library/legal/Re_J/2000.html2010 |accessdate=20192021-1011-1208}}</ref> (The National Health Service does not provide non-therapeutic circumcision.)</blockquote>

In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<ref>See, e.g., * The [[Margaret A. Somerville|Somerville]], "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; [[Abbie Chessler|ChesslerRoyal Australasian College of Physicians]], "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"/>) said:

==Video==<blockquote>Ethical and [[human rights]] concerns have been raised regarding elective infant male ===Is circumcision healthy?===because it is recognised that the foreskin has a functional role, the operation The video ''Is Circumcision Healthy'' is recommended for parental viewingnon-therapeutic and the infant is unable to consent.<br><br> <youtube>D_3LQjZgdbQ</youtube>

After reviewing the currently available evidence, the RACP believes that the frequency of diseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand. However it is reasonable for parents to weigh the benefits and risks of circumcision and to make the decision whether or not to circumcise their sons.<ref name="racp2010">{{REFdocument |title=Circumcision of Infant Males |url=Drhttps://www. Christopher Guest discusses racp.edu.au//docs/default-source/advocacy-library/circumcision-of-infant-males.pdf |contribution= |last= |first= |publisher=The Royal Australasian College of Physicians |format=PDF |date=2010-09-01 |accessdate=2021-11-08}}<br/ref><youtube>v=TQIp9f4krVQ</youtubeblockquote>

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

{{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==* Medical historian [[George Hill| HillRobert Darby]] (20072014) saidwrote simply:

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 "To avoid 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, injuriouscomplications,and unnecessary surgery. For all of these reasons the non-therapeutic avoid circumcision of boys should not be performed and the [[genital integrity]] of all children should be respected and protected."<ref name="hill2007">{{REFjournal |last=HillDarby |first=George |init=GR |author-link=George HillRobert Darby |etal=no |title=The case against To avoid circumcision complications, avoid circumcision |trans-title= |language= |journal=Journal of Men's Health and GenderCan Urol Assoc J |location= |date=20072014-08-14 |volume=48 |issue=37-8 |article= |page=231 |pages=318-23 |url=https://wwwcuaj.academiaca/index.eduphp/8367383journal/The_Case_Against_Circumcisionarticle/view/1709/1823 |archived=

|DOI=10.5489/cuaj.1709 |accessdate=20212022-0512-3016

* Andrew E. MacNeiiy, Head, Division of Pediatric Urology, Department of Urological Sciences, {{UNI|University of British Columbia|UBC}}, Vancouver, BC, The [[Canadian Paediatric Society]] (2008CPS) (2015) said:

<blockquote>Newborn circumcision remains an area of controversy. Social, cultural, aesthetic and religious pressures form the In most common reasons for non-therapeutic circumcision. Although penile cancer and UTIs are reduced compared with uncircumcised malesjurisdictions, the incidence of such illness authority is so low that circumcision cannot limited only to interventions deemed to be justified as prophylaxismedically necessary. The role of the foreskin In cases in [[HIV]] transmission in developed countries which medical necessity is not established or a proposed treatment is unclearbased on personal preference, and safe sexual practice remains interventions should be deferred until the cornerstone of prevention. There remains a lack of knowledge regarding what constitutes the normal foreskin both among parents and among primary care providers. This lack of knowledge results in a burden of costs individual concerned is able to our health care system in the form of unnecessary urological referrals, expansion of wait times and circumcisions. Routine circumcision of all infants is not justified from a health or cost-benefit perspectivemake their own choices.<refname="CPS2015">{{REFjournal |last=MacNeilySorokin |first=AndrewS. Todd |init=ST

|etallast2=Finlay |first2=JC |author2-link= |last3=noJeffries |titlefirst3=Routine circumcision: the opposing viewAL |transauthor3-titlelink= |etal=yes |languagetitle=Newborn male circumcision |journal=Can Urol Assoc JPaediatr Child Health

|date=20072015-1108 |volume=120 |issue=4 |article= |page=6 |pages=395311-720 |url=httphttps://europepmcwww.ncbi.orgnlm.nih.gov/articlepmc/PMCarticles/2422979PMC4578472/ |quote= |pubmedID=1854282526435672 |pubmedCID=4578472 |DOI=10.54891093/cuajpch/20.4556.311 |accessdate=20212019-1110-0827}}</ref></blockquote>

* The [[Royal Dutch Medical Canadian Urological Association]] (KNMGCUA) (2010) saidconsidered the matter of circumcision and issued a statement in February 2018. The CUA concluded:

