22,191
edits
Changes
Jump to navigation
Jump to search
m
-----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.
''The following text 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 taken from 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.''
== NonIn the Jewish religion, the tradition of circumcision goes back to a passage in the Book of Genesis (17, 10-medical indications for circumcision ==14). It is seen as a covenant between God and man, dating back to the patriarch Abraham.
Apart from {{Citation |Text=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 medical indication sign of pathological phimosisthe covenant between me and you. 12 For the generations to come every male among you who is eight days old must be circumcised, there also including those born in your household or bought with money from a foreigner—those who are other reasons for circumcisionnot 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}}
=== Aesthetic reasons ===According to the anthropologist and sociologist Nissan Rubin, 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]]. This was only added around 135 AD, to make it impossible to restore the [[foreskin]] by stretching, which became popular 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 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 Maimonides pointed out that circumcision was necessary, as it diminished sexual desires and reduced the pleasure to a degree just sufficient for mere reproduction.
The visual appearance In Islam, circumcision is also religiously founded, even though there is no mention of it in the Koran itself. According to tradition, the Prophet Mohammed was born without a [[penisforeskin]] is changed radically after circumcision. In this case, personal taste It is decisive whether an intact or seen as a sign of prophets that they are born without a cut [[penisforeskin]] already. It is more appealingconsidered an honour to "resemble the example of the Prophet", meaning to be circumcised. Since a circumcision cannot be undoneIn Islam, unlike Judaism, it there is essential to no specific age at which the circumcision should be fully informed about the risks performed. Most circumcisions take place at ages between 6 and possible later complications before embarking on an aesthetically motivated circumcision10 years, but the range goes from birth to decide whether the appearance will justify such bodily modificationadulthood.
Since In Christianity, circumcision is only common in a few orthodox churches. Nevertheless, Christian moral notions had decisive influence on the spread of this modification and its possible late effects will be practice. In the lifelong burden puritan influenced USA, circumcision of children was popular in the person who undertakes an aesthetically motivated circumcision 19th century as a means to suit his personal preferencesprevent [[masturbation]]. In those days, this so-called ‘self-abuse‘ was not only considered immoral, but was supposedly responsible for a valid decision variety of diseases. Even the mere existence of a [[foreskin]] was linked to proceed can only be made by many illnesses. Among them one could find syphilis, epilepsy, paralysis of the spine, bed wetting, scoliosis (spinal deformity), paralysis of the person to be circumcised himselfbladder, club foot, once he has reached nerve pain in the necessary age lower abdomen, tuberculosis and level lazy eye. One of the best known advocates of child circumcision was [[John Harvey Kellogg]], co-inventor of maturity to make that decision. This should normally be the case when adulthood is reachedCorn Flakes bearing his name.In 1888, he wrote:
It {{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 noted that every circumcision performed by a surgeon without administering an anaesthetic, as the brief pain attending the operation leaves will have a life long 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=[[circumcision scarJohn Harvey Kellogg]] that encircles |Source= |ref=<ref>{{REFbook |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 |pages=107}}</ref>}}Following the shaft discovery of bacteria as a cause of many diseases – such as tuberculosis – the penissearch began for other illnesses that could be prevented by circumcision.
In The sheer mass of studies and publications that were released during those almost 180 years on this topic are the United Statesreason that even arguments that have been disproved multiple times, payment for non-therapeutic especially regarding infant and child circumcision is made by most [[third party payment| third-party payers]] without question. Doctors frequently perform medically-unnecessary, non-therapeutic circumcision of infants and children simply to collect a fee for the surgical operation. The only beneficiary of such surgery is the [[Financial Incentive| bank account of the medical doctor]]tenaciously persist up until today.
=== Moral reasons ===An ever-recurring element of initiation rites found in many different cultures is the fixation upon the genitalia.
With It reflects the [[foreskin]]fascination that emerges from the ability to create new life. In most cultures, fertility is seen as the most precious good, circumcision removes approximately 70% 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 sensitive tissue boy reaches puberty, and are meant to symbolize his transition from boy to man. The removal of the male [[penisforeskin]], lowering the potential for sexual stimulation accordinglyis just one of many phenomena that developed in this context. Due to They range from the loss removal of around 50% the frenulum in boys and men through partial or complete removal of the entire penile skin, the [[penisforeskin]] loses the reserve skin that provides cutaneous mobility in the erect up to radical operations. Australian Aborigines, as mentioned above, have their [[penisforeskin]] and the s removed. It is also usual that, a few weeks later, young men have their [[gliding actionpenis]]es sliced open, resulting in a partly or completely divided urethra.
