Psychological injury of male circumcision: Difference between revisions
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Male [[circumcision]] is a surgical [[amputation]] of the [[foreskin]], which contains more than one-half of the erogenous epithelium of the [[penis]]. The [[amputation]] is most frequently carried out on infants and small boys who cannot and do not give consent for the loss of so much of their | Male [[circumcision]] is a surgical [[amputation]] of the [[foreskin]], which contains more than one-half of the erogenous epithelium of the [[penis]]. The [[amputation]] is most frequently carried out on infants and small boys who cannot and do not give consent for the loss of so much of their penis. There are many '''psychological issues of male circumcision''' that arise from the painful, traumatic, involuntary loss of the part of the penis with the erogenous tissue that provides much sexual sensation.<ref name ="uberoi2022">{{REFjournal | ||
|last=Uberoi | |last=Uberoi | ||
|first= | |first= | ||
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|pages= | |pages= | ||
|accessdate=2023-03-01 | |accessdate=2023-03-01 | ||
}}</ref> | }}</ref> | ||
==History== | ==History== | ||
[[Moses Maimonides]] wrote in the 12th century: | [[Moses Maimonides]] wrote in the 12th century: | ||
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}}</ref> | }}</ref> | ||
</blockquote> | </blockquote> | ||
So we see that [[circumcision]] has long been used to effect behavior change. | |||
== Profound lack of understanding of psychological issues == | == Profound lack of understanding of psychological issues == | ||
There was little awareness of emotional and/or psychological issues when child [[circumcision]] was being promoted in the late 19th century and early 20th century. For example, [[Douglas Gairdner]] | There was little awareness of emotional and/or psychological issues when child [[circumcision]] was being promoted in the late 19th century and early 20th century. For example, [[Douglas Gairdner]] made no mention at all of [[pain]], [[trauma]] behavior changes, or psychological issues in his landmark 1949 paper.<ref name="fate1949">{{GairdnerDM 1949}}</ref> | ||
}}</ref> | |||
==Increasing awareness== | ==Increasing awareness== | ||
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[[Anna Freud]], daughter of [[Sigmund Freud]], and a pioneer child psychologist read Levy's paper. She wrote (1952): | [[Anna Freud]], daughter of [[Sigmund Freud]], and a pioneer child psychologist read Levy's paper. She wrote (1952): | ||
<blockquote> | <blockquote> | ||
Ever since the discovery of the castration complex analysts have had ample opportunity in their therapeutic work to study the impact of surgical operations on normal and abnormal development. By now it is common knowledge that surgical interference with the child's body may serve as the focal point for the activation, reactivation, grouping and rationalization of ideas of being attacked, overwhelmed and (or) castrated.<ref name="freud1952">{{REFjournal | Ever since the discovery of the castration complex analysts have had ample opportunity in their therapeutic work to study the impact of surgical operations. on normal and abnormal development. By now it is common knowledge that surgical interference with the child's body may serve as the focal point for the activation, reactivation, grouping and rationalization of ideas of being attacked, overwhelmed and (or) castrated.<ref name="freud1952">{{REFjournal | ||
|last=Freud | |last=Freud | ||
|first=Anna | |first=Anna | ||
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</blockquote> | </blockquote> | ||
British child psychologist Gocke Cansever tested twelve Turkish boys before and after circumcision. Cansever (1965) confirmed the conclusions of Anna Freud (1952) and reported: | |||
<blockquote> | <blockquote> | ||
