Changes

"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]] The and [[amputationmutilation]] is the result. The amputation destroys the [[Foreskin#Physiological_functions| many protective, immunological, sexual, and sensory physiological functions ]] of the foreskin, so it is considered to be a very harmfuland [[Pain| painful]] surgery.

The procedure '''Posthectomy''' is most often an elective, non-therapeutic surgery performed on neonates the more accurate medical term that more accurately reflects the injury and children for religious and cultural reasons in violation loss of their functional body tissue, but the Biblical [[human rightseuphemism]], but in other cases may be indicated for both ''circumcision'', is more commonly used.With reference to involuntary, non-therapeutic and prophylactic reasons. It is a radical treatment option for pathological circumcision of children, [[phimosisChild Genital Cutting (CGC)]], refractory is a newer term that has been introduced to avoid issues associated with more traditional terms. Bollinger (2023) identifed CGC as an [[BalanitisAdverse Childhood Experiences (ACEs)| balanoposthitisadverse 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 chronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health-circumcision/ |title=Adverse Childhood Experiences, Dysfunctional Households, And Circumcision. |journal=Kindred |date=2023-02-28 |volume= |issue= |pages= |accessdate=2023-03-01}}</ref>

'''Posthectomy''' Deacon & Muir (2022) have reviewed the evidence and concluded that "there is no medical justification for performing a more accurate medical term circumcision prior to an age that more accurately reflects he can assess the injury known risks and loss potential benefits, and choose to give or withhold [[informed consent]] himself."<ref name="deacon2022">{{REFjournal |last=Deacon |first=Matthew |init=M |author-link= |last2=Muir |first2=Gordon |init2=G |author2-link= |etal=no |title=What is the medical evidence on non-therapeutic child circumcision? |journal= Int J Impot Res |date=2022-01-08 |url=https://www.nature.com/articles/s41443-021-00502-y |pubmedID=34997197 |DOI=10.1038/s41443-021-00502-y |accessdate=2022-01-30}}</ref> Circumcision was popularized in English-speaking nationns in the nineteeth century. The practice of functional body tissuenon-therapeutic circumcision of boys 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.

With reference to involuntary, non-therapeutic circumcision Circumcision is classified as a form of children, [[Child Genital Cutting (CGC)genital mutilation]] is a new term that has been introduced to avoid issues associated with more traditional terms.

|editoreditors=George C. Denniston, Marilyn Milos

[[Image:Circumcision Sakkara 3.jpg|200px|right]] For the [[Aborigines]], the [[Australia| Australian]] natives, the tradition of circumcision is said to go back to 10,000 BC. On the African continent, the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of circumcision date back to the time around 3000-2000 BC. The oldest known depiction<ref>{{REFweb

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 was seen as a [[Abrahamic covenant| covenant between God and man]], dating back to the patriarch Abraham. The validity of this passage is increasingly being questioned.

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]] pointed out claimed that circumcision was necessary, as it diminished sexual desires and reduced the pleasure to a degree just sufficient for mere reproduction.

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

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

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=httphttps://www.cirp.org/pages/cultural/christian.htmlphp

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:

|Text=A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of [[phimosis]]. The operation should be performed by a surgeon without administering an anaesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. In females, the author has found the application of pure carbolic acid to the [[clitoris ]] an excellent means of allaying the abnormal excitement, and preventing the recurrence of the practice in those whose will-power has become so weakened that the patient is unable to exercise entire self-control.

|pagespage=107

In [[Islam]], circumcision is also religiously founded, even though there is no mention of it in the Koran itself. According to tradition, the Prophet Mohammed was born without a [[foreskin]]. It is seen as a sign of prophets that they are born without a [[foreskin]] already. It is considered an honour to "resemble the example of the Prophet", meaning to be [[circumcised]]. In Islam, unlike [[Judaism]], there is no specific age at which the circumcision should be performed. Most circumcisions take place at ages between 6 and 10 years, but the range goes from birth to adulthood.

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]].

The circumcision of newborn boys is seen as a [[Abrahamic covenant| divine commandment]] in the [[Judaism| Jewish faith]]. Though absent in the Koran, male circumcision is considered a religious requirement in [[Islam]], and it is performed on male children of varying ages. Converts to these faiths may also choose to undergo [[Adolescent and adult circumcision| circumcision]], but it is not always required.

===Medical indication===There are no [[medical indication| medical indications]] for circumcision of the newborn. The form [[circumcision industry]] offers circumcision of circumcision adopted by the medical community essentially was equivalent newborn to the Jewish form with ''periah'', so it inflicted public because of the maximum injury[[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. In a few cases with older patients, circumcision is legitimately indicated; a patient may be suffering recurring infections, and other methods of treatment have failed. In other cases, a patient may be suffering from a severe case of [[phimosis]]. Overall, the actual medical necessity for circumcision is extremely raresince many conditions respond to conservative treatment. All circumcisions injure the patient by amputating the [[foreskin]] its with many protective, immunological, sensory, and sexual [[Foreskin#Physiological_functions| functions]].

