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''Circumcision is classified as a form of [[genital mutilation]]. == Historical background == The [[amputation]] of the [[foreskin]] is a very old ritual, whose exact origin cannot be verified beyond doubt. Circumcision is believed to have originated in east Africa near the Red Sea well before the dawn of recorded history.<ref name="demeo1997">{{REFbook |last=DeMeo |first= |author-link= |year=1997 |title=The geography of sexual mutilations |url=https://www.academia.edu/4212007/The_Geography_of_Male_and_Female_Genital_Mutilations |work=Sexual Mutilations: A Human Tragedy |editors=George C. Denniston, Marilyn Milos |edition= |volume= |chapter= |pages= |location=New York |publisher=Plenum |isbn=0-306-45589-7 |quote= |accessdate=2021-11-13 |note=}}</ref> Medical historians assume that circumcision already served in ancient history as a way to control the sexuality of slaves and members of the lower classes without compromising their ability to reproduce. In religious history circumcision may be seen as a substitute for human sacrifice. In prehistoric times it was not uncommon to placate the gods with human sacrifice. Castration of slaves or conquered enemies was common as well. Following religious changes this sacrifice was altered, and only a part of the very organ responsible for the creation of new life was sacrificed. [[Image:Circumcision Sakkara 3.jpg|200px|right]] For the [[Aborigines]], the [[Australia| Australian]] natives, the tradition of circumcision is said to go back to 10,000 BC. On the African continent, the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of circumcision date back to the time around 3000-2000 BC. The following text oldest known depiction<ref>{{REFweb |url=https://commons.wikimedia.org/wiki/File:Circumcision_Sakkara_3.jpg |title=File:Circumcision Sakkara 3.jpg |accessdate=2019-10-12}}</ref> is taken an Egyptian tomb relief from the 6th dynasty, approximately 2300-2000 BC. It is not known precisely who was circumcised and why in those times. In many cultures circumcision during puberty serves as a rite of passage, bringing adolescents into the community. As with other painful or humiliating initiation rites, proof of courage and mastering of critical situations are the key motivations. From some African tribes it is also known that the [[amputation]] of the [[Circumpendiumforeskin]]is seen as the removal of an inborn piece of femininity from the boys, thus making them men. ===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 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.''
Apart According to the anthropologist and sociologist Rabbi Nissan Rubin, the [[Jewish circumcision| Jewish form of circumcision]], called ''[[Brit Milah| brit mila]]'', during the first two millennia did not include the later customary ''[[periah]]'', namely the complete scraping of the inner [[foreskin]] from the medical indication [[Glans penis|glans]]. This was only added around 135 AD, to make it almost impossible to restore the [[foreskin]] by [[stretching]], which became popular in the wake of pathological phimosisHellenic influence. While originally only the tip of the [[foreskin]] was cut off, there also are other reasons for circumcision''[[periah]]'' removes the entire [[foreskin]].
=== Aesthetic reasons ===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.
The visual appearance of the ===Christianity===Jesus was born into a Jewish family in [[Israel]], where [[penisJudaism]] is changed radically after circumcision. In this casewas the prevailing religion, personal taste is decisive whether an intact or a cut so He was [[peniscircumcised]] is more appealingon the eighth day.<ref>{{REFweb |url=https://www.biblegateway. Since a com/passage/?search=Luke+2%3A21&version=NASB |title=Gospel of Luke |last=Luke |first= |publisher=NASB |website=Bible Gateway |date= |accessdate=2019-11-10 |format= |quote=And when eight days had passed, before His circumcision cannot be undone, it is essential to be fully informed about His name was then called Jesus, the name given by the risks and possible later complications angel before embarking on an aesthetically motivated circumcision, to decide whether He was conceived in the appearance will justify such bodily modificationwomb.}}</ref>
Since this modification and its possible late effects will The first Christians had been born Jewish, so a question arose whether one must be [[circumcised]] to be a Christian. When Christian leaders met at the lifelong burden of [[Council at Jerusalem]] in the person who undertakes an aesthetically motivated circumcision First Century to decide what was required to suit his personal preferencesbe a Christian, a valid decision letter was written to proceed can only be made by explain the person to be circumcised himselfrequirements, once he has reached but circumcision was omitted from the necessary age and level of maturity to make that decisionrequirements.<ref>{{REFweb |url=https://www. This should normally be the case when adulthood is reachedbiblegateway.com/passage/?search=Acts+15%3A1-30&version=NASB |title=Acts 15:1-30 |last=Luke |first= |accessdate=2019-11-10}}</ref>
With Nevertheless, Christian moral notions had decisive influence on the [[foreskin]]spread of this practice. In the puritan influenced USA, circumcision removes approximately 70% of the sensitive tissue of children was popular in the 19th century as a means to prevent [[penismasturbation]]. In those days, lowering the potential this so-called ‘self-abuse‘ was not only considered immoral, but was supposedly responsible for sexual stimulation accordinglya variety of diseases. Due to Masturbation, however, is not mentioned anywhere in the loss of around 50% of the entire penile skinHoly Bible, so there is no support for the [[penis]] loses the reserve skin belief that provides cutaneous mobility in the erect [[penis]] and the gliding actionit is somehow immoral or sinful.
In Even the past, this circumstance was used to make it harder for boys to masturbate, as masturbation was viewed as immoral and was assumed to cause mere existence of a variety of diseases. More on that can be found in the chapter "[[Circumcision#Historical_background|Historical backgroundforeskin]]"was falsoly linked to many illnesses. TodayAmong them one could find syphilis, it is known that masturbation has no negative health effectsepilepsy, but can contribute positively to paralysis of the child's sexual development. Sexuality is no longer a taboo nowadaysspine, bed wetting, scoliosis (spinal deformity), while masturbation is considered to be a natural part paralysis of human sexuality the bladder, club foot, nerve pain in the lower abdomen, tuberculosis and is no longer seen as immorallazy eye. ThereforeOne of the best known advocates of child circumcision was [[John Harvey Kellogg]], circumcision for moral reasons co- which would only affect boys too young to give informed consent - is no longer justifiable nowadaysinventor of the corn flakes bearing his name.In 1888, he wrote:
A common reason stated for ===Islam===In [[Islam]], circumcision is also religiously founded, even though there is no mention of it in the assumption of hygienic benefitsKoran itself. This argument has According to be viewed in tradition, the context Prophet Mohammed was born without a [[foreskin]]. It is seen as a sign of the environment the person in question grows up inprophets that they are born without a [[foreskin]] already. It is commonly known that bad hygienic circumstancesconsidered an honour to "resemble the example of the Prophet", especially insufficient access meaning to clean drinking waterbe [[circumcised]]. In Islam, pose a serious problemunlike [[Judaism]], there is no specific age at which the circumcision should be performed. The situation in disaster areas or refugee camps in Most circumcisions take place at ages between 6 and 10 years, but the so-called third world keep reminding us of thatrange goes from birth to adulthood.
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 underneath the [[foreskin]] is easy - they are simply washed along with the rest of the body, just like the areas between the toes.== Rationale ==
In small boysReasons for performing circumcision range widely by culture, where the [[foreskin]] cannot be retracted yetreligion, cleaning is not necessarylocation, since the membrane that fuses the [[foreskin]] to the [[Glans penis|glans]] prevents the accumulation of micro-organisms. The so-called "ballooning", where the [[foreskin]] inflates during urination, is not a serious problemand age.
The opening of the [[foreskin]] in small boys is often quite narrow and serves as a one-way valve, allowing the urine to flow out, but preventing entry of microbes, for example from a dirty diaper. As long as the child is able to pass water, everything works as nature intended.===Cultural===
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]], Many cultures perform circumcision itself is not without risk of complications. If the operation is carried out without proper sterility, there is as a high risk rite of an infection of the woundpassage into manhood. This also applies to is common in the treatment of common complications like post-operative bleedingMiddle East and amongst some indigenous African and Southeast Asian peoples.
Some people claim that The form of circumcision has prophylactic benefits. Especially in adopted by 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 medical community essentially was believed equivalent to be the cause. After bacteria and viruses had been discoveredJewish form with ''[[periah]]'', arguments changed, and one after another miscellaneous diseases were citedso it inflicted the maximum injury.
* [[Phimosis]]: as mentioned earlier, true [[phimosis]] is rare and can be treated effectively without surgery. According to In a study by Blalock et.al. (2003)<ref>Blalock HJfew cases with older patients, Vemulakonda V, Ritchey ML, Ribbeck M. Outpatient management of [[phimosis]] Following newborn circumcision. J Urol 2003is legitimately indicated;169(6):2332-4.</ref>a patient may be suffering recurring infections, 2.9% and other methods of those circumcised develop a post-operative [[phimosis]], in which the circumcision scar constrictstreatment have failed. In intact patientsother cases, the rate a patient may be suffering from a severe case of [[phimosis]] is only 1% (see also the study by Jakob Øster above). ThereforeOverall, the actual medical necessity for circumcision is not a preventive measure for [[phimosis]].* Sexually Transmitted Diseases (STDs): a vast number of studies has been conducted on the subject of transmission of STDs.* First, it has extremely rare since many conditions respond to be noted that any form of protection against these diseases only affects people who are sexually activeconservative treatment. Circumcision in childhood cannot be justified on these grounds, since any assumed protective effect will not occur before All circumcisions injure the boy is already old enough to decide about circumcision for himself.* As mentioned above, patient by amputating the [[foreskin]] keeps the [[Glans penis|glans]] moist. This subpreputial moisture contains, among other substances, the enzyme lysozyme, which breaks up the cell wall of bacteriaits with many protective, thereby providing a natural antibacterial screen. This explains the results of several studiesimmunological, such as Laumann et.al.<ref>Laumann EO, Masi CM, Zuckerman EW. Circumcision in the United States: prevalence, prophylactic effectssensory, and sexual practice. JAMA 1997;277:1052-7.</ref>, which found a higher rate of infection with bacterial venereal diseases in circumcised than in intact men.* The studies by Fleiss et.al.<ref>Fleiss PM, Hodges FM, Van Howe RS. Immunological functions of the human prepuce. Sex Transm Inf 1998;74:364-7.</ref> support this. According to the [[AAPForeskin#Physiological_functions| functions]], 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>Task Force on Circumcision. Circumcision policy statement. Pediatrics 1999;103(3):686-93.</ref>* HIV / AIDS: in the recent past, the argument that circumcision could help to contain the spread of HIV has been stated numerous times.*:First, two notes: for one, the use of condoms is still by far the most effective protection against an infection. During intercourse with that preventive measure, circumcision status does not make a difference.*:Secondly, the assumed protection would only affect healthy men who have intercourse with an infected woman. An infected man can infect a women by transmission of his bodily fluids, so that his circumcision status is irrelevant. Therefore, the use of condoms remains vital in containing the spread of HIV, which in return renders circumcision unnecessary* Due to the inevitable loss of sensitivity as a result of circumcision, there is also the temptation to go without condoms, in order not to lose even more sensitivity.<ref>Hooykaas C, van der Velde FW, van der Linden MM. et al. The importance of ethnicity as a risk factor for STDs and sexual behaviour among heterosexuals. Genitourin Med 1991; 67(5): 378-83.</ref><ref>Michael RT, Wadsworth J, Feinleib J, et al. Private sexual behavior, public opinion, and public health policy related to sexually transmitted diseases: a US-British comparison. Am J Public Health 1998;88(5):749-54.</ref><ref>Laumann EO, Masi CM, Zuckerman EW. Circumcision in the United States: prevalence, prophylactic effects, and sexual practice. JAMA 1997;277:1052-7.</ref>* Two studies that have been published in early 2007<ref>Gray RH and colleagues. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007:369;657-666.</ref><ref>Bailey RC and colleagues. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007:369;643-656.</ref>, which investigated the effectiveness of circumcision as a means of reducing the spread of HIV from infected women to heterosexual men in African high risk areas, have been repeatedly subjected to strong criticism. Both studies were ended prematurely, which distorted the results. The men who had been circumcised for the study had to stay sexually inactive during the wound healing, which gave the intact control group more relative opportunity to become infected. The fact that the USA has both the highest rate 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>Grosskurth H, Mosha F, Todd J, et al. A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results. AIDS 1995;9(8):927-34.</ref><ref>Barongo LR, Borgdorff MW, Mosha FF, et al. The epidemiology of HIV-1 infection in urban areas, roadside settlements and rural villages in Mwanza Region, Tanzania. AIDS 1992;6(12):1521-8.</ref><ref>Changedia SM, Gilada IS. Role of male circumcision in HIV transmission insignificant in conjugal relationship (abstract no. ThPeC7420). Presented at the Fourteenth International AIDS Conference, Barcelona, Spain, July 7-12, 2002.</ref><ref>Connolly CA, Shishana O, Simbayi L, Colvin M. HIV and circumcision in South Africa (Abstract No. MoPeC3491). Presented at the 15th International AIDS Conference, Bangkok, Thailand, July 11-16, 2004.</ref><ref>Thomas AG, Bakhireva LN, Brodine SK, Shaffer RA. Prevalence of male circumcision and its association with HIV and sexually transmitted infections in a U.S. navy population (Abstract no. TuPeC4861). Presented at the 15th International AIDS Conference, Bangkok, Thailand, July 11-16, 2004.</ref>* Urinary tract infections (UTI): a UTI can be effectively treated with antibiotics, this was also proven by studies<ref>McCracken G. Options in antimicrobial management of urinary tract infections in infants and children. Pediatr Infect Dis J 1989;8(8):552–55.</ref><ref>Larcombe J. Urinary tract infection in children. BMJ 1999;319:1173–5.</ref>. A Swedish study <ref>Mårild S, Jodal U. Incidence rate of first–time symptomatic urinary tract infection in children under 6 years of age. Acta Paediatr 1998;87(5):549–52.</ref> found that, during the first 6 years of life, the incidence of UTIs 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>Mueller ER, Steinhardt, G., Naseer S. The incidence of genitourinary abnormalities in circumcised and uncircumcised boys presenting with an initial urinary tract infection by 6 months of age. Pediatrics 1997;100 (Supplement): 580.</ref> did not find a significant difference in UTI rates between circumcised and intact boys with normal urinary tract anatomy.* Other studies suggest that circumcision is more likely to raise than to lower the generally low risk of acquiring UTI: multiple studies from Israel showed a strong correlation between ritual circumcision on the 8th day of life and postoperative UTI.<ref>Menahem S. Complications arising from ritual circumcision: pathogenesis and possible prevention. Isr J Med Sci 1981;17(1):45–8.</ref><ref>Cohen HA, Drucker MM, Vainer S, et al. Postcircumcision urinary tract infection. Clin Pediatr 1992;31(6):322–4.</ref><ref>Goldman M, Barr J, Bistritzer T, Aladjem M. Urinary tract infection following ritual Jewish circumcision Isr J Med Sci 1996;32:1098–102.</ref>* It can be concluded that circumcision is ineffective as a preventive measure against UTIs.* Penile and cervical cancer / HPV: first studies on those diseases and their assumed prevention by circumcision date back to 1932, a time when the cause for those illnesses was not yet fully understood<ref>Wolbarst A. Circumcision and penile cancer. Lancet 1932;1(5655):150–53.</ref>. Today, it is known that sexually transmitted human papillomavirus (HPV) is a major risk factor<ref>McCance DJ, Kalache A, Ashdown K, et al. Human papillomavirus types 16 and 18 in carcinomas of the penis from Brazil. Int J Cancer 1986;37(1):55–9.</ref>, as well as smoking<ref>Harish K, Ravi R. The role of tobacco in penile carcinoma. Brit J Urol 1995;75(3):375–7.</ref>. Studies have shown that there is no significant difference in the risk of getting penile cancer between circumcised and intact men. To prevent a single case of penile cancer, it would statistically take 600 to 900 circumcisions<ref>American Academy of Family Physicians. Position Paper on Neonatal Circumcision. Leawood, Kansas, (February 14, 2002).</ref>. The influence of circumcision on the infection risk of the female partner with cervical cancer has been refuted several times as well. HPV vaccination is an effective measure against carcinoma of the cervix.
In conclusion, circumcision # '''Deformed or malformed foreskin'''. A foreskin so deformed or malformed that it does not provide any proven benefits in preventive medicinefunction properly may be removed by circumcision.
== Circumcision in detail: Styles, techniques and instruments ==# '''Traumatically injured foreskin'''. A foreskin so traumatically damaged foreskin that cannot be surgically repaired is a valid medical reason for circumcision.
During circumcision# '''Diseased foreskin.''' A foreskin that is diseased is a valid indication for cirumcision. Some diseases that qualify are malignancy, lichen sclerosis, the [[foreskinBalanitis#Diabetic_males| yeast infection in men with diabetes]] of the , and recurrent [[penisbalanoposthitis]] is partly or completely removed. The exact amount and type of skin removed depends on the style and technique used, and therefore also on the tools being used.
=== FirstIn such cases, a look on the common styles: ===benefit of removing the problem foreskin may exceed the maleficial harms of tissue and function destruction.