In the pastAnother known, this circumstance was used to make it harder for boys to masturbate and [[masturbation]] less funparticularly massive, as [[masturbation]] was viewed as immoral and was assumed to cause a variety intervention is the stripping of diseases. More on that can be found in the chapter "entire skin off the [[Circumcision#Historical_background|Historical backgroundpenis]]". TodayIn Indonesia, it is known that boys have metal or bamboo balls inserted into their [[masturbationpenis]] has no negative health effects, but can contribute positively to the child's sexual development. Sexuality is no longer a taboo nowadays, while shaft or [[masturbationGlans penis|glans]] is considered to be a natural part at the beginning of human sexuality and is no longer seen as immoral. Thereforepuberty, circumcision for moral reasons - which would only affect boys too young to give informed consent - is no longer justifiable nowadaysform little "humps".
=== Hygiene reasons === A For many cultures it is also common reason stated for circumcision is the assumption of hygienic benefitsto perform similar rituals on girls. This argument has to be viewed in the context of the environment the person in question grows up in. It is commonly known that bad hygienic circumstances, especially insufficient access to clean drinking water, pose a serious problem. The situation in disaster areas or refugee camps in the so-called third world keep reminding us of that. 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. In range from relatively small boys, where interventions such as piercing or cutting the [[foreskin]] cannot be retracted yetclitoral hood, cleaning is not necessary, since the [[Synechia| membrane]] that fuses the [[foreskin]] to the [[Glans penis|glans]] prevents the accumulation of micro-organisms. The so-called "ballooning", where the [[foreskin]] inflates during urination, is not a serious problem. The opening of the [[foreskin]] in small boys is often quite narrow its complete removal and serves as a one-way valve, allowing the urine up to flow out, but preventing entry radical removal of microbesclitoral hood, for example from a dirty diaper. As long as the child is able to pass waterclitoris, everything works as nature intended. But even in areas where there are poorer hygienic conditions inner and an insufficient access to medical care, outer labia followed by sewing up the benefits of easier cleaning of a circumcised [[penis]] are to be viewed with a critical eye. Although even longer periods without personal hygiene will not result in an accumulation of germs under the [[foreskin]], circumcision itself is not without risk of complications. If the operation is carried out without proper sterility, there is a high risk of an infection of the wound. This also applies to the treatment of common complications like post-operative bleeding. The benefit of easier cleaning must be balanced against the risk of promoting serious infections - among others HIV - during the operation. In parts of Africa, several dozen of one tribe's boys die each year as a result of their circumcisionvagina.
== Historical background ==
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.
[[Image:Circumcision Sakkara 3.jpg|200px|right]] For the Aborigines, the 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 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 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 [[foreskin]] is seen as the removal of an inborn piece of femininity from the boys, thus making them men.
In the Jewish religion, the tradition of circumcision goes back to a passage in the Book of Genesis (17, 10-14). It is seen as a covenant between God and man, dating back to the patriarch Abraham.
{{Citation
|Text=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
}}
According to the anthropologist and sociologist Nissan Rubin, 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]]. This was only added around 135 AD, to make it impossible to restore the [[foreskin]] by stretching, which became popular 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 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 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 Islam, circumcision is also religiously founded, even though there is no mention of it in the Koran itself. According to tradition, the Prophet Mohammed was born without a [[foreskin]]. It is seen as a sign of prophets that they are born without a [[foreskin]] already. It is considered an honour to "resemble the example of the Prophet", meaning to be circumcised. In Islam, unlike Judaism, there is no specific age at which the circumcision should be performed. Most circumcisions take place at ages between 6 and 10 years, but the range goes from birth to adulthood.