# '''Diseased foreskin.''' A foreskin that is diseased is a valid indication for cirumcision. Some diseases that qualify are malignancy, lichen sclerosis, [[Balanitis#Diabetic_males| yeast infection in men with diabetes]], and recurrent [[Balanitis| balanoposthitis]].

|url=httphttps://www.cirp.org/library/history/encyclopaediabritannica1876/

Initially, circumcision was adopted in the 19th century as a way to stop boys and men from masturbating, where when [[masturbation]] was seen as claimed to be the cause for many diseases. As the myth that circumcision prevented masturbation became debunked, advocates of circumcision began the great search to find the "medical benefits" of circumcision.

|url=httphttps://www.cirp.org/library/anatomy/cold-mcgrath/

|url=httphttps://www.cirp.org/library/history/ephron1/

|pages=222-23333

|publisher={{UNI|Yale University |Yale}} Press

In 1870 the promiment prominent Dr. [[Lewis Albert Sayre|Lewis A. Sayre]] of NYC’s famed Bellevue Hospital<ref>https://nypost.com/2016/12/03/bellevues-doctors-invented-the-procedures-you-take-for-granted/</ref> claimed to cure a boy’s paralyzed legs with circumcision. Sayre's wild advocacy of circumcision exemplified how some [https://intaction.org/circumcision-facts-and-myths/ circumcision facts and myths] originated. He also claimed to cure epilepsy, mental disorders, hip-joint pain, & hernias with circumcision. “Genital irritations” & masturbation were deemed to be the cause of these issues. Sayre was later elected as the President of the American Medical Association. <ref>American Medical Association. Transactions of the American Medical Association. 1870;21:205–11</ref>

|pages=901-9033

[[Aaron J. Fink]] (1986), with no evidence whatsoever, claims that circumcision protects against [[AIDS ]] followed.<ref name="fink1986">{{REFjournal

|pagespage=1167

Retrospectively, circumcision was always advertised as a cure for whatever disease was in the public spotlight at the time. [[Doctors Opposing Circumcision(D.O.C.)]] (2016) statesstate:

|publisher=[[Doctors Opposing Circumcision(D.O.C.)]]

It reflects the fascination that emerges from the ability to create new life. In most cultures, fertility is seen as the most precious good, and the body parts involved frequently find themselves in the focus of ritual acts. In many parts of the world, those rites take place when the boy reaches puberty, and are meant to symbolize his transition from boy to man. The removal of the male [[foreskin]] is just one of many phenomena that developed in this context. They range from the removal of the frenulum in boys and men through partial or complete removal of the [[foreskin]] up to radical operations. Australian [[Aborigines]], as mentioned above, have their [[foreskin]]s removed. It is also usual that, a few weeks later, young men have their [[penis]]es sliced openin a [[subincision]], resulting in a partly or completely divided [[urethra]].

Another known, particularly massive, intervention is the stripping of the entire [[skin ]] off the [[penis]]. In Indonesia, boys have metal or bamboo balls inserted into their [[penis]] shaft or [[Glans penis|glans]] at the beginning of puberty, which form little "humps".

For many cultures it is also common to perform similar rituals on girls. This can range from relatively small interventions such as piercing or cutting the clitoral hood, to its complete removal and up to radical removal of clitoral hood, [[clitoris]], inner and outer labia followed by sewing up the vagina.

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)<refname="blalock2003">{{REFjournal

|pages=2332-23344 |url=httphttps://www.cirp.org/library/complications/blalock1/

}}</ref>, 2.9% of those circumcised develop a post-operative [[phimosis]], in which the circumcision scar constricts. In [[intact ]] patients, the rate of [[phimosis]] is only 1% (see also the study by [[Jakob Øster]]). Therefore, circumcision is not a preventive measure for [[phimosis]].

|pages=1052-10577 |url=httphttps://www.cirp.org/library/general/laumann/

}}</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">{{REFjournal |last=Fleiss |init=PM |last2=Hodges |init2=FM |last3=Van Howe |init3=RS |title=Immunological functions of the human prepuce |journal=Sex Transm Inf |date=FleissP HodgesF VanHoweRS 1998 |volume=74 |issue= |pages=364-367 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1758142/pdf/v074p00364.pdf |accessdate=2019-11-06}}</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

|url=httphttps://www.cirp.org/library/statements/aap1999/

* [[HIV ]] / [[AIDS]]: in the recent past, the argument that circumcision could help to contain the spread of [[HIV ]] has been stated numerous times.

*:Secondly, the assumed protection would only affect healthy men who have intercourse with an infected woman. An infected man can infect a women by transmission of his bodily fluids, so that his circumcision status is irrelevant. Therefore, the use of condoms remains vital in containing the spread of [[HIV]], which in return renders circumcision unnecessary

|pages=378-38383

|pages=749-75454

|pages=1052-10577 |url=httphttps://www.cirp.org/library/general/laumann/

* Two studies that have been published in early 2007<ref>{{REFjournal |last=RCT Gray |init=RH |etal=yes |title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial |journal=Lancet |date=et al 2007 |volume=369 |issue= |pages=657-666 |url= |accessdate=}}</ref><ref>{{REFjournal |last=RCT Bailey |first=Robert C. |init=RC |author-link=Robert C. Bailey |etal=yes |title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial |journal=Lancet |date=et al 2007 |volume=369 |issue= |pages=643-656 |url= |accessdate=}}</ref>, which investigated the effectiveness of circumcision as a means of reducing the spread of [[HIV ]] from infected women to heterosexual men in African high risk areas, have been repeatedly subjected to strong criticism. Both studies were ended prematurely, which distorted the results. The men who had been [[circumcised ]] for the study had to stay sexually inactive during the wound healing, which gave the intact control group more relative opportunity to become infected. These African randomized clinical trials have been demonstrated to have very serious methodological and statistical errors that distort the results in favor of circumcision.<ref name="boyle-hill2011">{{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

|pages=927-93434

|pages=1521-15288

* Urinary tract infections (UTI): a [[UTI ]] can be effectively treated with antibiotics, this was also proven by studies.<ref>{{REFjournal