The remaining part of Initially, circumcision was adopted in the inner 19th century as a way to stop boys and men from masturbating, when [[foreskinmasturbation]] is folded back and sewed was claimed to be the shaft skincause for many diseases. The scar is located closer to As the bodymyth that circumcision prevented masturbation became debunked, hence advocates of circumcision began the great search to find the term "highmedical benefits"of circumcision.
The inner Male and female circumcision involves the removal and disruption of normal anatomical structures that are primary areas of sexual sensation.<ref name="taylor1996"/> In the past, some advocates of mass circumcision have considered the [[foreskinprepuce]]to be a "mistake of nature, which originally faced inwards lying on the "<!--{{Cold and Wiswell (1995)}} | [[Glans penisTemplate:Cold and Wiswell (1995)|glanssee more]], now faces outward; --> but this causes notion has no validity because the differently coloured section between [[Glans penisprepuce is ubiquitous in primates and because it provides functional advantages.<ref name="cold-mcgrath1995">{{REFbook |last=Cold |first=Christopher |init=C |last2=McGrath |first2=Kenneth |init2=K |author2-link=Ken McGrath |year=1999 |glans]] title=Male and female circumcision: medical, legal, and shaft skin which is characteristic for this styleethical considerations in pediatric practice |url=https://www.cirp.org/library/anatomy/cold-mcgrath/ |work= |editor= |edition= |volume= |chapter=Anatomy and histology of the penile and clitoral prepuce in primates |pages= |location=New York |publisher= |isbn=0306461315 |quote= |accessdate=2019-10-12 |note=}}</ref>
Of all styles, the tight ones remove the most skinAll claims that circumcision prevents future disease are false. They already limit the mobility of the penile skin to a great extent when the [[penis]] is flaccid, and during an erection the skin is fully stretched and immobile<ref>{{REFweb |url=https://www.doctorsopposingcircumcision. An insufficient amount of reserve skin can hamper a complete erection org/for-professionals/alleged-medical-benefits/conclusions-and lead -references/ |title=Conclusions |last=Anonymous |first= |init= |publisher=Doctors Opposing Circumcision |date=2016 |accessdate=2023-10-22}}</ref> They are made to painful tension. Also, enable a skewed [[penis]] can occur due physician to an uneven distribution of the remaining skin, often caused by an inaccurately placed cut or perform circumcision and collect a uneven growth during wound healing. Due to the extensive shortening of the inner [[foreskin]], this style also means the loss of large amounts of sensitive tissuefee.<!--===Search for prophylactic reasons===
This style is Following the most radical, discovery of bacteria as it removes the entire sensitive tissue a cause of many diseases – such as tuberculosis – the [[foreskin]]. As in the high & tight style, large amounts of skin are removed. In a flaccid state, the skin is barely movable, and in an erect state it is totally immobilesearch began for other illnesses that could be prevented by circumcision.
An insufficient amount In 1870 the prominent Dr. [[Lewis Albert Sayre|Lewis A. Sayre]] of reserve skin can hamper an erection and lead NYC’s famed Bellevue Hospital<ref>https://nypost.com/2016/12/03/bellevues-doctors-invented-the-procedures-you-take-for-granted/</ref> claimed to painful tension and cure a skewed boy’s paralyzed legs with circumcision. Sayre's wild advocacy of circumcision exemplified how some [[penishttps://intaction.org/circumcision-facts-and-myths/ circumcision facts and myths]] in this style originated. He also claimed to cure epilepsy, mental disorders, hip-joint pain, & hernias with circumcision. “Genital irritations” & masturbation were deemed to be the cause of these issues. Sayre was later elected as wellthe President of the American Medical Association. <ref>American Medical Association. Transactions of the American Medical Association.1870;21:205–11</ref>
==== High & Loose<ref>David-matthias http://commonsIn the 1920s it was penile cancer.wikimedia[[Abraham L.org/wiki/File:Beschneidungsstile,_Styles_of_CircumcisionWolbarst]] (1926) claims that circumcision can prevent penile cancer.jpg</refname="wolbarst1926"> {{REFjournal |last=Wolbarst |first=Abraham L. |init=AL |author-link=Abraham L. Wolbarst |title=Is circumcision a prophylactic against penis cancer? |journal=Cancer[[image:High_and_loose.jpg |date=Jul 1926 |200pxvolume=3 |center]]issue=4The outer foreskin is completely removed, as well as parts of the shaft skin. The inner foreskin is folded back and sewed to the shaft skin. The scar is located towards the body, hence the term "high". Unlike the high & tight style, the inner [[foreskin]] is less reduced, and lies in folds behind the [[Glans penis |glans]].pages=301-10}}</ref>
There is enough remaining reserve skin to ensure a complete In the 1940s, prostate and unhindered erectiontongue cancer as well as STDs. Of all variants, this one removes the smallest amount [[Eugene H. Hand]] (1949) falsely explains that circumcision somehow protects against venereal diseases and tongue cancer.<ref name="hand1949">{{REFjournal |last=Hand |first=Eugene H. |init=EH |author-link=Eugene H. Hand |url=https://pubmed.ncbi.nlm.nih.gov/18135844/ |title=Circumcision and venereal disease |journal=Archives of sensitive tissueDermatology and Syphilology |date=1949-09 |volume=60 |issue=3 |pages341-6 |pubmedID=18135844 |DOI=10.1001/archderm.1949.01530030037004 |accessdate=2021-10-08}}</ref>
==== Low & Loose<ref>David-matthias http://commons.wikimedia.org/wiki/File:Beschneidungsstile,_Styles_of_CircumcisionIn the 1950s it was cervical cancer.jpg</ref> ====[[image:Low_and_loose.jpg|200px|centerAbraham Ravich]]The inner [[foreskin]] is removed, (1951) invents the outer [[foreskin]] is sewed on below myth that circumcision reduces the [[Glans penis|glans]]risk of women getting cervical cancer. The scar is therefore located close to the [[Glans penis|glans]], hence the term <ref name="lowravich1951". The outer [[foreskin]] lies in folds behind the [[Glans penis|glans]]. Enough skin is left in place to ensure a complete and unhindered erection.>{{Ravich1951}}</ref>
Since, in contrast In the late 1960s it was neuroses. [[Morris Fishbein]] (1969) calls for circumcision to the high & loose styleprevent nervousness and, the inner instead of the outer course, [[foreskinmasturbation]] is removed, this style results in the loss of almost all of the sensitive tissue.<ref>{{Fishbein1969}}</ref>
=== Techniques In the 1970s bladder- and instruments ===rectal cancer. [[Abraham Ravich]] (1971) claims that circumcision would prevent bladder cancer and rectal cancer.<ref>{{Ravich1971}}</ref>
Over timeIn the 1980s, a vast variety of methods has been developed to remove the UTIs. [[foreskinThomas E. Wiswell]]. A multitude of clamps and tools is available to ease (1985) claims that circumcision, using a methodologically flawed report, reduces the work risk of the circumciser, to improve the chance for visually symmetrical results and to prevent injuries to the [[Glans penisurinary tract infections.<ref name="wiswell1985">{{REFjournal |last=Wiswell |first=Thomas E. |init=TE |author-link=Thomas E. Wiswell |glans]] from inexpert cutsurl=https://pediatrics.aappublications. I will introduce some org/content/75/5/901 |title=Decreased incidence of the most widely spread variants.urinary tract infections in circumcised male infants |journal=Pediatrics |date=May 1985 |volume=75 |issue=5 |pages=901-3 |accessdate=2019-10-12}}</ref>
[[File:Circumpendium-6-2-1-c.jpg||center|thumb]]Completely freehand techniques are also common. The penile skin is first cut in two places along the circumference, in the area sheer mass of the shaft skin studies and [[foreskin]]. After publications that were released during those almost 180 years on this topic are the skin area between the cuts is removed reason that even arguments that have been disproved multiple times, especially regarding infant and the remaining skin suturedchild circumcision, tenaciously persist up until today.
Also among An ever-recurring element of initiation rites found in many different cultures is the freehand techniques are fixation upon the shield variantsgenitalia.
[[File:Circumpendium-6-2-1-Jewish-clampIt reflects the fascination that emerges from the ability to create new life.jpg||center|thumb|Jewish clamp]]In most cultures, fertility is seen as the most precious good, and the body parts involved frequently find themselves in the focus of ritual Jewish circumcision acts. In many parts of the world, those rites take place when the boy reaches puberty, and are meant to symbolize his transition from boy to man. The removal of the male [[foreskin]] is just one of many phenomena that developed in inserted into this context. They range from the slit removal of the shield (left) frenulum in boys and then cut on the upper side men through partial or complete removal of the shield[[foreskin]] up to radical operations. Australian [[Aborigines]], as mentioned above, have their [[foreskin]]s removed. It is also usual that, a few weeks later, young men have their [[penis]]es sliced open in a [[subincision]], resulting in a partly or completely divided [[urethra]].
[[File:Circumpendium-6-2-1-Sheldon-clamp.jpg||center|thumb|Sheldon-Clamp]]The Sheldon-Clamp (right) works in a For many cultures it is also common to perform similar wayrituals on girls. The inner clamp grasps This can range from relatively small interventions such as piercing or cutting the tip clitoral hood, to its complete removal and up to radical removal of the clitoral hood, [[foreskinclitoris]], pulling it into the inner and outer clamp which is closed. The outer clamp then grips the skin. After a few minutes of pressure, the [[foreskin]] is cut between labia followed by sewing up the two clampsvagina.
The tissue beyond the string * [[Phimosis]]: as mentioned earlier, true [[phimosis]] is cut off rare and the bell's handle cracked offcan be treated effectively without surgery. According to a study by Blalock et al. (2003)<ref name="blalock2003">{{REFjournal |last=Blalock |init=HJ |last2=Vemulakonda |init2=V |last3=Ritchey |init3=ML |last4=Ribbeck |init4=M |title=Outpatient management of [[phimosis]] Following newborn circumcision |journal=J Urol |date=2003 |volume=169 |issue=6 |pages=2332-4 |url=https://www.cirp.org/library/complications/blalock1/ |accessdate=2019-11-07}}</ref>, 2. The strangulated tissue dies off 9% of those circumcised develop a post-operative [[phimosis]], in which the following dayscircumcision scar constricts. In [[intact]] patients, and the ring falls off rate of [[phimosis]] is only 1% (see also the study by [[Jakob Øster]]). Therefore, circumcision is not a preventive measure for [[phimosis]].* Sexually Transmitted Diseases (STDs): a vast number of studies has been conducted on its ownthe subject of transmission of STDs. Since this * First, it has to be noted that any form of protection against these diseases only affects people who are sexually active. Circumcision in childhood cannot be justified on these grounds, since any assumed protective effect will not occur before the boy is already old enough to decide about circumcision means part for himself.* As mentioned above, the [[foreskin]] keeps the [[Glans penis|glans]] moist. This subpreputial moisture contains, among other substances, the enzyme lysozyme, which breaks up the cell wall of bacteria, thereby providing a natural antibacterial screen. This explains the results of several studies, such as Laumann et al.<ref>{{REFjournal |last=Laumann |init=EO |last2=Masi |init2=CM |last3=Zuckerman |init3=EW |title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice |journal=JAMA |date=1997 |volume=277 |issue= |pages=1052-7 |url=https://www.cirp.org/library/general/laumann/ |accessdate=2019-11-06}}</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 process goes circumcision status.<ref>{{REFjournal |last=Task Force on without medical supervisionCircumcision |first= |title=Circumcision policy statement |journal=Pediatrics |date=1999 |volume=103 |issue=3 |pages=686-93 |url=https://www.cirp.org/library/statements/aap1999/ |accessdate=2019-11-15}}</ref>* [[HIV]] / [[AIDS]]: in the recent past, the argument that circumcision could help to contain the spread of [[HIV]] has been stated numerous times.*:First, two notes: for one, the use of condoms is still by far the most effective protection against an infection. During intercourse with that preventive measure, it may circumcision status does not be possible make a difference.*:Secondly, the assumed protection would only affect healthy men who have intercourse with an infected woman. An infected man can infect a women by transmission of his bodily fluids, so that his circumcision status is irrelevant. Therefore, the use of condoms remains vital in containing the spread of [[HIV]], which in return renders circumcision unnecessary* Due to intervene promptly in the event inevitable loss of sensitivity as a result of swelling; also circumcision, there is also the temptation to go without condoms, in order not to lose even more sensitivity.<ref>{{REFjournal |last=Hooykaas |init=C |last2=van der Velde |init2=FW |last3=van der Linden |init3=MM |etal=yes |title=The importance of ethnicity as a risk factor for STDs and sexual behaviour among heterosexuals |journal=Genitourin Med |date=1991 |volume=67 |issue=5 |pages=378-83 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1194736/pdf/genitmed00041-0022.pdf |accessdate=2019-11-15}}</ref><ref>{{REFjournal |last=Michael |init=RT |last2=Wadsworth |init2=J |last3=Feinleib |init3=J |etal=yes |title=Private sexual behavior, public opinion, and public health policy related to sexually transmitted diseases: a US-British comparison |journal=Am J Public Health |date=1998 |volume=88 |issue=5 |pages=749-54 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1508929/pdf/amjph00017-0039.pdf |accessdate=2019-11-15}}</ref><ref>{{REFjournal |last=Laumann |init=EO |last2=Masi |init2=CM |last3=Zuckerman |init3=EW |title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice |journal=JAMA |date=1997 |volume=277 |issue= |pages=1052-7 |url=https://www.cirp.org/library/general/laumann/ |accessdate=2019-11-06}}</ref>* Two studies that have been published in early 2007<ref>{{RCT Gray et al 2007}}</ref><ref>{{RCT Bailey et al 2007}}</ref>, which investigated the effectiveness of circumcision as a means of reducing the ring being removed spread of [[HIV]] from infected women to heterosexual men in African high risk areas, have been repeatedly subjected to strong criticism. Both studies were ended prematurely due , which distorted the results. The men who had been [[circumcised]] for the study had to external influence. This may cause stay sexually inactive during the wound healing wound , which gave the intact control group more relative opportunity to become infected. These African randomized clinical trials have been demonstrated to burst open, necessitating additional suturinghave very serious methodological and statistical errors that distort the results in favor of circumcision.<ref name="boyle-hill2011">{{BoyleGJ HillG 2011}}</ref>
All of these methods have in common that the [[foreskin]] has to be separated from the [[Glans penis|glans]] first. In case of the conclusion, circumcision of a child, it is in most cases (see chart above) necessary to forcibly tear apart the balanopreputial membrane, which fuses the [[foreskin]] to the [[Glans penis|glans]], either by violently retracting the [[foreskin]] or separating it by pushing a blunt instrument underneath the [[foreskin]], both of which can result does not provide any proven benefits in injuries and inflammations of the [[Glans penis|glans]]preventive medicine.
Just like tonsil or appendix surgeryApart from the [[medical indication]] of pathological phimosis, there also are other reasons for circumcision is a surgical intervention and brings the usual risks related to surgical operations, alongside several specific risks of complications and late effects.
* Intolerance or allergic reactions to the narcotics used.* Especially in newborns, where the bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is often insufficient for the operation. Even in conjunction with regional anaesthesia of the dorsal nerve The visual appearance of the [[penis]], the rate of failure to provide sufficient anaesthetic even for experienced anaesthetists is still 5-10%. The general anaesthesia that would be needed for newborns, however, poses significant risks for the child, and, therefore, is only likely to be used in emergencies. A surgical operation without proper pain control can lead to the development of a specific pain memory<ref>Prof. Dr. med. Boris Zernikow http://www.spiegel.de/spiegel/vorab/experte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-849534.html</ref>. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months changed radically 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>Garry T. Circumcision: a survey of fees and practices. OBG Management 1994. (October): 34-6.</ref><ref>Howard CR, Howard FM, Garfunkel LC, de Blieck EA, Weitzman M. Neonatal circumcision and pain relief: current training practices. Pediatrics 1998; 101:423-428.</ref><ref>Stang HJ, Snellman LW. Circumcision practice patterns in the United States. Pediatrics 1998; 101: e5. 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 3- to 4-fold increase in cortisol levels, which equals a state of severe shock.<ref>Gunnar MR, Fisch RO, Korsvik S, Donhowe JM. The effects of circumcision on serum cortisol and behavior. Psychoneuroendocrinology 1981; 6(3):269-75.</ref>* Postoperative wound pain, in the In this case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions.* Postoperative bleeding of the wound. This can have severe consequences especially for very young infants, if they are not treated promptly. Their blood volume personal taste 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>Smart J, Nolan T. (Editors). Paediatric Handbook, Sixth Edition. Victoria, Australia: Blackwell Science Asia, 2000: p. 82</ref><ref>Wetli CV. Case 93-1711. Autopsy of Demetrius Manker. Miami: Dade County Medical Examiner Department, June 23, 1993.</ref><ref>Hiss J, Horowitz A, Kahana T. Fatal haemorrhage following male ritual circumcision. J Clin Forensic Med 2000;7:32-4.</ref><ref>Newell TEC. Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan. Burnaby, B.C.: B.C. Coroner's Service, Monday, 19 January 2004</ref>* Postoperative infections. This includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.<ref>Dr.med Wolfram Hartmann, Stellungnahme zur Anhörung am 26. November 2012 im Rechtsausschuss des Bundestages</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 decisive whether an [[Glans penis|glansintact]] with the neighbouring penile skin, causing skin pockets and bridges, as well as visually unpleasant results like uneven scars, which make or a re-circumcision necessary.* Postoperative [[phimosiscircumcised]]: a phimotic ring can develop during scarring, which makes a re-circumcision necessary. According to a study by Blalock et.al.<ref>Blalock HJ, Vemulakonda V, Ritchey ML, Ribbeck M. Outpatient management of [[phimosispenis]] Following newborn circumcision. J Urol 2003;169(6):2332-4.</ref>, the prevalence is 2more appealing.9%, according to Leitch<ref>Leitch IOW. Circumcision - Since a continuing enigma. Aust Paediatr J 1970;6:59-65</ref> 5.5%.* Meatal stenosis, a pathological narrowing of the opening of the urethra, which mostly occurs in infancy and early childhood. It is one of the most common complications of infant circumcision. A study from 2006 found meatal stenosis exclusively in previously circumcised boys. The incidence rate after a circumcision is at approximately 10%.<ref>Van Howe RS. Incidence of meatal stenosis following neonatal circumcision in a primary care setting. Clin Pediatr (Phila). Jan-Feb 2006;45(1):49-54.</ref><ref>Stenram, A., Malmfors, G., & Okmian, L. (1986): Circumcision for [[phimosis]]: a follow-up study. Scandinavian journal of urology and nephrology, 20(2), 89 PMID 3749823.</ref><ref>http://emedicine.medscape.com/article/1016016-overview</ref>* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]]cannot be undone, it 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 essential 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 fully informed about the [[Glans penis|glans]] or the [[penis]] can occur.* In rare cases, necrosis, gangrene, ischaemia, keloid formation risks and circulatory problems may also occur.* When the possible later complications before embarking on an aesthetically motivated 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>http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritualdecide whether the appearance will justify such bodily modification.html?_r=0</ref>
=== Physical late effects ===It should be noted that every circumcision operation leaves a life-long [[circumcision scar]] that encircles the shaft of the [[penis]]. In addition, there frequently a a color change at the circumcision scar which results in a two-tone appearance.
