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Circumcision

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"Male '''circumcision''' (from Latin ''circumcidere'', meaning "to cut around") is the surgical removal or [[amputation]] of the [[foreskin]] (prepuce) , a major part of the human [[penis]]. The foreskin comprises ''more than fifty percent'' of the epithelium of the [[penis]].<ref name="taylor1996">{{TaylorJR LockwoodAP TaylorAJ 1996}}</ref> When the "cutting around" is performed, the foreskin falls off, so [[amputation]] and [[mutilation]] is the result. The amputation destroys the [[Foreskin#Physiological_functions| many protective, immunological, sexual, and sensory physiological functions]] of the foreskin, so it is a very harmful and [[Pain| painful]] surgery.
Cepeda'''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-Emiliani et altherapeutic 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) commentedidentifed 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}}<blockquote/ref>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 Deacon & Muir (2022) have reviewed the penile body, evidence and to the extent concluded that the prepuce "there is still conceived by segments of the no medical community as "just justification for performing a small piece of skin", we are concerned circumcision prior to an age that aggressive circumcisions are intentionally or unintentionally being performed in pediatric he can assess the known risks and adult patients in the belief that "redundant" or " extra" tissue is being excisedpotential benefits, and choose to give or in the belief that "excesive sensitivitywithhold [[informed consent]] himself." is being reduced to augment ejaculatory latency time.<ref name="cepeda2023deacon2022">{{REFjournal |last=Cepeda-EmilianiDeacon |first=Matthew |init=AM |author-link=Alfonso Cepeda-Emiliani |last2=Gándara-Cortés Muir |first2=Gordon |init2=MG
|author2-link=
|last3=Otero-Alén
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|last4=García
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|last5=Suárez-Quintanilla
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|last6=García-Caballero
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|title=Immunohistological study of What is the density and distribution of human penile neural tissue: gradient hypothesis |transmedical evidence on non-title= |language=therapeutic child circumcision?
|journal= Int J Impot Res
|location= |date=20232022-0501-02 |volume=35 |issue=3 |article= |page= |pages=286-30508 |url=https://www.nature.com/articles/s41443-022021-0056100502-9 |archived= |quote=y |pubmedID=35501394 |pubmedCID=34997197 |DOI=10.1038/s41443-022021-0056100502-9 y |accessdate=20232022-1101-2330
}}</ref>
</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.
'''Posthectomy''' is a more accurate medical term that more accurately reflects Circumcision was popularized in English-speaking nationns in the injury and loss nineteeth century. The practice of non-therapeutic circumcision of functional body tissueboys now has greatly declined in [[Australia]], [[Canada]], but [[New Zealand]] and the [[United Kingdom]]. It has been gradually declining since 1985 in the Biblical [[euphemismUnited States]], . It has ''circumcisionnever'', is more commonly usedbeen a popular practice in other western nations.  == Historical background ==
With reference to involuntary, non-therapeutic circumcision The [[amputation]] of children, the [[Child Genital Cutting (CGC)foreskin]] is a newer term that has been introduced very old ritual, whose exact origin cannot be verified beyond doubt. Circumcision is believed to avoid issues associated with more traditional terms. Bollinger (2023) identifed CGC as an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]]have originated in east Africa near the Red Sea well before the dawn of recorded history.<ref name="bollinger2023demeo1997">{{REFjournalREFbook |last=BollingerDeMeo |initfirst=D |author-link=Dan Bollinger |last2year=1997 |init2= |author2-linktitle=The geography of sexual mutilations |url=https://kindredmediawww.org/2023academia.edu/02/adverse-childhood-experiences-dysfunctional-households-and-circumcision4212007/The_Geography_of_Male_and_Female_Genital_Mutilations |titlework=Adverse Childhood Experiences, Dysfunctional Households, And Circumcision.Sexual Mutilations: A Human Tragedy |journaleditors=KindredGeorge C. Denniston, Marilyn Milos |dateedition=2023-02-28
|volume=
|issuechapter=
|pages=
|location=New York |publisher=Plenum |isbn=0-306-45589-7 |quote= |accessdate=20232021-0311-0113 |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.
Deacon & Muir (2022) have reviewed [[Image:Circumcision Sakkara 3.jpg|200px|right]] For the [[Aborigines]], the [[Australia| Australian]] natives, the evidence and concluded that "there tradition of circumcision is no medical justification for performing a circumcision prior said to go back to an age that he can assess 10,000 BC. On the known risks and potential benefitsAfrican continent, and choose the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of circumcision date back to give or withhold [[informed consent]] himselfthe time around 3000-2000 BC."The oldest known depiction<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=2022-01-08REFweb |url=https://wwwcommons.naturewikimedia.comorg/articleswiki/s41443-021-00502-yFile:Circumcision_Sakkara_3.jpg |pubmedIDtitle=34997197 |DOI=10File:Circumcision Sakkara 3.1038/s41443-021-00502-y jpg |accessdate=20222019-0110-3012}}</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. ===Judaism===
The practice of non-therapeutic circumcision of boys has greatly declined in In [[AustraliaJudaism]], the tradition of [[CanadaBrit Milah| circumcision]], goes back to the [[New ZealandAbrahamic covenant]] and in a passage in the [[United Kingdom]]Book of Genesis (17:10-14). It has been gradually declining since 1985 in was seen as a covenant between God and man, dating back to the [[United States]]patriarch Abraham. The validity of this passage is increasingly being questioned.
{{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= Historical background =Bible |Source=Gen 17, 10-14, NIV}}
The 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 ''[[amputationperiah]] '', namely the complete scraping of the inner [[foreskin]] is a very old ritual, whose exact origin cannot be verified beyond doubt. Circumcision is believed to have originated in east Africa near from the Red Sea well before the dawn of recorded history.<ref name="demeo1997">{{REFbook [[Glans penis|last=DeMeo |first= |author-link= |year=1997 |title=The geography of sexual mutilations |url=https://wwwglans]].academia.edu/4212007/The_Geography_of_Male_and_Female_Genital_Mutilations |work=Sexual Mutilations: A Human Tragedy |editors=George C. DennistonThis was only added around 135 AD, 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 make it was not uncommon almost impossible to placate restore the [[foreskin]] by [[stretching]], which became popular in the gods with human sacrifice. Castration wake of slaves or conquered enemies was common as wellHellenic influence. Following religious changes this sacrifice was altered, and While originally only a part the tip of the very organ responsible for [[foreskin]] was cut off, ''[[periah]]'' removes the creation of new life was sacrificedentire [[foreskin]].
In the Greek society of the day, a denuded [[Image:Circumcision Sakkara 3.jpgGlans penis|200px|rightglans]] For was considered obscene and risible. In ultra-orthodox communities, circumcision is followed by the ''[[Aboriginesmohel]]'', the ritual circumciser, sucking blood from the wound with his mouth. This practice is highly controversial, as it can result in an [[Australia| Australianinfection]] with [[herpes]] simplex type 1. In New York City, between 2000 and 2011 eleven children were infected with [[herpes]] natives, the tradition 10 of circumcision is said whom had to go back to 10be treated in hospital. Two of them suffered permanent brain damage,000 BCtwo others died. On In the African continent12th century, the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of Jewish philosopher and doctor [[Moses Maimonides| Maimonides]] claimed that 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 dynastywas necessary, approximately 2300-2000 BC. It is not known precisely who was circumcised as it diminished sexual desires and why in those timesreduced the pleasure to a degree just sufficient for mere reproduction.
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. ===Judaism=== In [[Judaism]], the tradition of [[Brit Milah| circumcision]] goes back to the [[Abrahamic covenant]] in a passage in the Book of Genesis (17:10-14). It is seen as a covenant between God and man, dating back to the patriarch Abraham. The validity of this passage is increasingly being questioned. {{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 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 [[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 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 [[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. ===Christianity===Jesus was born into a Jewish family in [[Israel]], where [[Judaism]] was the prevailing religion, so He was [[circumcised]] on the eighth day.<ref>{{REFweb |url=https://www.biblegateway.com/passage/?search=Luke+2%3A21&version=NASB |title=Gospel of Luke |last=Luke |first= |publisher=NASB |website=Bible Gateway |date= |accessdate=2019-11-10 |format= |quote=And when eight days had passed, before His circumcision, His name was then called Jesus, the name given by the angel before He was conceived in the womb.}}</ref>
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 [[Council at Jerusalem]] in the First Century to decide what was required to be a Christian, a letter was written to explain the requirements, but circumcision was omitted from the requirements.<ref>{{REFweb
}}</ref>
In Christianity, circumcision is practiced only in the Coptic churchesdenomination. 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=The Holy Bible, Circumcision, False Prophets, and Christian Parents
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. Masturbation, however, is not mentioned anywhere in the Holy Bible, so there is no support for the belief that it is somehow immoral or sinful.
Even the mere existence of a [[foreskin]] was falsoly 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
Many cultures perform circumcision as a rite of passage into manhood. This is common in the Middle East and amongst some indigenous African and Southeast Asian peoples.
The [[United States]] and [[Israel ]] are the only industrialized countries in the world to have a high incidence of non-therapeutic infant male circumcision. The vast majority of infant circumcisions performed in the United States are for non-religious, non-medical reasons. See [[History of circumcision]].
===Religious===
=== 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]].
The form of circumcision adopted by the medical community essentially was equivalent to the Jewish form with ''[[periah]]'', so it inflicted the maximum injury.
|accessdate=2023-10-22
}}</ref> They are made to enable a physician to perform circumcision and collect a fee.
<!--
===Search for prophylactic reasons===
''The following text is taken from the [[Circumpendium]].''
-->
=== Prophylactic reasons ===
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 name="blalock2003">{{REFjournal
|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 circumcision status.<ref>{{REFjournal
|last=Task Force on Circumcision
|first=
* 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 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">{{BoyleGJ HillG 2011}}</ref>
The fact that the [[USA ]] has both the highest rate 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 [[HIV]].<ref>{{REFjournal
|last=Grosskurth
|init=H
|url=
|accessdate=
}}</ref> found that, during the first 6 years of life, the incidence of UTIs [[UTI]]s 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
|accessdate=
}}</ref> did not find a significant difference in UTI rates between [[circumcised]] and [[intact]] boys with normal urinary tract anatomy.
* Other studies suggest that circumcision is more likely to raise than to lower the generally low risk of acquiring UTI: multiple studies from [[Israel ]] showed a strong correlation between ritual circumcision on the 8th day of life and postoperative UTI.<ref>{{REFjournal
|last=Menahem
|init=S
|accessdate=
}}</ref>
* It can be concluded that circumcision is ineffective as a preventive measure against UTIs[[UTI]].