|pages=552-5555 |url=httphttps://www.cirp.org/library/disease/UTI/mccracken/

|pages=1173-11755

|pages=549-55252

}}</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

|title=The incidence of genitourinary abnormalities in [[circumcised ]] and [[uncircumcised]] boys presenting with an initial urinary tract infection by 6 months of age

|pagespage=580

}}</ref> did not find a significant difference in UTI rates between [[circumcised ]] and [[intact ]] boys with normal urinary tract anatomy.* Other studies suggest that circumcision is more likely to raise than to lower the generally low risk of acquiring UTI: multiple studies from [[Israel ]] showed a strong correlation between ritual circumcision on the 8th day of life and postoperative UTI.<ref>{{REFjournal

|pages=45-488

|pages=322-3244

* 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>{{REFjournal |last=Wolbarst |init=A |title=Circumcision and penile cancer |journal=Lancet |date=1932 |volume=1 |issue=5655 |pages=150-153 |url= |accessdate=Wolbarst1932}}</ref> Today, it is known that sexually transmitted human papillomavirus (HPV) is a major risk factor<ref>{{REFjournal

|pages=55-599

|pages=375-3777

}}</ref>. Studies have shown that there is no significant difference in the risk of getting penile cancer between [[circumcised ]] and [[intact ]] men. To prevent a single case of penile cancer, it would statistically take 600 to 900 circumcisions<ref>{{REFdocument

Apart from the [[medical indication ]] of pathological phimosis, there also are other reasons for circumcision.

The visual appearance of the [[penis]] is changed radically after circumcision. In this case, personal taste is decisive whether an [[intact]] or a [[circumcised ]] [[penis]] is more appealing. Since a circumcision cannot be undone, it is essential to be fully informed about the risks and possible later complications before embarking on an aesthetically motivated circumcision, to decide whether the appearance will justify such bodily modification.

Since this modification and its possible late effects will It should be noted that every circumcision operation leaves a life-long [[circumcision scar]] that encircles the lifelong burden shaft of the person who undertakes an aesthetically motivated circumcision to suit his personal preferences[[penis]]. In addition, there frequently a valid decision to proceed can only be made by a color change at the person to be circumcised himself, once he has reached the necessary age and level of maturity to make that decision. This should normally be the case when adulthood is reachedcircumcision scar which results in a two-tone appearance.

It should Since this modification and its possible late effects will be noted that every the lifelong burden of the person who undertakes an aesthetically motivated circumcision operation leaves to suit his personal preferences, a life-long valid decision to proceed can only be made by the person to be [[circumcision scarcircumcised]] that encircles himself, once he has reached the shaft necessary age and level of the penismaturity to make that decision. In addition, there frequently a a color change at This should normally be the circumcision scar which results in a two-tone appearancecase when adulthood is reached.

In the United States, payment for non-therapeutic circumcision is made by most [[third-party payment| third-party payers]] without questionof necessity. Doctors frequently perform medically-unnecessary, non-therapeutic circumcision of infants and children simply to collect a fee for the surgical operation. The only beneficiary of such surgery is the [[Financial Incentive| bank account of the medical doctor]].

With the [[foreskin]], circumcision removes approximately 70% of the sensitive tissue of the [[penis]], lowering the potential for sexual stimulation accordingly. Due to the loss of around 50% of the entire [[penile skin]], the [[penis]] loses the reserve skin that provides cutaneous mobility in the erect [[penis]] and the [[gliding action]].

In the past, this circumstance was used to make it harder for boys to masturbate and [[masturbation]] less fun, as [[masturbation]] was viewed as immoral and was assumed to cause a variety of mental diseases, caused by the thinking of immoral thoughts! More on that can be found in the chapter "[[Circumcision#Historical_background|Historical background]]". Today, it is known that [[masturbation]] has no negative health effects, but can contribute positively to the child's sexual development. Sexuality is no longer a taboo nowadays, while [[masturbation]] is considered to be a natural part of human sexuality and is no longer seen as immoral. Therefore, circumcision for moral reasons - which would only affect boys too young to give [[informed consent ]] - is no longer justifiable nowadays.

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

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.

 == Risks and late effects Pain == Just like tonsil or appendix surgeryIn the past, advocates of circumcision is claimed that a surgical intervention and brings the usual risks related to surgical operationsnewborn child's nerve system was not yet fully developed, alongside several specific risks of complications and late effects. === Possible operative and postoperative complications === Circumcision is surgery. Surgical complications of circumcision generally may be classified that as hemorrhagea result, infection, or surgical misadventure up to and including loss of the penis and child felt no [[pain]] during the circumcision procedure. [[Kanwaljeet J. Singh Anand| Anand]] & Hickey (1987) have shown that newborn children do in fact feel [[deathpain]], and more acutely than adults.<ref name="williamsanand-kapilla1993hickey1987">{{REFjournal |last=WilliamsAnand |initfirst=NKJS |author-link=Kanwaljeet J. Singh Anand |last2=KapillaHickey |init2first2=LPR

|title=Complications of circumcisionPain and its effects in the human neonate and fetus

|journal=Brit New Engl J SurgMed

|date=19931987-1011-19 |volume=80317 |issue=1021 |pages=12311321-69 |url=httphttps://www.cirp.org/library/complicationspain/williams-kapilaanand/ |quote=However, in decisions about the use of these techniques, current knowledge suggests that humane considerations should apply as forcefully to the care of neonates and young, nonverbal infants as they do to children and adults in similar painful and stressful situations. |pubmedID=82422853317037

|DOI=10.10021056/bjs.1800801005NEJM198711193172105 |accessdate=2019-11-2708}}</ref>This has led American health associations to recommend doctors take measures to reduce the [[pain]] of circumcision in infants.