* An unavoidable Since this modification and its possible late effect of any circumcision is effects will be the permanent loss lifelong burden of sexual sensitivity. This is partly due to the removal of sensory tissue. The [[foreskin]] contains approximately 20,000 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 person who undertakes an aesthetically motivated circumcision 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 ML, Snyder JLsuit his personal preferences, Reiss MD, et al. Fine-touch pressure thresholds in the adult [[penis]]. BJU Int 2007;99:864-9.</ref> found a significant reduction of sensitivity to touch for circumcised compared valid decision 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 proceed can occur when there is too little reserve skin left to support a full erection<ref>Taylor, J.R., Lockwood, A.P., & Taylor, A.J. (1996). The prepuce: „Specialized mucosa of only be made by the [[penis]] and its loss person to circumcision.“ British Journal of Urology, 77, 291-295.</ref>. This risk is partly dependent on the anatomy of the be [[penis]]. While some [[penis]]es already have the majority of their full size when flaccid ([[Flesh Peniscircumcised]]himself, or "[[shower]]"), others are rather short when flaccid and double or more their size during an erection ([[Blood Penis]], or "[[grower]]"). Especially in children's circumcision, where the [[penis]] is not yet fully developed, the amount of reserve skin needed in adulthood cannot be estimated.* Erectile dysfunction: Both the damage inflicted to once he has reached the blood vessels in the [[foreskin]] and the reduced sexual sensitivity can be causes for reduced erectile function with advancing necessary age.<ref>Money, J., & Davison, J. (1983): Adult penile circumcision: Erotosexual and cosmetic sequelae. Journal of Sex Research, 19, 289-292</ref>* Orgasm problems: In the wake of reduced sexual sensitivity, due to the loss of sensory tissue and gradual keratinization of the surface level of the [[Glans penis|glans]], orgasm problems may develop with increasing age. In this case, the sexual arousal created by intercourse or masturbation is not enough maturity to achieve orgasmmake that decision. A preliminary stage of this late effect is This should normally be the prolonged time circumcised men need to reach an orgasm. This case when adulthood is often fielded as the "cut men have more endurance" argument for circumcision.* Vaginal dryness: Due to the loss of the natural gliding action, which comes from the mobility of the fore- and shaft skin, a much increased friction between [[penis]] and vagina occurs during intercourse. This can make intercourse painful for both partners and lead to abrasions<ref>[[Morten Frisch]], Morten Lindholm, Morten Grønbæk: Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark. In: International Journal of Epidemiology Oktober 2011, 40(5), S. 1367-1381, doi:10.1093/ije/dyr104, PMID 21672947.</ref><ref>Cortés-González, J., Arratia-Maqueo, J., & Gómez-Guerra, L. (2008): Does circumcision has an effect on female's perception of sexual satisfaction? Rev Invest Clin, 60(3), 227 PMID 18807735.</ref> The prolonged time it takes circumcised men to reach orgasm, as well as the often longer and more vigorous thrusting movements - compared to intact men - play a part in this.<ref>Cold CJ, Taylor JR. The prepuce BJU Int 1999;83 Suppl. 1:34-44.</ref><ref>Fink KS, Carson CC, DeVellis RF. Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction. J Urol 2002;167(5):2113-2116reached.</ref>
Psychological late effects are also possible after a circumcision, especially if In the operation was carried out in childhood. On this occasion a variety of trauma may occurUnited States, which depend, among others, on age and circumstances payment for non-therapeutic circumcision is made by most [[third-party payment| third-party payers]] without question of the circumcisionnecessity. For exampleDoctors frequently perform medically-unnecessary, whether the non-therapeutic circumcision took place with or without sufficient anaesthesia, if the individual has been informed about of infants and children simply to collect a fee for the surgical operation beforehand, if he was circumcised against his will or without his consent, and also, in . The only beneficiary of such surgery is the case [[Financial Incentive| bank account of infant circumcision, if he was told about it during childhood or had to find it out coincidentally on his ownthe medical doctor]].
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.=== Moral reasons ===
* It was observed that infantsWith the [[foreskin]], following circumcision without pain control, had a disturbed bond with their mother<ref>Marshall RE, Porter FL, Rogers AG, et al. Circumcision: II effects upon mother-infant interaction. Early Hum Dev 1982; 7(4):367-74.</ref>, as well as problems with nurturing, up to removes approximately 70% of the point of refusal to be fed. The sleeping habits sensitive tissue of these babies were also disturbed, with prolonged non-REM sleep and increased waking.* In boys circumcised in childhood, post traumatic stress disorder (PTSD) could be diagnosed. In a study on Philippine boys, in whom no PTSD was found prior to the operation[[penis]], 69% of lowering the boys circumcised in the traditional ritual and 51% of those circumcised by standard medical procedures (including anaesthesia) fulfilled the DSM-IV criteria potential for PTSD following the operationsexual stimulation accordingly.<ref>Ramos S, Boyle GJ. Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder. In: Denniston GC, Hodges FM, Milos MF (eds) Understanding circumcision: A Multi-Disciplinary Approach Due to a Multi-Dimensional Problem. New York: Kluwer Academic/Plenum Publishers, 2001: pp. 253-70.</ref>* Circumcisions, especially those that happen without consent, can spark feelings the loss of helplessness and alienation, which can persist as trauma. These feeling can also be triggered later, when someone circumcised as an infant becomes aware of his circumcision. In an online study, interviewed men stated they felt betrayed - 55% by the mother, around 50% by the father, and 58% by the doctor, and 73% felt that their human rights had been violated.<ref>http://www.circumcisionharm.org/</ref>* It can frequently be found that the loss is denied, much as happens with the loss of other body parts. This denial can lead to fathers having their sons circumcised in order not to be reminded of their own loss. In this process, their own body is defined as "normal" and the entire [[foreskinpenile skin]] redefined as a foreign object. Their own parents are seen as "good", so that this image is projected onto the circumcision their parents carried out as well, in order to keep the positive emotion intact. The father wants to be a "good" father later in life as well, and so, following an idealised image of his own parents, circumcision, which has been redefined as a "good thing", is passed on to his son by having him circumcised as well.<ref>van der Kolk BA. The compulsion to repeat the trauma: re-enactment, revictimization, and masochism. Psychiatr Clin North Am 1989;12(2):389-411.</ref><ref>Goldman R. The psychological impact of circumcision. BJU Int 1999;83 Suppl. 1:93-103.</ref>* If the circumcised male feels incomplete, or due to the missing [[foreskinpenis]] disadvantaged compared to intact males, an inferiority complex and depression may occur. This can be accompanied by conscious recognition of his own incompleteness, or loses the deficiency may remain completely subconscious<ref>Rhinehart J. Neonatal circumcision reconsidered. Transactional Analysis J 1999;29(3):215-21.</ref>. In an online study, 75% of those interviewed stated reserve skin that they felt incomplete, and 66% said they felt inferior compared with intact males.<ref>http://www.circumcisionharm.org/</ref>* Cases provides cutaneous mobility in which children felt ill treated or punished have been documented as well. G. Cansever found in her study on 12 boys aged between 4 and 7 years, who had previously been prepared for their impending circumcision, that the children experienced the operation as an aggressive assault on their bodies.<ref>Cansever, G. (1965). Psychological effects of circumcision. Brit. J. Med. Psychol. 38: 321-331.</ref>* Fear of being alone or darkness.<ref>David M. Levy, Psychic trauma of operations in children; erect [[penis]] and a note on combat neurosis, American Journal of Diseases of Children, Vol. 69, 1945, 7-25</ref>* Fear of doctors, clinics and also closed rooms.<ref>David M. Levy, Psychic trauma of operations in children; and a note on combat neurosis, American Journal of Diseases of Children, Vol. 69, 1945, 7-25</ref>* Relapse into the state of bed-wetting, even if the child was already dry before.<ref>David M. Levy, Psychic trauma of operations in children; and a note on combat neurosis, American Journal of Diseases of Children, Vol[[gliding action]]. 69, 1945, 7-25</ref>
== 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.
The amputation of the [[foreskin]] is a very old ritual, whose exact origin cannot be verified beyond doubt. Medical historians assume that circumcision already served in ancient history as a way to control the sexuality of slaves and members of the lower classes without compromising their ability to reproduce. In religious history circumcision may be seen as a substitute for human sacrifice. In prehistoric times it was not uncommon to placate the gods with human sacrifice. Castration of slaves or conquered enemies was common as well. Following religious changes this sacrifice was altered, and only a part of the very organ responsible for the creation of new life was sacrificed.=== Hygiene reasons ===
[[Image:Circumcision Sakkara 3.jpg|200px|right]] For the Aborigines, the Australian natives, the tradition of circumcision is said ''Hygiene'' refers to go back to 10,000 BC. On the African continent, the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of circumcision date back health and only secondarily to the time around 3000-2000 BC. The oldest known depiction<ref>http://commons.wikimedia.org/wiki/File:Circumcision Sakkara 3.jpg</ref> is an Egyptian tomb relief from the 6th dynasty, approximately 2300-2000 BC. It is not known precisely who was circumcised and why in those timescleanliness.
In many cultures circumcision during puberty serves as a rite of passage, bringing adolescents into One should note that the community. As human [[foreskin]] is endowed by nature with other painful or humiliating initiation rites, proof of courage and mastering of critical situations are [[Foreskin#Immunological_functions| immunological functions]] that serve to protect the key motivationshuman body from disease. From some African tribes it is also known that the amputation of the <ref name="fleiss-hodges-vanhowe1998"/> The [[foreskinglans penis]] is seen as receives blood through the removal frenular artery.<ref>{{REFjournal |last=Persad |init=R |author-link= |last2=Sharma |init2=S |author2-link= |last3=McTavish |init3=J |author3-link= |etal=yes |title=Clinical presentation and pathophysiology of an inborn piece meatal stenosis following circumcision |journal=Brit J Urol |date=1995 |volume=75 |issue=1 |pages=91-3 |url=https://www.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.1995.tb07242.x |quote= |pubmedID=7850308 |pubmedCID= |DOI=10.1111/j.1464-410x.1995.tb07242.x |accessdate=2019-11-26}}</ref> These facts are generally overlooked in arguments for alleged hygienic benefits of femininity from the boys, thus making them mencircumcision.
In the Jewish religion, the tradition of A common reason stated for circumcision goes back to a passage in is the Book assumption of Genesis (17, 10-14). It is seen as a covenant between God and man, dating back to the patriarch Abrahamhygienic benefits.{{Citation| Text=10 This is my covenant with you and your descendants after you, the covenant you are argument has to keep: Every male among you shall be circumcised. 11 You are to undergo circumcision, and it will be viewed in the sign context of the covenant between me and you. 12 For environment the generations to come every male among you who is eight days old must be circumcised, including those born person in your household or bought with money from a foreigner—those who are not your offspring. 13 Whether born question grows up in your household or bought with your money, they must be circumcised. My covenant in your flesh It is to be an everlasting covenant. 14 Any uncircumcised male, who has not been circumcised in the flesh, will be cut off from his people; he has broken my covenant.” | Author=Bible| Source=Gen 17, 10-14commonly known that bad hygienic circumstances, NIV}}According especially insufficient access to the anthropologist and sociologist Nissan Rubinclean drinking water, the Jewish form of circumcision, called brit mila, during the first two millennia did not include the later customary periah, namely the complete scraping of the inner [[foreskin]] from the [[Glans penis|glans]]pose a serious problem. This was only added around 135 AD, to make it impossible to restore the [[foreskin]] by stretching, which became popular The situation in disaster areas or refugee camps in the wake of Hellenic influence. While originally only the tip of the [[foreskin]] was cut off, periah removes the entire [[foreskin]]. In the Greek society of the day, a denuded [[Glans penis|glans]] was considered obscene and risible. In ultraso-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 called third world keep reminding us 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 Maimonides pointed out that circumcision was necessary, as it diminished sexual desires and reduced the pleasure to a degree just sufficient for mere reproduction.
In The opening of the 1920s it was penile cancer<ref>Abraham L. Wolbarst behauptet, die Beschneidung könne dem Peniskrebs vorbeugen. [Is circumcision a prophylactic against penis cancer? Cancer 1926 Jul;3(4):301-10[foreskin]]</ref>, in the 1940 prostate- small boys is often quite narrow and tongue cancer serves as well as STDs<ref>Eugene H. Hand erklärt, dass die Beschneidung irgendwie gegen Geschlechtskrankheiten und Zungenkrebsschütze. [Circumcision and venereal disease. Archives of Dermatology and Syphilology 1949 Sep;60(3):341a one-6]</ref>way valve, in allowing the 1950s it was cervical cancer<ref>Abraham Ravich erfindet den Mythos, die Beschneidung verringere das Risiko von Frauen an Gebärmutterhalskrebs zu erkranken. [Prophylaxis of cancer of the prostate, penis, and cervix by circumcision. New York State Journal of Medicine 1951 Jun;51(12):1519-20</ref>, in the late 1960s it was neuroses<ref>Morris Fishbein fordert die Beschneidung zur Prävention von Nervosität und natürlich auch Masturbation. [Sex hygiene. Modern Home Medical Adviser. Garden City, New York: Doubleday & Co: 1969 pp 90, 119urine]</ref>, in the 1970s bladder- and rectal cancer<ref>Abraham Ravich behauptet, dass die Beschneidung Blasenkrebs und Rektumskrebs vorbeugen würde. [Viral carcinogenesis in venereally susceptible organs. Cancer 1971 Jun;27(6)1493-6]</ref>, nd in the 1980s UTIs<ref>Thomas E. Wiswell behauptetto flow out, eine Beschneidung verringere das Risiko für Harntraktinfektionen. [Decreased incidence but preventing entry of urinary tract infections in circumcised male infants. Pediatrics 1985 May;75(5):901-3]</ref> and AIDS<ref>Aaron J. Fink behauptetmicrobes, dass die Beschneidung gegen AIDS schütze. [A possible explanation for heterosexual male infection with AIDSexample from a dirty diaper. New England Journal of Medicine 1986 Oct 30;31(18):1167]</ref> followed. RetrospectivelyAs long as the child is able to pass water, circumcision was always advertised everything works as a cure for whatever disease was in the public spotlight at the timenature intended.
The sheer mass But even in areas where there are poorer hygienic conditions and an insufficient access to medical care, the benefits of studies and publications that were released during those almost 180 years on this topic 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 reason that even arguments that have been disproved multiple times[[foreskin]], especially regarding infant and child circumcisionitself is not without risk of complications. If the operation is carried out without proper sterility, tenaciously persist up until todaythere is a high risk of an [[infection]] of the wound. This also applies to the treatment of common complications like post-operative [[bleeding]].
An ever-recurring element The benefit of initiation rites found in many different cultures is easier cleaning must be balanced against the fixation upon risk of promoting serious infections — among others [[HIV]] — during the genitaliaoperation. In parts of Africa, several dozen of one tribe's boys die each year as a result of their circumcision.