* 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 a major risk factor<ref>{{REFjournal
|last=McCance
''Hygiene'' refers to health and only secondarily to cleanliness.
One should note that the human [[foreskin ]] is endowed by nature with [[Foreskin#Immunological_functions| immunological functions]] that serve to protect the human body from disease.<ref name="fleiss-hodges-vanhowe1998"/> The [[glans penis ]] receives blood through the frenular artery.<ref>{{REFjournal
|last=Persad
|init=R
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 [[preputial sac]] underneath the [[foreskin]] is easy - — they are simply [[Preputial_sac#Washing| washed with warm water 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 of the foreskin| ballooning]]", where the [[foreskin]] inflates during urination, is not a serious problemconcern.
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 ==
The [[Circumcision methods]] are discussed in a separate article.
== 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. [[Kanwaljeet J. Singh Anand| Anand]] & Hickey (1987) have shown that newborn children do in fact feel [[pain]], and more acutely than adults.<ref name="anand-hickey1987">{{REFjournal |last=Anand |first=KJS |author-link= Risks Kanwaljeet J. Singh Anand |last2=Hickey |first2=PR |author2-link= |etal=no |title=Pain and late its effects in the human neonate and fetus |trans-title= |language= |journal=New Engl J Med |location= |date=1987-11-19 |volume=317 |issue=21Just like tonsil or appendix surgery |pages=1321-9 |url=https://www.cirp.org/library/pain/anand/ |quote=However, circumcision is a surgical intervention and brings in decisions about the usual risks related use of these techniques, current knowledge suggests that humane considerations should apply as forcefully to surgical operationsthe care of neonates and young, alongside several specific risks 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 complications and late effectscircumcision in infants. The [https://www. Uberoi et alcirp. org/library/statements/aap1999/|AAP Circumcision Policy Statement] (20221999) report states quite clearly that ''"some men There is considerable evidence that newborns who are experiencing a complex negative constellation of psychological[[circumcised]] without analgesia experience pain and physiologic stress"''. Furthermore, physicalthe pain is quite severe, and sexual associations that lead to significant emotional distress directed both internally requires injections for proper pain management. Sucrose and externallyAcetaminophen ''"cannot be recommended as the sole method of analgesia"''. The posts also reveal a discovery phenomenon wherein men discover Topical cream is no longer thought sufficient as ''"the analgesic effect is limited during the physical and psychological manifestations phases associated with extensive tissue trauma such as...tightening of the decisions made by others to modify their genitalsclamp"''."<ref name ="uberoi2022">{{REFjournal |last=Uberoi
|first=
|inittitle=MAmerican Academy of Pediatrics: Circumcision Policy Statement; Task Force on Circumcision |author-linkjournal=Pediatrics |last2date=Abdulcadir1999-03 |first2volume=103 |init2issue=J3 |author2pages=686-link=93 |last3=Ohi |first3url=https://pediatrics.aappublications.org/content/103/3/686#sec-9 |init3accessdate=DA2019-11-26 |author3-linknote=Statement Reaffirmed Sept. 1, 2005 |last4=Santiago}}</ref> |first4= |init4=JE |author4-link= The [[AAFP]] (2002) states quite simply in their [https://www.cirp.org/library/statements/aafp2002/|last5= |first5=position paper], ''"Newborns experience pain during circumcision".''<ref>{{REFweb |init5title=Circumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed |author5-linkwebsite=Official American Academy of Family Physicians Website |last6url=http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html |first6accessdate=2011-05-02 |init6= |author6-link= |last7= |first7= |init7= |author7-link= |last8= |first8= |init8= |author8-link=}}</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. |last9= |first9= |init9= |author9Penile injections of local anesthetic are now recommended by all of the major medical institutions if a circumcision is to be performed. In their [http://www.ama-link= |etal=yes |title=Potentially underassn.org/ama/no-recognized lateindex/about-stage physical and psychosexual complications ama/13585.shtml Report 10 of non-therapeutic neonatal penile the Council on Scientific Affairs], the AMA states ''"When the decision is made to proceed with 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=, local anesthesia should be provided for the procedure. [[Ring block]] or [[dorsal penile nerve block]] [injections] are most effective. [[EMLA]] cream has limited utility"''. Alarmingly, ''"Despite the clear evidence that newborn males generate brisk pain responses during circumcision, a recent survey of residency training programs found that 26% of programs that taught circumcision provided no instruction on the use of local anesthesia". The AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, and 25% of obstetricians"''.<ref>{{REFweb |urltitle=httpsReport 10 of the Council on Scientific Affairs (I-99): Neonatal Circumcision |website=American Medical Association Official Website |url=http://www.natureama-assn.comorg/articlesama/s41443no-022index/about-00619-8ama/13585.shtml |archivedaccessdate=2011-05-04 |quote=}}</ref> |pubmedID=36274189 |pubmedCID= |DOI=10The AAP's [http://www.healthychildren.1038org/English/s41443ages-022stages/prenatal/decisions-00619to-make/pages/Where-8 |accessdate=2023We-01Stand-08}}Circumcision.aspx Heatlhy Children website] suggests ''"Your pediatrician (or your obstetrician) should discuss the forms of analgesia that are available"''.</ref>{{REFweb |title=Where We Stand: Circumcision |publisher=== Possible operative and postoperative complications ===[[AAP]] 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" date=2011-03-23 |url=http://www.healthychildren.org/English/ages-stages/prenatal/><ref name="williamsdecisions-kapilla1993">{{REFjournalto-make/pages/Where-We-Stand-Circumcision.aspx |lastaccessdate=Williams |init=N |author2019-10-link=12 |last2=Kapilla |init2=L |author2-link=}}</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. |etal=no |title=Complications 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 circumcision |trans-title= |language= |journal=Brit J Surg |location= |date=1993-10 |volume=80 |issue=10 |pages=1231-6 |url=https://wwwlocal 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.cirpOne may not expect to find this kind of advice on such a website, and yet, anything less than this is a dangerously weak statement.org/library/complications/williams-kapila/ To 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. |pubmedID=8242285 |pubmedCIDurl= |DOI=10http://www.1002/bjspollockclinics.1800801005com/circumcision/circumcision-guide.html |accessdatetitle=2019-11-27Parents' Guide to Circumcision}}</ref> |last= |first= |publisher=* Intolerance or allergic reactions to the narcotics used. |date=* Especially in newborns, where the bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is often insufficient for |accessdate=2011-04-08}}</ref><ref>{{REFweb |quote=During the operation. Even in conjunction with regional anaesthesia of the dorsal nerve of the [[penis]]circumcision, the rate of failure your son will receive sugar pacifiers to provide sufficient anaesthetic even for experienced anaesthetists is still 5-10%suck on which reduce his pain perceptions. 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 |url=http://www.pollockclinics.com/circumcision/circumcision-before. A surgical operation without proper [[pain]] control can lead to the development of a specific pain memory<ref>{{REFwebhtml |title=Before the Circumcision |last= |urlfirst=http://www.spiegel.de/spiegel/vorab/experte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-849534.html |titlepublisher=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder |transdate=2011-title=Children's pain expert warns: Ritual circumcision changes the brain of children04-08 |languageaccessdate=German2011-04-08 |last=Prof. Dr. med. Boris Zernikow}}</ref> a topical cream,<ref>{{REFweb |firstquote=Then in our office, he will have topical anesthetic applied to his penis. |publisher=Spiegel Online |websiteurl=http://www.pollockclinics.com/circumcision/circumcision-before.html |datetitle=2012-08-12Before the Circumcision |accessdatelast=2019-10-11 |formatfirst= |quotepublisher= |date=2011-04-08 |accessdate=2011-04-08}}</ref>. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation. Overall, their pain threshold was lower and the risk of chronic pain increased/or a local anaesthetic injection called a dorsal penile ring block. Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFjournalREFweb |lastquote=GarryWe use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection. |initurl=T |title=Circumcisionhttp: a survey of fees and practices//www.pollockclinics.com/circumcision/circumcision-guide.html |journaltitle=OBG ManagementParents' Guide to Circumcision |datelast=1994 |volumefirst=October |issuepublisher= |pages=34-6 |urldate= |accessdate=2011-04-08}}</ref><ref>{{REFjournal |last=Howard 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|init=CR |last2pain of circumcision]].<ref name=Howard"Journal of Perinatology April/May 2002">{{REFjournal |init2last=FMTaeusch |last3first=GarfunkelH. William |init3init=LCHW |last4last2=de BlieckMartinez |init4first2=EAAlma M. |last5init2=WeitzmanAM |init5last3=MPartridge |titlefirst3=Neonatal circumcision and pain relief: current training practicesJ. Colin |journalinit3=PediatricsJC |datelast4=1998Sniderman |volumefirst4=101Susan |issueinit4=S |pageslast5=423Armstrong-8Wells |urlfirst5=Jennifer |accessdateinit5=}}</ref><ref>{{REFjournalJ |lastlast6=StangFuentes-Afflick |initfirst6=HJElena |last2init6=Snellman |init2=LWE |title=Pain During Mogen or Plastibell Circumcision practice patterns in the United States |journal=Pediatrics |date=1998Journal of Perinatology |volume=10122 |issue=e53 |pages=214-8 |url=http://www.nature.com/jp/journal/v22/n3/full/7210653a.html |accessdate= |notequote=Link to [[AAP]] website}}</ref>. During procedures which take several minutes, babies tend to fall into a state ...more than half of the study group had what we considered excessive pain/discomfort over the course 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 entire procedure. |pubmedID= |pubmedCID= |DOI= |lastnote=GunnarApril/May 2002 |initdate=MR2002-04 |last2accessdate=Fisch2011-04-08 |init2}}</ref><ref name=RO"Clinical Pediatrics August 1986">{{REFjournal |last3last=KorsvikWilliamson |init3first=Paul S. |last4init=DonhowePS |init4last2=Evans |first2=JMNolan Donovan |titleinit2=The effects of circumcision on serum cortisol and behaviorND |journaltitle=PsychoneuroendocrinologyNeonatal Cortisol Response to Circumcision with Anesthesia |datejournal=1981Clinical Pediatrics |volume=625 |issue=38 |pages=269412-756 |url=httpshttp://wwwcpj.cirpsagepub.orgcom/librarycontent/pain25/gunnar8/412.abstract |accessdatequote=2019-11-26The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine.}}</ref> |pubmedID=* Postoperative wound pain, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions. |pubmedCID=* 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. |DOI=* Postoperative [[bleeding]] |date=1986-08 |accessdate=2011-04-08}}</ref> During circumcision, somp physicians give children sugar pacifiers to "reduce the perception of the wound. This can have severe consequences especially for very young infantspain", if they are not treated promptly. Their blood volume is only about 85 ml per kilogram of body weight<ref>{{REFweb |quote=During the circumcision, and even moderate blood loss can lead your son will receive sugar pacifiers to hypovolaemia, hypovolaemic [[shock]] and even deathsuck on which reduce his pain perceptions.<ref>{ |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> 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">{REFbook{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 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>{{TaddioA etal 1995}}</ref><ref>{{TaddioA KatzJ IlersichAL KorenG 1997}}</ref> {{Box|Boxtext=<big><b>However, none of the 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]].</b></big>}} == 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. Uberoi et al. (2022) report "some men are experiencing a complex negative constellation of psychological, physical, and sexual associations that lead to significant emotional distress directed both internally and externally. The posts also reveal a discovery phenomenon wherein men discover the physical and psychological manifestations of the decisions made by others to modify their genitals."<ref name ="uberoi2022">{{REFjournal |last=Uberoi
|first=
|yearinit=2000M |titleauthor-link=Paediatric Handbook |urllast2=Abdulcadir |workfirst2= |editorsinit2=Smart J, Nolan T. |editionauthor2-link= |last3=6Ohi |volumefirst3= |chapterinit3=DA |pageauthor3-link=82 |locationlast4={{AUSCSantiago |VIC}}, Australiafirst4= |publisherinit4=Blackwell Science AsiaJE |isbnauthor4-link= |quotelast5= |accessdatefirst5= |noteinit5=}}</ref><ref>{{REFdocument |author5-link= |titlelast6=Autopsy of Demetrius Manker |urlfirst6= |contributioninit6=Case 93 |author6-1711link= |lastlast7=Wetli |firstfirst7=CV |publisherinit7=Miami: Dade County Medical Examiner Department |formatauthor7-link= |datelast8=1993-06-23 |accessdatefirst8=}}</ref> <ref>{{REFjournal |init8= |lastauthor8-link=Hiss |initlast9=J |last2first9=Horowitz |init2init9=A |last3author9-link=Kahana |init3etal=Tyes |title=Fatal haemorrhage following male ritual 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 Clin Forensic MedImpot Res |datelocation=2000 |volumedate=72022-10-23 |issuevolume= |pagesissue=32-4 |urlarticle=https://www.cirp.org/library/death/hiss1/ |accessdatepage=2019-11-06}}</ref><ref>{{REFdocument |titlepages=Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan |url=httphttps://www.circumstitionsnature.com/deatharticles/s41443-022-00619-exsang.html8 |contributionarchived= |lastquote=Newell |firstpubmedID=TEC36274189 |publisherpubmedCID=Burnaby, B.C.: B.C. Coroner's Service |formatDOI= |date=200410.1038/s41443-022-0100619-198 |accessdate=20192023-1101-2608
}}</ref>
 === Physical effects ===* Post operative [[lymphoedemaBodily harm]]* [[Circumcision scar]] is an invariable effect.* Postoperative An unavoidable effect of any circumcision is the permanent loss of sexual sensitivity. This is partly due to the removal of sensory tissue. The [[Infectionforeskin]] 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| infectionsglans]]reacts to the missing protection from friction and drying out by developing a callus layer. This includes both local infectionsreduces the sensitivity of the remaining nerves in the [[Glans penis|glans]] gradually over the years. The study conducted by Sorrells et al.<ref>{{Sorrells etal 2007}}</ref> found a significant reduction of sensitivity to touch for [[circumcised]] compared to [[intact]] [[penis]]es in adult males. Other studies revealed that [[circumcised]] men use condoms significantly less often than [[intact]] men, which since they further limit the sexual sensitivity (see above). * Painful tension can be treated with local therapyoccur when there is too little reserve [[skin]] left to support a full [[erection]]<ref name="taylor1996"/>. This risk is partly dependent on the anatomy of the [[penis]]. While some [[penis]]es already have the majority of their full size when flaccid ([[Flesh Penis]], or "[[shower]]"), others are rather short when flaccid and systemic infectionsdouble or more their size during an [[erection]] ([[Blood Penis]], or "[[grower]]"). Especially in children's circumcision, where the [[penis]] is not yet fully developed, requiring systemic antibiotic treatmentthe 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>{{REFconferenceREFjournal |last=Dr. med. HartmannMoney |init=J |last2=Davison |init2=J |title=Adult penile circumcision: Erotosexual and cosmetic sequelae |journal=Journal of Sex Research |date=1983 |volume=19 |issue= |firstpages=Wolfgang289-92
|url=
|place=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German)
|title=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German)
|date=2012-11-26
|accessdate=
}}</ref>
 * Orgasm problems: In the wake of reduced sexual sensitivity, due to the loss of sensory tissue and gradual [[Wound dehiscencekeratinization]], 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]] , orgasm problems may develop with increasing age. In this case, the neighbouring sexual arousal created by intercourse or [[penile skinmasturbation]], causing is not enough to achieve orgasm. A preliminary stage of this late effect is the prolonged time [[skincircumcised]]] pockets and bridges, men need to reach an orgasm. This is often fielded as well as visually unpleasant results like uneven scars, which make a re-the "cut men have more endurance" argument for circumcision necessary.* Postoperative Vaginal dryness: Due to the loss of the natural [[phimosisgliding action]]: a phimotic ring can develop during scarring, which makes comes from the mobility of the [[foreskin]] and [[shaft skin]], a re-circumcision necessarymuch increased friction between [[penis]] and [[vagina]] occurs during intercourse. According This can make intercourse painful for both partners and lead to a study by Blalock et al.abrasions<ref>{{FrischM LindholmM GroenbaekM 2011}}</ref><ref>{{REFjournal |last=BlalockCortés-González |init=HJJ |last2=VemulakondaArratia-Maqueo |init2=VJ |last3=RitcheyGómez-Guerra |init3=MLL |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 |last4url=Ribbeck |init4pubmedID=M18807735 |titleaccessdate=Outpatient management of }}</ref> The prolonged time it takes [[circumcised]] men to reach orgasm, as well as the often longer and more vigorous thrusting movements - compared to [[phimosisintact]] Following newborn circumcisionmen - play a part in this.<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=20032002 |volume=169167 |issue=65 |pages=2332-4 |url=https://www.cirp.org/library/complications/blalock1/ |accessdate=2019-11-26}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal |last=Leitch |init=IOW |title=Circumcision 2113- 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 veins. If the dorsal vein, which originates in the tip of the [[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 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.html?_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>
=== Physical late effects ===* [[Lymphoedema]] of the penis is a normal and expected complication of male circumcision.
* 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 [[foreskinMeatal stenosis]] contains very many nerve endings and touch receptors, which account for a pathological narrowing of the major part opening of male sexual sensation. If the [[foreskinurethra]] is removed, they can no longer provide sexual stimulationwhich mostly occurs in infancy and early childhood. It is also partly due to the fact that the surface one of the [[Glans penis|glans]] reacts to the missing protection from friction and drying out by developing a callus layer. This reduces the sensitivity most common complications of the remaining nerves in the [[Glans penis|glans]] gradually over the yearsinfant circumcision. The A study conducted by Sorrells et al.<ref>{{Sorrells etal 2007}}</ref> from 2006 found a significant reduction of sensitivity to touch for [[circumcised]] compared to [[intact]] [[penis]]es meatal stenosis exclusively in adult males. Other studies revealed that previously [[circumcised]] men use condoms significantly less often than [[intact]] men, since they further limit the sexual sensitivity (see above)boys. * Painful tension can occur when there The incidence rate after a circumcision is too little reserve [[skin]] left approximately 10 to support a full [[erection]]20 percent.<ref name="taylor1996vanhowe2006"/>{{REFjournal |last=Van Howe |init=RS |author-link=Robert S. This risk is partly dependent on the anatomy Van Howe |title=Incidence of the [[penis]]. While some [[penis]]es already have the majority of their full size when flaccid meatal stenosis following neonatal circumcision in a primary care setting |journal=Clin Pediatr ([[Flesh Penis]], or "[[shower]]"), others are rather short when flaccid and double or more their size during an [[erection]] ([[Blood Penis]], or "[[grower]]"Phila) |note=Jan-Feb 2006 |date=2006-01 |volume=45 |issue=1 |pages=49-54 |url=https://www. Especially in children's circumcision, where the [[penis]] is not yet fully developed, the amount of reserve [[skin]] needed in adulthood cannot be estimatedacademia.edu/6992015/Incidence_of_Meatal_Stenosis_following_Neonatal_Circumcision_in_a_Primary_Care_Setting |accessdate=2019-12-15* 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><ref>{{REFjournal |last=MoneyStenram |init=JA |last2=DavisonMalmfors |init2=JG |last3=Okmian |init3=L |title=Adult penile circumcisionCircumcision for [[phimosis]]: Erotosexual and cosmetic sequelaea follow-up study |journal=Journal Scandinavian journal of Sex Researchurology and nephrology |date=19831986 |volume=1920 |issue=2 |pagespage=289-9289 |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>