In Christianity, circumcision is only common in a few orthodox churches. Nevertheless, Christian moral notions had decisive influence on the spread of this practice. In 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 syphilis, epilepsy, paralysis of the spine, bed wetting, scoliosis (spinal deformity), paralysis of the bladder, club foot, nerve pain in the lower abdomen, tuberculosis and lazy eye. One of the best known advocates of child circumcision was [[John Harvey Kellogg]], co-inventor of the Corn Flakes bearing his name. In 1888, he wrote:
{{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=
|ref=<ref>{{REFbook
|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
|pages=107
}}</ref>
}}
Following the discovery of bacteria as a cause of many diseases – such as tuberculosis – the search began for other illnesses that could be prevented by circumcision.
In the 1920s it was penile cancer<ref>Abraham L. Wolbarst claims that circumcision can prevent penile cancer. {{REFjournal
|last=Wolbarst
|first=Abraham L.
|author-link=Abraham L. Wolbarst
|title=Is circumcision a prophylactic against penis cancer?
|journal=Cancer
|date=Jul 1926
|volume=3
|issue=4
|pages=301-10
}}</ref>, in the 1940 prostate- and tongue cancer as well as STDs<ref>Eugene H. Hand explains that circumcision somehow protects against venereal diseases and tongue cancer. {{REFjournal
|title=Circumcision and venereal disease.
|last=Hand
|first=Eugene H.
|journal=Archives of Dermatology and Syphilology
|date=Sep 1949
|volume=60
|issue=3
|pages=341-346
}}</ref>. In the 1950s it was cervical cancer<ref>Abraham Ravich invents the myth that circumcision reduces the risk of women getting cervical cancer. {{REFjournal
|url=https://www.ncbi.nlm.nih.gov/pubmed/14853120
|title=Prophylaxis of cancer of the prostate, penis, and cervix by circumcision
|last=Ravich
|first=Abraham
|last2=Ravich
|first2=R.A.
|journal=New York State Journal of Medicine
|date=Jun 1951
|volume=51
|issue=12
|pages=1519-1520
|pubmedID=14853120
|accessdate=2019-10-12
}}</ref>, in the late 1960s it was neuroses<ref>Morris Fishbein calls for circumcision to prevent nervousness and, of course, [[masturbation]]. {{REFbook
|last=Fishbein
|first=Morris
|chapter=Sex hygiene
|title=Modern Home Medical Adviser
|location=Garden City, New York
|publisher=Doubleday & Co
|year=1969
|pages=90, 119
|url=https://openlibrary.org/works/OL95362W/Modern_home_medical_adviser
|accessdate=2019-10-12
}}</ref>, in the 1970s bladder- and rectal cancer<ref>Abraham Ravich claims that circumcision would prevent bladder cancer and rectal cancer. {{REFjournal
|last=Ravich
|first=Abraham
|url=https://www.deepdyve.com/lp/wiley/viral-carcinogenesis-in-venereally-susceptible-organs-HCeWmTLmKl
|title=Viral carcinogenesis in venereally susceptible organs
|journal=Cancer
|date=Jun 1971
|volume=27
|issue=6
|pages=1493-1496
|accessdate=2019-10-12
}}</ref>, and in the 1980s UTIs<ref>Thomas E. Wiswell claims that circumcision reduces the risk of urinary tract infections. {{REFjournal
|last=Wiswell
|first=Thomas E.
|author-link=Thomas E. Wiswell
|url=https://pediatrics.aappublications.org/content/75/5/901
|title=Decreased incidence of urinary tract infections in circumcised male infants
|journal=Pediatrics
|date=May 1985
|volume=75
|issue=5
|pages=901-903
|accessdate=2019-10-12
}}</ref> and AIDS<ref>Aaron J. Fink claims that circumcision protects against AIDS. {{REFjournal
|last=Fink
|first=Aaron J.
|author-link=Aaron J. Fink
|title=A possible explanation for heterosexual male infection with AIDS
|journal=New England Journal of Medicine
|date=1986-10-30
|volume=31
|issue=18
|pages=1167
|url=https://www.nejm.org/doi/full/10.1056/NEJM198610303151818
|DOI=10.1056/NEJM198610303151818
|accessdate=
}}</ref> followed. Retrospectively, circumcision was always advertised as a cure for whatever disease was in the public spotlight at the time.
The sheer mass of studies and publications that were released during those almost 180 years on this topic are the reason that even arguments that have been disproved multiple times, especially regarding infant and child circumcision, tenaciously persist up until today.