It reflects the fascination that emerges from the ability to create new life. In most cultures, fertility is seen as the most precious good, and the body parts involved frequently find themselves in the focus of ritual acts. In many parts of the world, those rites take place when the boy reaches puberty, and are meant to symbolize his transition from boy to man. The removal of the male [[foreskin]] is just one of many phenomena that developed in this context. They range from the removal of the frenulum in boys and men through partial or complete removal of the [[foreskin]] up to radical operations. Australian Aborigines, as mentioned above, have their [[foreskin]]s removed. It is also usual that, a few weeks later, young men have their [[penis]]es sliced open, resulting in a partly or completely divided urethra.== Circumcision methods ==
Another knownThe [[Circumcision methods]] are discussed in a separate article.== Pain ==It is too dangerous to administer general anesthesia to newborn infants, particularly massiveso 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, intervention is the stripping advocates of circumcision claimed that a newborn child's nerve system was not yet fully developed, and that as a result, the entire skin off the child felt no [[penispain]]during the circumcision procedure. In Indonesia, boys have metal or bamboo balls inserted into their [[penisKanwaljeet J. Singh Anand| Anand]] shaft or & Hickey (1987) have shown that newborn children do in fact feel [[Glans penis|glanspain]] at , and more acutely than adults.<ref name="anand-hickey1987">{{REFjournal |last=Anand |first=KJS |author-link=Kanwaljeet J. Singh Anand |last2=Hickey |first2=PR |author2-link= |etal=no |title=Pain and its effects in the beginning human neonate and fetus |trans-title= |language= |journal=New Engl J Med |location= |date=1987-11-19 |volume=317 |issue=21 |pages=1321-9 |url=https://www.cirp.org/library/pain/anand/ |quote=However, in decisions about the use of these techniques, current knowledge suggests that humane considerations should apply as forcefully to the care of pubertyneonates and young, which form little "humps"nonverbal infants as they do to children and adults in similar painful and stressful situations. |pubmedID=3317037 |pubmedCID= |DOI=10.1056/NEJM198711193172105 |accessdate=2019-11-08}}</ref> This has led American health associations to recommend doctors take measures to reduce the [[pain]] of circumcision in infants.
For many cultures it The [https://www.cirp.org/library/statements/aap1999/|AAP Circumcision Policy Statement] (1999) states quite clearly that ''"There is also common to perform similar rituals on girlsconsiderable evidence that newborns who are [[circumcised]] without analgesia experience pain and physiologic stress"''. This can range from relatively small interventions such as piercing or cutting Furthermore, the clitoral hoodpain is quite severe, to its complete removal and up to radical removal requires injections for proper pain management. Sucrose and Acetaminophen ''"cannot be recommended as the sole method of analgesia"''. Topical cream is no longer thought sufficient as ''"the analgesic effect is limited during the phases associated with extensive tissue trauma such as...tightening of clitoral hood, clitoris, inner and outer labia followed by sewing up the vaginaclamp"''.<ref>{{REFjournal |last= |first= |title=American Academy of Pediatrics: Circumcision Policy Statement; Task Force on Circumcision |journal=Pediatrics |date=1999-03 |volume=103 |issue=3 |pages=686-93 |url=https://pediatrics.aappublications.org/content/103/3/686#sec-9 |accessdate=2019-11-26 |note=Statement Reaffirmed Sept.1, 2005}}</ref>
Non-therapeutic Penile injections of local anesthetic are now recommended by all of the major medical institutions if a circumcision of children is not only one to be performed. In their [http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml Report 10 of the most widespread surgical operations in Council on Scientific Affairs], the world, but also one of AMA states ''"When the oldest. It decision is probably due made to this long traditionproceed with circumcision, that despite its violating local anesthesia should be provided for the common basic rights to bodily integrity and medical ethics in the western world, it is still widely tolerated there, even though there procedure. [[Ring block]] or [[dorsal penile nerve block]] [injections] are barely any legal exemptions in placemost effective. [[EMLA]] cream has limited utility"''. The few regulationsAlarmingly, which mostly emerged in ''"Despite the clear evidence that newborn males generate brisk pain responses during circumcision, a recent past, usually only deal with survey of residency training programs found that 26% of programs that taught circumcision provided no instruction on the basic conditionsuse of local anesthesia". They regulate how The AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, and under what conditions 25% of obstetricians"''.<ref>{{REFweb |title=Report 10 of the operation should be carried out, while the general compatibility with basic human rights is rarely questioned, let alone taken into considerationCouncil on Scientific Affairs (I-99): Neonatal Circumcision |website=American Medical Association Official Website |url=http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml |accessdate=2011-05-04}}</ref>
=== Examples 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 legal regulationsanalgesia that are available"''.<ref>{{REFweb |title=Where We Stand: Circumcision |publisher=[[AAP]] |date=2011-03-23 |url=http://dewww.wikipediahealthychildren.org/wikiEnglish/ages-stages/prenatal/decisions-to-make/pages/Zirkumzision#Regelung_der_Beschneidung_MinderjWhere-We-Stand-Circumcision.C3.A4hriger_in_einzelnen_Staatenaspx |accessdate=2019-10-12}}</ref> ===Be that as it may, few forms of analgesia are recommended. There are basically two types of injections to choose from, and the website does not go into the difference between a 'dorsal nerve block' and a 'ring block' injection.
==== Germany ====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.
GenerallyTo control [[pain]], some physicians that circumcise use Tylenol, sugar,<ref>{{REFweb |quote=To calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, and soothing music is played in the room. |url=http://www.pollockclinics.com/circumcision/circumcision-guide.html |title=Parents' Guide to Circumcision |last= |first= |publisher= |date= |accessdate=2011-04-08}}</ref><ref>{{REFweb |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 |last= |first= |publisher= |date=2011-04-08 |accessdate=2011-04-08}}</ref> a topical cream,<ref>{{REFweb |quote=Then in our office, he will have topical anesthetic applied to his penis. |url=http://www.pollockclinics.com/circumcision/circumcision-before.html |title=Before the Circumcision |last= |first= |publisher= |date=2011-04-08 |accessdate=2011-04-08}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb |quote=We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection. |url=http://www.pollockclinics.com/circumcision/circumcision-guide.html |title=Parents' Guide to Circumcision |last= |first= |publisher= |date= |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]].<ref name="Journal of Perinatology April/May 2002">{{REFjournal |last=Taeusch |first=H. William |init=HW |last2=Martinez |first2=Alma M. |init2=AM |last3=Partridge |first3=J. Colin |init3=JC |last4=Sniderman |first4=Susan |init4=S |last5=Armstrong-Wells |first5=Jennifer |init5=J |last6=Fuentes-Afflick |first6=Elena |init6=E |title=Pain During Mogen or Plastibell Circumcision |journal=Journal of Perinatology |volume=22 |issue=3 |pages=214-8 |url=http://www.nature.com/jp/journal/v22/n3/full/7210653a.html |quote=...more than half of children met the criteria study group had what we considered excessive pain/discomfort over the course of the entire procedure. |pubmedID= |pubmedCID= |DOI= |note=April/May 2002 |date=2002-04 |accessdate=2011-04-08}}</ref><ref name="Clinical Pediatrics August 1986">{{REFjournal |last=Williamson |first=Paul S. |init=PS |last2=Evans |first2=Nolan Donovan |init2=ND |title=Neonatal Cortisol Response to Circumcision with Anesthesia |journal=Clinical Pediatrics |volume=25 |issue=8 |pages=412-6 |url=http://cpj.sagepub.com/content/25/8/412.abstract |quote=The adrenal cortisol response to surgery was not significantly reduced by the administration of bodily assault until December 2012lidocaine. Practically |pubmedID= |pubmedCID= |DOI= |date=1986-08 |accessdate=2011-04-08}}</ref> During circumcision, howeversomp physicians give children sugar pacifiers to "reduce the perception of pain", it was not legally pursued<ref>{{REFweb |quote=During the circumcision, since it was considered unclear whether parents had 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 right Circumcision |last= |first= |publisher= |date=2011-04-08 |accessdate=2011-04-08}}</ref> but in at least one study, data shows that giving sugar to consent a child doesn't help to reduce the perception of pain in the operation on behalf child.<ref name="Lancet, The 2010-10-09">{{REFjournal |last=Slater |first=Rebeccah |init=R |first2=Laura |init2=L |last2=Cornelissen |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 |init7=S |last7=Boyd |first8=Judith |init8=J |last8=Meek |first9=Maria |init9=M |last9=Prof. Fitzgerald |title=Oral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial |journal=The Lancet |volume=376 |issue=9748 |pages=1225-32 |url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2961303-7/fulltext |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 their children (see §228 StGB)sucrose to reduce clinical observational scores after noxious events in newborn infants should not be interpreted as pain relief. |pubmedID= |pubmedCID= |DOI= |date=2010-10-09 |accessdate=2011-04-08}}</ref> Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals.
In 2004, the ''LandgerichtIt has been shown that an infant'' (regional court) of Frankenthal ruled in s response to [[pain]] can be altered for years as a case consequence of a circumcision done by non-medical people, that parental consent was not legally valid.<ref>{{TaddioA etal 1995}}</ref><ref>{{TaddioA KatzJ IlersichAL KorenG 1997}}</ref>
In August 2007 the ''Oberlandesgericht'' (upper regional court) Frankfurt/Main found that the decision about a circumcision{{Box|Boxtext=<big><b>However, because none of the "bodily modifications that cannot be reversed [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]] belongs to the core of a person's rights to decide upon for themselves".</b></big>}}
The ''Landgericht'' == 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. (regional court2022) report "some men are experiencing a complex negative constellation of Colognepsychological, physical, in and sexual associations that lead to significant emotional distress directed both internally and externally. The posts also reveal a second trial, ruled on May 7th, 2012discovery phenomenon wherein men discover the physical and psychological manifestations of the decisions made by others to modify their genitals."<refname ="uberoi2022">http{{REFjournal |last=Uberoi |first= |init=M |author-link= |last2=Abdulcadir |first2= |init2=J |author2-link= |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=yes |title=Potentially under-recognized late-stage physical and psychosexual complications of non-therapeutic neonatal penile circumcision: a qualitative and quantitative analysis of self-reports from an online community forum |trans-title= |language= |journal=Int J Impot Res |location= |date=2022-10-23 |volume= |issue= |article= |page= |pages= |url=https://dejurewww.orgnature.com/dienstearticles/vernetzung/rechtsprechung?Gerichts41443-022-00619-8 |archived= |quote= |pubmedID=36274189 |pubmedCID=LG%20K%F6ln&Datum |DOI=0710.05.2012&Aktenzeichen1038/s41443-022-00619-8 |accessdate=151%20Ns%20169/112023-01-08}}</ref>, that circumcision is a bodily assault, which is not justified by the religious motivation and wishes of the parents and is not in the interest of a child's well-being.
On August 23rd, 2012, * 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 ''Deutscher Ethikrat'' majority of their full size when flaccid (German Council of Ethics[[Flesh Penis]], or "[[shower]]"), others are rather short when flaccid and double or more their size during a publicly held plenary sessionan [[erection]] ([[Blood Penis]], came to terms or "despite profound differences[[grower]]" (!) upon four minimum requirements for legal regulation . Especially in children's circumcision, where the [[penis]] is not yet fully developed, the amount of circumcision:reserve [[skin]] needed in adulthood cannot be estimated.
The explicitly mentioned profound differences point out * Orgasm problems: In the difficulty wake of legally regulating reduced sexual sensitivity, due to the circumcision loss of sensory tissue and gradual [[keratinization]] of the surface of underaged boysthe [[Glans penis|glans]], orgasm problems may develop with increasing age. In this case, the sexual arousal created by intercourse or [[masturbation]] is not enough to achieve orgasm. The legislative procedure led A preliminary stage of this late effect is the prolonged time [[circumcised]]] men need to a broad public debate over reach an orgasm. This is often fielded as the legitimacy and legality of "cut men have more endurance" argument for circumcision of minors in German society. Despite * Vaginal dryness: Due to the fierce resistance loss of medical associationsthe natural [[gliding action]], juristswhich comes from the mobility of the [[foreskin]] and [[shaft skin]], constitution expertsa much increased friction between [[penis]] and [[vagina]] occurs during intercourse. This can make intercourse painful for both partners and lead to abrasions<ref>{{FrischM LindholmM GroenbaekM 2011}}</ref><ref>{{REFjournal |last=Cortés-González |init=J |last2=Arratia-Maqueo |init2=J |last3=Gómez-Guerra |init3=L |title=Does circumcision has an effect on female's perception of sexual satisfaction? |journal=Rev Invest Clin |date=2008 |volume=60 |issue=3 |page=227 |url= |pubmedID=18807735 |accessdate=}}</ref> The prolonged time it takes [[circumcised]] men to reach orgasm, child and human rights activists as well as 100 Members of Parliament, the following Act was adopted often longer and more vigorous thrusting movements - compared to [[intact]] men - play a part in December 2012this.<ref name="ColdCJ TaylorJR 1999">{{ColdCJ TaylorJR 1999}}</ref><ref>{{REFjournal |last=Fink |init=KS |last2=Carson |init2=CC |last3=DeVellis |init3=RF |title=Adult Circumcision Outcomes Study:Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction |journal=J Urol |date=2002 |volume=167 |issue=5 |pages=2113-6 |url= |accessdate=}}</ref>
<blockquote>''§ 1631d BGB''* [[Lymphoedema]] of the penis is a normal and expected complication of male circumcision.
''* [[Meatal stenosis]], a pathological narrowing of the opening of the [[urethra]], which mostly occurs in infancy and early childhood. It is one of the most common complications of infant circumcision. A study from 2006 found meatal stenosis exclusively in previously [[circumcised]] boys. The incidence rate after a circumcision is approximately 10 to 20 percent.<ref name="vanhowe2006">{{REFjournal |last=Van Howe |init=RS |author-link=Robert S. Van Howe |title=Incidence of meatal stenosis following neonatal circumcision in a primary care setting |journal=Clin Pediatr (Phila) |note=Jan-Feb 2006 |date=2006-01 |volume=45 |issue=1 |pages=49-54 |url=https://www.academia.edu/6992015/Incidence_of_Meatal_Stenosis_following_Neonatal_Circumcision_in_a_Primary_Care_Setting |accessdate=2019-12-15}}</ref><ref>{{REFjournal |last=Stenram |init=A |last2=Malmfors |init2=G |last3=Okmian |init3=L |title=Circumcision for [[phimosis]]: a follow-up study |journal=Scandinavian journal of the male child''urology and nephrology |date=1986 |volume=20 |issue=2 |page=89 |url= |pubmedID=3749823 |accessdate=}}</ref><ref>{{REFweb |url=http://emedicine.medscape.com/article/1016016-overview |title=Meatal Stenosis |publisher=Medscape |accessdate=2019-10-11}}</ref>
''* Shorter adult penile length was reported by Park et al. (2016) as a result of NMC (1newborn male circumcision) Personal Care also includes .{{Citation |Title= |Text=In conclusion, second to fourth digit ratio, flaccid penile length, and age of circumcision were significant predictive factors for erectile penile length. Furthermore, the right to consent to penile lengths of the circumcision NMC group were shorter than those of the non-NMC group. |Author=Park et al. |Source= |ref=<ref>{{REFjournal |last=Park |first= |init=JK |author-link= |last2=Doo |first2= |init2=AR |author2-link= |last3=Kim |first3= |init3=JH |author3-link= |last4=Park |first4= |init4=HS |author4-link= |etal=yes |title=Prospective investigation of penile length with newborn male child who lacks competence circumcision and understanding, if it is second to be performed according to proper medical standardsfourth digit ratio. This does not apply when the circumcision, also considering the motivation, endangers the child's well |trans-title= |language= |journal=Can Urol Assoc J |location= |date=2016-09 |season= |volume=10 |issue=9-being10 |article= |page= |pages= |url=https://www.''ncbi.nlm.nih.gov/pmc/articles/PMC5028213/ |archived= |quote= |pubmedID=27695583 |pubmedCID=5028213 |DOI=10.5489/cuaj.3590 |accessdate=2022-09-04}}</ref>}}
''=== Sexual effects ===Cepeda-Emiliani et al (22023) During cited six reports in the first 6 months literature of detrimental effects of lifecircumcision, persons appointed by a religious group may perform circumcisions according to paragraph 1including erectile function, sensation, masturbatory pleasure, orgasm, if they are specially trained andsexual satisfaction. The authors also cited three studies of severe distress in [[circumcised]] men, without being a medical doctor, are similarly competent due to perform their infant circumcision, with complaints of [[glans]] insensitivity, delayed [[ejaculation]], and unpleasant 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=J |author5-link= |last6=García-Caballero |first6= |init6=T |author6-link= |last7=Gallego |first7= |init7=R |author7-link= |last8=García-Caballero |first8= |init8=R |author8-link= |etal=no |title=Immunohistological study of the density and distribution 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.com/articles/s41443-022-00561-9 |archived= |quote= |pubmedID=35501394 |pubmedCID= |DOI=10.1038/s41443-022-00561-9 |accessdate=2023-11-26}}</blockquoteref>
ThereforeCircumcision and frenectomy remove tissues with heightened erogenous sensitivity.<ref name="garrett2024-01-09" /><ref name="cepeda2023" /> <ref name="winkleman1959">{{WinkelmannRK 1959}}</ref> They concluded, a non-therapeutic "Evidence has also started to accumulate that male circumcision of a male child lacking competence and understanding for whatever reason is generally legal. A right of veto for the affected boys was turned down may result in parliamentlifelong physical, sexual, and sometimes psychological harm as well as a proposed change destined to introduce an evaluation of the regulations after five years. Giving the Ministry of Heath the right to determine more specific guidance - for example regarding pain management and the qualification and training of non-medical circumcisers - by issuing additional regulations was also rejected. A call for mandatory documentation of non-therapeutic circumcisions was ignored. Merely stating the intent to have the operation performed according to proper medical standards was considered sufficient."