<blockquote>The official viewpoint of KNMG "Given the socioeconomic, educational status, and other related medical/scientific organisations is that non-therapeutic circumcision of male minors is a violation health demographics of children’s rights to autonomy and physical integrity. Contrary to popular beliefour population, universal neonatal 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 cannot be justified based on the absence of medical benefits and the danger of complicationscurrent evidence available.<refname="cua2018">{{REFdocumentREFjournal |last=Dave |first=Sumit |init=S |author-link= |etal=yes |title=NonCanadian Urological Association guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants (abridged version) |journal=Can Urol Assoc J |location= |date=2018-therapeutic circumcision of male minors02 |volume=12 |issue=2 |pages=18-28 |url=https://wwwcuaj.doctorsopposingcircumcisionca/index.orgphp/wp-contentjournal/uploadsarticle/2016view/095034/knmg-non-therapeutic-circumcision-of-male-minors-27-05-2010.pdf |contribution=3470 |lastquote= |firstpubmedID= |publisherpubmedCID=Royal Dutch Medical Association |formatDOI=PDF |date=2010 |accessdate=2021-11-0809}}</ref></blockquote>==British family court opinion==* The issue of non-therapeutic circumcision of male children came before the court in the case of ''[[Royal Australasian College of PhysiciansRe B and G (children) (No 2) EWFC 3]] (20102015) said: <blockquote>Ethical and [[human rights]] concerns have been raised regarding elective infant male circumcision because it is recognised '' . In that the foreskin has a functional rolecase, the operation Judge Sir James Munby ruled that circumcision of male children caused ''significant harm''. is non-therapeutic == Rights and the infant is unable to consent. ethics ==

After reviewing the currently available evidence, the RACP believes that the frequency of diseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant The [[Rights situation on circumcision |rights situation]] is discussed in Australia and New Zealand. However it is reasonable for parents to weigh the benefits and risks of circumcision and to make the decision whether or not to circumcise their sons.<ref name="racp2010">{{REFdocument |title=Circumcision of Infant Males |url=https://www.racp.edu.au//docs/default-source/advocacy-library/circumcision-of-infant-malesa separate article.pdf |contribution= |last= |first= |publisher=The Royal Australasian College of Physicians |format=PDF |date=2010-09-01 |accessdate=2021-11-08}}</ref></blockquote>

* The [[American Academy of PediatricsImage:Intact vs circumcised.JPG |thumbnail|right|300px| The intact and circumcised human penis, side by side.]] (AAP) has not re-affirmed its disastrous, failed 2012 Circumcision Policy Statement, which expired in 2017, so currently has no position on child circumcision.

* Medical historian 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 [[Robert Darbyforeskin]] (2014) wrote simply:, which in adults comprises about fifteen square inches of highly functional erogenous tissue. <blockquote>"To avoid 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 complicationsof non-consenting minors to be unethical and a [[human rights]] violation, avoid circumcisionunless there is concrete [[medical indication]].=== Consent by surrogates ===Medical ethics has long recognized limitations on the power of consent by surrogates."<ref>{{REFjournal |last=Darby |first= |init=R |author-link=Robert DarbyCommittee on Bioethics, American Academy of Pediatrics

|title=To avoid circumcision complicationsInformed consent, avoid circumcisionparental permission, and assent in pediatric practice

|journal=Can Urol Assoc JPediatrics

|date=2014-08-141995 |volume=895 |issue=7-82

|page=231 |pages=314-17 |url=https://cuajwww.ca/indexcirp.php/journalorg/articlelibrary/viewethics/1709AAP/1823

|pubmedID=7478854

|DOI=10.5489/cuaj.1709 |accessdate=20222023-1205-1621}}</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=SorokinCommittee on Bioethics |firstetal=S. Toddno |inittitle=ST |authorInformed Consent in Decision-link= |last2=FinlayMaking in Pediatric Practice |first2=JC |author2trans-linktitle= |last3=Jeffries |first3=AL |author3-link= |etal=yes |titlelanguage=Newborn male circumcision |journal=Paediatr Child HealthPediatrics

|date=20152016-08 |volume=20138 |issue=62 |article= |page=e20161485 |pages=311-20 |url=https://wwwwatermark.ncbisilverchair.nlmcom/peds_20161485.nih.gov/pmc/articles/PMC4578472/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=

|pubmedID=2643567227456510 |pubmedCID=4578472 |DOI=10.10931542/pch/20peds.6.3112016-1485 |format=PDF |accessdate=20192023-1005-2721}}</ref></blockquote> * The [[Canadian Urological Association]] (CUA) considered the matter of circumcision and issued a statement in February 2018. The CUA concluded: <blockquote>"Given the socioeconomic, educational status, and health demographics of our population, universal neonatal circumcision cannot be justified based on the current evidence available.<ref name="cua2018">{{REFjournal |last=DaveCommittee on Bioethics |first|etal=Sumitno |inittitle=SInformed Consent in Decision-Making in Pediatric Practice |authortrans-linktitle= |etallanguage=yes |title=Canadian Urological Association guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants (abridged version) |journal=Can Urol Assoc JPediatrics

|date=20182016-0208 |volume=12138

|article= |page=e20161484 |pages=18-28 |url=https://cuajwatermark.silverchair.cacom/indexpeds_20161484.php/journal/article/view/5034/3470pdf?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=

|pubmedID=27456514

|DOI=10.1542/peds.2016-1484 |format=PDF |accessdate=20212023-1105-0921}}</ref></blockquote>==British family court opinion==The issue of non-therapeutic circumcision of male children came before the court in the case of ''[[Re B and G (children) (No 2) EWFC 3]] (2015)'' . In that case, Judge Sir James Munby ruled that circumcision of male children caused ''significant harm''. == Rights and ethics ==