* Intolerance or allergic reactions to the narcotics usedThe [https://www.cirp.* Especially in org/library/statements/aap1999/|AAP Circumcision Policy Statement] (1999) states quite clearly that ''"There is considerable evidence that newborns, where the bodily pain reduction mechanisms who 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 [[peniscircumcised]]without analgesia experience pain and physiologic stress"''. Furthermore, the rate of failure to provide sufficient anaesthetic even for experienced anaesthetists pain is still 5-10%. The general anaesthesia that would be needed for newbornsquite severe, however, poses significant risks and requires injections for the child, proper pain management. Sucrose and, therefore, is only likely to Acetaminophen ''"cannot be used in emergenciesrecommended as the sole method of analgesia"''. A surgical operation without proper pain control can lead to Topical cream is no longer thought sufficient as ''"the analgesic effect is limited during the development phases associated with extensive tissue trauma such as...tightening of a specific pain memorythe clamp"''.<ref>{{REFweb |url=http://www.spiegel.de/spiegel/vorab/experte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-849534.html |title=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder |trans-title=Children's pain expert warns: Ritual circumcision changes the brain of children |language=GermanREFjournal |last=Prof. Dr. med. Boris Zernikow

|publishertitle=Spiegel OnlineAmerican Academy of Pediatrics: Circumcision Policy Statement; Task Force on Circumcision |websitejournal=Pediatrics |date=20121999-0803 |volume=103 |issue=3 |pages=686-1293 |accessdateurl=2019-10https://pediatrics.aappublications.org/content/103/3/686#sec-119 |formataccessdate=2019-11-26 |quotenote=Statement Reaffirmed Sept. 1, 2005}}</ref> The [[AAFP]] (2002) states quite simply in their [https://www. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operationcirp. Overallorg/library/statements/aafp2002/| position paper], their ''"Newborns experience pain threshold was lower and the risk of chronic pain increasedduring circumcision". Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice''<ref>{{REFjournal |last=Garry |init=TREFweb |title=Circumcision: a survey of fees and practicesPosition Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed |journalwebsite=OBG Management |date=1994 |volume=October |issue= |pages=34-36Official American Academy of Family Physicians Website |url=http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html |accessdate=2011-05-02}}</ref>This is not a debatable fact, and yet, it is not widely accepted, even by some doctors. It might be hard for some doctors to accept, as they may have been taught that the infant does not feel [[pain]], and may have performed countless circumcisions with this idea. Usage of anesthesia for infant circumcision is still by no means the rule. Penile 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-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 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>{{REFjournal |last=Howard |init=CR |last2=Howard |init2=FM |last3=Garfunkel |init3=LC |last4=de Blieck |init4=EA |last5=Weitzman |init5=MREFweb |title=Report 10 of the Council on Scientific Affairs (I-99): Neonatal circumcision and pain relief: current training practicesCircumcision |journalwebsite=PediatricsAmerican Medical Association Official Website |dateurl=1998 |volume=101 |issue= |pages=423http://www.ama-assn.org/ama/no-index/about-428 |url=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>{{REFjournal |last=Stang |init=HJ |last2=Snellman |init2=LWREFweb |title=Where We Stand: Circumcision practice patterns in the United States |journalpublisher=Pediatrics[[AAP]] |date=19982011-03-23 |volumeurl=101 |issue=e5 |http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages= |url=/Where-We-Stand-Circumcision.aspx |accessdate= |note=Link to [[AAP]] website2019-10-12}}</ref>Be that as it may, few forms of analgesia are recommended. During procedures which take several minutesThere are basically two types of injections to choose from, babies tend to fall and the website does not go into the difference between a state 'dorsal nerve block' and a 'ring block' injection. 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 stuporlocal anesthesia, which in the past was falsely interpreted as peaceful sleepand make sure your baby is given an injection. This is your responsibility, nurturing because your doctor may or may not be up to date on the belief that babies felt no latest understandings of infant sensitivity to [[pain]] during circumcision. Measurements taken "'' 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 those cases revealed general. One may not expect to find this kind of advice on such a typically 3- to 4-fold increase in cortisol levelswebsite, and yet, which equals anything less than this is a state of severe shockdangerously weak statement. To control [[pain]], some physicians that circumcise use Tylenol, sugar,<ref>{{REFjournalREFweb |lastquote=GunnarTo 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. |initurl=MRhttp://www.pollockclinics.com/circumcision/circumcision-guide.html |last2title=FischParents' Guide to Circumcision |init2last=RO |last3first=Korsvik |init3publisher=S |last4date=Donhowe |init4accessdate=JM2011-04-08}}</ref><ref>{{REFweb |titlequote=The effects of During the circumcision , your son will receive sugar pacifiers to suck on serum cortisol and behaviorwhich reduce his pain perceptions. |journalurl=Psychoneuroendocrinologyhttp://www.pollockclinics.com/circumcision/circumcision-before.html |datetitle=1981Before the Circumcision |volumelast=6 |issuefirst=3 |pagespublisher=269-275 |urldate=http://www.cirp.org/library/pain/gunnar/2011-04-08 |accessdate=20192011-1104-2608}}</ref>a topical cream,<ref>{{REFweb* Postoperative wound pain |quote=Then in our office, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesionshe will have topical anesthetic applied to his penis.* Postoperative pain from the exposure of the sensitive glans penis to clothing |url=http://www.pollockclinics. This pain will endure for several weeks or even longer in some casescom/circumcision/circumcision-before.html* Postoperative bleeding of |title=Before 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>{{REFbookCircumcision