* Orgasm problems: Shorter adult penile length was reported by Park et al. (2016) as a result of NMC (newborn male circumcision).{{Citation |Title= |Text=In the wake of reduced sexual sensitivityconclusion, due second to the loss of sensory tissue fourth digit ratio, flaccid penile length, and gradual [[keratinization]] age of the surface of the [[Glans penis|glans]], orgasm problems may develop with increasing agecircumcision were significant predictive factors for erectile penile length. In this caseFurthermore, the sexual arousal created by intercourse or [[masturbation]] is not enough to achieve orgasm. A preliminary stage penile lengths of this late effect is the prolonged time [[circumcised]]] men need to reach an orgasm. This is often fielded as NMC group were shorter than those of the "cut men have more endurance" argument for circumcisionnon-NMC group.* Vaginal dryness: Due to the loss of the natural [[gliding action]], which comes from the mobility of the [[foreskin]] and [[shaft skin]], a much increased friction between [[penis]] and [[vagina]] occurs during intercourse |Author=Park et al. This can make intercourse painful for both partners and lead to abrasions< |Source= |ref>{{FrischM LindholmM GroenbaekM 2011}}</ref>=<ref>{{REFjournal |last=Cortés-GonzálezPark |first= |init=JJK |author-link= |last2=Arratia-MaqueoDoo |first2= |init2=JAR |author2-link= |last3=Gómez-GuerraKim |first3= |init3=LJH |titleauthor3-link= |last4=Does circumcision has an effect on female's perception of sexual satisfaction?Park |journalfirst4=Rev Invest Clin |dateinit4=2008HS |volumeauthor4-link=60 |issueetal=3yes |pagetitle=227Prospective investigation of penile length with newborn male circumcision and second to fourth digit ratio. |urltrans-title= |pubmedIDlanguage=18807735 |accessdatejournal=Can Urol Assoc J}}</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 name |location="ColdCJ TaylorJR 1999">{{ColdCJ TaylorJR 1999}}</ref><ref>{{REFjournal |lastdate=Fink2016-09 |initseason=KS |last2volume=Carson10 |init2issue=CC9-10 |last3article=DeVellis |init3page=RF |titlepages=Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction |journalurl=J Urolhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028213/ |datearchived=2002 |volumequote=167 |issuepubmedID=527695583 |pagespubmedCID=2113-65028213 |urlDOI=10.5489/cuaj.3590 |accessdate=2022-09-04
}}</ref>
}}
* [[Lymphoedema]] === Sexual effects ===Cepeda-Emiliani et al (2023) cited six reports in the literature of the penis is a normal and expected complication detrimental effects of male circumcision, including erectile function, sensation, masturbatory pleasure, orgasm, and sexual satisfaction. * The authors also cited three studies of severe distress in [[Meatal stenosiscircumcised]]men, a pathological narrowing of the opening due to their infant circumcision, with complaints of the [[urethraglans]]insensitivity, 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 delayed [[circumcisedejaculation]] boys. The incidence rate after a circumcision is approximately 10 to 20 percent, and unpleasant sensation.<ref name="vanhowe2006cepeda2023">{{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=JanCepe da-Feb 2006Emiliani |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 |lastfirst=Stenram
|init=A
|last2author-link=MalmforsAlfonso Cepeda-Emiliani |init2last2=GGándara-Cortés |last3first2=Okmian |init3init2=LM |title=Circumcision for [[phimosis]]: a followauthor2-up study |journallink=Scandinavian journal of urology and nephrology |datelast3=1986Otero-Alén |volumefirst3=20 |issueinit3=2M |pageauthor3-link=89 |urllast4=García |pubmedIDfirst4=3749823 |accessdateinit4=}}</ref><ref>{{REFwebH |url=http://emedicine.medscape.com/article/1016016author4-overview |title=Meatal Stenosis |publisherlink=Medscape |accessdatelast5=2019-10Suárez-11}}</ref> * Shorter adult penile length was reported by Park et al. (2016) as a result of NMC (newborn male circumcision).{{CitationQuintanilla |Titlefirst5= |Textinit5=In conclusion, second to fourth digit ratio, flaccid penile length, and age of circumcision were significant predictive factors for erectile penile length. Furthermore, the penile lengths of the NMC group were shorter than those of the non-NMC group. |Author=Park et al. |Source= |ref=<ref>{{REFjournal |last=Park |first= |init=JKJ |authorauthor5-link= |last2last6=DooGarcía-Caballero |first2first6= |init2init6=ART |author2author6-link= |last3last7=KimGallego |first3first7= |init3init7=JHR |author3author7-link= |last4last8=ParkGarcía-Caballero |first4first8= |init4init8=HSR |author4author8-link= |etal=yesno |title=Prospective investigation Immunohistological study of the density and distribution of human penile length with newborn male circumcision and second to fourth digit ratio.neural tissue: gradient hypothesis |trans-title= |language= |journal=Can Urol Assoc Int JImpot Res |location= |date=20162023-05-09 |season=02 |volume=1035 |issue=9-103 |article=
|page=
|pages=286-305 |url=https://www.ncbinature.nlm.nih.gov/pmccom/articles/PMC5028213/s41443-022-00561-9
|archived=
|quote=
|pubmedID=2769558335501394 |pubmedCID=5028213 |DOI=10.54891038/cuaj.3590 s41443-022-00561-9 |accessdate=20222023-0911-0426
}}</ref>
}}
Circumcision and frenectomy remove tissues with heightened erogenous sensitivity.<ref name="cepeda2023" /> <ref name== Psychological late effects ==="winkleman1959">{{WinkelmannRK 1959}}</ref> They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well."
The [[amputation]] of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the [[penis]], leaving only the uninhibited protopathic sensibility of the artificially externalized [[glans penis]]. The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of the changes in sexual behavior noted in [[circumcised]] human males.<ref>{{REFjournal
|last=Van Howe
|init=RS
|author-link=Robert S. Van 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=1052-7
|url=http://www.ncbi.nlm.nih.gov/pubmed/9218663
|quote=
|pubmedID=9218663
|pubmedCID=
|DOI=
|date=1997-04-02
|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="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.
 
See [[Sexual effects of circumcision]] for more information.
 
=== 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. 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.
|accessdate=2019-10-12
}}</ref>
* If the [[circumcised]] male feels incomplete, or due to the missing [[foreskin]] disadvantaged compared to [[intact]] males, an inferiority complex and [[depression ]] may occur. This can be accompanied by conscious recognition of his own incompleteness, or the deficiency may remain completely subconscious<ref>{{REFjournal
|last=Rhinehart
|init=J
* Fear of doctors, clinics and also closed rooms.<ref name="Levy1945"/>
* Relapse into the state of bed-wetting, even if the child was already dry before.<ref name="Levy1945"/>
* [[Circumcised ]] males who become fathers frequently manifest [[adamant father syndrome]].
[[Intact America]] (2019) called circumcision an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]],<ref name-"bollinger2019">{{REFdocument
== Complications ==
=== Pain Possible operative and postoperative complications ===In the past, advocates Circumcision is surgery. Surgical complications of circumcision claimed that a newborn child's nerve system was not yet fully developed, and that generally may be classified as a result[[Bleeding| hemorrhage]], the child felt no [[paininfection]] during , or surgical misadventure up to and including loss of the circumcision procedure. Anand & Hickey (1987) have shown that newborn children do in fact feel penis and [[paindeath]], and more acutely than adults.<ref name="ananddeacon2022" /><ref name="williams-hickey1987kapilla1993">{{REFjournal |last=AnandWilliams |firstinit=N
|author-link=
|last2=HickeyKapilla |first2init2=L
|author2-link=
|etal=no
|title=Pain and its effects in the human neonate and fetusComplications of circumcision
|trans-title=
|language=
|journal=New Engl Brit J MedSurg
|location=
|date=19871993-11-1910 |volume=31780 |issue=2110 |pages=13211231-96 |url=https://www.cirp.org/library/paincomplications/anandwilliams-kapila/
|quote=
|pubmedID=33170378242285
|pubmedCID=
|DOI=10.1002/bjs.1800801005 |accessdate=2019-11-0827}}</ref> This has led American health associations to recommend doctors take measures to reduce the pain of circumcision in infants.
The [https://www* Intolerance or allergic reactions to the narcotics used.cirp.org/library/statements/aap1999/|AAP Circumcision Policy Statement] (1999) states quite clearly that ''"There is considerable evidence that * Especially in newborns who , 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 of the [[circumcisedpenis]] without analgesia experience pain and physiologic stress"''. Furthermore, the pain rate of failure to provide sufficient anaesthetic even for experienced anaesthetists is quite severestill 5-10%. The general anaesthesia that would be needed for newborns, however, and requires injections poses significant risks for proper pain management. Sucrose the child, and Acetaminophen ''"cannot , therefore, is only likely to be recommended as the sole method of analgesia"''used in emergencies. Topical cream is no longer thought sufficient as ''"the analgesic effect is limited during A surgical operation without proper [[pain]] control can lead to the phases associated with extensive tissue trauma such as...tightening development of the clamp"''.a specific pain memory<ref>{{REFjournalREFweb |lasturl=http://www.spiegel.de/spiegel/vorab/experte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-849534.html |firsttitle=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder |trans-title=American Academy Children's pain expert warns: Ritual circumcision changes the brain of Pediatrics: Circumcision Policy Statement; Task Force on Circumcisionchildren |journallanguage=PediatricsGerman |datelast=1999-03Prof. Dr. med. Boris Zernikow |volumefirst=103 |issuepublisher=3Spiegel Online |pageswebsite=686-93 |urldate=https://pediatrics.aappublications.org/content/103/3/686#sec2012-08-912 |accessdate=2019-10-11-26 |noteformat= |quote=Statement Reaffirmed Sept. 1, 2005}}</ref> The [[AAFP]] (2002) states quite simply in their [https://www.cirpIn unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation.org/library/statements/aafp2002/| position paper]Overall, ''"Newborns experience their pain threshold was lower and the risk of chronic pain during circumcision"increased.''Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFwebREFjournal |last=Garry |init=T |title=Circumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmeda survey of fees and practices |journal=OBG Management |date=1994 |volume=October |issue= |websitepages=Official American Academy of Family Physicians Website34-6 |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. Penile injections of anesthetic are now recommended by all of the major medical institutions. In their [http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml Report 10 of the Council on Scientific Affairs], the AMA states ''"When the decision is made to proceed with circumcision, local anesthesia should be provided for the procedure. Ring block or dorsal penile blocks [injections] are most effective. [[EMLA]] cream has limited utility"''. Alarmingly, ''"Despite the clear evidence that newborn males generate brisk pain responses during circumcision, a recent survey of residency training programs found that 26% of programs that taught circumcision provided no instruction on the use of local anesthesia". The AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, and 25% of obstetricians"''.<ref>{{REFwebREFjournal |last=Howard |init=CR |last2=Howard |init2=FM |last3=Garfunkel |init3=LC |last4=de Blieck |init4=EA |last5=Weitzman |init5=M |title=Report 10 of the Council on Scientific Affairs (I-99)Neonatal circumcision and pain relief: Neonatal Circumcisioncurrent training practices |journal=Pediatrics |date=1998 |volume=101 |issue= |websitepages=American Medical Association Official Website423-8 |url=http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml |accessdate=2011-05-04}}</ref> 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 analgesia that are available"''.