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Circumcision

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"Male '''circumcision''' (from Latin ''circumcidere'', meaning "to cut around") is the surgical removal or [[amputation]] of the [[foreskin]] (prepuce), a major part of the human [[penis]]. The foreskin comprises ''more than fifty percent'' of the epithelium of the [[penis]].<ref name="taylor1996">{{TaylorJR LockwoodAP TaylorAJ 1996}}</ref> When the "cutting around" is performed, the foreskin falls off, so [[amputation]] 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 |url=https://intactamerica.org/pros-and-cons-of-circumcision/ |title=Pros and Cons of Circumcision (Spoiler: You’ve Been Lied to) |last=Garrett |first=Connor |init= |author-link=Connor Judson Garrett |publisher=Intact America |date=2023-11-10 |accessdate=2024-06-02}}</ref>
'''Posthectomy''' is the more accurate medical term that more accurately reflects the injury and loss of functional body tissue, but the Biblical [[euphemism]], ''circumcision'', is more commonly used.
}}</ref>
Circumcision was popularized in English-speaking nationns nations in the nineteeth 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]].
== Historical background ==
===Judaism===
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.
{{Citation
===Christianity===
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
|url=https://www.biblegateway.com/passage/?search=Luke+2%3A21&version=NASB
|title=Gospel of Luke
Many cultures perform circumcision as a rite of passage into manhood. This is common in the Middle East and amongst some indigenous African and Southeast Asian peoples.
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]].
===Religious===
|accessdate=
}}</ref> did not find a significant difference in UTI rates between [[circumcised]] and [[intact]] boys with normal urinary tract anatomy.
* Other studies suggest that circumcision is more likely to raise than to lower the generally low risk of acquiring UTI: multiple studies from [[Israel ]] showed a strong correlation between ritual circumcision on the 8th day of life and postoperative UTI.<ref>{{REFjournal
|last=Menahem
|init=S
With the [[foreskin]], circumcision removes approximately 70% of the sensitive tissue of the [[penis]], lowering the potential for sexual stimulation accordingly. Due to the loss of around 50% of the entire [[penile skin]], the [[penis]] loses the reserve skin that provides cutaneous mobility in the erect [[penis]] and the [[gliding action]].
In the past, this circumstance was used to make it harder for boys to masturbate and [[masturbation]] less fun, as [[masturbation]] was viewed as immoral and was assumed to cause a variety of mental diseases, caused by the thinking of immoral thoughts! More on that can be found in the chapter "[[Circumcision#Historical_background|Historical background]]". Today, it is known that [[masturbation]] has no negative health effects, but can contribute positively to the child's sexual development. Sexuality is no longer a taboo nowadays, while [[masturbation]] is considered to be a natural part of human sexuality and is no longer seen as immoral. Therefore, circumcision for moral reasons - which would only affect boys too young to give [[informed consent]] - is no longer justifiable nowadays.
=== Hygiene reasons ===
The [[Circumcision methods]] are discussed in a separate article.
== 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=Intact America
|date=2024-01-09
|accessdate=3034-06-04
}}</ref>
In the past, advocates of circumcision claimed that a newborn child's nerve system was not yet fully developed, and that as a result, the child felt no [[pain]] during the circumcision procedure. [[Kanwaljeet J. Singh Anand| Anand]] & Hickey (1987) have shown that newborn children do in fact feel [[pain]], and more acutely than adults.<ref name="anand-hickey1987">{{REFjournal
|last=Anand
}}</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 ''"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.
To control [[pain]], some physicians that circumcise use Tylenol, sugar,<ref>{{REFweb
== Risks and effects ==
Just like tonsil or appendix surgery, circumcision is a surgical intervention and brings the usual risks related to surgical operations, alongside several specific risks of complications and late effects. <ref name="garrett2024-01-09" /> Uberoi et al. (2022) report "some men are experiencing a complex negative constellation of psychological, physical, and sexual associations that lead to significant emotional distress directed both internally and externally. 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 ="uberoi2022">{{REFjournal
|last=Uberoi
|first=
=== Physical effects ===
* [[Bodily harm]]
* [[Circumcision scar]] is an invariable effect.
* An unavoidable 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).
* Painful tension can occur when there is too little reserve [[skin]] left to support a full [[erection]]<ref name="taylor1996"/>. This risk is partly dependent on the anatomy of the [[penis]]. While some [[penis]]es already have the majority of their full size when flaccid ([[Flesh Penis]], or "[[shower]]"), others are rather short when flaccid and double or more their size during an [[erection]] ([[Blood Penis]], or "[[grower]]"). Especially in children's circumcision, where the [[penis]] is not yet fully developed, the amount of reserve [[skin]] needed in adulthood cannot be estimated.
}}</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
=== 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.
|accessdate=2019-10-12
}}</ref>
* If the [[circumcised]] male feels incomplete, or due to the missing [[foreskin]] disadvantaged compared to [[intact]] males, an inferiority complex and [[depression ]] may occur. This can be accompanied by conscious recognition of his own incompleteness, or the deficiency may remain completely subconscious<ref>{{REFjournal
|last=Rhinehart
|init=J
* Fear of doctors, clinics and also closed rooms.<ref name="Levy1945"/>
* Relapse into the state of bed-wetting, even if the child was already dry before.<ref name="Levy1945"/>
* [[Circumcised ]] males who become fathers frequently manifest [[adamant father syndrome]].
[[Intact America]] (2019) called circumcision an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]],<ref name-"bollinger2019">{{REFdocument
|accessdate=2021-11-02
}}</ref>
 