In December 2012, a representative poll done by Infratest dimap revealed that only 24 percent The [[amputation]] of the interviewed citizens were prepuce results in favour the loss of the majority of fine-touch neuroreceptors found in the law[[penis]], while 70 percent explicitly disapproved 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 itthe changes in sexual behavior noted in [[circumcised]] human males.<ref>http://die{{REFjournal |last=Van Howe |init=RS |author-betroffenenlink=Robert S.de/blog/mehrheit-der-bevoelkerung-lehntVan 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-beschneidungsgesetz-ab/ und 7 |url=http://www.infratest-dimapncbi.nlm.nih.de/umfragen-analysengov/bundesweitpubmed/umfragen/aktuell/bewertung9218663 |quote= |pubmedID=9218663 |pubmedCID= |DOI= |date=1997-der04-gesetzlichen-regelung-zu-beschneidungen/02 |accessdate=}}</ref>
In Austria, bodily assault is, as in Germany, punishable, without any specific regulations regarding See [[Sexual effects of circumcision. There is, however – unlike in Germany - no specific basic right to an unharmed body in the constitution. It is regulated in §146a ABGB that "the application of bodily violence and the infliction of bodily or mental suffering" by the parents is unlawful. According to §90 (3) StGB it is impossible to consent to "a mutilation or other injuring of the genitals, that is able to inflict a lasting impairment of the sexual sensitivity" even for adults. On the other hand, the ''"Israelitengesetz"'' (Law ]] for the Israelites) entitles the Jewish religious group and their members to "bring their children and juveniles, also outside of school, through all traditional rites and to educate them according to their religious commandments". Circumcision of boys for religious reasons is not considered punishable by the Austrian Ministry of Justice, and is justified by the parental rightsmore information.
In France, there is no specific regulation for circumcision. The question psychological late effects of parental consent is neither debated under religious aspects nor by the parenting lawscircumcision are not yet fully researched, and many studies took place on rather a small scale. Article 16.3 of This situation needs to be rectified, because the civil code states that "available studies, as well as the integrity histories of the human body may not be harmed, other then in cases of medical necessity for those negatively affected". Howevermen, there is a "silent toleration" of the circumcision of minorssuggest that these late effects may have more impact than previously assumed.
In a ruling by the [[Intact America]] (2019) called circumcision an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]],<ref name-"High Court of Cassationbollinger2019" from Nov>{{REFdocument |title=Child genital cutting as an adverse childhood experience |url=http://adversechildhoodexperiences. 24th, 2011, a mother was found not guilty, whose son almost bled to death after being circumcised by a medically unqualified laymannet/CGC_as_an_ACE.pdf |last=Bollinger |first=Dan |author-link=Dan Bollinger |last2=Chapin |first2=Georganne |author2-link=Georganne Chapin |publisher=Intact America |location=Tarrytown |format=PDF |date=2019-08 |accessdate=2021-11-02}}</ref>
At * Intolerance or allergic reactions to the narcotics used.* Especially in newborns, where the bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is often insufficient for the operation. Even in conjunction with regional anaesthesia of the end dorsal nerve of 1999the [[penis]], the Finnish parliament issued rate of failure to provide sufficient anaesthetic even for experienced anaesthetists is still 5-10%. The general anaesthesia that would be needed for newborns, however, poses significant risks for the child, and, therefore, is only likely to be used in emergencies. A surgical operation without proper [[pain]] control can lead to the development of a specific pain memory<ref>{{REFweb |url=http://www.spiegel.de/spiegel/vorab/experte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a declaration regarding ritual -849534.html |title=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder |trans-title=Children's pain expert warns: Ritual circumcisionchanges the brain of children |language=German |last=Prof. Dr. med. Ombudsman RiitaBoris Zernikow |first= |publisher=Spiegel Online |website= |date=2012-08-12 |accessdate=2019-10-Leena Paunio stated, that 11 |format= |quote=}}</ref>. In unsedated and partially sedated infants increased secretion of the operation stress hormone cortisol could not be recommended without observed for months after the operation. Overall, their pain threshold was lower and the risk of chronic pain increased. Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFjournal |last=Garry |init=T |title=Circumcision: a survey of fees and practices |journal=OBG Management |date=1994 |volume=October |issue= |pages=34-6 |url= |accessdate=}}</ref><ref>{{REFjournal |last=Howard |init=CR |last2=Howard |init2=FM |last3=Garfunkel |init3=LC |last4=de Blieck |init4=EA |last5=Weitzman |init5=M |title=Neonatal circumcision and pain relief: current training practices |journal=Pediatrics |date=1998 |volume=101 |issue= |pages=423-8 |url= |accessdate=}}</ref><ref>{{REFjournal |last=Stang |init=HJ |last2=Snellman |init2=LW |title=Circumcision practice patterns in the United States |journal=Pediatrics |date=1998 |volume=101 |issue=e5 |pages= |url= |accessdate= |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 medical indicationtypically 3- to 4-fold increase in cortisol levels, which equals a state of severe [[shock]].<ref>{{REFjournal |last=Gunnar |init=MR |last2=Fisch |init2=RO |last3=Korsvik |init3=S |last4=Donhowe |init4=JM |title=The effects of circumcision on serum cortisol and that behavior |journal=Psychoneuroendocrinology |date=1981 |volume=6 |issue=3 |pages=269-75 |url=https://www.cirp.org/library/pain/gunnar/ |accessdate=2019-11-26}}</ref>* Postoperative wound pain, in the affected case of children should 's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions.* Postoperative pain from the exposure of the sensitive glans penis to clothing. This pain will endure for several weeks or even longer in some cases.* Postoperative [[bleeding]] of the wound. This can have severe consequences especially for very young infants, if they are not treated promptly. Their blood volume is only about 85 ml per kilogram of body weight, and even moderate blood loss can lead to hypovolaemia, hypovolaemic [[shock]] and even death.<ref>{{REFbook |last= |first= |year=2000 |title=Paediatric Handbook |url= |work= |editors=Smart J, Nolan T. |edition=6 |volume= |chapter= |page=82 |location={{AUSC|VIC}}, Australia |publisher=Blackwell Science Asia |isbn= |quote= |accessdate= |note=}}</ref><ref>{{REFdocument |title=Autopsy of Demetrius Manker |url= |contribution=Case 93-1711 |last=Wetli |first=CV |publisher=Miami: Dade County Medical Examiner Department |format= |date=1993-06-23 |accessdate=}}</ref> <ref>{{REFjournal |last=Hiss |init=J |last2=Horowitz |init2=A |last3=Kahana |init3=T |title=Fatal haemorrhage following male ritual circumcision |journal=J Clin Forensic Med |date=2000 |volume=7 |issue= |pages=32-4 |url=https://www.cirp.org/library/death/hiss1/ |accessdate=2019-11-06}}</ref><ref>{{REFdocument |title=Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan |url=http://www.circumstitions.com/death-exsang.html |contribution= |last=Newell |first=TEC |publisher=Burnaby, B.C.: B.C. Coroner's Service |format= |date=2004-01-19 |accessdate=2019-11-26}}</ref>* Post operative [[lymphoedema]].* Postoperative [[Infection| infections]]. This includes both local infections, which can be consulted treated with local therapy, and give consentsystemic infections, requiring systemic antibiotic treatment.<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. She saidNovember 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 Finnish parliament had 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 weigh a study by Blalock et al.<ref>{{REFjournal |last=Blalock |init=HJ |last2=Vemulakonda |init2=V |last3=Ritchey |init3=ML |last4=Ribbeck |init4=M |title=Outpatient management of [[phimosis]] Following newborn circumcision |journal=J Urol |date=2003 |volume=169 |issue=6 |pages=2332-4 |url=https://www.cirp.org/library/complications/blalock1/ |accessdate=2019-11-26}}</ref>, the religious rights prevalence is 2.9%, according to Leitch<ref>{{REFjournal |last=Leitch |init=IOW |title=Circumcision - a continuing enigma |journal=Aust Paediatr J |date=1970 |volume=6 |issue= |pages=59-65 |url=https://www.cirp.org/library/general/leitch1/ |accessdate=2019-12-15}}</ref> 5.5%.* [[Sudden Infant Death Syndrome]] (SIDS).* Knot formation of the parents against veins. If the responsibility dorsal vein, which originates in the tip of the society [[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 protect their children 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=http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritual operations that have no immediate benefit for them. Since thenhtml?_r=0 |title=Baby’s Death Renews Debate Over a Circumcision Ritual |last=Robbins |first=Liz |date=2012-03-07 |accessdate=2019-10-11}}</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 |first=Dan |init=D |author-link=Dan Bollinger |last2=Boy's Health Advisory |title=Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths |journal=Thymos: Journal of Boyhood Studies |volume=4 |issue=1 |pages=78-90 |url=http://www.mensstudies.com/content/b64n267w47m333x0/?p=7ebbd6b446d940cbbd4274c095754b12π=5 |quote= |pubmedID= |pubmedCID= |DOI=10.3149/thy.0401.78 |date=2010-04-26 |accessdate=2019-10-12}}</ref><ref>{{REFweb |url=http://www.icgi.org/2010/04/infant-circumcision-causes-100-deaths-each-year-in-us |title=Infant circumcision causes 100 deaths each year in US |last= |first= |publisher=ICGI |website=[[International Coalition for Genital Integrity]] |date=2010-04-26 |accessdate=}}</ref> See also the written consent list of both parents is mandatory[[fatalities]].
In SwedenHuman babies, because they are not yet in possession of language, non-therapeutic are incapable of giving or refusing consent to be [[circumcised]]. The element of force has led some scholars to view the circumcision of baby boys under 18 years as a category of forced circumcision.<ref>For example, Frederick M. Hodges, a medical historian, writes: "In the late 1970s, as the Americans were growing increasingly aware of age is regulated since 2001 by the abuses of power rampant throughout the nation''s social institutions, influential grass-roots movements protesting the forced circumcision of American children sprang up nationwide." F. Hodges, "Lag (2001:499) om omskärelse av pojkarA Short History,"p. 31; see also [[Leonard B. Glick|Glick]], ''Marked in Your Flesh'' (Law regarding , pp. 273-281.</ref> There are, however, physicians in the United States who argue strongly for non-therapeutic circumcision of boys)newborn babies; and circumcision is widely accepted as a postnatal procedure in American hospitals.<ref>{{REFbook |last=Fletcher |first=Christopher R. According to it |init=CR |year=1999 |title=Circumcision in America in 1998: Attitudes, Beliefs, such circumcisions are a surgical procedure and have to be carried out by a qualified doctor Charges of American Physicians |url=http://www.springerlink.com/content/h2150v731233m177/ |work=Male and under anaesthesiaFemale Circumcision |editors=[[George C. Denniston]], [[Frederick M. For boys under 2 month of ageHodges]], [[Marilyn Fayre Milos]] |edition= |volume= |chapter=Section 5 |pages=259-71 |location=New York |publisher=Kluwer Academic/Plenum Publishers |isbn= |quote= |accessdate=2019-10-12 |note=ID 10.1007/978-0-585-39937-9_19}}</ref> Parental consent is required.<ref>See, e.g., Shephard and Shephard, ''The Complete Guide'', circumcision may also be carried out by another competent person with a government licensep. 125. This applies to persons that have been nominated </ref> A statement published by religious groups the [[American Academy of Pediatrics]] in which circumcision 1999 claimed that "parents should determine what is part in the best interest of the religious traditionchild. Persons who perform a circumcision without the necessary qualification or license face a fine or prison sentence of up to six months. The circumcision requires the consent of the legal guardians. It may not be carried out against is legitimate for parents to take into account cultural, religious, and ethnic traditions, in additions to the child's willmedical factors, if he has the age when making a decision."<ref>Lannon and level of maturity Bailey, "Circumcision Policy Statement," p. 691.</ref> however surrogate consent for such a statementnon-therapeutic circumcision is now viewed as unethical.
The USA In recent years, legal writers in several English-speaking countries have by far been questioning the highest rate practice of circumcision among 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 western nations[[United States]], more than 1. In many maternity wards 3% of male neonatal deaths are attributable to the routine complications of non-therapeutic circumcision surgery.<ref name="Bollinger 2010"/>==Recommendations of medical authorities==* [[George Hill| Hill]] (2007) said:<blockquote>Male circumcision is harmful because it excises healthy tissue and permanently impairs beneficial physiological functions. Male circumcision also causes psychological problems that tend to perpetuate the cycle of newborn boys abuse. Male circumcision is commona costly diversion of medical resources away from beneficial services. The US paediatric societyMale circumcision violates legal rights, [[AAPhuman rights]], is and ethical standards. Finally, we must remember that males are the more vulnerable and sensitive of the only major medical society in two genders and, therefore, deserve the world still advocating greater degree of protection from traumatic, invasive, injurious,and unnecessary surgery. For all of these reasons the non-therapeutic circumcision of newborns boys should not be performed and the [[genital integrity]] of all childrenshould be respected and protected.<ref name="hill2007">{{REFjournal |last=Hill |first=George |init=G |author-link=George Hill |title=The case against circumcision |journal=Journal of Men's Health and Gender |date=2007 |volume=4 |issue=3 |pages=318-23 |url=https://www.academia.edu/8367383/The_Case_Against_Circumcision |quote= |pubmedID= |pubmedCID= |DOI= |accessdate=2021-05-30}}</ref></blockquote>* Andrew E. MacNeiiy, Head, Division of Pediatric Urology, Department of Urological Sciences, {{UNI|University of British Columbia|UBC}}, Vancouver, BC, (2008) said:<blockquote>Newborn circumcision remains an area of controversy. Social, cultural, aesthetic and religious pressures form the most common reasons for non-therapeutic circumcision. Although penile cancer and UTIs are reduced compared with uncircumcised males, the incidence of such illness is so low that circumcision cannot be justified as prophylaxis. The role of the foreskin in [[HIV]] transmission in developed countries is unclear, and safe sexual practice remains 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 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 perspective.<ref>{{REFjournal |last=MacNeily |first=Andrew |init= |author-link= |etal=no |title=Routine circumcision: the opposing view |trans-title= |language= |journal=Can Urol Assoc J |location= |date=2007-11 |volume=1 |issue=4 |article= |page= |pages=395-7 |url=http://europepmc.org/article/PMC/2422979 |pubmedID=18542825 |pubmedCID= |DOI=10.5489/cuaj.455 |accessdate=2021-11-08}}</ref></blockquote>
In the autumn of * The [[Royal Dutch Medical Association]] (KNMG) (2010, Californian intactivists called for a ban of routine infant circumcision and thereby sparked a nation-wide discussion of the topic.) said:
• • •<blockquote>The official viewpoint of KNMG and other related medical/scientific organisations is that non-therapeutic circumcision of male minors is a violation of children’s rights to autonomy and physical integrity. Contrary to popular belief, circumcision can cause complications – [[bleeding]], infection, [[urethra]]l stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications.<ref>{{REFdocument |title=Non-therapeutic circumcision of male minors |url=https://www.doctorsopposingcircumcision.org/wp-content/uploads/2016/09/knmg-non-therapeutic-circumcision-of-male-minors-27-05-2010.pdf |contribution= |last= |first= |publisher=Royal Dutch Medical Association |format=PDF |date=2010 |accessdate=2021-11-08}}</ref></blockquote>
It is noteworthy that, despite the wide spread of non-therapeutic circumcision of children and the fact that it contradicts many national laws, there is barely a country that has issued explicit exemptions. * The principle of "silent toleration" is, regardless [[Royal Australasian College of a possible illegality, common practice.Physicians]] (2010) said:
=== Legal <blockquote>Ethical and ethical issues ===[[human rights]] concerns have been raised regarding elective infant male circumcision because it is recognised that the foreskin has a functional role, the operation is non-therapeutic and the infant is unable to consent.