The results of the tests showed that [[circumcision]], performed around the phallic stage is perceived by the child as an act of aggression and castration. It has detrimental effects on the child's functioning and adaptation, particularly on his ego strength. By weakening the controlling and defensive mechanisms of the ego, and initiating regression, it loosens the previously hidden fears, anxieties, and instinctual impulses, and renders a feeling of reality to them. What is expressed following the operation is primitive, archaic and unsocialized in character. As a defensive control and protection against the surge of the instinctual forces coming from within and the threats coming from outside, the ego of the child seeks safety in total withdrawal, this isolates and insulates itself from disturbing stimuli.<ref name="cansever1965">{{REFjournal | The results of the tests showed that [[circumcision]], performed around the phallic stage is perceived by the child as an act of aggression and castration. It has detrimental effects on the child's functioning and adaptation, particularly on his ego strength. By weakening the controlling and defensive mechanisms of the ego, and initiating regression, it loosens the previously hidden fears, anxieties, and instinctual impulses, and renders a feeling of reality to them. What is expressed following the operation is primitive, archaic and unsocialized in character. As a defensive control and protection against the surge of the instinctual forces coming from within and the threats coming from outside, the ego of the child seeks safety in total withdrawal, this isolates and insulates itself from disturbing stimuli.<ref name="cansever1965">{{REFjournal | ||
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}}</ref> so they blamed the observed effects on "stress", not pain. | }}</ref> so they blamed the observed effects on "stress", not pain. | ||
Luther, Kraybill & Potter (1976) tested cortisol and cortisone in the blood of newborn infants before and after | Luther, Kraybill & Potter (1976) tested cortisol and cortisone in the blood of newborn infants before and after circumcision. Dramatic increases in cortisol and a lesser increase in cortisone was recorded.<ref name="luther1976">{{REFjournal | ||
|last=Talbot | |last=Talbot | ||
|init=LM | |init=LM | ||
| Line 337: | Line 315: | ||
}}</ref> | }}</ref> | ||
Rawlins, Miller & Engel (1980) investigated the blood oxygen content after [https://www.thefreedictionary.com/unanesthetized unanesthetized] non-therapeutic | Rawlins, Miller & Engel (1980) investigated the blood oxygen content after [https://www.thefreedictionary.com/unanesthetized unanesthetized] non-therapeutic circumcision. They reported that blood oxygen content decreased during non-therapeutic neonatal circumcision, although it returned to baseline or above later.<ref name="rawlins-miller-engel1980">{{REFjournal | ||
|last=Rawlins | |last=Rawlins | ||
|init=DJ | |init=DJ | ||
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|author3-link= | |author3-link= | ||
|etal=yes | |etal=yes | ||
|title=Circumcision I: | |title=Circumcision I: effects upon newborn behavior | ||
|journal=Infant Behavior and Development | |journal=Infant Behavior and Development | ||
|location= | |location= | ||
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}}</ref> | }}</ref> | ||
Gunnar et al. (1984) tested the effects of a pacifier during | Gunnar et al. (1984) tested the effects of a pacifier during circumcision. They reported: | ||
<blockquote> | <blockquote> | ||
The results showed that stimulating the newborn with the pacifier reduced crying by about 40%. Reducing crying, however, had no significant effect on adrenocortical response. Elevations of serum cortisol predicted average behavioral state following circumcision, whereas crying during circumcision did not. Furthermore, there was evidence that the neonatal adrenocortical system was sensitive in variations in surgical procedures. The results indicate the importance of obtaining data on both behavioral and hormonal systems in studies of stress and coping in human newborns.<ref name="gunnar1984">{{REFjournal | The results showed that stimulating the newborn with the pacifier reduced crying by about 40%. Reducing crying, however, had no significant effect on adrenocortical response. Elevations of serum cortisol predicted average behavioral state following circumcision, whereas crying during circumcision did not. Furthermore, there was evidence that the neonatal adrenocortical system was sensitive in variations in surgical procedures. The results indicate the importance of obtaining data on both behavioral and hormonal systems in studies of stress and coping in human newborns.<ref name="gunnar1984">{{REFjournal | ||