The Two ethicists, Myers & Earp (2020), have conducted a detailed review and analysis of the claimed medical benefits of ''non-therapeutic'' [[Rights situation on circumcision|rights situation]] is discussed in a separate article. [[Image:Intact vs circumcised.JPG |thumbnail|right|300px| The intact and circumcised human penisThey have determined than the alleged benefits are not material, side so they do not support granting of consent by sidea surrogate.]] The term "circumcision" without a gender qualifier refers specifically to male In other words, ''Non-therapeutic'' circumcisionis not truly healthcare. It means "to cut aroundMoreover," and it refers to they comment that even the most perfectly executed surgery produces [[excisiontrauma]] of the [[foreskin]] from and harm to the penispatient. The term is inaccurate Circumcision also produces tissue loss and a euphemism because loss of function, therefore, circumcision should be performed only after the operation actually cuts off or [[amputation| amputates]] individual reaches the [[foreskin]], which in adults comprises about fifteen square inches age of highly functional erogenous tissueconsent.  Circumcision is most often performed in healthy males <u>Consent by a surrogate for [[Religion and Culture|religious or cultural]] reasons. The procedure may be performed on consenting adults, but it is most often performed on a ''non-consenting minors, particularly newborn children, which is why the ritual is so controversial. Opponents of circumcision consider the therapeutic'' circumcision of non-consenting minors to be unethical and a [[human rights]] violation, unless there minor child is concrete [[medical indication]]an unethical practice.</u><ref name="myers2020">{{REFjournal |last=Myers |first= |init= Consent by surrogates A |author-link= |last2=Earp |first2=Medical ethics has long recognized limitations on the power of consent by surrogates.<ref>{{REFjournal |init2=BD |lastauthor2-link=Committee on Bioethics, American Academy of Pediatrics Brian D. Earp

|title= Informed consent, parental permission, What is the best age to circumcise? A medical and assent in pediatric practiceethical analysis

|journal=PediatricsJ Biosoc Sci

|date=19952020-09 |volume=9534 |issue=2 |article= |page=7 |pages=314560-1772 |url=https://wwwonlinelibrary.cirpwiley.orgcom/librarydoi/ethicsabs/AAP10.1111/bioe.12714