|yearpublisher=2000 |titledate=Paediatric Handbook2011-04-08 |urlaccessdate=2011-04-08 |work=}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb |editorsquote=Smart JWe use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, Nolan Tand a local anesthetic injection. |editionurl=6http://www.pollockclinics.com/circumcision/circumcision-guide.html |volumetitle=Parents' Guide to Circumcision |chapterlast= |pagesfirst=82 |location=Victoria, Australia |publisher=Blackwell Science Asia |isbn= |quotedate= |accessdate= |note=2011-04-08}}</ref>Topical anaesthetic only serves to numb the area to lessen the pain of the injection, but studies have shown that a [[dorsal penile nerve block]] is only partially effective in stopping the [[Pain| pain of circumcision]].<refname="Journal of Perinatology April/May 2002">{{REFdocumentREFjournal |last=Taeusch |titlefirst=Autopsy of Demetrius MankerH. William |urlinit=HW |contributionlast2=Case 93-1711Martinez |lastfirst2=WetliAlma M. |firstinit2=CVAM |publisherlast3=Miami: Dade County Medical Examiner DepartmentPartridge |formatfirst3=J. Colin |dateinit3=1993-06-23JC |accessdatelast4=Sniderman}}</ref> <ref>{{REFjournal |first4=Susan |lastinit4=HissS |initlast5=JArmstrong-Wells |last2first5=HorowitzJennifer |init2init5=AJ |last3last6=KahanaFuentes-Afflick |init3first6=TElena |titleinit6=Fatal haemorrhage following male ritual circumcisionE |journaltitle=J Clin Forensic MedPain During Mogen or Plastibell Circumcision |datejournal=2000Journal of Perinatology |volume=722 |issue=3 |pages=32214-348 |url=http://www.cirpnature.orgcom/jp/journal/libraryv22/deathn3/hiss1full/7210653a.html |quote=...more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure. |pubmedID= |pubmedCID= |DOI= |note=April/May 2002 |date=2002-04 |accessdate=20192011-1104-0608}}</ref><refname="Clinical Pediatrics August 1986">{{REFdocumentREFjournal |last=Williamson |first=Paul S. |init=PS |last2=Evans |first2=Nolan Donovan |init2=ND |title=Judgement of inquiry into the death of McWillis, Ryleigh Roman BryanNeonatal Cortisol Response to Circumcision with Anesthesia |journal=Clinical Pediatrics |volume=25 |issue=8 |pages=412-6 |url=http://wwwcpj.circumstitionssagepub.com/death-exsangcontent/25/8/412.htmlabstract |contributionquote=The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine. |lastpubmedID=Newell |firstpubmedCID=TEC |publisher=Burnaby, B.C.: B.C. Coroner's Service |formatDOI= |date=20041986-01-1908 |accessdate=20192011-1104-2608}}</ref>* Post operative [[lymphoedema]].* Postoperative infections. This includes both local infectionsDuring circumcision, which can be treated with local therapysomp physicians give children sugar pacifiers to "reduce the perception of pain", and systemic infections, requiring systemic antibiotic treatment.<ref>{{REFconferenceREFweb |lastquote=DrDuring the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. med |url=http://www. Hartmannpollockclinics.com/circumcision/circumcision-before.html |firsttitle=WolfgangBefore the Circumcision |urllast= |placefirst=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German) |titlepublisher=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German) |date=20122011-1104-2608 |accessdate=2011-04-08}}</ref>* [[Wound dehiscence]]but in at least one study, meaning data shows that giving sugar to a child doesn't help to reduce the separation perception of pain in the edges of the wound or the tissue after suturingchild.* Adhesion between the surface or rim of the [[Glans penis|glans]] with the neighbouring penile skin, causing skin pockets and bridges<ref name="Lancet, as well as visually unpleasant results like uneven scars, which make a reThe 2010-circumcision necessary.* Postoperative [[phimosis]]: a phimotic ring can develop during scarring, which makes a re10-circumcision necessary. According to a study by Blalock et al.<ref09">{{REFjournal |last=BlalockSlater |first=Rebeccah |init=HJR |last2first2=VemulakondaLaura |init2=VL |last2=Cornelissen |last3first3=RitcheyLorenzo |init3=MLL |last3=Fabrizi |last4first4=RibbeckDebbie |init4=MD |last4=Patten |titlefirst5=Outpatient management of [[phimosis]] Following newborn circumcisionJan |journalinit5=J Urol |datelast5=Yoxen |first6=Alan |init6=A |last6=2003Worley |volumefirst7=169Stewart |issueinit7=6S |pageslast7=2332-2334Boyd |urlfirst8=http://www.cirp.org/library/complications/blalock1/Judith |accessdateinit8=2019-11-26J}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal |last8=Meek |lastfirst9=LeitchMaria |initinit9=IOWM |titlelast9=Circumcision - a continuing enigmaProf. Fitzgerald |journaltitle=Aust Paediatr JOral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial |datejournal=1970The Lancet |volume=6376 |issue=9748 |pages=591225-6532 |url=http://www.cirpthelancet.orgcom/journals/librarylancet/generalarticle/leitch1PIIS0140-6736%2810%2961303-7/fulltext |accessdatequote=2019-12-15}}</ref> 5.5%.* [[Sudden Infant Death Syndrome]] (SIDS).* Knot formation of the veins. If the dorsal vein, which originates Our data suggest that oral sucrose does not significantly affect activity in the tip of the [[foreskin]]neonatal brain or spinal cord nociceptive circuits, 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 therefore might not be ruled outan effective analgesic drug. 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 The ability 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 sucrose to brain damage or [[death]].<ref>{{REFweb |url=http://www.nytimes.com/2012/03/08/nyregion/reduce clinical observational scores after noxious events in newborn infants-death-renews-debate-over-a-circumcision-ritualshould not be interpreted as pain relief.html?_r=0 |titlepubmedID=Baby’s Death Renews Debate Over a Circumcision Ritual |lastpubmedCID=Robbins |firstDOI=Liz |date=20122010-0310-0709 |accessdate=20192011-1004-1108}}</ref> === Physical late effects ===Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals.