Considering After reviewing the severity of currently available evidence, the intrusion into RACP believes that the body frequency of diseases modifiable by circumcision, the affected person, level of protection offered by circumcision and the question arises, whether complication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand. However it is both legally reasonable for parents to weigh the benefits and risks of circumcision and morally acceptable to leave make the decision about a non-therapeutic operation on a child too young to understand whether or give valid consent, not to the parents alonecircumcise their sons. In Germany, several basic rights are concerned<ref name="racp2010">{{REFdocument |title=Circumcision of Infant Males |url=https://www.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}}</ref></blockquote>
If you take a look at the list of possible bodily and mental harms and late-effects listed in * Medical historian [[Circumcision#Risks_and_late_effects|"Risks and late effects"Robert Darby]](2014) wrote simply:<blockquote>"To avoid circumcision complications, the imbalance becomes apparentavoid circumcision. Spanking is already unlawful"<ref>{{REFjournal |last=Darby |first= |init=R |author-link=Robert Darby |etal=no |title=To avoid circumcision complications, but the irreversible amputation of an important, healthy part of the genital organ is notavoid circumcision |trans-title= |language= |journal=Can Urol Assoc J |location= |date=2014-08-14 |volume=8 |issue=7-8 |article= |page=231 |pages= |url=https://cuaj.ca/index. The inevitable and possible consequences of this operation are ignored to a degree that is in harsh contrast to the established protection of childrenphp/journal/article/view/1709/1823 |archived= |quote= |pubmedID= |pubmedCID= |DOI=10. Legalization, therefore, represents a considerable limitation of the male child's right to bodily integrity and protection from potentially harmful methods of upbringing5489/cuaj.1709 |accessdate=2022-12-16}}</ref></blockquote>* The [[Canadian Paediatric Society]] (CPS) (2015) said:
There are also ethical problems. Can a child be denied the right to determine the visible appearance and degree of functionality of his body? Should a circumcised boy later in life decide that he would prefer to have an intact [[penis]]<blockquote>In most jurisdictions, he has no means of reversing the decision his parents made. Other people's ideas about his body‘s appearance and functionality are imposed upon him irreversibly. He authority is denied the possibility of deciding upon that according limited only to his own preferences, which can lead interventions deemed to inferiority complexes and depression - regardless of the parents‘ reasons or their idea of what would be best for their childmedically necessary. So great In cases in which medical necessity is not established or a level of paternalism regarding such a severe intrusionproposed treatment is based on personal preference, especially in the most intimate area of the child, cannot interventions should be justified by deferred until the parents‘ willindividual concerned is able to make their own choices.<ref name="CPS2015">{{REFjournal |last=Sorokin |first=S. Todd |init=ST |author-link= |last2=Finlay |first2=JC |author2-link= |last3=Jeffries |first3=AL |author3-link= |etal=yes |title=Newborn male circumcision |journal=Paediatr Child Health |location= |date=2015-08 |volume=20 |issue=6 |pages=311-20 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4578472/ |quote= |pubmedID=26435672 |pubmedCID=4578472 |DOI=10.1093/pch/20.6.311 |accessdate=2019-10-27}}</ref></blockquote>
It is not much different with * The [[Canadian Urological Association]] (CUA) considered the right to sexual self-determination. Here, the consequences that matter of circumcision has and can have for the body, play a significant role. Normally, issued a man has free choice as to how he wants to experience his sexuality. It is solely up to him to decide statement in which way he wants to be stimulated, and he can - if he so desires - limit his sexual experience without a problem. A circumcised man does not have these optionsFebruary 2018. The full range of his sexual experience and sensation is not available to him due the to bodily modification.CUA concluded:
An intact [[penis]] enables many men to reach orgasm just by manipulation <blockquote>"Given the socioeconomic, educational status, and health demographics of our population, universal neonatal circumcision cannot be justified based on the [[foreskin]]current evidence available. During masturbation, the man can choose whether he wants to stimulate the [[Glans penis<ref name="cua2018">{{REFjournal |last=Dave |first=Sumit |init=S |author-link= |etal=yes |glans]] directly or indirectly through title=Canadian Urological Association guideline on the movement care of the [[normal foreskin]]and neonatal circumcision in Canadian infants (abridged version) |journal=Can Urol Assoc J |location= |date=2018-02 |volume=12 |issue=2 |pages=18-28 |url=https://cuaj. Since he has the full, naturally given potential of sensitivity at his disposal, he can use it to according to his own preferencesca/index. php/journal/article/view/5034/3470 |quote= |pubmedID= |pubmedCID= |DOI= |accessdate=2021-11-09}}</ref></blockquote>==British family court opinion==The circumcised man, however, does not have that freedom issue of choice. He has neither the opportunity to include the [[foreskin]] into the stimulation, nor can he utilize its nerves and touch receptors. He also only has access to 15non-50% therapeutic circumcision of male children came before the potential sensitivity of an intact man, depending on court in the amount and kind case of tissue that was removed, and the degree of keratinization of the ''[[Glans penis|glansRe B and G (children) (No 2) EWFC 3]](2015)'' . In some cases, the limitation can be even more severe. On a heavily desensitized [[penis]]that case, condoms can limit the sexual stimulation to the point where not enough arousal can be built up to reach an orgasm - which means Judge Sir James Munby ruled that fulfilling safer sex is not possiblecircumcision of male children caused ''significant harm''.== Rights and ethics ==
In particular, the tight styles of circumcision bear the risk, that the loss of the friction-reducing gliding effect leads to unpleasant feelings or even pain for both partners during intercourse. The ability to masturbate without aid - for example, from lubricants - can be significantly reduced or even be lost in such a case. In a study<ref>DaiSik Kim, Myung-Geol Pang: The effect of male [[Rights situation on circumcision on sexuality. In: BJU international, Volume 99, Issue 3, März 2007, S. 619-622. doi:10.1111/j.1464-410X.2006.06646.x, PMID 17155977</ref>, 63% of the men interviewed reported problems with masturbation after being circumcised. If a boy or man |rights situation]] is circumcised, without him making that decision for himself after thorough consideration and discussed in full knowledge and understanding of all possible consequences, he is denied his constitutionally guaranteed freedom to experience his sexuality according to his own preferences. This is much like parental interference to promote a prohibition of masturbation, or to inhibit a homosexual relationship - with the key difference that the parental intervention in form of a circumcision, unlike prohibitions during childhood, will have an irreversible, lifelong effect. Both do not comply with modern views of children's well-being and accepting the child as an autonomous individual, and are, therefore, not ethically justifiableseparate article.
The basic right to equal treatment of the sexes is also breached, since girls are legally protected from violations of their genital integrity, while boys are not. This not only contradicts the constitution, but also is contrary to all efforts of equal treatment[[Image:Intact vs circumcised. Because in this case, decisions are made during childhood that will affect the entire later life, it equals the attempt to have certain educational grades open to one gender unconditionally, while giving parents the JPG |thumbnail|right to deny them to the other gender for life. That such an unequal treatment of genders is not justifiable, neither legally nor morally|300px| The intact and circumcised human penis, is obviousside by side.]]
Last not leastThe term "circumcision" without a gender qualifier refers specifically to male circumcision. It means "to cut around, religious freedom is impaired" and it refers to the [[excision]] of the [[foreskin]] from the penis. If a boy The term is circumcised for religious reasons as inaccurate and a child before he reaches euphemism because the operation actually cuts off or [[amputation| amputates]] the age of competence[[foreskin]], he will carry the sign of that religion on his body for his entire life - even if he decides to abjure that religion which in the course adults comprises about fifteen square inches of his lifehighly functional erogenous tissue.
While his condition will not keep him from changing his religionCircumcision is most often performed in healthy males for [[Religion and Culture|religious or cultural]] reasons. The procedure may be performed on consenting adults, or to renounce but it entirelyis most often performed on non-consenting minors, he has no way to discard particularly newborn children, which is why the symbol ritual is so controversial. Opponents of his old religion. This could be compared to a tattoo in circumcision consider the form circumcision of non-consenting minors to be unethical and a religious symbol[[human rights]] violation, with unless there is concrete [[medical indication]].=== Consent by surrogates ===Medical ethics has long recognized limitations on the difference that such a tattoo could still be removed power of consent by laser or covered with a new tattoosurrogates.<ref>{{REFjournal |last=Committee on Bioethics, American Academy of Pediatrics |etal=no |title= Informed consent, parental permission, if need beand assent in pediatric practice |trans-title= |language= |journal=Pediatrics |location= |date=1995 |volume=95 |issue=2 |article= |page= |pages=314-17 |url=https://www.cirp.org/library/ethics/AAP/ |archived= |quote= |pubmedID=7478854 |pubmedCID= |DOI= |accessdate=2023-05-21}}</ref> <ref>{{REFjournal |last=Committee on Bioethics |etal=no |title=Informed Consent in Decision-Making in Pediatric Practice |trans-title= |language= |journal=Pediatrics |location= |date=2016-08 |volume=138 |issue=2 |article= |page=e20161485 |pages= |url=https://watermark.silverchair.com/peds_20161485.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQM8zYHFd0Ylu9Annq_AgEQgIICT24ikc839aJMYOiypqC2G9f7_yKGAGkAekzzbCtck5TElALWVCGNoVSOaA6rDA_dOkQ_LyJnxYlZ88J9-uk15tvlIBbE82_aNyYfq5e9xmEfqD2vh374q3Naz57dxZaUbgxUkKX4PqsiLmYHLvVrr7bQK2MZuuUOKiQU8JZy7lLjkp-PjJO1U9cyIplTAgs_EdvgK8MWWoIsj-X-ZUDImAG63-rlj_qLsy5dYwytmxfCuVa47RdZseLSr2_bdDpwKAKGhq_Ly9rlHZeW_f7fYktVfF_sFTgcJziAlvEQmdyWIw0qf-hlO31Qb3sH6kDdcvHAbm7llY5xa34XLYIt8QR0YFIimgDGFliN4-ce2vjvvrwS85WeeNFhpn-Ywn4Qjpy06hPuLDL-MtI2Z3BZbBsKq4dp8qGu1q9GlXaKw193riTFG9G5bF5GCKmxmt0nCQTthrb_CcK2UhKjZwPekC9zkIUHPZ9BXJt0SM03F_g-GgqbE0hTYKMqNdJ3sHDQu2luFrJ9JEiMzxtP28gJoYh20d2APA0xrRbXBYsFdAlr50gb1BSAbNJhTyx-Kh3geoSHsAYMjPaG7cIbh0jd42pWCUx30vjlAGK8zXTuf7-31oi81CLbHTAJLuzK3NT4Whi17jVq1SbXsIXlWpKc_d-HujCvlb74rkZQ6RG9wkxW7gAKaDqtKv5zTOTMBD9vLVxgp8lDmVA8PFB59Bqd6w-fi86tW132oWQM-mTfwdIBXFbUFXkeTUC5RYyqJQIXAEwLJSRm1RX-LRbKRzgaRQ |archived= |quote= |pubmedID=27456510 |pubmedCID= |DOI=10.1542/peds.2016-1485 |format=PDF |accessdate=2023-05-21}}</ref> <ref>{{REFjournal |last=Committee on Bioethics ||etal=no |title=Informed Consent in Decision-Making in Pediatric Practice |trans-title= |language= |journal=Pediatrics |location= |date=2016-08 |volume=138 |issue=2 |article= |page=e20161484 |pages= |url=https://watermark.silverchair.com/peds_20161484.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMYv3coRY-UCYMgTaqAgEQgIICT4di03qn2Hbho3i8Li_78lod0lNMunch25nx1rKvaM_aeFerz5eN6_k8VVeNv-DLocZp28whQr1x4WYDVwSs4uF73vZpYZYuDphYQkwxV1HHgMbZAbHBFuE8QyCHyDvSY-fhQcUl-JrYxa3TbhYgd4bKiU9zfIyXUsCnItroCc9iNrMicPg0v_A0AJJlhxioOlAU-im6OPI06OcCBj78yqkPO0J4nMTN1FLochsOyvZZdtFQQzLhrnM_Gey8K75lFYIBJHA7uzMmP2o5KZ-FTGUkEA_eSpEIpwv2WI4SbtrA8WYk3cQqXOmLIWjkSs9CTELD7CQP29xarr1ANrF_id4CiCX7zIomC2Ciz9lHBEgz8EH2i9Woke_YuZeLax52_6JpdhH1qdMQyF1bByjP8mU98V5_B4BPPiBpKt4pVA_UgtaABRHL8oPv6SwOUQZ2Bc-0_E2tod0VIF1FJBwZRZJm2ZkJPgBSKUo8VBe5Pz_6Vpt2DqLzwqVUYscPsIJMvxl09mMtvJrsBa8yVoTRWj4Rd0OBTMV7zhZskDnYYyrAZ6sHMk0MzvbHilPNbNgU5o7mXmcbFGDgGgWbqrIdT6sVSSfPJm4TnR0HSWbc_EnHhhyye7tVlFGjAsR0R46_DSwEMz8M5DkSln8xfKtX_so9rjCvYeq45wqn09g8DqtV-WHEA9PIrcw5kTcz5I0JkNuW4-vKVU1Xz9XHiYi4Zqbq0vx9NWLdNSYHQSOGMZ1MCAxT152evQdipQB5wokR8Q4rICoJYII5bsmRMYd7JQ |archived= |quote= |pubmedID=27456514 |pubmedCID= |DOI=10.1542/peds.2016-1484 |format=PDF |accessdate=2023-05-21}}</ref>
Therefore Two ethicists, Myers & Earp (2020), have conducted a detailed review and analysis of the claimed medical benefits of ''non-therapeutic'' [[circumcision does ]]. They have determined than the alleged benefits are not impair the ability to change religionmaterial, so they do not support granting of consent by a surrogate. In other words, but it makes it impossible to discard one's old religion entirely. This 'Non-therapeutic'' circumcision is not truly healthcare. Moreover, they comment that even the most perfectly executed surgery produces [[trauma]] and harm to the patient. Circumcision also produces tissue loss and loss of function, therefore, circumcision should be performed only after the individual reaches the age of consent. <u>Consent by a violation surrogate for a ''non-therapeutic'' circumcision of a minor child is an unethical practice.</u><ref name="myers2020">{{REFjournal |last=Myers |first= |init=A |author-link= |last2=Earp |first2= |init2=BD |author2-link=Brian D. Earp |etal=no |title=What is the basic law, it best age to circumcise? A medical and ethical analysis |trans-title= |language= |journal=J Biosoc Sci |location= |date=2020-09 |volume=34 |issue=7 |pages=560-72 |url=https://onlinelibrary.wiley.com/doi/abs/10.1111/bioe.12714 |archived= |quote= |pubmedID=32068898 |pubmedCID= |DOI=10.1111/bioe.12714 |accessdate=2023-05-18}}</ref> == Tipping point ==[[Intact America]] (2024) argues that public opinion regarding non-therapeutic [[circumcision]] of children is also ethically unjustifiable to force someone to carry approaching or at a religious symbol for his entire life "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- especially in his most private body area.09}}</ref>
So why ==Financial and other costs==Infant male circumcision is an extra-cost option after birth. There are no medical indications for it. It is circumcision tolerated as a means of upbringingmedically-unnecessary, and even explicitly legalized? In Germanynon-therapeutic, this stems from non- although 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 not stated in a hospital fee, a set-up fee, pharmaceutical fees, a separate fee for the medical doctor who performs the law amputation, and various possible additional costs for legal reasons - the belief that a ban would impair the religious freedom treatment of the parentscomplications. Even though it is stated in Art<ref name="garrett2023-12-21">{{REFweb |url=https://intactamerica.140 GG (German basic law)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>
<blockquote>''(1) Civic rights There also are additional non-financial costs, which include sexual and duties are neither dependant sensory losses that adversely impact onthe sexual experience in adult life, nor impaired byand psychological losses such as [[PTSD]], the exercise and grieving of religious freedomlosses.==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>
''(4) No one may be forced to take part in a religious act or ceremony, or to participation in religious rites or to the use of a religious oath=== Dr.''Eric discusses circumcision ===<br><youtube>v=iZ64pqWZRW8</blockquoteyoutube>Dr. Eric understates the numerous functions of the foreskin.===Plastibel circumcision===
Still, it was considered intolerable for the parents to be unable to perform {{UNI|Stanford University|SU}} has published a religious rite that involved interference with the body video of another person an actual non- in the case therapeutic plastibell circumcision. The infant has received two injections of that person being their son. While normally local anesthesia to deaden the religious freedom ends "at someone else‘s nose", an exemption was legalized to enable parents to comply with their own, personal, religious duties, even if that means that several of their son's basic rights are impaireddorsal nerves. This does, however, The ventral nerves were not apply for other religious traditions, deadened so that a ritual beating - no matter how religiously important it may be to the parents - is infant still considered child abuse and would likely result in feels pain. One can his cries on the loss of child custody heresoundtrack.* [https://med.stanford.edu/newborns/professional-education/circumcision/plastibell-technique.html Plastibell Technique]
Only very few will supposedly know that circumcision has become a lucrative business. '''Not only for the operation itself, but also the potentially needed aftercare, bring profits. But while this is still obvious, there are also other trades that make money from it.squeamish:'''
Baby [[foreskin]]s are This is a coveted resource. Under the name "Apligraf" video of an artificial skin product is marketed worldwide, which is used - among other uses - as an alternative to skin grafts using the patient’s own skin. It is grown from the [[foreskin]]s of children as young as possible. Since they are also mostly free of pathogenic organisms, they are also used as the basis for collagen, which is, among other purposes, used for anti wrinkle therapy and for lip augmentationactual circumcision with a Gomco clamp. The manufacturer of the british product "Vavelta" advertised with the use of "freshly harvested infant boy received two dorsal penile nerve block (!DPNB) [[foreskin]]s". It is ''inter alia'' used as a replacement for animal experiments testing the compatibility of cosmetic products. In the face of the falling numbers of routine infant circumcisions in the USA, manufacturers have already expressed concerns that analgesic injections but they might did not "bring in enough harvest" more than 10 years ago. The parents of the circumcised boys, however, very rarely know of the "secondary use" of their son's "donated" body parts. While preimplantation genetic diagnosis, stem cell research and genetic engineering are time and again critically questioned and discussed, the lifelong, significant modification of infant bodies for the good of the cosmetic industry is still common practice - supposedly partly because many women do not know what their augmented lips and wrinkle-free cheeks are made of - baby [[foreskin]]. An ethical justification cannot be valid hereseem to work.