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}}</ref></blockquote> | }}</ref></blockquote> | ||
Porter et al. (1986) recorded the | Porter et al. (1986) recorded the pain cries of boys undergoing circumcision. They reported that "Subjective judgments and objective quantitative data converge to demonstrate that infants' cries are perceived as varying and objectively, do systematically vary with respect to the the intensity of the painful stimuli."<ref name="porter1986">{{REFjournal | ||
|last=Porter | |last=Porter | ||
|first=Fran Lang | |first=Fran Lang | ||
| Line 514: | Line 492: | ||
}}</ref> | }}</ref> | ||
Porter et al. (1988) recorded the cries of boys undergoing non-therapeutic child | Porter et al. (1988) recorded the cries of boys undergoing non-therapeutic child circumcision. They found that the pitch of the cries increased as stress ([[euphemism]] for [[pain]]) increases.<ref name="porter1988">{{REFjournal | ||
|last=Porter | |last=Porter | ||
|first=Fran Lang | |first=Fran Lang | ||
| Line 543: | Line 521: | ||
}}</ref> | }}</ref> | ||
The research reported in this section clearly establish the the distress shown by male infants during unanesthetized circumcision does not come from being restrained, that infants feel extreme | The research reported in this section clearly establish the the distress shown by male infants during unanesthetized circumcision does not come from being restrained, that infants feel extreme pain, that sucking on a pacifier does not reduce pain, although it may reduce crying, and that neonatal non-therapeutic [[circumcision]] is traumatic for the child. | ||
==Trauma of circumcision== | ==Trauma of circumcision== | ||
[[Dan Bollinger| Bollinger]] & [[Georganne Chapin| Chapin]] (1999) documented the extremely painful and traumatic nature of infant [[circumcision]].<ref name="bollinger2019">{{REFdocument | [[Dan Bollinger| Bollinger]] & [[Georganne Chapin| Chapin]] (1999) documented the extremely painful and traumatic nature of infant [[circumcision]].<ref name="bollinger2019">{{REFdocument | ||
|title=Child Genital Cutting as an Adverse Childhood Experience | |title=Child Genital Cutting as an Adverse Childhood Experience | ||
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}}</ref> | }}</ref> | ||
Male circumcision | Male circumcision is part of the culture of the Philippine Islands. Boys usually are not neonatally circumcised. Instead, [[Tuli| circumcision]] is done when they are somewhat older. Some are medically circumcised while others are [[circumcised]] in a traditional manner. Ramos & Boyle (2001) studied the psychological effects of [[circumcision]] on Philippine boys. They reported that sixty-nine percent of traditionally circumcised boys and fifty-one percent of medically circumcised boys met the criteria for a diagnosis of post-traumatic stress disorder ([[PTSD]]).<ref name="ramos-boyle2001">{{REFbook | ||
|last=Ramos | |last=Ramos | ||
|first=Samuel | |first=Samuel | ||
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}}</ref> | }}</ref> | ||
Rhinehart (1999) was a practicing psychiatrist who had patients with later life problems stemming from their neonatal | Rhinehart (1999) was a practicing psychiatrist who had patients with later life problems stemming from their neonatal circumcision. He listed some possibilities: | ||
* a sense of personal powerlessness | * a sense of personal powerlessness | ||
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}}</ref> | }}</ref> | ||
</blockquote> | </blockquote> | ||
