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Some people claim that circumcision has prophylactic benefits. Especially in the USA those arguments have persisted for more then a 100 years, with ever changing diseases circumcision is said to protect against. At first, these were diseases where masturbation was believed to be the cause. After bacteria and viruses had been discovered, arguments changed, and one after another miscellaneous diseases were cited.
* [[Phimosis]]: as mentioned earlier, true [[phimosis]] is rare and can be treated effectively without surgery. According to a study by Blalock ''et.al. '' (2003)<ref>{{REFjournal |last=Blalock HJ, |first=H.J. |last2=Vemulakonda |first2=V, . |last3=Ritchey ML, |first3=M.L. |last4=Ribbeck |first4=M.
|title=Outpatient management of [[phimosis]] Following newborn circumcision
|journal=J Urol
* Sexually Transmitted Diseases (STDs): a vast number of studies has been conducted on the subject of transmission of STDs.
* 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 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 EO, |first=E.O. |last2=Masi CM, |first2=C.M. |last3=Zuckerman EW |firstfirst3=E.W.
|title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice
|journal=JAMA
|accessdate=
}}</ref>, which found a higher rate of infection with bacterial venereal diseases in circumcised than in intact men.
* The studies by Fleiss ''etal.al''. (1998<ref>{{REFjournal |last=Fleiss PM, |first=P.M. |last2=Hodges FM, |first2=F.M. |last3=Van Howe RS |firstfirst3=R.S.
|title=Immunological functions of the human prepuce
|journal=Sex Transm Inf
*: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>{{REFjournal
|last=Hooykaas |first=C, . |last2=van der Velde FW, |first2=F.W. |last3=van der Linden MM |first3=M. et alM. |firstetal=yes
|title=The importance of ethnicity as a risk factor for STDs and sexual behaviour among heterosexuals
|journal=Genitourin Med
|accessdate=
}}</ref><ref>{{REFjournal
|last=Michael RT, |first=R.T. |last2=Wadsworth |first2=J, . |last3=Feinleib |first3=J, et al. |firstetal=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
|accessdate=
}}</ref><ref>{{REFjournal
|last=Laumann EO, |first=E.O. |last2=Masi CM, |first2=C.M. |last3=Zuckerman EW |firstfirst3=E.W.
|title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice
|journal=JAMA
}}</ref>
* Two studies that have been published in early 2007<ref>{{REFjournal
|last=Gray RH , R.H. and colleagues
|first=
|title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial
|accessdate=
}}</ref><ref>{{REFjournal
|last=[[Robert C. Bailey|Bailey RC, R.C.]] and colleagues
|first=
|title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial
|accessdate=
}}</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>{{REFjournal
|last=Grosskurth |first=H, . |last2=Mosha |first2=F, . |last3=Todd |first3=J, et al. |firstetal=yes
|title=A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results
|journal=AIDS
|accessdate=
}}</ref><ref>{{REFjournal
|last=Barongo LR, |first=L.R. |last2=Borgdorff MW, |first2=M..W. |last3=Mosha FF, et al |first3=F.F. |firstetal=yes
|title=The epidemiology of HIV-1 infection in urban areas, roadside settlements and rural villages in Mwanza Region, Tanzania
|journal=AIDS
|accessdate=
}}</ref>. A Swedish study <ref>{{REFjournal
|last=Mårild |first=S, . |last2=Jodal U |firstfirst2=U.
|title=Incidence rate of first–time symptomatic urinary tract infection in children under 6 years of age
|journal=Acta Paediatr
|url=
|accessdate=
}}</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 ''etal.al''. <ref>{{REFjournal |last=Mueller ER, |first=E.R. |last2=Steinhardt, |first2=G., |last3=Naseer S |firstfirst3=S.
|title=The incidence of genitourinary abnormalities in circumcised and uncircumcised boys presenting with an initial urinary tract infection by 6 months of age
|journal=Pediatrics
|accessdate=
}}</ref><ref>{{REFjournal
|last=Cohen HA, |first=H.A. |last2=Drucker MM, |first2=M.M. |last3=Vainer |first3=S, et al. |firstetal=yes
|title=Postcircumcision urinary tract infection
|journal=Clin Pediatr
|accessdate=
}}</ref><ref>{{REFjournal
|last=Goldman |first=M, . |last2=Barr |first2=J, . |last3=Bistritzer |first3=T, . |last4=Aladjem M |firstfirst4=M.