-----* [https://www.reddit.com/r/Intactivism/comments/qbpzqr/trained_medical_professionals_restrain_infant_to/ Circumcision video]
== See also =={{SEEALSO}}* [[Adolescent and adult circumcision]]* [[Bodily harm]]* [[Breastfeeding]]* [[Case Histories]]* [[Circumcision maps]]* [[Circumcision methods]]* [[Circumcision scar]]* [[Circumpendium]]* [[Circumstraint]]* [[Documented severe complications of circumcision]]* [[Ethics of non-therapeutic child circumcision]]
== References ==[[Category:Circumcision]]<references />[[Category:Genital mutilation]][[Category:Body modification]][[Category:Genital surgery]][[Category:Islam]][[Category:Judaism]][[Category:Male circumcision]][[Category:Parental information]][[Category:Penile surgery]][[Category:Medical term]][[Category:Male genital mutilation]]
→Video: Add video.
{{GraphicWarning}}"Male '''circumcision''' (from Latin ''circumcidere'', meaning "to cut around") is the surgical removal or [[amputation]] of the [[foreskin]] (prepuce) from , a major part of the human [[penis]]. The foreskin comprises ''more than fifty percent'' of the epithelium of the [[penis]]...] The procedure <ref name="taylor1996">{{TaylorJR LockwoodAP TaylorAJ 1996}}</ref> When the "cutting around" is most often an elective surgery performed on neonates and children for religious and cultural reasons, but in other cases may be indicated for both therapeutic the foreskin falls off, so [[amputation]] and prophylactic reasons[[mutilation]] is the result. It is a treatment option for pathological phimosisThe amputation destroys the [[Foreskin#Physiological_functions| many protective, immunological, sexual, refractory balanoposthitis and chronic urinary tract infections (UTIs); sensory physiological functions]] of the foreskin, so it is contraindicated in cases of certain genital structure abnormalities or poor general healtha very harmful and [[Pain| painful]] surgery.<ref name="garrett2023-11-10" (Source: [http>{{REFweb |url=https://en.wikipediaintactamerica.org/wikipros-and-cons-of-circumcision/ |title=Pros and Cons of Circumcision Wikipedia](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.
With reference to involuntary, non-therapeutic circumcision of children, [[Child Genital Cutting (CGC)]] is a newer term that has been introduced to avoid issues associated with more traditional terms. Bollinger (2023) identifed CGC as an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]].<ref name="bollinger2023">{{REFjournal
|last=Bollinger
|init=D
|author-link=Dan Bollinger
|last2=
|init2=
|author2-link=
|url=https://kindredmedia.org/2023/02/adverse-childhood-experiences-dysfunctional-households-and-circumcision/
|title=Adverse Childhood Experiences, Dysfunctional Households, And Circumcision.
|journal=Kindred
|date=2023-02-28
|volume=
|issue=
|pages=
|accessdate=2023-03-01
}}</ref>
Deacon & Muir (2022) have reviewed the evidence and concluded that "there is no medical justification for performing a circumcision prior to an age that he can assess the known risks and potential benefits, and choose to give or withhold [[informed consent]] himself."<ref name="deacon2022">{{REFjournal |last=Deacon |first=Matthew |init=M |author-link= |last2=Muir |first2=Gordon |init2=G |author2-link= |etal=no |title=What is the medical evidence on non-therapeutic child circumcision? |journal= Int J Impot Res |date=2022-01-08 |url=https://www.nature.com/articles/s41443-021-00502-y |pubmedID=34997197 |DOI=10.1038/s41443-021-00502-y |accessdate=2022-01-30}}</ref>
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.
{{Citation |Text== Non-medical indications for 10 This is my covenant with you and your descendants after you, the covenant you are to keep: Every male among you shall be circumcised. 11 You are to undergo circumcision , and it will be the sign of the covenant between me and you. 12 For the generations to come every male among you who is eight days old must be circumcised, including those born in your household or bought with money from a foreigner—those who are not your offspring. 13 Whether born in your household or bought with your money, they must be circumcised. My covenant in your flesh is to be an everlasting covenant. 14 Any [[uncircumcised]] male, who has not been circumcised in the flesh, will be cut off from his people; he has broken my covenant.” |Author=Bible |Source=Gen 17, 10-14, NIV}}
In Christianity, circumcision is practiced only in the Coptic denomination. There is no general belief that circumcision is a requirement of Christianity.<ref name="hill2004">{{REFweb |url=https://www.cirp.org/pages/cultural/christian.php |title= Moral reasons The Holy Bible, Circumcision, False Prophets, and Christian Parents |last=Hill |first=George |author-link=George Hill |publisher=Circumcision Reference Library |website= |date=2004-08-29 |accessdate=2019-11-10 |format=HTML |quote=The falseness of those who advocate circumcision is a recurrent theme in the New Testament. }}</ref>
{{Citation |Text=A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of [[phimosis]]. The operation should be performed by a surgeon without administering an anaesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. In females, the author has found the application of pure carbolic acid to the [[clitoris]] an excellent means of allaying the abnormal excitement, and preventing the recurrence of the practice in those whose will-power has become so weakened that the patient is unable to exercise entire self-control. |Author=[[John Harvey Kellogg]] |Source= Hygiene reasons |ref=<ref>{{REFbook |last=Kellogg |first=John Harvey |init=JH |author-link=John Harvey Kellogg |url=https://archive.org/details/plainfaorold00kell/page/290 |chapter=Treatment for Self-abuse and Its Effects |title=Plain Facts for Old and Young |location=Burlington, Iowa |publisher=F. Segner & Co. |year=1888 |page=107}}</ref>}}
The benefit of easier cleaning must be balanced against [[United States]] and [[Israel]] are the only industrialized countries in the risk world to have a high incidence of promoting serious infections non- among others HIV - during the operationtherapeutic infant male circumcision. In parts The vast majority of Africainfant circumcisions performed in the United States are for non-religious, several dozen of one tribe's boys die each year as a result non-medical reasons. See [[History of their circumcision]].
===Religious===
The circumcision of newborn boys is seen as a [[Abrahamic covenant| divine commandment]] in the [[Judaism| Jewish faith]]. Though absent in the Koran, male circumcision is considered a religious requirement in [[Islam]], and it is performed on male children of varying ages. Converts to these faiths may also choose to undergo [[Adolescent and adult circumcision| circumcision]], but it is not always required.
=== Prophylactic reasons 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]].
==== High & Tight<ref>de.Wikipedia user Tinoel</ref> Arguments of prophylaxia====[[Image:Penis_unlabeled.jpg|200px|center]]This style is Though the most common in practice of ritual circumcision of males, both consenting and non-consenting, has existed for millenia, the USAsearch for "potential medical benefits" began relatively recently. In this style{''Potential'' means to exist in possibility, the outer [[foreskin]]but not in actuality, parts so a "''potential'' benefit" is not a genuine proven benefit.) The discussion of circumcision in the inner [[foreskin]] and parts Ninth Edition of the shaft skin are removed''Encyclopǽdia Britannica'' (1876) made no mention of any prophylactic, medical, or therapeutic value or function.<ref>{{REFweb |url=https://www.cirp.org/library/history/encyclopaediabritannica1876/ |title=Circumcision |last=Cheyne |first=T. K. |author-link= |publisher=Encyclopǽdia Brittanica |website=Circumcision Reference Library |date=1876 |accessdate=2019-11-10 |format= |quote=}}</ref>
The practice of finding prophylactic reasons for infant circumcision started in Germany in the nineteenth century, when non-Jewish Germans criticized the Jewish practice of infant circumcision as being barbaric, Jewish doctors sprang to the defense of the religious practice by claiming health benefits.<ref name="ephron2001">{{REFbook |last=Ephron |first=John M. |init= Low & Tight<ref>DavidJM |author-matthias httplink= |year=2001 |title=Medicine and the German Jews |url=https://commonswww.wikimediacirp.org/wikilibrary/history/File:Beschneidungsstile,_Styles_of_Circumcision.jpg<ephron1/ref> |work= |editor= |edition= |volume= |chapter=6 |pages=222-33 |location=New Haven |publisher={{UNI|Yale University|Yale}} Press[[Image:Low_and_tight.jpg |200pxisbn=0-300-08377-7 |center]]quote=In this style, both the inner and outer [[foreskin]] are completely removed. The shaft skin is sewed just below the rim of the [[Glans penis |glans]]. The scar is located close the [[Glans penisaccessdate=2019-11-20 |glans]], hence note=}}</ref> And so started the term "low"long tradition of Jewish doctors inventing reasons for circumcision (and deceving gentile doctors).
[[Aaron J. Fink]] (1986), with no evidence whatsoever, claims that circumcision protects against [[AIDS]] followed.<ref name="fink1986">{{REFjournal |last=Fink |first=Aaron J. |init= FreehandAJ |author-techniques link=Aaron J. Fink |title=A possible explanation for heterosexual male infection with AIDS |journal=New England Journal of Medicine |date=[[File:Circumpendium1986-610-2-1.jpg30 |volume=31 |centerissue=18 |thumb]]page=1167The oldest method of removing the [[foreskin]] uses just a few instruments |url=https://www.nejm.org/doi/full/10. In the simplest case, the [[foreskin]] is pulled out with a cord, a knife is placed directly above the [[Glans penis1056/NEJM198610303151818 |glans]], and the skin finally cut with a hit on the blunt edge of the knife. No stitches are placed and the skin is left to grow together naturallyDOI=10.1056/NEJM198610303151818 |accessdate=2019-11-20}}</ref>
Retrospectively, circumcision was always advertised as a cure for whatever disease was in the public spotlight at the time. [[FileDoctors Opposing Circumcision (D.O.C.)]] (2016) state:Circumpendium<blockquote>These claims date originally from before the advent of evidence-6based medicine, when doctors relied on the opinions of other clinicians to inform their practice, rather than on scientifically collected evidence.<ref name="doc2016">{{REFweb |url=https://www.doctorsopposingcircumcision.org/for-2professionals/alleged-1medical-b.jpgbenefits/ |title=Alleged Medical Benefits |center|thumb]]In modern operating theatres the publisher=[[foreskinDoctors Opposing Circumcision (D.O.C.)]] is first grasped with forceps, pulled out and clamped above the [[Glans penis |website= |date=2016-05 |accessdate=2019-11-20 |format= |glans]] for a while to reduce bleeding. Next, the skin is cut along the forceps with a scalpel. Following that, the remaining skin is manually trimmed according to the desired style and finally sutured.quote=}}</ref></blockquote>
Another known, particularly massive, intervention is the stripping of the entire [[File:Circumpendium-6-2-1-Mogen-clamp.jpg||center|thumb|Mogen-clampskin]]The Mogen-Clamp works in a similar way (middle), with the difference that it is locked shut after off the [[foreskinpenis]] is . In Indonesia, boys have metal or bamboo balls inserted, thus clamping it. After a few minutes the into their [[foreskinpenis]] is cut in the same fashion as with the simple shield. The clamping is meant to reduce shaft or prevent bleeding from [[Glans penis|glans]] at the woundbeginning of puberty, which form little "humps".
''The use of a shield, rather than forceps, following text is meant to provide a better protection of the [[Glans penis|glans]] taken from cutting injuries. However, if used improperly both the Mogen and the Sheldon clamp are subject to the risk of the tip of the [[Glans penis|glansCircumpendium]] being accidentally clamped and being cut into or severed.''-->
===Prophylactic reasons = Complex clamps ====[[File:Circumpendium-6-2-2-Gomco-clamp.jpg|center|thumb|Gomco clamp]]One of the most widely used clamps in the USA is the Gomco clamp. First, a cut is placed into the [[foreskin]], then the metal bell is placed over the [[Glans penis|glans]]. After that, the bell, together with the [[foreskin]], is pulled through the opening in the base plate and hung into the lever. By fastening the screw the lever pulls the bell upwards, jamming the [[foreskin]] between bell and base plate. After several minutes of clamping, the skin is cut off with a scalpel along the upper side of the base plate and the clamp removed.
Some people claim that circumcision has prophylactic benefits. Especially in the [[File:Circumpendium-6-2-2-plastibell.jpg|center|thumb|plastibell methodUSA]]In the plastibell methodthose arguments have persisted for more then a 100 years, the skin with ever changing diseases circumcision is said to protect against. At first cut lengthwise, then a plastic ring is placed over the these were diseases where [[Glans penis|glansmasturbation]] and was believed to be the [[foreskin]] pulled over itcause. A tightly tied string is used to fix the [[foreskin]] to a rim in the ringAfter bacteria and viruses had been discovered, arguments changed, thereby strangulating itand one after another miscellaneous diseases were cited.
The fact that the [[USA]] has both the highest 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 [[FileHIV]].<ref>{{REFjournal |last=Grosskurth |init=H |last2=Mosha |init2=F |last3=Todd |init3=J |etal=yes |title=A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania:Circumpendium2. Baseline survey results |journal=AIDS |date=1995 |volume=9 |issue=8 |pages=927-634 |url=https://insights.ovid.com/aids/aids/1995/08/000/community-trial-impact-improved-2sexually/15/00002030 |accessdate=2019-211-Smartclamp.jpg15}}</ref><ref>{{REFjournal |last=Barongo |init=LR |last2=Borgdorff |init2=MW |centerlast3=Mosha |thumbinit3=FF |Smartclamp]]etal=yes |title=The Smartclamp epidemiology of HIV-1 infection in urban areas, roadside settlements and a couple rural villages in Mwanza Region, Tanzania |journal=AIDS |date=1992 |volume=6 |issue=12 |pages=1521-8 |url= |accessdate=}}</ref><ref>{{REFconference |last=Changedia SM, Gilada IS |first= |title=Role of similar designs are one way clampsmale circumcision in HIV transmission insignificant in conjugal relationship (abstract no. ThPeC7420) |url= |place=Barcelona, Spain |source=Presented at the Fourteenth International AIDS Conference |datefrom=2002-07-07 |dateto=2002-07-12 |accessdate=}}</ref><ref>{{REFconference |last=Connolly CA, Shishana O, Simbayi L, Colvin M |first= |title=HIV and circumcision in South Africa (Abstract No. MoPeC3491) |url= |place=Bangkok, Thailand |source=Presented at the 15th International AIDS Conference |datefrom=2004-07-11 |dateto=2004-07-16 |accessdate=}}</ref><ref>{{REFconference |last=Thomas AG, Bakhireva LN, Brodine SK, representing a mixture Shaffer RA |first= |title=Prevalence of the Gomco male circumcision and its association with HIV and Plastibell methodssexually transmitted infections in a U.S. navy population (Abstract no. TuPeC4861) |url=https://apps. The dtic.mil/dtic/tr/fulltext/u2/a458066.pdf |place=Bangkok, Thailand |source=Presented at the 15th International AIDS Conference |datefrom=2004-07-11 |dateto=2004-07-16 |accessdate=2019-11-15}}</ref>* Urinary tract infections (UTI): a [[Glans penis|glansUTI]] is inserted into can be effectively treated with antibiotics, this was also proven by studies.<ref>{{REFjournal |last=McCracken |init=G |title=Options in antimicrobial management of urinary tract infections in infants and children |journal=Pediatr Infect Dis J |date=1989 |volume=8 |issue=8 |pages=552-5 |url=https://www.cirp.org/library/disease/UTI/mccracken/ |accessdate=2019-11-19}}</ref><ref>{{REFjournal |last=Larcombe |init=J |title=Urinary tract infection in children |journal=BMJ |date=1999 |volume=319 |issue= |pages=1173-5 |url= |accessdate=}}</ref> A Swedish study<ref>{{REFjournal |last=Mårild |init=S |last2=Jodal |init2=U |title=Incidence rate of first–time symptomatic urinary tract infection in children under 6 years of age |journal=Acta Paediatr |date=1998 |volume=87 |issue=5 |pages=549-52 |url= |accessdate=}}</ref> found that, during the plastic tubefirst 6 years of life, the incidence of [[foreskinUTI]] pulled over its 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 |last=Mueller |init=ER |last2=Steinhardt |init2=G |last3=Naseer |init3=S |title=The base plate incidence of genitourinary abnormalities in [[circumcised]] and [[uncircumcised]] boys presenting with an initial urinary tract infection by 6 months of the outer clamping mechanism is pushed over the age |journal=Pediatrics |date=1997 |volume=100 (Supplement) |issue= |page=580 |url= |accessdate=}}</ref> did not find a significant difference in UTI rates between [[foreskincircumcised]] and cocked shut, jamming [[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 [[foreskinIsrael]] showed a strong correlation between ritual circumcision on the bulging lower rim 8th day of the tube life and the lower base platepostoperative UTI. The <ref>{{REFjournal |last=Menahem |init=S |title=Complications arising from ritual circumcision: pathogenesis and possible prevention |journal=Isr J Med Sci |date=1981 |volume=17 |issue=1 |pages=45-8 |url= |accessdate=}}</ref><ref>{{REFjournal |last=Cohen |init=HA |last2=Drucker |init2=MM |last3=Vainer |init3=S |etal=yes |title=Postcircumcision urinary tract infection |journal=Clin Pediatr |date=1992 |volume=31 |issue=6 |pages=322-4 |url= |accessdate=}}</ref><ref>{{REFjournal |last=Goldman |init=M |last2=Barr |init2=J |last3=Bistritzer |init3=T |last4=Aladjem |init4=M |title=Urinary tract infection following ritual Jewish circumcision |journal=Isr J Med Sci |date=1996 |volume=32 |issue= |pages=1098-1102 |url= |accessdate=}}</ref>* It can be concluded that circumcision is ineffective as a preventive measure against [[foreskinUTI]] .* Penile and cervical cancer / HPV: first studies on those diseases and their assumed prevention by circumcision date back to 1932, a time when the cause for those illnesses was not yet fully understood.<ref>{{Wolbarst1932}}</ref> Today, it is known that sexually transmitted human papillomavirus (HPV) is now cut off along a major risk factor<ref>{{REFjournal |last=McCance |init=DJ |last2=Kalache |init2=A |last3=Ashdown |init3=K |etal=yes |title=Human papillomavirus types 16 and 18 in carcinomas of the upper side penis from Brazil |journal=Int J Cancer |date=1986 |volume=37 |issue=1 |pages=55-9 |url= |accessdate=}}</ref>, as well as smoking<ref>{{REFjournal |last=Harish |init=K |last2=Ravi |init2=R |title=The role of the base platetobacco in penile carcinoma |journal=Brit J Urol |date=1995 |volume=75 |issue=3 |pages=375-7 |url= |accessdate=}}</ref>. The entire clamping mechanism remains on Studies have shown that there is no significant difference in the risk of getting penile cancer between [[peniscircumcised]] and [[intact]]men. To prevent a single case of penile cancer, until it would statistically take 600 to 900 circumcisions<ref>{{REFdocument |title=Position Paper on Neonatal Circumcision |url= |contribution= |last= |first= |publisher=American Academy of Family Physicians (Leawood, Kansas) |format= |date=2002- like 02-14 |accessdate=}}</ref>. The influence of circumcision on the plastibell - falls off by itself after infection risk of the clamped skin dies off in female partner with cervical cancer has been refuted several times as well. HPV vaccination is an effective measure against carcinoma of the following dayscervix.