===Feelings and behavior of circumcised men=== | ===Feelings and behavior of circumcised men=== | ||
[[Ronald Goldman|Goldman]] (1999) described the long-term psychological effects of [[circumcision]] as "anger, sense of loss, shame, sense of having been victimized and violated, feal, distrust, grief, and jealousy of [[intact]] men.<ref name="goldman1999">{{REFjournal | [[Ronald Goldman|Goldman]] (1999) described the long-term psychological effects of [[circumcision]] as "anger, sense of loss, shame, sense of having been victimized and violated, feal, distrust, grief, and jealousy of [[intact]] men.<ref name="goldman1999">{{REFjournal | ||
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===Circumcised medical doctors=== | ===Circumcised medical doctors=== | ||
Most male doctors in the | Most [[Circumcised doctors| male doctors in the United States are men who were [[circumcised]] as infants]]. Consequently, despite being medical doctors they have no personal knowledge of the human [[foreskin]]. These men share the [[trauma]] and attitudes of other [[circumcised]] men and are just as likely to want to repeat the [[trauma]]. [[Eleanor LeBourdais| LeBourdais]] (1995) pointed out that the "age of the attending physician, sex and circumcision status" were important factors in determining the likelihood of a baby boy being [[circumcised]].<ref>{{REFjournal | ||
|last=LeBourdais | |last=LeBourdais | ||
|first=Eleanor | |first=Eleanor | ||
| Line 1,008: | Line 930: | ||
}}</ref> Trivialization of the loss is a frequent defense mechanism. Another is the production of fantasies about the alleged horrors of [[smegma]], [[Pheromone| aroma]], and [[Acroposthion| appearance]]. | }}</ref> Trivialization of the loss is a frequent defense mechanism. Another is the production of fantasies about the alleged horrors of [[smegma]], [[Pheromone| aroma]], and [[Acroposthion| appearance]]. | ||
''Anger'' is the second stage of grief.<ref name="kr1969"/> <ref name="cc2022"/> Research done since the 1960's forward to the present day has elucidated the nature, functions, and purpose of the [[foreskin]]. Circumcised men are learning what they have lost from the Internet, so they are less able to maintain the ego defense of ''denial of loss'',<ref name="watson2017">{{REFjournal | |||
|last=Watson | |||
|last=Watson | |||
|first=Lindsay R. | |first=Lindsay R. | ||
|init=LR | |init=LR | ||
| Line 1,041: | Line 953: | ||
|DOI= | |DOI= | ||
|accessdate=2019-12-14 | |accessdate=2019-12-14 | ||
}}</ref> so they increasingly responding with feelings of anxiety, | }}</ref> so they increasingly responding with feelings of anxiety, suicidal thoughts, depression, rage, [[PTSD]] and grief.<ref name="watson2017"/> | ||
Uberoi et al. {2022) collected the sentiments of [[circumcised]] men regarding their involuntary, unnecessary [[circumcision]].<ref name="uberoi2022 /> They published a supplement to their article on line in a 67-page Microsoft Word file with statements by 135 men | Uberoi et al. {2022) collected the sentiments of [[circumcised]] men regarding their involuntary, unnecessary [[circumcision]].<ref name="uberoi2022 /> They published a supplement to their article on line in a 67-page Microsoft Word file with statements by 135 men.<ref>{{REFweb | ||
|url=https://static-content.springer.com/esm/art%3A10.1038%2Fs41443-022-00619-8/MediaObjects/41443_2022_619_MOESM1_ESM.docx | |url=https://static-content.springer.com/esm/art%3A10.1038%2Fs41443-022-00619-8/MediaObjects/41443_2022_619_MOESM1_ESM.docx | ||
|title=Complete list of all "I" statements analyzed | |title=Complete list of all "I" statements analyzed | ||
| Line 1,054: | Line 966: | ||
}}</ref> | }}</ref> | ||
'' | ''Depression'' is the fourth stage of grief.<ref name="kr1969"/> <ref name="cc2022"/> Several cases of [[suicide]] have been reported.<ref name="lowbridge2019">{{REFnews | ||
|title=My son killed himself after circumcision | |title=My son killed himself after circumcision | ||
|url=https://www.bbc.com/news/uk-england-47292307 | |url=https://www.bbc.com/news/uk-england-47292307 | ||