* An unavoidable late effect of any circumcision is the permanent loss of sexual sensitivity. This is partly due It has been shown that an infant's response to the removal of sensory tissue. The [[foreskinpain]] contains very many nerve endings and touch receptors, which account can be altered for the major part of male sexual sensation. If the [[foreskin]] is removed, they can no longer provide sexual stimulation. It is also partly due to the fact that the surface of the [[Glans penis|glans]] reacts to the missing protection from friction and drying out by developing years as a callus layer. This reduces the sensitivity consequence of the remaining nerves in the [[Glans penis|glans]] gradually over the years. The study conducted by Sorrells et alcircumcision.<ref>{{Sorrells TaddioA etal 20071995}}</ref><ref>{{TaddioA KatzJ IlersichAL KorenG 1997}}</ref> found a significant reduction of sensitivity to touch for circumcised compared to intact [[penis]]es in adult males. Other studies revealed that circumcised men use condoms significantly less often than intact men, since they further limit the sexual sensitivity (see above).

* Painful tension can occur when there is too little reserve skin left to support a full erection<ref>{{REFjournal |last=Taylor |init=JR |last2=Lockwood |init2=AP Box|last3Boxtext=Taylor |init3=AJ |title=The prepuce: <qbig>Specialized mucosa of the [[penis]] and its loss to circumcision</qb> |journal=British Journal However, none of Urology |date=1996 |volume=77 |issue= |pages=291-295 |url= |accessdate=}}</ref>the above three procedures totally eliminate pain. This risk is partly dependent on the anatomy A baby boy will still experience some pain despite any of the [[penis]]those analgesic procedures. While some [[penis]]es already have the majority Prevention of their full size when flaccid ([[Flesh Penispain]], or "[[shower]]"), others requires protecting a boy from elective neonatal non-therapeutic circumcision. Only boys who are rather short when flaccid and double or more their size during an erection (protected from the medically unnecessary circumcision surgery experience no [[Blood Penispain]], or "[[growertrauma]]"). Especially in children's circumcision, where the [[penis]] is not yet fully developed, the amount of reserve skin needed in adulthood cannot be estimated.</b></big>}}

* Erectile dysfunction: Both == Risks and effects ==Just like tonsil or appendix surgery, circumcision is a surgical intervention and brings the damage inflicted 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 blood vessels in the [[foreskin]] physical and psychological manifestations of the reduced sexual sensitivity can be causes for reduced erectile function with advancing agedecisions made by others to modify their genitals."<refname ="uberoi2022">{{REFjournal |last=MoneyUberoi |first= |init=JM |author-link= |last2=DavisonAbdulcadir |first2=

|author2-link= |last3=Ohi |first3= |init3=DA |author3-link= |last4=Santiago |first4= |init4=JE |author4-link= |last5= |first5= |init5= |author5-link= |last6= |first6= |init6= |author6-link= |last7= |first7= |init7= |author7-link= |last8= |first8= |init8= |author8-link= |last9= |first9= |init9= |author9-link= |etal=yes |title=Adult Potentially under-recognized late-stage physical and psychosexual complications of non-therapeutic neonatal penile circumcision: Erotosexual a qualitative and cosmetic sequelaequantitative analysis of self-reports from an online community forum |trans-title= |language= |journal=Journal of Sex ResearchInt J Impot Res |location= |date=19832022-10-23 |volume=19

|article= |page= |pages= |url=https://www.nature.com/articles/s41443-022-00619-8 |archived= |quote= |pubmedID=36274189 |pubmedCID= |DOI=10.1038/s41443-022-00619-8 |accessdate=2023-01-08}}</ref> === Physical effects ===* [[Bodily harm]]* [[Circumcision scar]] is an invariable effect.* An unavoidable effect of any circumcision is the permanent loss of sexual sensitivity. This is partly due to the removal of sensory tissue. The [[foreskin]] contains very many nerve endings and touch receptors, which account for the major part of male sexual sensation. If the [[foreskin]] is removed, they can no longer provide sexual stimulation. It is also partly due to the fact that the surface of the [[Glans penis|glans]] reacts to the missing protection from friction and drying out by developing a callus layer. This reduces the sensitivity of the remaining nerves in the [[Glans penis|glans]] gradually over the years. The study conducted by Sorrells et al.<ref>{{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, since they further limit the sexual sensitivity (see above). * Painful tension can occur when there is too little reserve [[skin]] left to support a full [[erection]]<ref 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 double or more their size during an [[erection]] ([[Blood Penis]], or "[[grower]]"). Especially in children's circumcision, where the [[penis]] is not yet fully developed, the amount of reserve [[skin]] needed in adulthood cannot be estimated. * Erectile dysfunction: Both the damage inflicted to the blood vessels in the [[foreskin]] and the reduced sexual sensitivity can be causes for reduced erectile function with advancing age.<ref>{{REFjournal |last=Money |init=J |last2=Davison |init2=J |title=Adult penile circumcision: Erotosexual and cosmetic sequelae |journal=Journal of Sex Research |date=1983 |volume=19 |issue= |pages=289-29292