<ref>{{REFwebREFjournal |last=Stang |init=HJ |last2=Snellman |init2=LW |title=Where We Stand: Circumcisionpractice patterns in the United States |publisherjournal=[[AAP]]Pediatrics |date=2011-03-231998 |volume=101 |issue=e5 |pages= |url=http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx |accessdate=2019-10-12 |note=Link to [[AAP]] website}}</ref> Be that as it may. During procedures which take several minutes, few forms of analgesia are recommended. There are basically two types of injections babies tend to choose from, and the website does not go fall into the difference between a 'dorsal nerve block' and a 'ring block' injection. Given what is known from aforementioned official documentsstate of stupor, which in 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 anesthesiapast was falsely interpreted as peaceful sleep, 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 nurturing the latest understandings of infant sensitivity to belief that babies felt no 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 Measurements taken in general. One may not expect those cases revealed a typically 3- to find this kind of advice on such a website4-fold increase in cortisol levels, and yet, anything less than this is which equals a dangerously weak statement. To control state of severe [[painshock]], some physicians that circumcise use Tylenol, sugar,.<ref>{{REFwebREFjournal |last=Gunnar |init=MR |last2=Fisch |init2=RO |quotelast3=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.Korsvik |urlinit3=http://www.pollockclinics.com/circumcision/circumcision-guide.htmlS |titlelast4=Parents' Guide to CircumcisionDonhowe |lastinit4=JM |firsttitle=The effects of circumcision on serum cortisol and behavior |publisherjournal=Psychoneuroendocrinology |date=1981 |accessdatevolume=2011-04-086}}</ref><ref>{{REFweb |issue=3 |quotepages=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.269-75 |url=httphttps://www.pollockclinicscirp.comorg/library/pain/circumcisiongunnar/circumcision-before.html |titleaccessdate=Before 2019-11-26}}</ref>* Postoperative wound pain, in the Circumcisioncase of children'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=
|publisheryear=2000 |datetitle=2011-04-08Paediatric Handbook |accessdateurl=2011-04-08}}</ref> a topical cream,<ref>{{REFweb |work= |quoteeditors=Then in our officeSmart J, he will have topical anesthetic applied to his penisNolan T. |urledition=6 |volume=http://www.pollockclinics.com/circumcision/circumcision-before.html |titlechapter=Before the Circumcision |lastpage=82 |firstlocation={{AUSC|VIC}}, Australia |publisher=Blackwell Science Asia |dateisbn= |quote=2011-04-08 |accessdate=2011-04-08 |note=}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFwebREFdocument |quotetitle=We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection.Autopsy of Demetrius Manker |url=http://www.pollockclinics.com/circumcision/circumcision-guide.html |titlecontribution=Parents' Guide to CircumcisionCase 93-1711 |last=Wetli |first=CV |publisher=Miami: Dade County Medical Examiner Department |format= |date=1993-06-23 |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=TaeuschHiss |firstinit=H. WilliamJ |initlast2=HWHorowitz |last2init2=MartinezA |first2last3=Alma M.Kahana |init2init3=AMT |last3title=PartridgeFatal haemorrhage following male ritual circumcision |first3journal=J. ColinClin Forensic Med |init3date=JC2000 |last4volume=Sniderman7 |first4issue=Susan |init4pages=S32-4 |last5url=Armstrong-Wellshttps://www.cirp.org/library/death/hiss1/ |first5accessdate=Jennifer2019-11-06}}</ref><ref>{{REFdocument |init5title=JJudgement of inquiry into the death of McWillis, Ryleigh Roman Bryan |last6url=Fuenteshttp://www.circumstitions.com/death-Afflickexsang.html |first6contribution=Elena |init6last=ENewell |titlefirst=Pain During Mogen or Plastibell CircumcisionTEC |journalpublisher=Journal of PerinatologyBurnaby, B.C.: B.C. Coroner's Service |volumeformat=22 |issuedate=32004-01-19 |pagesaccessdate=2142019-811-26 |url=http:}}<//wwwref>* Post operative [[lymphoedema]].nature* Postoperative [[Infection| infections]].com/jp/journal/v22/n3/full/7210653aThis includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.html<ref>{{REFconference |quotelast=Dr.med..more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure.Hartmann |pubmedIDfirst=Wolfgang |pubmedCIDurl= |DOIplace=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German) |notetitle=April/May 2002Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German) |date=20022012-0411-26 |accessdate=2011-04-08}}</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 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 name="Clinical Pediatrics August 1986">{{REFjournal |last=WilliamsonBlalock |firstinit=HJ |last2=Paul S.Vemulakonda |initinit2=PSV |last2last3=EvansRitchey |first2init3=Nolan DonovanML |init2last4=NDRibbeck |init4=M |title=Neonatal Cortisol Response to Circumcision with AnesthesiaOutpatient management of [[phimosis]] Following newborn circumcision |journal=Clinical PediatricsJ Urol |date=2003 |volume=25169 |issue=86 |pages=4122332-64 |url=httphttps://cpjwww.sagepubcirp.comorg/contentlibrary/25complications/8blalock1/412.abstract |quoteaccessdate=The adrenal cortisol response to surgery was not significantly reduced by 2019-11-26}}</ref>, the administration of lidocaineprevalence is 2.9%, according to Leitch<ref>{{REFjournal |last=Leitch |pubmedIDinit=IOW |pubmedCIDtitle=Circumcision - a continuing enigma |DOIjournal=Aust Paediatr J |date=19861970 |volume=6 |issue= |pages=59-0865 |url=https://www.cirp.org/library/general/leitch1/ |accessdate=20112019-0412-0815}}</ref> During 5.5%.* [[Sudden Infant Death Syndrome]] (SIDS).* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], is cut during circumcisionwithout being clamped and sutured at its origin separately, it starts to develop new branches over time, somp physicians give children sugar pacifiers which can lead to "reduce the perception development of knots.* Possible deformities due 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 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 pain"infection with [[herpes]] simplex type 1,which can lead to brain damage or [[death]].<ref>{{REFweb |quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |url=http://www.pollockclinicsnytimes.com/circumcision2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-beforeritual.html?_r=0 |title=Before the Baby’s Death Renews Debate Over a CircumcisionRitual |last=Robbins |first= |publisher=Liz |date=20112012-0403-0807 |accessdate=20112019-0410-0811}}</ref> but === Death ===A study in at least 2010 estimated approximately 117 neonatal circumcision-related [[Death| deaths]] occur annually in the [[United States]], about one studyout of every 77 male neonatal deaths, more than suffocation, auto accidents, data shows that giving sugar to a child doesn't help to reduce the perception of pain in the childor even [[SIDS]].<ref name="Lancet, The Bollinger 2010-10-09">{{REFjournal |last=SlaterBollinger |first=RebeccahDan |init=RD |first2author-link=Laura |init2=LDan Bollinger |last2=CornelissenBoy's Health Advisory |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 |init7title=Lost Boys: An Estimate of U.S |last7=Boyd |first8=Judith |init8=J |last8=Meek |first9=Maria |init9=M |last9=Prof. FitzgeraldCircumcision-Related Infant Deaths |titlejournal=Oral sucrose as an analgesic drug for procedural pain in newborn infantsThymos: a randomised controlled trial |journal=The LancetJournal of Boyhood Studies |volume=3764 |issue=97481 |pages=122578-3290 |url=http://www.thelancetmensstudies.com/journalscontent/lancetb64n267w47m333x0/article/PIIS0140-6736%2810%2961303-7/fulltext?p=7ebbd6b446d940cbbd4274c095754b12π=5 |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=10.3149/thy.0401.78 |date=2010-04-26 |accessdate=2019-10-0912}}</ref><ref>{{REFweb |accessdateurl=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=20112010-04-0826 |accessdate=}}</ref> Post-operative pain and the pain See also the child must endure during recovery is hardly, if ever, addressed by professionalslist of [[fatalities]].
It has been shown that an infant's response == Forced circumcision ==<!--=== United States military ===American soldiers serving in World War II were subjected to [[pain]] can be altered for years as a consequence regular inspections of their genitals. If intact, the soldiers risked being ordered to undergo immediate circumcision.<ref>{{TaddioA etal 1995REFbook |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><ref>{{TaddioA KatzJ IlersichAL KorenG 1997}}</refThis practice was discontinued at least six decades ago.-->=== Non-therapeutic circumcision of male children ===
{{Box|Boxtext=Human babies, because they are not yet in possession of language, 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 as a category of forced circumcision.<bigref><b>HoweverFor example, Frederick M. Hodges, a medical historian, writes: "In the late 1970s, none as the Americans were growing increasingly aware of the abuses of power rampant throughout the above three procedures totally eliminate painnation's social institutions, influential grass-roots movements protesting the forced circumcision of American children sprang up nationwide." F. Hodges, "A baby boy will still experience some pain despite any of those analgesic proceduresShort History," p. Prevention of 31; see also [[painLeonard B. Glick|Glick]] requires protecting a boy from elective neonatal , ''Marked in Your Flesh'', pp. 273-281.</ref> There are, however, physicians in the United States who argue strongly for non-therapeutic circumcisionof newborn babies; and circumcision is widely accepted as a postnatal procedure in American hospitals.<ref>{{REFbook |last=Fletcher |first=Christopher R. |init=CR |year=1999 |title=Circumcision in America in 1998: Attitudes, Beliefs, and Charges of American Physicians |url=http://www.springerlink. Only boys who are protected from the medically unnecessary circumcision surgery experience no com/content/h2150v731233m177/ |work=Male and Female Circumcision |editors=[[George C. Denniston]], [[painFrederick M. Hodges]] or , [[traumaMarilyn Fayre Milos]].</b></big>}} |edition= |volume= |chapter=Section 5 |pages=259-71 |location=New York |publisher=Kluwer Academic/Plenum Publishers |isbn= Sexual effects |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'', p. 125.</ref> A statement published by the [[American Academy of Pediatrics]] in 1999 claimed that "parents should determine what is in the best interest of the child... It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in additions to the medical factors, when making a decision."<ref>Lannon and Bailey, "Circumcision Policy Statement," p. 691.</ref> however surrogate consent for non-therapeutic circumcision is now viewed as unethical.