== Risks and late effects Non-medical indications for circumcision ==
=== Possible operative and postoperative complications Aesthetic reasons ===
=== Psychological late effects Financial reasons===
In Islamwestern industrial nations, circumcision is also religiously foundedhowever, this problem does not exist, even though there is no mention in view of it in the Koran itselfavailability of clean water for daily personal hygiene. According to tradition, If the cleaning of the Prophet Mohammed was born without genitals is performed on a daily basis — and that may be assumed — no pathogens can accumulate under the [[foreskin]]. It is seen as a sign Cleaning of prophets that they are born without a the [[Glans penis|glans]] and the [[preputial sac]] underneath the [[foreskin]] already. It is considered an honour to "resemble easy — they are simply [[Preputial_sac#Washing| washed with warm water along with the example rest of the Prophet"body]], meaning to be circumcised. In Islam, unlike Judaism, there is no specific age at which just like the circumcision should be performed. Most circumcisions take place at ages areas between 6 and 10 years, but the range goes from birth to adulthoodtoes.
In Christianitysmall boys, circumcision is only common in a few orthodox churches. Nevertheless, Christian moral notions had decisive influence on the spread of this practice. In where the puritan influenced USA, circumcision of children was popular in the 19th century as a means to prevent masturbation. In those days, this so-called ‘self-abuse‘ was not only considered immoral, but was supposedly responsible for a variety of diseases. Even the mere existence of a [[foreskin]] was linked to many illnesses. Among them one could find syphiliscannot be retracted yet, epilepsycleaning is not necessary, 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 since the best known advocates of child circumcision was [[John Harvey KelloggSynechia| membrane]], co-inventor of that fuses the Corn Flakes bearing his name. In 1888, he wrote:{{Citation| Text=A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of [[phimosisforeskin]]. The operation should be performed by a surgeon without administering an anaesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. In females, the author has found the application of pure carbolic acid to the clitoris an excellent means of allaying the abnormal excitement, and preventing [[Glans penis|glans]] prevents the recurrence accumulation of the practice in those whose willmicro-power has become organisms. The so weakened that -called "[[Ballooning of the patient is unable to exercise entire self-control.foreskin| Author=John Harvey Kellogg| Source=| ref=<ref>Treatment for Self-abuse and Its Effectsballooning]]", Plain Facts for Old and Youngwhere the [[foreskin]] inflates during urination, Burlington, Iowa, F. Segner & Co. (1888) p. 107</ref>}}Following the discovery of bacteria as is not a cause of many diseases – such as tuberculosis – the search began for other illnesses that could be prevented by circumcisionconcern.
The [[AAFP]] (2002) states quite simply in their [https://www.cirp.org/library/statements/aafp2002/| position paper], ''"Newborns experience pain during circumcision".''<ref>{{REFweb |title=Circumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed |website= Rights and Ethics 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, 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.
=== 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 ruling from May 2012 sparked fierce protests by representatives [[foreskin]] contains very many nerve endings and touch receptors, which account for the major part of religious groupsmale sexual sensation. If the [[foreskin]] is removed, which were instantly answered by politicians with they can no longer provide sexual stimulation. It is also partly due to the assurance fact that religiously motivated circumcision the surface of underage Muslim the [[Glans penis|glans]] reacts to the missing protection from friction and Jewish boys 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 Germany would remain legaladult males. Other studies revealed that [[circumcised]] men use condoms significantly less often than [[intact]] men, since they further limit the sexual sensitivity (see above).
* Fully informed consent by Erectile dysfunction: Both the legal guardiansdamage inflicted to the blood vessels in the [[foreskin]] and the reduced sexual sensitivity can be causes for reduced erectile function with advancing age.<ref>{{REFjournal* Qualified pain management |last=Money* The operation to be performed by a professional |init=J |last2=Davison |init2=J |title=Adult penile circumcision: Erotosexual andcosmetic sequelae* Approval |journal=Journal of a right of veto depending on the maturity of the affected boySex Research |date=1983 |volume=19 |issue= |pages=289-92 |url= |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=== Austria ===="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.
==== France 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.
* It was observed that infants, following circumcision without [[pain]] control, had a disturbed bond with their mother<ref>{{REFjournal |last=Marshall |init=RE |last2=Porter |init2= Italy FL |last3=Rogers |init3=AG |etal=yes |title=Circumcision: II effects upon mother-infant interaction |journal=Early Hum Dev |date=1982 |volume=7 |issue=4 |pages=367-74 |url=https://www.cirp.org/library/birth/marshall2/ |accessdate=2020-02-01}}</ref>, as well as problems with nurturing, up to the point of refusal to be fed. The sleeping habits of these babies were also disturbed, with prolonged non-REM sleep and increased waking.
* In Italyboys [[circumcised]] in childhood, there is [[post-traumatic stress disorder]] ([[PTSD]]) could be diagnosed. In a basic agreement between study on Philippine boys, in whom no [[PTSD]] was found prior to the operation, 69% of the boys [[circumcised]] in the State traditional ritual and 51% of those [[circumcised]] by standard medical procedures (including anaesthesia) fulfilled the Jewish communities DSM-IV criteria for PTSD following the operation.<ref>{{REFbook |last=Ramos |init=S |last2=Boyle |init2=GJ |year=2001 |title=Understanding circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem |url=https://link.springer.com/chapter/10.1007/978-1-4757-3351-8_14 |work= |editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |edition= |volume= |chapter=Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder |pages=253-70 |location=New York |publisher=Kluwer Academic/Plenum Publishers |isbn= |quote= |accessdate= |note=}}</ref>* Circumcisions, especially those that was formulated in 1987 happen without consent, can spark feelings of helplessness and alienation, which can persist as [[trauma]]. These feeling can also be triggered later, when someone [[circumcised]] as an infant becomes aware of his circumcision. In an online study, interviewed men stated they felt betrayed - 55% by the mother, 50% by the father, and secured in 58% by the law in 1989doctor, and 73% felt that their [[human rights]] had been violated.<ref name="GSoCH">{{REFweb |url=http://www.circumcisionharm. org/ |title=Global Survey of Circumcision Harm |accessdate=2019-10-12}}</ref>* It implies can frequently be found that the Jewish way of circumcision loss is in accord denied, much as happens with the Italian system loss of lawsother body parts. According This denial can lead to fathers having their sons [[circumcised]] in order not to Article 19 be reminded of their own loss. In this process, their own body is defined as "normal" and the Italian constitution[[foreskin]] redefined as a foreign object. Their own parents are seen as "good", religious freedom so that this image is projected onto the circumcision their parents carried out as well, in order to keep the positive emotion intact. The father wants to be respecteda "good" father later in life as well, and so, following an idealised image of his own parents, circumcision, which has been redefined as long a "good thing", is passed on to his son by having him [[circumcised]] as no acts are performed well.<ref>{{VanderKolkBA 1989}}</ref><ref>{{REFjournal |last=Goldman |init=R |author-link=Ronald Goldman |url=https://www.cirp.org/library/psych/goldman1/ |title=The psychological impact of circumcision |journal=BJU Int |date=1999 |volume=83 |issue=Suppl. 1 |pages=93-103 |accessdate=2019-10-12}}</ref>* If the [[circumcised]] male feels incomplete, or due to the missing [[foreskin]] disadvantaged compared to [[intact]] males, an inferiority complex and [[depression]] may occur. This can be accompanied by conscious recognition of his own incompleteness, or the deficiency may remain completely subconscious<ref>{{REFjournal |last=Rhinehart |init=J |url=https://www.cirp.org/library/psych/rhinehart1/ |title=Neonatal circumcision reconsidered |journal=Transactional Analysis J |date=1999 |volume=29 |issue=3 |pages=215-21 |accessdate=2019-10-12}}</ref>. In an online study, 75% of those interviewed stated that they felt incomplete, and 66% said they felt inferior compared with [[intact]] males.<ref name="GSoCH"/>* Cases in which children felt ill treated or punished have been documented as well. G. Cansever found in her study on 12 boys aged between 4 and 7 years, who had previously been prepared for their impending circumcision, that contradict good mannersthe children experienced the operation as an aggressive assault on their bodies.<ref>{{REFjournal |last=Cansever |init=G |date=1965 |url=https://www.cirp.org/library/psych/cansever/ |title=Psychological effects of circumcision |journal=Brit. J. Med. Psychol |volume=38 |pages=321-31 |accessdate=2019-10-12}}</ref>* Fear of being alone or darkness.<ref name="Levy1945">{{REFjournal |last=Levy |first=David M. |init=DM |url=https://www.cirp.org/library/psych/levy1/ |title=Psychic trauma of operations in children; and a note on combat neurosis |journal=American Journal of Diseases of Children |volume=69 |date=1945 |pages=7-25 |accessdate=2019-10-12}}</ref>* 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]].
==Complications == Finland ===Possible operative and postoperative complications ===Circumcision is surgery. Surgical complications of circumcision generally may be classified as [[Bleeding| hemorrhage]], [[infection]], or surgical misadventure up to and including loss of the penis and [[death]].<ref name="deacon2022" /><ref name="williams-kapilla1993">{{REFjournal |last=Williams |init=N |author-link= |last2=Kapilla |init2=L |author2-link= |etal=no |title=Complications of circumcision |trans-title= |language= |journal=Brit J Surg |location= |date=1993-10 |volume=80 |issue=10 |pages=1231-6 |url=https://www.cirp.org/library/complications/williams-kapila/ |quote= |pubmedID=8242285 |pubmedCID= |DOI=10.1002/bjs.1800801005 |accessdate=2019-11-27}}</ref>
==Forced circumcision == Sweden <!--=== United States military ===American soldiers serving in World War II were subjected to regular inspections of their genitals. If intact, the soldiers risked being ordered to undergo immediate circumcision.<ref>{{REFbook |last=Schoen |first=Ed |init=E |author-link=Edgar J. Schoen |year=2005 |title=On Circumcision |url=https://books.google.de/books?id=-zUhdvSt7cgC |work= |editor=Dianne Yeakey |edition= |volume= |chapter= |pages=72-3 |location=Georgetown, Canada |publisher=RDR Books |isbn=1-157143-123-3 |quote=For a critical view, see Sorrells, "The History of Circumcision," p. 333 |accessdate= |note=}}</ref> This practice was discontinued at least six decades ago.-->=== Non-therapeutic circumcision of male children ===
In the [[United Kingdom]], where non-therapeutic circumcision has now become far less prevalent than in the [[United States]], the written consent of both parents is required, if a physician is to perform a non-therapeutic circumcision of a child.<ref>{{REFjournal |last= |first= |title=Re J (child's religious upbringing and circumcision) |journal= USA Family Court Reports |date=2000 |volume=1 |issue= |pages=307-14 |url=https://www.cirp.org/library/legal/Re_J/2000.html |accessdate=2019-10-12}}</ref> (The National Health Service does not provide non-therapeutic circumcision.)
* the right to bodily integrity* the right to sexual self-determination* the right to equal treatment The [[American Academy of genders Pediatrics]] (circumcision/FGM of females is illegalAAP)* the right to religious freedom (where the circumcision has a religious motive) These four basic rights are relevant from the legal as well as the ethical point of view. Let us begin with the most obvious intrusion not re- the one into the bodily integrity. Under German lawaffirmed its disastrous, children enjoy far-reaching protection, that limits the parental rights and the powers delegated to third persons overseeing the upbringing (such as kindergarten staff or teachers). Methods of upbringing that may cause physical or mental harm are prohibited. This is not only corporal punishmentfailed 2012 Circumcision Policy Statement, which was common expired in families2017, schools and vocational training for ages, which may cause direct (and sometimes severe) bodily harm - it also covers spanking, which is included under degrading treatment. It is assumed that not only does the immediate injury harm the so currently has no position on child, but also the feeling of helplessness and of being at someone's mercy at the time of punishment by an authority figure. This also applies to other treatment that harms the dignity of a child - for example being forced to publicly change clothes in front of the kindergarten group after wetting his pantscircumcision.
=== Business Interests Gomco clamp circumcision===
* [[FGM]]
* [[Human rights]]
* [[Lymphoedema]]
* [[MGM]]
* [[CircumpendiumPain]]* [[Psychological issues of male circumcision]]* [[Rights situation on circumcision]]* [[Risks and complications]]* [[Sexual effects of circumcision]]* [[Sudden Infant Death Syndrome]] (SIDS)* [[Trauma]]{{LINKS}} * {{REFweb |url=https://www.cirp.org/library/anatomy/garcia/ |title=What exactly is circumcision and what is it not? |last=Garcia |first=Francisco |date=1995-12-11 |accessdate=2020-09-08}}* {{REFjournal |last=Fleiss |first=Paul |init=P |author-link=Paul M. Fleiss |title=The foreskin is necessary |journal=Mothering |date=1997-01 |volume= |issue= |pages=36-45 |url=http://www.noharmm.org/mothering.htm |accessdate=2020-06-29}}*{{REFweb |url=https://15square.org.uk/losses-from-circumcision/ |title=Losses from Circumcision |last=Ball |first=Peter |publisher=15 Square |date=2003-08-09 |accessdate=2023-02-23}}* {{REFweb |url=http://members.tranquility.net/~rwinkel/MGM/primer.html |title=Male Circumcision in the USA: A Human Rights Primer |last=Winkel |first=Rich |author-link=Rich Winkel |date=2005-05-12 |accessdate=2021-01-27}} * {{REFjournal |last=Testa |first=Patrick |init= |author-link= |last2=Block |first2=Walter E. |init2= |author2-link= |etal=no |title=Libertarianism and circumcision |trans-title= |language= |journal=Int J Health Poiicy Manag |location= |date=2014-05-26 |volume=3 |issue= |article= |page= |pages=33-40 |url=https://www.academia.edu/7587653/Libertarianism_and_Circumcision?email_work_card=view-paper |pubmedID=24987720 |pubmedCID=4075101 |DOI=10.15171/ijhpm.2014.51 |accessdate=}} * {{REFweb |url=https://intaction.org/what-is-circumcision/ |title=What is circumcision? |last=Simone |first=Judy |author-link= |publisher=Intaction |website=https://intaction.org/ |date=2020-07-26 |accessdate=2020-10-04 |format= |quote=}}* {{REFjournal |last=Deacon |first= |init=M |author-link= |last2=Muir |first2= |init2=G |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}}
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