|title=Urinary tract infection following ritual Jewish circumcision
|journal=Isr J Med Sci
|accessdate=
}}</ref>. Today, it is known that sexually transmitted human papillomavirus (HPV) is a major risk factor<ref>{{REFjournal
|last=McCance DJ, |first=D.J. |last2=Kalache |first2=A, . |last3=Ashdown |first3=K, et al. |firstetal=yes
|title=Human papillomavirus types 16 and 18 in carcinomas of the penis from Brazil
|journal=Int J Cancer
|accessdate=
}}</ref>, as well as smoking<ref>{{REFjournal
|last=Harish |first=K, . |last2=Ravi R |firstfirst2=R.
|title=The role of tobacco in penile carcinoma
|journal=Brit J Urol
|accessdate=
}}</ref><ref>{{REFjournal
|last=Howard CR, |first=C.R. |last2=Howard FM, |first2=F.M. |last3=Garfunkel LC, |first3=L.C. |last4=de Blieck EA, |first4=E.A. |last5=Weitzman M |firstfirst5=M.
|title=Neonatal circumcision and pain relief: current training practices
|journal=Pediatrics
|accessdate=
}}</ref><ref>{{REFjournal
|last=Stang HJ, |first=H.J. |last2=Snellman LW |firstfirst2=L.W.
|title=Circumcision practice patterns in the United States
|journal=Pediatrics
|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 typically 3- to 4-fold increase in cortisol levels, which equals a state of severe shock.<ref>{{REFjournal
|last=Gunnar MR, |first=M.R. |last2=Fisch RO, |first2=R.O. |last3=Korsvik |first3=S, . |last4=Donhowe JM |firstfirst4=J.M.
|title=The effects of circumcision on serum cortisol and behavior
|journal=Psychoneuroendocrinology
|accessdate=
}}</ref><ref>{{REFjournal
|last=Hiss |first=J, . |last2=Horowitz |first2=A, . |last3=Kahana T |firstfirst3=T.
|title=Fatal haemorrhage following male ritual circumcision
|journal=J Clin Forensic Med
* Wound dehiscence, meaning the separation of the edges of the wound or the tissue after suturing.
* Adhesion between the surface or rim of the [[Glans penis|glans]] with the neighbouring penile skin, causing skin pockets and bridges, as well as visually unpleasant results like uneven scars, which make a re-circumcision necessary.
* Postoperative [[phimosis]]: a phimotic ring can develop during scarring, which makes a re-circumcision necessary. According to a study by Blalock ''et.al.''<ref>{{REFjournal |last=Blalock HJ, |first=H.J. |last2=Vemulakonda |first2=V, . |last3=Ritchey ML, |first3=M.L. |last4=Ribbeck M |firstfirst4=M.
|title=Outpatient management of [[phimosis]] Following newborn circumcision
|journal=J Urol
}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal
|last=Leitch
|first=IOWI.O.W.
|title=Circumcision - a continuing enigma
|journal=Aust Paediatr J
* 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>{{REFjournal
|last=Van Howe
|first=RSR.S.
|title=Incidence of meatal stenosis following neonatal circumcision in a primary care setting
|journal=Clin Pediatr (Phila)
|accessdate=
}}</ref><ref>{{REFjournal
|last=Stenram, |first=A., |last2=Malmfors, |first2=G., & |last3=Okmian, L. |firstfirst3=L.
|title=Circumcision for [[phimosis]]: a follow-up study
|journal=Scandinavian journal of urology and nephrology
=== Physical late effects ===
* An unavoidable late effect of any circumcision is the permanent loss of sexual sensitivity. This is partly due to the removal of sensory tissue. The [[foreskin]] contains very many nerve endings and touch receptors, which account for the major part of male sexual sensation. If the [[foreskin]] is removed, they can no longer provide sexual stimulation. It is also partly due to the fact that the surface of the [[Glans penis|glans]] reacts to the missing protection from friction and drying out by developing a callus layer. This reduces the sensitivity of the remaining nerves in the [[Glans penis|glans]] gradually over the years. The study conducted by Sorrells ''et.al.''<ref>{{REFjournal |last=Sorrells ML, |first=M.L. |last2=Snyder JL, |first2=J..L. |last3=Reiss MD, et al |first3=M.D. |firstetal=yes
|title=Fine-touch pressure thresholds in the adult [[penis]]
|journal=BJU Int
}}</ref> found a significant reduction of sensitivity to touch for circumcised compared to intact [[penis]]es in adult males. Other studies revealed that circumcised men use condoms significantly less often than intact men, since they further limit the sexual sensitivity (see above).