| Line 1,103: | Line 1,015: | ||
|DOI=10.1136/bmj.316.7137.1086 | |DOI=10.1136/bmj.316.7137.1086 | ||
|accessdate=2019-12-10 | |accessdate=2019-12-10 | ||
}}</ref> | }}</ref> Unfortunately, Watson & Golden (2017) report: | ||
Unfortunately, Watson & Golden (2017) report: | |||
<blockquote> | <blockquote> | ||
We found that therapists were reluctant to accept that the grief was real, were unaware of foreskin functions, denied circumcision had physical or psychological sequelae and minimized patient grief using humor, cultural aesthetics, controversial | We found that therapists were reluctant to accept that the grief was real, were unaware of foreskin functions, denied circumcision had physical or psychological sequelae and minimized patient grief using humor, cultural aesthetics, controversial | ||
health benefits, sexism and an erroneous understanding of penile anatomy and sexual function. Male therapists were more likely to deny that circumcision is harmful and to be less empathetic than female therapists.<ref name="watson2017" /> | health benefits, sexism and an erroneous understanding of penile anatomy and sexual function. Male therapists were more likely to deny that circumcision is harmful and to be less empathetic than female therapists.<ref name="watson2017" /> | ||
</blockquote> | </blockquote> | ||
[[Lindsay R. Watson|Watson]] & [[Ronald Goldman|Goldman]] recommend that men "embrace the anguish and try to feel it as strongly as they can." They also recommend non-surgical [[foreskin restoration]] "since it empowers the patient."<ref name="watson2017" /> | |||
</blockquote> | |||
==Sources of help== | |||
[[Your Whole Baby]] maintains a short list of therapists knowledgeable in issues of circumcision grief.<ref name="yhb>{{REFweb | |||
|url=https://www.yourwholebaby.org/trauma | |||
|title=Resources for Circumcision Trauma & Regret | |||
|url= | |trans-title= | ||
| | |language= | ||
|last= | |||
| | |||
| | |||
|last= | |||
|first= | |first= | ||
|author-link= | |author-link= | ||
| | |publisher=Your Whole Baby | ||
| | |website= | ||
| | |date= | ||
| | |accessdate=2019-12-10 | ||
|format= | |||
|quote= | |||
}}</ref> | |||
| | There is a new blog at Reddit, where grieving [[circumcised]] men discuss their feelings of grief.<ref>{{REFweb | ||
| | |url=https://www.reddit.com/r/CircumcisionGrief/ | ||
|title=Circumcision Grief | |||
|last= | |||
|url=https://www. | |||
| | |||
|last= | |||
|first= | |first= | ||
| | |Publisher=Reddit | ||
| | |accessdate=2019-12-10 | ||
}}</ref> | }}</ref> | ||
There is another blog at Reddit, where non-surgical [[foreskin restoration]] is discussed.<ref>{{REFweb | |||
|url=https://www.reddit.com/r/foreskin_restoration/ | |||
|title=Foreskin Restoration | |||
|url=https://www. | |||
| | |||
|last= | |last= | ||
|first= | |first= | ||
| | |Publisher=Reddit | ||
|accessdate=2019-12-10 | |accessdate=2019-12-10 | ||
}}</ref> | }}</ref> | ||
[[15 Square]], the British charity, has established the [https://15square.org.uk/talking-therapies-circumcision-and-mental-health/ Talking Therapies – Circumcision and Mental Health]. The service is only available to persons in the [[United Kingdom]] due to legislative reasons. 15 Square advises there is an alternative available for persons outside of the United Kingdom through their Discord server. | |||
[[15 Square]], the British charity, has established the [https://15square.org.uk/talking-therapies-circumcision-and-mental-health/ Talking Therapies – Circumcision and Mental Health]. The service is only available to persons in the [[United Kingdom]] due to legislative reasons. 15 Square advises there is an alternative available for persons outside of the United Kingdom through their Discord server. | |||
==Autism spectrum disorder== | ==Autism spectrum disorder== | ||
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</blockquote> | </blockquote> | ||