An ever-recurring element of initiation rites found in many different cultures is the fixation upon the genitalia.
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.
Another known, particularly massive, intervention is the stripping of the entire skin off the [[penis]]. In Indonesia, boys have metal or bamboo balls inserted into their [[penis]] shaft or [[Glans penis|glans]] at the beginning of puberty, which form little "humps".
For many cultures it is also common to perform similar rituals on girls. This can range from relatively small interventions such as piercing or cutting the clitoral hood, to its complete removal and up to radical removal of clitoral hood, clitoris, inner and outer labia followed by sewing up the vagina.
adjusted REFbook parameters
|accessdate=2019-10-14
}}</ref> [...] The procedure 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 and prophylactic reasons. It is a treatment option for pathological phimosis, refractory balanoposthitis and chronic urinary tract infections (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health." (Source: [http://en.wikipedia.org/wiki/Circumcision Wikipedia])
'''Posthectomy''' is a more accurate medical term, but the Biblical euphemism, ''circumcision'', is more commonly used
== Historical background ==
[[Image:Circumcision Sakkara 3.jpg|200px|right]] For the Aborigines, the 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 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 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 the 1920s it was penile cancer<ref>Abraham L. Wolbarst claims that circumcision can prevent penile cancer. {{REFjournal |last=Wolbarst |first=Abraham L. |author-link=Financial reasonsAbraham L. Wolbarst |title=Is circumcision a prophylactic against penis cancer? |journal=Cancer |date=Jul 1926 |volume=3 |issue=4 |pages=301-10}}</ref>, in the 1940 prostate- and tongue cancer as well as STDs<ref>Eugene H. Hand explains that circumcision somehow protects against venereal diseases and tongue cancer. {{REFjournal |title=Circumcision and venereal disease. |last=Hand |first=Eugene H. |journal=Archives of Dermatology and Syphilology |date=Sep 1949 |volume=60 |issue=3 |pages=341-346}}</ref>. In the 1950s it was cervical cancer<ref>Abraham Ravich invents the myth that circumcision reduces the risk of women getting cervical cancer. {{REFjournal |url=https://www.ncbi.nlm.nih.gov/pubmed/14853120 |title=Prophylaxis of cancer of the prostate, penis, and cervix by circumcision |last=Ravich |first=Abraham |last2=Ravich |first2=R.A. |journal=New York State Journal of Medicine |date=Jun 1951 |volume=51 |issue=12 |pages=1519-1520 |pubmedID=14853120 |accessdate=2019-10-12}}</ref>, in the late 1960s it was neuroses<ref>Morris Fishbein calls for circumcision to prevent nervousness and, of course, [[masturbation]]. {{REFbook |last=Fishbein |first=Morris |chapter=Sex hygiene |title=Modern Home Medical Adviser |location=Garden City, New York |publisher=Doubleday & Co |year=1969 |pages=90, 119 |url=https://openlibrary.org/works/OL95362W/Modern_home_medical_adviser |accessdate=2019-10-12}}</ref>, in the 1970s bladder- and rectal cancer<ref>Abraham Ravich claims that circumcision would prevent bladder cancer and rectal cancer. {{REFjournal |last=Ravich |first=Abraham |url=https://www.deepdyve.com/lp/wiley/viral-carcinogenesis-in-venereally-susceptible-organs-HCeWmTLmKl |title=Viral carcinogenesis in venereally susceptible organs |journal=Cancer |date=Jun 1971 |volume=27 |issue=6 |pages=1493-1496 |accessdate=2019-10-12 }}</ref>, and in the 1980s UTIs<ref>Thomas E. Wiswell claims that circumcision reduces the risk of urinary tract infections. {{REFjournal |last=Wiswell |first=Thomas E. |author-link=Thomas E. Wiswell |url=https://pediatrics.aappublications.org/content/75/5/901 |title=Decreased incidence of urinary tract infections in circumcised male infants |journal=Pediatrics |date=May 1985 |volume=75 |issue=5 |pages=901-903 |accessdate=2019-10-12}}</ref> and AIDS<ref>Aaron J. Fink claims that circumcision protects against AIDS. {{REFjournal |last=Fink |first=Aaron J. |author-link=Aaron J. Fink |title=A possible explanation for heterosexual male infection with AIDS |journal=New England Journal of Medicine |date=1986-10-30 |volume=31 |issue=18 |pages=1167 |url=https://www.nejm.org/doi/full/10.1056/NEJM198610303151818 |DOI=10.1056/NEJM198610303151818 |accessdate=}}</ref> followed. Retrospectively, circumcision was always advertised as a cure for whatever disease was in the public spotlight at the time.