* Painful tension can occur when there is too little reserve skin left to support a full erection<ref>{{REFjournal
|last=Taylor, |first=J.R., |last2=Lockwood, |first2=A.P., & |last3=Taylor, |first3=A.J. |first=
|title=The prepuce: <q>Specialized mucosa of the [[penis]] and its loss to circumcision</q>
|journal=British Journal of Urology
}}</ref>. This risk is partly dependent on the anatomy of the [[penis]]. While some [[penis]]es already have the majority of their full size when flaccid ([[Flesh Penis]], or "[[shower]]"), others are rather short when flaccid and double or more their size during an erection ([[Blood Penis]], or "[[grower]]"). Especially in children's circumcision, where the [[penis]] is not yet fully developed, the amount of reserve skin needed in adulthood cannot be estimated.
* Erectile dysfunction: Both the damage 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
|last=Money, |first=J., & |last2=Davison, J. |firstfirst2=J.
|title=Adult penile circumcision: Erotosexual and cosmetic sequelae
|journal=Journal of Sex Research
* Orgasm problems: In the wake of reduced sexual sensitivity, due to the loss of sensory tissue and gradual keratinization of the surface 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 to achieve orgasm. A preliminary stage of this late effect is the prolonged time circumcised men need to reach an orgasm. This 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>{{REFjournal
|last=[[Frisch |first=Morten |author-link=Morten Frisch]], |first2=Morten |last2=Lindholm, |first3=Morten Grønbæk |firstlast3=Grønbæk
|title=Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark
|journal=International Journal of Epidemiology
|accessdate=
}}</ref><ref>{{REFjournal
|last=Cortés-González, |first=J., |last2=Arratia-Maqueo, |first2=J., & |last3=Gómez-Guerra, L. |firstfirst3=L.
|title=Does circumcision has an effect on female's perception of sexual satisfaction?
|journal=Rev Invest Clin
|accessdate=
}}</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>{{REFjournal
|last=Cold CJ, |first=C.J. |last2=Taylor JR |firstfirst2=J.R.
|title=The prepuce
|journal=BJU Int
|accessdate=
}}</ref><ref>{{REFjournal
|last=Fink KS, |first=K.S. |last2=Carson CC, |first2=C.C. |last3=DeVellis RF |firstfirst3=R.F.
|title=Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction
|journal=J Urol
* It was observed that infants, following circumcision without pain control, had a disturbed bond with their mother<ref>{{REFjournal
|last=Marshall RE, |first=R.E. |last2=Porter FL, |first2=F.L. |last3=Rogers AG, et al |first3=A.G. |firstetal=yes
|title=Circumcision: II effects upon mother-infant interaction
|journal=Early Hum Dev
* 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 [[foreskin]] 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>{{REFjournal
|last=van der Kolk
|first=BAB.A.
|url=http://www.cirp.org/library/psych/vanderkolk/
|title=The compulsion to repeat the trauma: re-enactment, revictimization, and masochism
|first=Abraham
|last2=Ravich
|first2=RAR.A.
|journal=New York State Journal of Medicine
|date=Jun 1951
Male and female circumcision involves the removal and disruption of normal anatomical structures that are primary areas of sexual sensation.<ref>{{REFjournal
| last=Taylor | first=J.R. | coauthorslast2=Lockwood |first2=A.P. Lockwood and |last3=Taylor |first3=A.J. Taylor | title=The prepuce: Specialized mucosa of the penis and its loss to circumcision | journal=British Journal of Urology International | volume=77 | issue= | pages=291-95 | url=http://www.cirp.org/library/anatomy/taylor/ | quote= | pubmedID=8800902 | pubmedCID= | DOI= | date=1996-2 | accessdate=2019-10-12
}}</ref> In the past, some advocates of mass circumcision have considered the prepuce to be a "mistake of nature,"<ref>
<nowiki>{{Cold and Wiswell (1995)}} | [[Template:Cold and Wiswell (1995)|see more]]</nowiki></p>
| 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 ring block is not always effective in stopping the pain of circumcision.<ref name='Journal of Perinatology April/May 2002'>{{REFjournal
| last=Taeusch | first=H . William | coauthorslast2=Martinez |first2=Alma M Martinez, . |last3=Partridge |first3=J . Colin Partridge, |last4=Sniderman |first4=Susan Sniderman, Jennifer |last5=Armstrong-Wells, Elena |first5=Jennifer |last6=Fuentes-Afflick |first6=Elena | title=Pain During Mogen or PlastiBell Circumcision | journal=Journal of Perinatology | volume=22 | issue=3 | pages=214-218 | url=http://www.nature.com/jp/journal/v22/n3/full/7210653a.html | quote=...more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure. | pubmedID= | pubmedCID= | DOI= | date=April/May 2002 | accessdate=2011-04-08
}}</ref><ref name='Clinical Pediatrics August 1986'>{{REFjournal
| last=Williamson | first=Paul S. | coauthorslast2=Evans |first2=Nolan Donovan Evans | title=Neonatal Cortisol Response to Circumcision with Anesthesia | journal=Clinical Pediatrics | volume=25 | issue=8 | pages=412-416 | 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 lidocaine. | pubmedID= | pubmedCID= | DOI= | date=August 1986 | accessdate=2011-04-08
}}</ref> During circumcision, somp physicians give children sugar pacifiers to "reduce the perception of pain",<ref>{{REFweb
| quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.