After the medical community belatedly learned that infants actually feel [[pain]], | After the medical community belatedly learned that infants actually feel [[pain]], Howard, Howard, & Weitzman (1994) tested the use of acetaminophen (paracetamol) for post-surgical pain following neonatal non-therapeutic circumcision.<ref name="howard1994">{{REFjournal | ||
|last=Howard | |last=Howard | ||
|first=Cynthia R. | |first=Cynthia R. | ||
| Line 1,288: | Line 1,109: | ||
|issue=4 | |issue=4 | ||
|pages=641-6 | |pages=641-6 | ||
|url=https://www. | |url=https://www.i2researchhub.org/articles/acetaminophen-analgesia-in-neonatal-circumcision/ | ||
|archived= | |||
|quote= | |quote= | ||
|pubmedID=8134222 | |pubmedID=8134222 | ||
| Line 1,322: | Line 1,144: | ||
Morten & Simonsen (2015) associated neonatal non-therapeutic circumcision with autism spectrum disorder.<ref>{{REFjournal | Morten & Simonsen (2015) associated neonatal non-therapeutic circumcision with autism spectrum disorder.<ref>{{REFjournal | ||
|last=Frisch | |last=Frisch | ||
|first= | |first=Morten | ||
|init=M | |init=M | ||
|author-link= | |author-link= | ||
|last2=Simonsen | |last2=Simonsen | ||
|first2= | |first2=Jacob | ||
|init2=J | |init2=J | ||
|author2-link= | |author2-link= | ||
| Line 1,368: | Line 1,190: | ||
|url=https://jamanetwork.com/journals/jama/fullarticle/2800182?guestAccessKey=ed7c3ab4-13c4-4e61-b07d-9450c0aa0221 | |url=https://jamanetwork.com/journals/jama/fullarticle/2800182?guestAccessKey=ed7c3ab4-13c4-4e61-b07d-9450c0aa0221 | ||
|archived= | |archived= | ||
|quote= | |quote= | ||
|pubmedID=36625807 | |pubmedID=36625807 | ||
|pubmedCID= | |pubmedCID= | ||
|DOI=10.1001/jama.2022.23661 | |DOI=10.1001/jama.2022.23661 | ||
|accessdate=2023-01-13 | |accessdate=2023-01-13 | ||
}}</ref> | }}</ref> | ||
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To test the theory, they surveyed American men. They studied "408 men [[circumcised]] within the first month of life and 211 non-circumcised men and measured socio-affective behaviors and stress."<ref name="miani2020" /> | To test the theory, they surveyed American men. They studied "408 men [[circumcised]] within the first month of life and 211 non-circumcised men and measured socio-affective behaviors and stress."<ref name="miani2020" /> | ||
The authors reported their "analysis shows differences between early [[circumcised]] and non-circumcised men in psychological measures of socio-affectivity and provides initial support for the hypothesis that this alteration stems from the most crucial neurodevelopmentally plastic period of an individual's life. | The authors reported their "analysis shows differences between early [[circumcised]] and non-circumcised men in psychological measures of socio-affectivity and provides initial support for the hypothesis that this alteration stems from the most crucial neurodevelopmentally plastic period of an individual's life. They called for "replication of the current study with a larger sample size and better ability to control for socioeconomic variables."<ref name="miani2020" /> | ||
{{SEEALSO}} | {{SEEALSO}} | ||
* [[Adamant father syndrome]] | * [[Adamant father syndrome]] | ||
| Line 1,570: | Line 1,357: | ||
* [[Trauma]] | * [[Trauma]] | ||
== Videos == | |||
=== Voices of those affected De drabbades röst === | |||
The following poignant video expresses the emotional pain that many men who were [[circumcised]] in infancy feel. There is a short NSFW section: | |||
<youtube>v=3AulRgBt6ls&feature=youtu.be</youtube> | |||
=== A Therapist on Men's Hidden Circumcision Grief === | |||
<youtube>tNCJ7AL_ThY</youtube> | |||
{{LINKS}} | {{LINKS}} | ||
* {{REFweb | * {{REFweb | ||
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|url=http://acroposthion.com/psychological-implications/ | |url=http://acroposthion.com/psychological-implications/ | ||
|title=Psychological implications of circumcision | |title=Psychological implications of circumcision | ||
|last= | |last= | ||
|first= | |first= | ||
|date= | |date= | ||
|accessdate=2022-08-19 | |accessdate=2022-08-19 | ||
| Line 1,714: | Line 1,511: | ||
|accessdate=2022-02-18 | |accessdate=2022-02-18 | ||
}} | }} | ||
{{ABBR}} | {{ABBR}} | ||
{{REF}} | {{REF}} | ||