''The following text is taken from the [[Circumpendium]].''
=== Prophylactic reasons ===
|url=
|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. These African randomized clinical trials have been demonstrated to have very serious methodological and statistical errors that distort the results in favor of circumcision.<ref name="boyle-hill2011">{{REFjournal |last=Boyle |first=Gregory J. |author-link= |last2=Hill |first2=George |author2-link=George Hill |title=Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns |journal=J Law Med |date=2011-12 |volume=19 |issue=2 |pages=316-34 |url=http://www.salem-news.com/fms/pdf/2011-12_JLM-Boyle-Hill.pdf |quote= |pubmedID=22320006 |pubmedCID= |DOI= |accessdate=2019-11-09}}</ref> 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.
In conclusion, circumcision does not provide any proven benefits in preventive medicine.
== Non-medical indications for circumcision ==
Apart from the medical indication of pathological phimosis, there also are other reasons for circumcision.
=== Aesthetic reasons ===
The visual appearance of the [[penis]] is changed radically after circumcision. In this case, personal taste is decisive whether an intact or a cut [[penis]] is more appealing. Since a circumcision cannot be undone, it is essential to be fully informed about the risks and possible later complications before embarking on an aesthetically motivated circumcision, to decide whether the appearance will justify such bodily modification.
Since this modification and its possible late effects will be the lifelong burden of the person who undertakes an aesthetically motivated circumcision to suit his personal preferences, a valid decision to proceed can only be made by the person to be circumcised himself, once he has reached the necessary age and level of maturity to make that decision. This should normally be the case when adulthood is reached.
It should be noted that every circumcision operation leaves a life-long [[circumcision scar]] that encircles the shaft of the penis.
===Financial reasons===
In the United States, payment for non-therapeutic circumcision is made by most [[third-party payment| third-party payers]] without question. Doctors frequently perform medically-unnecessary, non-therapeutic circumcision of infants and children simply to collect a fee for the surgical operation. The only beneficiary of such surgery is the [[Financial Incentive| bank account of the medical doctor]].
=== Moral reasons ===
With the [[foreskin]], circumcision removes approximately 70% of the sensitive tissue of the [[penis]], lowering the potential for sexual stimulation accordingly. Due to the loss of around 50% of the entire penile skin, the [[penis]] loses the reserve skin that provides cutaneous mobility in the erect [[penis]] and the [[gliding action]].
In the past, this circumstance was used to make it harder for boys to masturbate and [[masturbation]] less fun, as [[masturbation]] was viewed as immoral and was assumed to cause a variety of diseases. More on that can be found in the chapter "[[Circumcision#Historical_background|Historical background]]". Today, it is known that [[masturbation]] has no negative health effects, but can contribute positively to the child's sexual development. Sexuality is no longer a taboo nowadays, while [[masturbation]] is considered to be a natural part of human sexuality and is no longer seen as immoral. Therefore, circumcision for moral reasons - which would only affect boys too young to give informed consent - is no longer justifiable nowadays.
=== Hygiene reasons ===
A common reason stated for circumcision is the assumption of hygienic benefits. This argument has to be viewed in the context of the environment the person in question grows up in. It is commonly known that bad hygienic circumstances, especially insufficient access to clean drinking water, pose a serious problem. The situation in disaster areas or refugee camps in the so-called third world keep reminding us of that.
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.
In small boys, where the [[foreskin]] cannot be retracted yet, cleaning is not necessary, since the [[Synechia| membrane]] that fuses the [[foreskin]] to the [[Glans penis|glans]] prevents the accumulation of micro-organisms. The so-called "ballooning", where the [[foreskin]] inflates during urination, is not a serious problem.
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.