| accessdate=2011-04-08
}}</ref> but in at least one study, data shows that giving sugar to a child doesn't help to reduce the perception of pain in the child.<ref name='Lancet, The 2010-10-09'>{{REFjournal
| last=Slater | first=Rebeccah | coauthorsfirst2=Laura |last2=Cornelissen, |first3=Lorenzo |last3=Fabrizi, |first4=Debbie |last4=Patten, |first5=Jan |last5=Yoxen, |first6=Alan |last6=Worley, |first7=Stewart |last7=Boyd, |first8=Judith |last8=Meek, |first9=Maria |last9=Prof Maria . 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=1225-1232 | 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 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.
It has been shown that an infant's response to pain can be altered for years as a consequence of circumcision.<ref>{{REFjournal
| last=Taddio | first=Anna | coauthorsfirst2=Morton |last2=Goldbach, |first3=Moshe |last3=Ipp, |first4=Bonnie |last4=Stevens, |first5=Gideon |last5=Koren | title=Effect of neonatal circumcision on pain responses during vaccination in boys | journal=The Lancet | volume=345 | issue=8945 | pages=291-2 | url=http://www.cirp.org/library/pain/taddio/ | quote= | pubmedID=7837863 | pubmedCID= | DOI= | date=1995 | accessdate=
}}</ref><ref>{{REFjournal
| last=Taddio | first=Anna | coauthorslast2=Katz |first2=J, . |last3=Ilersich AL, |first3=A.L. |last4=Koren |first4=G. | title=Effects of neonatal circumcision on pain response during subsequent routine vaccination | journal=The Lancet | volume=349 | issue=9052 | pages=599-603 | url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(96)10316-0/fulltext | quote= | pubmedID=9057731 | pubmedCID= | DOI=10.1016/S0140-6736(96)10316-0 | date=March 1997 | accessdate=
}}</ref>
Circumcision and frenectomy remove tissues with heightened erogenous sensitivity. Boyle ''et al.'' (2002) wrote, "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings—many of which are lost to circumcision."<ref>{{REFjournal
| last=Boyle | first=Gregory J. | coauthorsauthor-link=Gregory Boyle |first2=Gillian A. |last2=Bensley | title=Adverse Sexual and Psychological Effects of Male Infant Circumcision | journal=Psychological reports | volume=88 | issue=3, Part 2 | pages=1105–1106 | url=http://www.cirp.org/library/psych/boyle5/ | quote= | pubmedID=11597060 | pubmedCID= | DOI=10.1046/j.1464-410x.1999.0830s1085.x | date=July 2001 | accessdate=
}}</ref> They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well."
The amputation of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the penis, leaving only the uninhibited protopathic sensibility of the artificially externalized glans penis. The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of the changes in sexual behavior noted in circumcised human males.<ref>{{REFjournal
| last=Van Howe | first=RSR.S. | coauthorsauthor-link=Robert Van Howe |last2=Cold CJ |first2=C.J. | title=Advantages and Disadvantages of Neonatal Circumcision | journal=The Journal of the American Medical Association | volume=277 | issue=13 | pages=1052-7 | url=http://www.ncbi.nlm.nih.gov/pubmed/9218663 | quote= | pubmedID=9218663 | pubmedCID= | DOI= | date=1997-04-02 | accessdate=
}}</ref>
|last=Cold
|first=C.J.
|coauthorsfirst2=J.R. |last2=Taylor
|title=The prepuce
|journal=British Journal of Urology International
|first=Dan
|author-link=Dan Bollinger
|title=Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths
|journal=Thymos: Journal of Boyhood Studies