|pubmedID=747885432068898

|DOI=10.1111/bioe.12714 |accessdate=2023-05-2118}}</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>{{REFjournalREFweb |lasturl=Committee https://intactamerica.org/public-opinion-on Bioethics |etal=no-circumcision/ |title=Informed Consent in Decision-Making in Pediatric Practice Public Opinion on Circumcision: Can Intactivists Hit A Tipping Point? |trans-titlelast=Anonymous |languagefirst= |journalinit=Pediatrics |locationpublisher=Intact America |date=20162024-03-0823 |volumeaccessdate=1382024-04-09}}</ref> |issue==2 |articleFinancial and other costs= |page=e20161485 |pagesInfant 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">{{REFweb |url=https://watermarkintactamerica.silverchair.comorg/peds_20161485.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQM8zYHFd0Ylu9Annq_AgEQgIICT24ikc839aJMYOiypqC2G9f7_yKGAGkAekzzbCtck5TElALWVCGNoVSOaA6rDA_dOkQ_LyJnxYlZ88J9economics-uk15tvlIBbE82_aNyYfq5e9xmEfqD2vh374q3Naz57dxZaUbgxUkKX4PqsiLmYHLvVrr7bQK2MZuuUOKiQU8JZy7lLjkpof-PjJO1U9cyIplTAgs_EdvgK8MWWoIsj-X-ZUDImAG63-rlj_qLsy5dYwytmxfCuVa47RdZseLSr2_bdDpwKAKGhq_Ly9rlHZeW_f7fYktVfF_sFTgcJziAlvEQmdyWIw0qf-hlO31Qb3sH6kDdcvHAbm7llY5xa34XLYIt8QR0YFIimgDGFliN4-ce2vjvvrwS85WeeNFhpn-Ywn4Qjpy06hPuLDL-MtI2Z3BZbBsKq4dp8qGu1q9GlXaKw193riTFG9G5bF5GCKmxmt0nCQTthrb_CcK2UhKjZwPekC9zkIUHPZ9BXJt0SM03F_g-GgqbE0hTYKMqNdJ3sHDQu2luFrJ9JEiMzxtP28gJoYh20d2APA0xrRbXBYsFdAlr50gb1BSAbNJhTyx-Kh3geoSHsAYMjPaG7cIbh0jd42pWCUx30vjlAGK8zXTuf7-31oi81CLbHTAJLuzK3NT4Whi17jVq1SbXsIXlWpKc_d-HujCvlb74rkZQ6RG9wkxW7gAKaDqtKv5zTOTMBD9vLVxgp8lDmVA8PFB59Bqd6w-fi86tW132oWQM-mTfwdIBXFbUFXkeTUC5RYyqJQIXAEwLJSRm1RX-LRbKRzgaRQcircumcision/ |title=The Economics of Circumcision: A Full Breakdown of This Penis Business |archivedlast=Garrett |quotefirst=Connor |pubmedIDinit=27456510 |pubmedCIDauthor-link=Connor Judson Garrett |DOIpublisher=10.1542/peds.2016-1485Intact America |formatdate=PDF2023-12-21 |accessdate=20232024-05-2115}}</ref> <ref>{{REFjournal |last=Committee There also are additional non-financial costs, which include sexual and sensory losses that adversely impact on Bioethicsthe sexual experience in adult life, and psychological losses such as [[PTSD]], and grieving of losses. ||etal=no=Video== |title=Informed Consent in Decision-Making in Pediatric Practice==Is circumcision healthy?===The video ''Is Circumcision Healthy'' is recommended for parental viewing.<br><br> |trans-title<youtube>D_3LQjZgdbQ</youtube> ===Dr. Christopher Guest discusses circumcision=== |language<br><youtube>v=TQIp9f4krVQ</youtube> |journal=== Dr. Eric discusses circumcision ===Pediatrics |location<br><youtube>v=iZ64pqWZRW8</youtube> |dateDr. Eric understates the numerous functions of the foreskin.===Plastibel circumcision=2016-08 |volume=138 |issue=2 |article= {{UNI|page=e20161484 Stanford University|pages=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. |url=* [https://watermarkmed.silverchairstanford.comedu/newborns/peds_20161484.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMYv3coRYprofessional-UCYMgTaqAgEQgIICT4di03qn2Hbho3i8Li_78lod0lNMunch25nx1rKvaM_aeFerz5eN6_k8VVeNveducation/circumcision/plastibell-DLocZp28whQr1x4WYDVwSs4uF73vZpYZYuDphYQkwxV1HHgMbZAbHBFuE8QyCHyDvSY-fhQcUl-JrYxa3TbhYgd4bKiU9zfIyXUsCnItroCc9iNrMicPg0v_A0AJJlhxioOlAU-im6OPI06OcCBj78yqkPO0J4nMTN1FLochsOyvZZdtFQQzLhrnM_Gey8K75lFYIBJHA7uzMmP2o5KZ-FTGUkEA_eSpEIpwv2WI4SbtrA8WYk3cQqXOmLIWjkSs9CTELD7CQP29xarr1ANrF_id4CiCX7zIomC2Ciz9lHBEgz8EH2i9Woke_YuZeLax52_6JpdhH1qdMQyF1bByjP8mU98V5_B4BPPiBpKt4pVA_UgtaABRHL8oPv6SwOUQZ2Bc-0_E2tod0VIF1FJBwZRZJm2ZkJPgBSKUo8VBe5Pz_6Vpt2DqLzwqVUYscPsIJMvxl09mMtvJrsBa8yVoTRWj4Rd0OBTMV7zhZskDnYYyrAZ6sHMk0MzvbHilPNbNgU5o7mXmcbFGDgGgWbqrIdT6sVSSfPJm4TnR0HSWbc_EnHhhyye7tVlFGjAsR0R46_DSwEMz8M5DkSln8xfKtX_so9rjCvYeq45wqn09g8DqtV-WHEA9PIrcw5kTcz5I0JkNuW4-vKVU1Xz9XHiYi4Zqbq0vx9NWLdNSYHQSOGMZ1MCAxT152evQdipQB5wokR8Q4rICoJYII5bsmRMYd7JQtechnique.html Plastibell Technique]  |archived===Gomco clamp circumcision=== |quote= |pubmedID=27456514'''Not for the squeamish:''' |pubmedCID= |DOI=10This is a video of an actual circumcision with a Gomco clamp.1542/pedsThe infant boy received two dorsal penile nerve block (DPNB) analgesic injections but they did not seem to work.2016-1484 |format=PDF |accessdate=2023-05-21}}<* [https://www.reddit.com/r/Intactivism/comments/qbpzqr/trained_medical_professionals_restrain_infant_to/ref>Circumcision video]

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

|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 |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}}