Circumcision and frenectomy remove tissues with heightened erogenous sensitivityIn 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 name="winkleman1959">{{WinkelmannRK 1959}}</ref> <ref name="cepeda2023">{{REFjournal |last=Cepeda-Emiliani
|first=
|inittitle=ARe J (child's religious upbringing and circumcision) |author-linkjournal=Alfonso Cepeda-EmilianiFamily Court Reports |last2date=Gándara-Cortés 2000 |first2volume=1 |init2issue=M |author2pages=307-link=14 |last3url=Otero-Alénhttps://www.cirp.org/library/legal/Re_J/2000.html |first3accessdate=2019-10-12}}</ref> (The National Health Service does not provide non-therapeutic circumcision.) In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<ref>See, e.g., [[Margaret A. Somerville|init3=M Somerville]], "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; [[Abbie Chessler|author3Chessler]], "Justifying the Unjustifiable"; Smith, "Male Circumcision."</ref> For example, critics have pointed out that, in the [[United States]], more than 1.3% of male neonatal deaths are attributable to the complications of non-linktherapeutic circumcision surgery.<ref name="Bollinger 2010"/> |last4=García =Video== |first4===Is circumcision healthy?===The video ''Is Circumcision Healthy'' is recommended for parental viewing.<br><br> |init4<youtube>D_3LQjZgdbQ</youtube> ===Dr. Christopher Guest discusses circumcision===H |author4-link<br><youtube>v=TQIp9f4krVQ</youtube>  |last5=Suárez-Quintanilla==Plastibel circumcision=== |first5= {{UNI|init5=J Stanford University|author5SU}} has published a video of an actual non-link=therapeutic plastibell circumcision. The infant has received two injections of local anesthesia to deaden the dorsal nerves. The ventral nerves were not deadened so the infant still feels pain. One can his cries on the soundtrack. |last6=García* [https://med.stanford.edu/newborns/professional-education/circumcision/plastibell-Caballerotechnique.html Plastibell Technique]  |first6===Gomco clamp circumcision=== '''Not for the squeamish:''' This is a video of an actual circumcision with a Gomco clamp. The infant boy received two dorsal penile nerve block (DPNB) analgesic injections but they did not seem to work. * [https://www.reddit.com/r/Intactivism/comments/qbpzqr/trained_medical_professionals_restrain_infant_to/ Circumcision video]  |init6=T |author6-link= |last7Recommendations of medical authorities==Gallego * [[George Hill|first7=Hill]] (2007) said: |init7=R<blockquote> |author7Male 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 abuse. Male circumcision is a costly diversion of medical resources away from beneficial services. Male circumcision violates legal rights, [[human rights]], and ethical standards. Finally, we must remember that males are the more vulnerable and sensitive of the two genders and, therefore, deserve the greater degree of protection from traumatic, invasive, injurious,and unnecessary surgery. For all of these reasons the non-linktherapeutic circumcision of boys should not be performed and the [[genital integrity]] of all children should be respected and protected.<ref name="hill2007">{{REFjournal |last8last=García-CaballeroHill |first8first=George |init8init=RG |author8author-link=George Hill |etaltitle=noThe case against circumcision |titlejournal=Immunohistological study Journal of the density Men's Health and distribution of human penile neural tissue: gradient hypothesis |trans-title= |language= |journal= Int J Impot Res |location=Gender |date=2023-05-022007 |volume=354
|issue=3
|article= |page= |pages=286318-30523 |url=https://www.natureacademia.comedu/articles8367383/s41443-022-00561-9 |archived=The_Case_Against_Circumcision
|quote=
|pubmedID=35501394
|pubmedCID=
|DOI=10.1038/s41443-022-00561-9 |accessdate=20232021-1105-2130}}</ref> Boyle et al</blockquote>* Andrew E. (2002) wroteMacNeiiy, Head, "the genitally intact male has thousands Division of fine touch receptors and other highly erogenous nerve endings&mdash;many Pediatric Urology, Department of which are lost to circumcision."<ref>Urological Sciences, {{REFjournal UNI|last=Boyle |first=Gregory J. |init=GJ |author-link=Gregory Boyle |first2=Gillian A. |init2=GA |last2=Bensley |title=Adverse Sexual and Psychological Effects University of Male Infant Circumcision British Columbia|journal=Psychological reports |volume=88 |issue=3UBC}}, Vancouver, BC, Part 2 |pages=1105–6 |url=https(2008) said://www.cirp.org/library/psych/boyle5/ |quote=<blockquote> |pubmedID=11597060 |pubmedCID= |DOI=10Newborn circumcision remains an area of controversy.1046/j.1464Social, cultural, aesthetic and religious pressures form the most common reasons for non-410xtherapeutic circumcision.1999.0830s1085.x |date=July 2001 |accessdate=}}</ref> They concludedAlthough penile cancer and UTIs are reduced compared with uncircumcised males, "Evidence has also started to accumulate the incidence of such illness is so low that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm cannot be justified as wellprophylaxis." The role of the foreskin in [[amputationHIV]] 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 prepuce normal foreskin both among parents and among primary care providers. This lack of knowledge results in the loss a burden of costs to our health care system in the majority form of fine-touch neuroreceptors found in the [[penis]]unnecessary urological referrals, leaving only the uninhibited protopathic sensibility expansion of the artificially externalized [[glans penis]]wait times and circumcisions. The imbalance caused by Routine circumcision of all infants is not having the input justified from the now ablated finea health or cost-touch receptors may be a leading cause of the changes in sexual behavior noted in [[circumcised]] human malesbenefit perspective.<ref>{{REFjournal |last=Van HoweMacNeily |first=Andrew |init=RS |author-link=Robert S. Van Howe |last2etal=Coldno |init2title=CJRoutine circumcision: the opposing view |trans-title=Advantages and Disadvantages of Neonatal Circumcision |language= |journal=The Journal of the American Medical AssociationCan Urol Assoc J |location= |date=2007-11 |volume=2771 |issue=134 |article= |page= |pages=1052395-7 |url=http://wwweuropepmc.ncbi.nlm.nih.govorg/article/pubmedPMC/9218663 |quote=2422979 |pubmedID=921866318542825 |pubmedCID= |DOI=10.5489/cuaj.455 |dateaccessdate=19972021-0411-02 |accessdate=08
}}</ref>
</blockquote>
Histology of the male circumcision scar shows * The [[amputationRoyal Dutch Medical Association]] 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"/>(KNMG) (2010) said:
See <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, [[Sexual effects 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> * The [[Royal Australasian College of Physicians]] for more information.(2010) said:
=== Death ===<blockquote>Ethical and [[human rights]] concerns have been raised regarding elective infant male A study in 2010 estimated approximately 117 neonatal circumcisionbecause it is recognised that the foreskin has a functional role, the operation is non-related deaths occur annually in therapeutic and the infant is unable to consent.  After reviewing the United Statescurrently available evidence, about one out the RACP believes that the frequency of every 77 male neonatal deaths, more than suffocation, auto accidentsdiseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand. However it is reasonable for parents to weigh the benefits and risks of circumcision and to make the decision whether or even [[SIDS]]not to circumcise their sons.<ref name="Bollinger 2010racp2010">{{REFjournal |last=Bollinger |first=Dan |init=D |author-link=Dan Bollinger |last2=Boy's Health AdvisoryREFdocument |title=Lost Boys: An Estimate Circumcision of U.S. Circumcision-Related Infant Deaths |journal=Thymos: Journal of Boyhood Studies |volume=4 |issue=1 |pages=78-90Males |url=httphttps://www.mensstudiesracp.edu.comau/content/b64n267w47m333x0docs/?p=7ebbd6b446d940cbbd4274c095754b12π=5 |quote= |pubmedID= |pubmedCID= |DOI=10.3149default-source/thy.0401.78 |date=2010advocacy-04-26 |accessdate=2019-10-12}}</ref><ref>{{REFweb |url=http://www.icgi.orglibrary/2010/04/infant-circumcision-causesof-100infant-deaths-each-year-in-usmales.pdf |titlecontribution=Infant circumcision causes 100 deaths each year in US
|last=
|first=
|publisher=ICGIThe Royal Australasian College of Physicians |websiteformat=[[International Coalition for Genital Integrity]]PDF |date=2010-0409-2601 |accessdate=2021-11-08}}</ref> See also the list of [[fatalities]].</blockquote>
== Forced * The [[American Academy of Pediatrics]] (AAP) has not re-affirmed its disastrous, failed 2012 Circumcision Policy Statement, which expired in 2017, so currently has no position on child circumcision ==.
* Medical historian [[Robert Darby]] (2014) wrote simply:<!--=== United States military ===blockquote> American soldiers serving in World War II were subjected to regular inspections of their genitals. If intact"To avoid circumcision complications, the soldiers risked being ordered to undergo immediate avoid circumcision."<ref>{{REFbookREFjournal |last=SchoenDarby |first=Ed |init=ER |author-link=Edgar J. SchoenRobert Darby |yearetal=2005no |title=On CircumcisionTo avoid circumcision complications, avoid circumcision |urltrans-title=https://books.google.de/books?id |language=-zUhdvSt7cgC |workjournal=Can Urol Assoc J |editorlocation=Dianne Yeakey |editiondate=2014-08-14 |volume=8 |issue=7-8 |chapterarticle= |page=231 |pages=72-3 |locationurl=https://cuaj.ca/index.php/journal/article/view/1709/1823 |archived=Georgetown, Canada |publisherquote=RDR Books |isbnpubmedID=1-157143-123-3 |quotepubmedCID=For a critical view, see Sorrells, "The History of Circumcision," p. 333 |accessdateDOI=10.5489/cuaj.1709 |noteaccessdate=2022-12-16}}</ref> This practice was discontinued at least six decades ago.--</blockquote> === Non-therapeutic circumcision of male children ===* The [[Canadian Paediatric Society]] (CPS) (2015) said:
Human babies<blockquote>In most jurisdictions, because they are not yet in possession of language, are incapable of giving or refusing consent authority is limited only to interventions deemed to be [[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 Mmedically necessary. 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 cases in Your Flesh''which medical necessity is not established or a proposed treatment is based on personal preference, pp. 273-281.</ref> There are, however, physicians in interventions should be deferred until the United States who argue strongly for non-therapeutic circumcision of newborn babies; and circumcision individual concerned is widely accepted as a postnatal procedure in American hospitalsable to make their own choices.<refname="CPS2015">{{REFbookREFjournal |last=FletcherSorokin |first=Christopher RS.Todd |init=CRST |author-link= |last2=Finlay |first2=JC |yearauthor2-link=1999 |titlelast3=Circumcision in America in 1998: Attitudes, Beliefs, and Charges of American PhysiciansJeffries |urlfirst3=http://www.springerlink.com/content/h2150v731233m177/AL |workauthor3-link=Male and Female Circumcision |editorsetal=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]yes |editiontitle=Newborn male circumcision |volumejournal=Paediatr Child Health |chapterlocation=Section 5 |pagesdate=2592015-7108 |locationvolume=New York20 |publisherissue=Kluwer Academic/Plenum Publishers6 |pages=311-20 |isbnurl=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4578472/
|quote=
|accessdatepubmedID=26435672 |pubmedCID=2019-10-124578472 |noteDOI=ID 10.10071093/pch/97820.6.311 |accessdate=2019-010-585-39937-9_1927}}</ref> Parental consent is required.<ref>See, e.g., Shephard and Shephard, ''The Complete Guide'', p. 125.</ref> A statement published by the [[American Academy of Pediatrics]] in 1999 claimed that "parents should determine what is in the best interest of the child... It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in additions to the medical factors, when making a decision."<ref>Lannon and Bailey, "Circumcision Policy Statement," p. 691.</refblockquote> however surrogate consent for non-therapeutic circumcision is now viewed as unethical.