But even in areas where there are poorer hygienic conditions and an insufficient access to medical care, the benefits of easier cleaning of a circumcised [[penis]] are to be viewed with a critical eye. Although even longer periods without personal hygiene will not result in an accumulation of germs under the [[foreskin]], circumcision itself is not without risk of complications. If the operation is carried out without proper sterility, there is a high risk of an infection of the wound. This also applies to the treatment of common complications like post-operative bleeding.
The benefit of easier cleaning must be balanced against the risk of promoting serious infections - among others HIV - during the operation. In parts of Africa, several dozen of one tribe's boys die each year as a result of their circumcision.
== Circumcision methods ==
=== Possible operative and postoperative complications ===
Circumcision is surgery. Surgical complications of circumcision generally may be classified as hemorrhage, infection, or surgical misadventure up to and including loss of the penis and [[death]].
* Intolerance or allergic reactions to the narcotics used.
* Postoperative wound pain, in the 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 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=Smart J, Nolan T. (Editors)
|first=
|year=2000
|url=
|work=
|editoreditors=Smart J, Nolan T.
|edition=6
|volume=
|accessdate=
}}</ref>
* [http://www.circumstitions.com/Restric/Botched9wd.html 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
|first2=GJ
|year=2001
|title=Ritual and medical Understanding circumcision among Filipino boys: evidence of postA Multi-traumatic stress disorderDisciplinary Approach to a Multi-Dimensional Problem
|url=https://link.springer.com/chapter/10.1007/978-1-4757-3351-8_14
|work=Understanding circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem |editoreditors=[[George C. Denniston GC]], [[Frederick M. Hodges FM]], [[Marilyn Fayre Milos MF]]
|edition=
|volume=
|chapter=Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder
|pages=253-270
|location=New York
* Relapse into the state of bed-wetting, even if the child was already dry before.<ref name="Levy1945"/>
== Rights and Ethics ==
Many cultures perform circumcision as a rite of passage into manhood. This is common in the Middle East and amongst some indigenous African and Southeast Asian peoples.
The United States and Israel are the only industrialized countries in the world to have a high incidence of routine non-therapeutic infant male circumcision. The vast majority of infant circumcisions performed in the United States are for non-religious, non-medical reasons. See [[History of circumcision]].
===Religious===
== Complications ==
=== Pain ===
In the past, advocates of circumcision claimed that a newborn child's nerve system was not yet fully developed, and that as a result, the child felt no pain during the circumcision procedure. Research has Anand & Hickey (1987) have shown that newborn children do in fact feel pain, and more acutely than adults. <ref name="anand-hickey1987">{{REFjournal |last=Anand |first= |author-link= |last2=Hickey |first2= |author2-link= |etal=no |title=Pain and its effects in the 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=http://www.cirp.org/library/pain/anand/ |quote= |pubmedID=3317037 |pubmedCID= |DOI= |accessdate=2019-11-08}}</ref> This has led American health associations to recommend doctors take measures to reduce the pain of circumcision in infants.
The [[Position Statements on Infant Circumcision|AAP Circumcision Policy Statement]] states quite clearly that ''"There is considerable evidence that newborns who are circumcised without analgesia experience pain and physiologic stress"''. Furthermore, the pain is quite severe, and requires injections for proper pain management. Sucrose and Acetaminophen ''"cannot be recommend 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 the clamp"''.<ref>{{REFjournal
|last=
|first=
=== Non-therapeutic circumcision of male children ===
Human babies, because they are not yet in possession of language, are incapable of giving or refusing consent for being circumcised. The element of force has led some scholars to view the circumcision of baby boys 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 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, "A Short History," p. 31; see also [[Leonard B. Glick|Glick]], ''Marked in Your Flesh'', pp. 273-281.</ref> There are, however, physicians in the United States who argue strongly for routine non-therapeutic circumcision of newborn babies; and circumcision is widely accepted as a postnatal procedure in American hospitals.<ref>{{REFbook
|last=Fletcher
|first=Christopher R.
|url=http://www.springerlink.com/content/h2150v731233m177/
|work=Male and Female Circumcision
|editoreditors=[[George C. Denniston]], [[Frederick M. Hodges|Frederick Mansfield Hodges]], [[Marilyn Fayre Milos]]
|edition=
|volume=