* Orgasm problems: In the wake of reduced sexual sensitivity, due to the loss of sensory tissue and gradual [[keratinization]] of the surface of the [[Glans penis|glans]], orgasm problems may develop with increasing age. In this case, the sexual arousal created by intercourse or [[masturbation]] is not enough to achieve orgasm. A preliminary stage of this late effect is the prolonged time [[circumcised ]]] men need to reach an orgasm. This is often fielded as the "cut men have more endurance" argument for circumcision.* Vaginal dryness: Due to the loss of the natural [[gliding action]], which comes from the mobility of the fore- [[foreskin]] and [[shaft skin]], a much increased friction between [[penis]] and [[vagina]] occurs during intercourse. This can make intercourse painful for both partners and lead to abrasions<ref>{{FrischM LindholmM GroenbaekM 2011}}</ref><ref>{{REFjournal

|pagespage=227

}}</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="ColdCJ TaylorJR 1999">{{ColdCJ TaylorJR 1999}}</ref><ref>{{REFjournal

|pages=2113-21166

* [[Meatal stenosis]], a pathological narrowing of the opening of the [[urethra]], which mostly occurs in infancy and early childhood. It is one of the most common complications of infant circumcision. A study from 2006 found meatal stenosis exclusively in previously [[circumcised ]] boys. The incidence rate after a circumcision is approximately 10 to 20 percent.<ref name="vanhowe2006">{{REFjournal

|pagespage=89

=== Psychological late effects === [[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effects]] are also possible after a circumcision, especially if the operation * Shorter adult penile length was carried out in childhoodreported by Park et al. On this occasion (2016) as a variety result of trauma may occurNMC (newborn male circumcision).{{Citation |Title= |Text=In conclusion, which dependsecond to fourth digit ratio, among othersflaccid penile length, on and age and circumstances of the circumcisionwere significant predictive factors for erectile penile length. For exampleFurthermore, whether the circumcision took place with or without sufficient anaesthesia, if penile lengths of the individual has been informed about NMC group were shorter than those of 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 ownnon-NMC group. The psychological late effects of circumcision are not yet fully researched, and many studies took place on rather a small scale. This situation needs to be rectified, because the available studies, as well as the histories of negatively affected men, suggest that these late effects may have more impact than previously assumed |Author=Park et al. |Source=* It was observed that infants, following circumcision without pain control, had a disturbed bond with their mother |ref=<ref>{{REFjournal |last=MarshallPark |first= |init=REJK |author-link= |last2=PorterDoo |first2= |init2=FLAR |author2-link= |last3=RogersKim |first3= |init3=AGJH |author3-link= |last4=Park |first4= |init4=HS |author4-link=

|title=Circumcision: II effects upon motherProspective investigation of penile length with newborn male circumcision and second to fourth digit ratio. |trans-infant interactiontitle= |language= |journal=Early Hum DevCan Urol Assoc J |location= |date=19822016-09 |season= |volume=710 |issue=49-10 |article= |page= |pages=367-374 |url=httphttps://www.cirpncbi.nlm.nih.orggov/librarypmc/birtharticles/marshall2PMC5028213/ |archived= |quote= |pubmedID=27695583 |pubmedCID=5028213 |DOI=10.5489/cuaj.3590 |accessdate=20202022-0209-0104}}</ref>, as well as problems with nurturing, up to the point of refusal to be fed. The sleeping habits of these babies were also disturbed, with prolonged non-REM sleep and increased waking.}}

* In boys circumcised === Sexual effects ===Cepeda-Emiliani et al (2023) cited six reports in childhoodthe literature of detrimental effects of circumcision, including erectile function, sensation, masturbatory pleasure, orgasm, and sexual satisfaction. The authors also cited three studies of severe distress in [[posttraumatic stress disordercircumcised]] (men, due to their infant circumcision, with complaints of [[PTSDglans]]) could be diagnosed. In a study on Philippine boysinsensitivity, in whom no delayed [[PTSDejaculation]] was found prior to the operation, 69% of the boys circumcised in the traditional ritual and 51% of those circumcised by standard medical procedures (including anaesthesia) fulfilled the DSM-IV criteria for PTSD following the operationunpleasant sensation.<refname="cepeda2023">{{REFbookREFjournal |last=RamosCepe da-Emiliani |first=S |init=A |author-link=Alfonso Cepeda-Emiliani |last2=BoyleGándara-Cortés |first2=GJ |yearinit2=M |author2-link= |last3=Otero-Alén |first3= |init3=M |author3-link= |last4=García |first4= |init4=H |author4-link= |last5=Suárez-Quintanilla |first5= |init5=J |author5-link= |last6=García-Caballero |first6= |init6=T |author6-link= |last7=Gallego |first7= |init7=R |author7-link= |last8=2001García-Caballero |first8= |init8=R |author8-link= |etal=no |title=Understanding circumcisionImmunohistological study of the density and distribution of human penile neural tissue: A Multigradient hypothesis |trans-title= |language= |journal= Int J Impot Res |location= |date=2023-05-Disciplinary Approach to a Multi02 |volume=35 |issue=3 |article= |page= |pages=286-Dimensional Problem305 |url=https://linkwww.springernature.com/chapterarticles/s41443-022-00561-9 |archived= |quote= |pubmedID=35501394 |pubmedCID= |DOI=10.10071038/978-1s41443-4757022-335100561-8_149 |workaccessdate=2023-11-26}}</ref> Circumcision and frenectomy remove tissues with heightened erogenous sensitivity.<ref name="cepeda2023" /> <ref name="winkleman1959">{{WinkelmannRK 1959}}</ref> |editors=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 [[George C. Dennistonpenis]], leaving only the uninhibited protopathic sensibility of the artificially externalized [[Frederick M. Hodgesglans 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 [[Marilyn Fayre Miloscircumcised]]human males.<ref>{{REFjournal |editionlast=Van Howe |volumeinit=RS |author-link=Robert S. Van Howe |last2=Cold |init2=CJ |chaptertitle=Ritual Advantages and medical circumcision among Filipino boys: evidence Disadvantages of Neonatal Circumcision |journal=The Journal of post-traumatic stress disorderthe American Medical Association |pagesvolume=253-270277 |locationissue=New York13 |publisherpages=Kluwer Academic/Plenum Publishers1052-7 |isbnurl=http://www.ncbi.nlm.nih.gov/pubmed/9218663