In the * The [[United KingdomCanadian Urological Association]], where non-therapeutic circumcision has now become far less prevalent than in (CUA) considered the [[United States]], the written consent matter of both parents is required, if a physician is to perform a non-therapeutic circumcision of and issued a childstatement in February 2018.<ref>{{REFjournal |last= |first= |title=Re J (child's religious upbringing and circumcision) |journal=Family Court Reports |date=2000 |volume=1 |issue= |pages=307-14 |url=httpsThe CUA concluded://www.cirp.org/library/legal/Re_J/2000.html |accessdate=2019-10-12}}</ref> (The National Health Service does not provide non-therapeutic circumcision.)
In recent years<blockquote>"Given the socioeconomic, educational status, and health demographics of our population, legal writers in several English-speaking countries have been questioning universal neonatal circumcision cannot be justified based on the practice of acceding to parental wishescurrent evidence available.<refname="cua2018">See, e.g., [[Margaret A. Somerville{{REFjournal |last=Dave |first=Sumit |init=S |author-link= |etal=yes |Somerville]], "Therapeutic title=Canadian Urological Association guideline on the care of the normal foreskin and Nonneonatal circumcision in Canadian infants (abridged version) |journal=Can Urol Assoc J |location= |date=2018-02 |volume=12 |issue=2 |pages=18-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; [[Abbie Chessler28 |Chessler]], "Justifying the Unjustifiable"; Smith, "Male Circumcisionurl=https://cuaj.ca/index."php/journal/article/view/5034/3470 |quote= |pubmedID= |pubmedCID= |DOI= |accessdate=2021-11-09}}</ref> For example, critics have pointed out that, </blockquote>==British family court opinion==The issue of non-therapeutic circumcision of male children came before the court in the case of ''[[United StatesRe B and G (children) (No 2) EWFC 3]](2015)'' . In that case, more than 1.3% Judge Sir James Munby ruled that circumcision of male neonatal deaths are attributable to the complications of non-therapeutic circumcision surgerychildren caused ''significant harm''.<ref name== Rights and ethics =="Bollinger 2010"/>
==Video=====Is The [[Rights situation on circumcision healthy?===The video ''Is Circumcision Healthy'' |rights situation]] is recommended for parental viewingdiscussed in a separate article.<br><br> <youtube>D_3LQjZgdbQ</youtube>
===Dr[[Image:Intact vs circumcised. Christopher Guest discusses circumcision===<br><youtube>v=TQIp9f4krVQ</youtube>JPG |thumbnail|right|300px| The intact and circumcised human penis, side by side.]]
===Plastibel The term "circumcision===" without a gender qualifier refers specifically to male circumcision. It means "to cut around," and it refers to the [[excision]] of the [[foreskin]] from the penis. The term is inaccurate and a euphemism because the operation actually cuts off or [[amputation| amputates]] the [[foreskin]], which in adults comprises about fifteen square inches of highly functional erogenous tissue.
{{UNICircumcision is most often performed in healthy males for [[Religion and Culture|Stanford University|SU}} has published a video of an actual non-therapeutic plastibell circumcisionreligious or cultural]] reasons. The infant has received two injections of local anesthesia to deaden the dorsal nerves. The ventral nerves were not deadened so the infant still feels pain. One can his cries procedure may be performed on consenting adults, but it is most often performed on the soundtrack.* [https://med.stanford.edu/newborns/professionalnon-education/circumcision/plastibell-technique.html Plastibell Technique] ===Gomco clamp circumcision=== '''Not for consenting minors, particularly newborn children, which is why the squeamish:''' This ritual is a video of an actual circumcision with a Gomco clampso controversial. The infant boy received two dorsal penile nerve block (DPNB) analgesic injections but they did not seem to work. * [https://www.reddit.com/r/Intactivism/comments/qbpzqr/trained_medical_professionals_restrain_infant_to/ Circumcision video] ==Recommendations Opponents 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 consider the circumcision also causes psychological problems that tend of non-consenting minors to perpetuate the cycle of abuse. Male circumcision is be unethical and a costly diversion of medical resources away from beneficial services. Male circumcision violates legal rights, [[human rights]]violation, and ethical standards. Finally, we must remember that males are the more vulnerable and sensitive of the two genders and, therefore, deserve the greater degree of protection from traumatic, invasive, injurious,and unnecessary surgery. For all of these reasons the non-therapeutic circumcision of boys should not be performed and the unless there is concrete [[genital integritymedical indication]] .=== Consent by surrogates ===Medical ethics has long recognized limitations on the power of all children should be respected and protectedconsent by surrogates.<ref name="hill2007">{{REFjournal |last=HillCommittee on Bioethics, American Academy of Pediatrics |firstetal=Georgeno |inittitle=GInformed consent, parental permission, and assent in pediatric practice |authortrans-linktitle=George Hill |titlelanguage=The case against circumcision |journal=Journal of Men's Health and GenderPediatrics |location= |date=20071995 |volume=495 |issue=32 |article= |page= |pages=318314-2317 |url=https://www.academiacirp.eduorg/8367383library/The_Case_Against_Circumcisionethics/AAP/ |archived=
|quote=
|pubmedID=7478854
|pubmedCID=
|DOI=
|accessdate=20212023-05-3021}}</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=Committee on Bioethics |etal=no |title=Routine circumcision: the opposing viewInformed Consent in Decision-Making in Pediatric Practice |trans-title=
|language=
|journal=Can Urol Assoc JPediatrics
|location=
|date=20072016-1108 |volume=1138 |issue=42
|article=
|page=e20161485 |pages=395-7 |url=httphttps://europepmcwatermark.silverchair.orgcom/article/PMC/2422979peds_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=1854282527456510
|pubmedCID=
|DOI=10.54891542/cuajpeds.4552016-1485 |format=PDF |accessdate=20212023-05-21}}</ref> <ref>{{REFjournal |last=Committee on Bioethics ||etal=no |title=Informed Consent in Decision-11Making 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>
</blockquote>
* The [[Royal Dutch Medical Association]] Two ethicists, Myers & Earp (KNMG2020) (2010) said: <blockquote>The official viewpoint , have conducted a detailed review and analysis of KNMG and other related the claimed medical/scientific organisations is that benefits of ''non-therapeutic '' [[circumcision ]]. They have determined than the alleged benefits are not material, so they do not support granting of male minors is consent by a violation of children’s rights to autonomy and physical integritysurrogate. Contrary to popular beliefIn other words, ''Non-therapeutic'' circumcision can cause complications – [[bleeding]], infectionis not truly healthcare. Moreover, they comment that even the most perfectly executed surgery produces [[urethratrauma]]l stricture and panic attacks are particularly commonharm to the patient. KNMG is Circumcision also produces tissue loss and loss of function, therefore urging a strong policy of deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering , circumcision should be performed only after the procedure of individual reaches the absence age of medical benefits and the danger consent. <u>Consent by a surrogate for a ''non-therapeutic'' circumcision of complicationsa minor child is an unethical practice.</u><refname="myers2020">{{REFdocumentREFjournal |titlelast=Non-therapeutic circumcision of male minorsMyers |urlfirst=https://www.doctorsopposingcircumcision.org/wp-content/uploads/2016/09/knmg-non-therapeutic-circumcision-of-male-minors-27-05-2010.pdf |contributioninit=A |lastauthor-link= |firstlast2=Earp |publisherfirst2=Royal Dutch Medical Association |formatinit2=PDFBD |dateauthor2-link=2010Brian D. Earp |accessdateetal=2021-11-08no}}</ref></blockquote> * The [[Royal Australasian College of Physicians]] (2010) said: <blockquote>Ethical and [[human rights]] concerns have been raised regarding elective infant male circumcision because it |title=What is recognised that the foreskin has a functional role, the operation best age to circumcise? A medical and ethical analysisis non |trans-therapeutic and the infant is unable to consent. title= |language=After reviewing the currently available evidence, the RACP believes that the frequency of |journal=J Biosoc Scidiseases modifiable by circumcision, the level of protection offered by circumcision and the |location=complication rates of circumcision do not warrant routine infant circumcision in Australia |date=2020-09and New Zealand. However it is reasonable for parents to weigh the benefits and risks of |volume=34circumcision and to make the decision whether or not to circumcise their sons.<ref name |issue="racp2010">{{REFdocument7 |titlepages=Circumcision of Infant Males560-72 |url=https://www.racponlinelibrary.eduwiley.aucom/doi/docsabs/default-source/advocacy-library10.1111/circumcision-of-infant-malesbioe.pdf12714 |contributionarchived= |lastquote= |firstpubmedID=32068898 |publisherpubmedCID=The Royal Australasian College of Physicians |formatDOI=PDF |date=2010-09-0110.1111/bioe.12714 |accessdate=20212023-1105-0818}}</ref></blockquote>{{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]]* [[FGM]]* [[Human rights]]* [[Lymphoedema]]* [[MGM]]* [[Pain]]* [[Psychological issues of male circumcision]]* [[Rights situation on circumcision]]* [[Risks and complications]]* [[Sexual effects of circumcision]]* [[Sudden Infant Death Syndrome]] (SIDS)* [[Trauma]]{{LINKS}}