== Complications ==
=== Possible operative and postoperative complications ===
}}</ref>
=== Death ===
There is indeed a risk of [[death]] from non-therapeutic neonatal circumcision,<ref name="garrett2024-01-09" /> although the [[circumcision industry]] takes care to not reveal it.
A study in 2010 estimated approximately 117 neonatal circumcision-related [[Death| deaths]] occur annually in the [[United States]], about one out of every 77 male neonatal deaths, more than suffocation, auto accidents, or even [[SIDS]].<ref name="Bollinger 2010">{{REFjournal
|last=Bollinger
In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<ref>See, e.g., [[Margaret A. Somerville|Somerville]], "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; [[Abbie Chessler|Chessler]], "Justifying the Unjustifiable"; Smith, "Male Circumcision."</ref> For example, critics have pointed out that, in the [[United States]], more than 1.3% of male neonatal deaths are attributable to the complications of non-therapeutic circumcision surgery.<ref name="Bollinger 2010"/>
==Video==
===Is circumcision healthy?===
The video ''Is Circumcision Healthy'' is recommended for parental viewing.
<br><br>
<youtube>D_3LQjZgdbQ</youtube>
 
===Dr. Christopher Guest discusses circumcision===
<br>
<youtube>v=TQIp9f4krVQ</youtube>
 
===Plastibel circumcision===
 
{{UNI|Stanford University|SU}} has published a video of an actual non-therapeutic plastibell circumcision. The infant has received two injections of local anesthesia to deaden the dorsal nerves. The ventral nerves were not deadened so the infant still feels pain. One can his cries on the soundtrack.
* [https://med.stanford.edu/newborns/professional-education/circumcision/plastibell-technique.html Plastibell Technique]
 
===Gomco clamp circumcision===
 
'''Not for the squeamish:'''
 
This is a video of an actual circumcision with a Gomco clamp. The infant boy received two dorsal penile nerve block (DPNB) analgesic injections but they did not seem to work.
 
* [https://www.reddit.com/r/Intactivism/comments/qbpzqr/trained_medical_professionals_restrain_infant_to/ Circumcision video]
 
==Recommendations of medical authorities==
* [[George Hill| Hill]] (2007) said:
|accessdate=2023-05-18
}}</ref>
== Tipping point ==
[[Intact America]] (2024) argues that public opinion regarding non-therapeutic [[circumcision]] of children is approaching or at a "tipping point" at which [[intact]] genitals would be preferred over the [[circumcised]] variety.<ref>{{REFweb
|url=https://intactamerica.org/public-opinion-on-circumcision/
|title=Public Opinion on Circumcision: Can Intactivists Hit A Tipping Point?
|last=Anonymous
|first=
|init=
|publisher=Intact America
|date=2024-03-23
|accessdate=2024-04-09
}}</ref>
 
==Financial and other costs==
Infant male circumcision is an extra-cost option after birth. There are no medical indications for it. It is a medically-unnecessary, non-therapeutic, non-beneficial irreversible amputation of a functional body part, so medical insurance may or may not pay for it. There are several financial costs associated with infant circumcision. There is a hospital fee, a set-up fee, pharmaceutical fees, a separate fee for the medical doctor who performs the amputation, and various possible additional costs for the treatment of complications.<ref name="garrett2023-12-21">{{REFweb
|url=https://intactamerica.org/economics-of-circumcision/
|title=The Economics of Circumcision: A Full Breakdown of This Penis Business
|last=Garrett
|first=Connor
|init=
|author-link=Connor Judson Garrett
|publisher=Intact America
|date=2023-12-21
|accessdate=2024-05-15
}}</ref>
 
There also are additional non-financial costs, which include sexual and sensory losses that adversely impact on the sexual experience in adult life, and psychological losses such as [[PTSD]], and grieving of losses.
==Video==
===Is circumcision healthy?===
The video ''Is Circumcision Healthy'' is recommended for parental viewing.
<br><br>
<youtube>D_3LQjZgdbQ</youtube>
 
===Dr. Christopher Guest discusses circumcision===
<br>
<youtube>v=TQIp9f4krVQ</youtube>
 
=== Dr. Eric discusses circumcision ===
<br>
<youtube>v=iZ64pqWZRW8</youtube>
Dr. Eric understates the numerous functions of the foreskin.
===Plastibel circumcision===
 
{{UNI|Stanford University|SU}} has published a video of an actual non-therapeutic plastibell circumcision. The infant has received two injections of local anesthesia to deaden the dorsal nerves. The ventral nerves were not deadened so the infant still feels pain. One can his cries on the soundtrack.
* [https://med.stanford.edu/newborns/professional-education/circumcision/plastibell-technique.html Plastibell Technique]
 
===Gomco clamp circumcision===
 
'''Not for the squeamish:'''
 
This is a video of an actual circumcision with a Gomco clamp. The infant boy received two dorsal penile nerve block (DPNB) analgesic injections but they did not seem to work.
 
* [https://www.reddit.com/r/Intactivism/comments/qbpzqr/trained_medical_professionals_restrain_infant_to/ Circumcision video]
 
{{SEEALSO}}
* [[Adolescent and adult circumcision]]
* [[Bodily harm]]
* [[Breastfeeding]]
* [[Case Histories]]
|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
|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}}
 
{{REF}}
[[Category:Circumcision]]
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