* The [[American Academy of Pediatrics]] (AAP) has {{REFweb |url=https://www.cirp.org/library/anatomy/garcia/ |title=What exactly is circumcision and what is it not re? |last=Garcia |first=Francisco |date=1995-affirmed its disastrous, failed 2012 Circumcision Policy Statement, which expired in 2017, so currently has no position on child circumcision.12-11 |accessdate=2020-09-08}}* Medical historian [[Robert Darby]] (2014) wrote simply:<blockquote>"To avoid circumcision complications, avoid circumcision."<ref>{{REFjournal |last=DarbyFleiss |first=Paul |init=RP |author-link=Robert DarbyPaul M. Fleiss |etaltitle=noThe foreskin is necessary |titlejournal=To avoid circumcision complications, avoid circumcisionMothering |transdate=1997-title01 |volume= |languageissue= |journalpages=Can Urol Assoc J36-45 |locationurl=http://www.noharmm.org/mothering.htm |dateaccessdate=2020-06-29}}*{{REFweb |url=2014https://15square.org.uk/losses-08from-14circumcision/ |volumetitle=Losses from Circumcision |last=8Ball |issuefirst=7-8Peter |articlepublisher=15 Square |pagedate=2312003-08-09 |pagesaccessdate=2023-02-23}}* {{REFweb |url=httpshttp://cuajmembers.ca/indextranquility.phpnet/journal~rwinkel/articleMGM/view/1709/1823primer.html |archivedtitle=Male Circumcision in the USA: A Human Rights Primer |quotelast=Winkel |pubmedIDfirst=Rich |pubmedCIDauthor-link=Rich Winkel |DOIdate=10.5489/cuaj.1709 2005-05-12 |accessdate=20222021-1201-1627}}</ref></blockquote>* The [[Canadian Paediatric Society]] (CPS) (2015) said:
<blockquote>In most jurisdictions, authority is limited only to interventions deemed to be medically necessary. In cases in which medical necessity is not established or a proposed treatment is based on personal preference, interventions should be deferred until the individual concerned is able to make their own choices.<ref name="CPS2015">* {{REFjournal |last=SorokinTesta |first=S. ToddPatrick |init=ST
|author-link=
|last2=FinlayBlock |first2=JCWalter E. |init2=
|author2-link=
|last3etal=Jeffriesno |first3title=ALLibertarianism and circumcision |author3trans-linktitle= |etallanguage=yes |title=Newborn male circumcision |journal=Paediatr Child Int J HealthPoiicy Manag
|location=
|date=20152014-0805-26 |volume=203 |issue=6 |article= |page= |pages=31133-2040 |url=https://www.ncbiacademia.nlm.nih.govedu/pmc7587653/articles/PMC4578472/ |quoteLibertarianism_and_Circumcision?email_work_card=view-paper |pubmedID=2643567224987720 |pubmedCID=45784724075101 |DOI=10.109315171/pch/20ijhpm.62014.31151 |accessdate=2019-10-27
}}
</ref></blockquote>
* The [[Canadian Urological Association]] (CUA) considered the matter of circumcision and issued a statement in February 2018{{REFweb |url=https://intaction. The CUA concluded: <blockquote>"Given the socioeconomic, educational status, and health demographics of our population, universal neonatal org/what-is-circumcision cannot be justified based on the current evidence available.<ref name="cua2018">{{REFjournal/ |lasttitle=DaveWhat is circumcision? |firstlast=SumitSimone |initfirst=SJudy
|author-link=
|etalpublisher=yesIntaction |title=Canadian Urological Association guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants (abridged version) |journal=Can Urol Assoc J |locationwebsite=https://intaction.org/ |date=20182020-0207-26 |volumeaccessdate=12 |issue=2 |pages=182020-10-2804 |urlformat=https://cuaj.ca/index.php/journal/article/view/5034/3470
|quote=
}}* {{REFjournal |pubmedIDlast=Deacon |pubmedCIDfirst= |DOIinit=M |accessdate=2021-11author-09}}</ref></blockquote>==British family court opinion=link=The issue of non-therapeutic circumcision of male children came before the court in the case of ''[[Re B and G (children) (No 2) EWFC 3]] (2015)'' . In that case, Judge Sir James Munby ruled that circumcision of male children caused ''significant harm''. == Rights and ethics = |last2=Muir The [[Rights situation on circumcision |rights situation]] is discussed in a separate article.first2= [[Image:Intact vs circumcised.JPG |thumbnail|right|300px| The intact and circumcised human penis, side by side.]] The term "circumcision" without a gender qualifier refers specifically to male circumcision. It means "to cut around," and it refers to the [[excision]] of the [[foreskin]] from the penis. The term is inaccurate and a euphemism because the operation actually cuts off or [[amputation| amputates]] the [[foreskin]], which in adults comprises about fifteen square inches of highly functional erogenous tissue.  Circumcision is most often performed in healthy males for [[Religion and Culture |religious or cultural]] reasons. The procedure may be performed on consenting adults, but it is most often performed on non-consenting minors, particularly newborn children, which is why the ritual is so controversial. Opponents of circumcision consider the circumcision of non-consenting minors to be unethical and a [[human rights]] violation, unless there is concrete [[medical indication]].init2=== Consent by surrogates ===Medical ethics has long recognized limitations on the power of consent by surrogates.<ref>{{REFjournalG |lastauthor2-link=Committee on Bioethics, American Academy of Pediatrics |etal=no |title= Informed consent, parental permission, and assent in pediatric practiceWhat is the medical evidence on non-therapeutic child circumcision? |trans-title=
|language=
|journal=PediatricsInt J Impot Res
|location=
|date=19952022-01-08 |volume=95 |issue=2
|article=
|page=
|pages=314-17 |url=https://www.cirpnature.orgcom/library/ethics/AAParticles/s41443-021-00502-y
|archived=
|quote=
|pubmedID=747885434997197
|pubmedCID=
|DOI=10.1038/s41443-021-00502-y |accessdate=2023-0504-2130}}</ref> <ref>* {{REFjournalREFweb |lasturl=Committee on Bioethics |etal=nohttps://intactamerica.org/pros-and-cons-of-circumcision/ |title=Informed Consent in Decision-Making in Pediatric Practice Pros and Cons of Circumcision (Spoiler: You’ve Been Lied to) |trans-titlelast=Garrett |languagefirst= |journalinit=PediatricsCJ |locationpublisher=Intact America |date=20162023-11-0810 |volumeaccessdate=1382024-03-22 |issue=2}} |article= |page=e20161485 |pages=* {{REFweb |url=https://watermark.silverchairintactamerica.comorg/peds_20161485.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQM8zYHFd0Ylu9Annq_AgEQgIICT24ikc839aJMYOiypqC2G9f7_yKGAGkAekzzbCtck5TElALWVCGNoVSOaA6rDA_dOkQ_LyJnxYlZ88J9groups-uk15tvlIBbE82_aNyYfq5e9xmEfqD2vh374q3Naz57dxZaUbgxUkKX4PqsiLmYHLvVrr7bQK2MZuuUOKiQU8JZy7lLjkpwho-PjJO1U9cyIplTAgs_EdvgK8MWWoIsjpressure-Xyou-ZUDImAG63to-rlj_qLsy5dYwytmxfCuVa47RdZseLSr2_bdDpwKAKGhq_Ly9rlHZeW_f7fYktVfF_sFTgcJziAlvEQmdyWIw0qf-hlO31Qb3sH6kDdcvHAbm7llY5xa34XLYIt8QR0YFIimgDGFliN4-ce2vjvvrwS85WeeNFhpn-Ywn4Qjpy06hPuLDL-MtI2Z3BZbBsKq4dp8qGu1q9GlXaKw193riTFG9G5bF5GCKmxmt0nCQTthrb_CcK2UhKjZwPekC9zkIUHPZ9BXJt0SM03F_g-GgqbE0hTYKMqNdJ3sHDQu2luFrJ9JEiMzxtP28gJoYh20d2APA0xrRbXBYsFdAlr50gb1BSAbNJhTyx-Kh3geoSHsAYMjPaG7cIbh0jd42pWCUx30vjlAGK8zXTuf7-31oi81CLbHTAJLuzK3NT4Whi17jVq1SbXsIXlWpKc_d-HujCvlb74rkZQ6RG9wkxW7gAKaDqtKv5zTOTMBD9vLVxgp8lDmVA8PFB59Bqd6w-fi86tW132oWQM-mTfwdIBXFbUFXkeTUC5RYyqJQIXAEwLJSRm1RX-LRbKRzgaRQcircumcise/ |archivedtitle=The 4 Authority Figures and Groups Who Will Pressure You to Circumcise (and What You Can Do) |quotelast=Anonymous |pubmedIDfirst=27456510 |pubmedCIDinit= |DOIpublisher=10.1542/peds.2016-1485Intact America |formatdate=PDF2024-01-24 |accessdate=20232024-0501-2127}}</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=REFweb |url=https://watermark.silverchairintactamerica.comorg/peds_20161484.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMYv3coRYkeeping-UCYMgTaqAgEQgIICT4di03qn2Hbho3i8Li_78lod0lNMunch25nx1rKvaM_aeFerz5eN6_k8VVeNvyour-DLocZp28whQr1x4WYDVwSs4uF73vZpYZYuDphYQkwxV1HHgMbZAbHBFuE8QyCHyDvSYsons-fhQcUlpenis-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=10.1542intact/peds.2016-1484 |formattitle=PDF |accessdate=2023-05-21}}</ref> Two ethicists, Myers & Earp (2020), have conducted a detailed review and analysis of the claimed medical benefits of ''non-therapeutic'' [[circumcision]]. They have determined than the alleged benefits are not material, so they do not support granting of consent by a surrogate. In other words, ''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 surrogate Keeping Your Son’s Penis Intact: A Guide for a ''non-therapeutic'' circumcision of a minor child is an unethical practice.</u><ref name="myers2020">{{REFjournalParents |last=MyersAnonymous
|first=
|init=A |author-link= |last2=Earp |first2= |init2=BD |author2-link=Brian D. Earp |etal=no |title=What is the best age to circumcise? A medical and ethical analysis |trans-title= |language= |journal=J Biosoc Sci |locationpublisher=Intact America |date=20202024-09 |volume=34 |issue=7 |pages=56001-72 |url=https://onlinelibrary.wiley.com/doi/abs/10.1111/bioe.12714 |archived= |quote= |pubmedID=32068898 |pubmedCID= |DOI=10.1111/bioe.1271424 |accessdate=20232024-05-18}}</ref> {{SEEALSO}}* [[Adolescent and adult circumcision]]* [[Breastfeeding]]* [[Case Histories]]* [[Circumcision maps]]* [[Circumcision methods]]* [[Circumcision scar]]* [[Circumpendium]]* [[Circumstraint]]* [[Documented severe complications of circumcision]]* [[Ethics of non01-therapeutic child circumcision]]* [[FGM]]* [[Human rights]]29* [[Lymphoedema]]* [[MGM]]* [[Pain]]* [[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://15squareintactamerica.org.uk/lossestimeline-fromof-circumcision/ |title=Losses from Circumcision |last=Ball |first=Peter |publisher=15 Square |date=2003-08-09 |accessdate=2023-02-23}}* {{REFweb |url=http:suffering//members.tranquility.net/~rwinkel/MGM/primer.html |title=Male A Timeline of Circumcision in the USASuffering: A Human Rights Primer |last=Winkel |first=Rich |author-link=Rich Winkel |date=2005-05-12 |accessdate=2021-01-27}} * {{REFjournalDetailed Look |last=TestaAnonymous |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 |locationpublisher=Intact America |date=20142024-0502-2602 |volume=3 |issue= |article= |page= |pagesaccessdate=332024-40 |url=https://www.academia.edu/7587653/Libertarianism_and_Circumcision?email_work_card=view02-paper |pubmedID=24987720 |pubmedCID=4075101 |DOI=10.15171/ijhpm.2014.51 |accessdate=09
}}
{{REF}}
* {{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
}}
{{REF}}
[[Category:Circumcision]]
[[Category:Male circumcision]]
[[Category:Parental information]]
[[Category:Penile surgery]]
[[Category:Medical term]]
[[Category:Male genital mutilation]]
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