* CircumcisionsHistology of the male circumcision scar shows [[amputation]] neuromas, especially those that happen without consent, can spark feelings Schwann cell proliferation and the bulbous collection of helplessness variably sized neurites. [[Amputation]] neuromas do not mediate normal sensation and alienation, which can persist as traumaare notorious for generating pain.<ref name="ColdCJ TaylorJR 1999"/> Cepeda-Emiliani et al. These feeling can also be triggered later, when someone circumcised (2023) commented:<blockquote> Taking the sleve technique as an infant becomes aware example of his surgical flexibility during circumcision. In an online study, interviewed men stated they felt betrayed - 55% by 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 motherpenile body, 50% and to the extent that the prepuce is still conceived by segments of the fathermedical community as "just a small piece of skin", we are concerned that aggressive circumcisions are intentionally or unintentionally being performed in pediatric and 58% by adult patients in the doctorbelief that "redundant" or " extra" tissue is being excised, and 73% felt or in the belief that their human rights had been violated"excesive sensitivity" is being reduced to augment ejaculatory latency time.<ref name="GSoCHcepeda2023"/>{{REFweb |url=http://www.circumcisionharm.org</blockquote> |title=Global Survey of Circumcision Harm |accessdate=2019The un-10anesthetized and un-12}}</ref>* It can frequently be found that sedated newborn infant is restrained by being strapped to a special plastic board called the loss [[circumstraint]]. The procedure is deniedmost often an elective, much as happens with non-therapeutic surgery without [[medical indication]] performed on neonates and children for religious and cultural reasons in violation of the loss of other body parts. This denial can lead child's [[human rights]] to fathers having their sons circumcised [[physical integrity]], but in order not to older patients may be reminded of their own lossrarely indicated for therapeutic reasons. In this process It is a radical treatment option for pathological [[phimosis]], their own body refractory [[balanoposthitis]] and chronic [[urinary tract infection]]s (UTIs); it is defined as "normal" and the contraindicated in cases of certain genital structure abnormalities or poor general health.  See [[foreskinSexual effects of circumcision]] redefined as a foreign objectfor more information. Their own parents  === Psychological effects ===[[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effects]] are seen as "good"also possible after a circumcision, so that this image is projected onto especially if the circumcision their parents operation was carried out as well, in order to keep the positive emotion intactchildhood. The father wants to be On this occasion a "good" father later in life as wellvariety of [[trauma]] may occur, which depend, among others, on age and so, following an idealised image circumstances of his own parentsthe circumcision. For example, whether the circumcisiontook place with or without sufficient anaesthesia, which if the individual has been redefined as a "good thing"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. The psychological late effects of circumcision are not yet fully researched, is passed and many studies took place on rather a small scale. This situation needs to his son by having him circumcised be rectified, because the available studies, as wellas the histories of negatively affected men, suggest that these late effects may have more impact than previously assumed. * It was observed that infants, following circumcision without [[pain]] control, had a disturbed bond with their mother<ref>{{REFjournal |last=van der KolkMarshall |init=BARE |urllast2=http://www.cirp.org/library/psych/vanderkolk/Porter |titleinit2=The compulsion to repeat the trauma: re-enactment, revictimization, and masochismFL |journallast3=Psychiatr Clin North AmRogers |dateinit3=1989AG |volumeetal=12yes |issuetitle=2Circumcision: II effects upon mother-infant interaction |pagesjournal=389-411Early Hum Dev |accessdatedate=2019-10-12}}</ref><ref>{{REFjournal1982 |lastvolume=Goldman7 |initissue=R4 |authorpages=367-link=Ronald Goldman74 |url=httphttps://www.cirp.org/library/psychbirth/goldman1marshall2/ |title=The psychological impact of circumcision |journal=BJU Int |date=1999 |volume=83 |issue=Suppl. 1 |pages=93-103 |accessdate=20192020-1002-1201}}</ref>, as well as problems with nurturing, up to the point of refusal to be fed. The sleeping habits of these babies were also disturbed, with prolonged non-REM sleep and increased waking. * If the In boys [[circumcised male feels incomplete]] in childhood, [[post-traumatic stress disorder]] ([[PTSD]]) could be diagnosed. In a study on Philippine boys, or due in whom no [[PTSD]] was found prior to the missing operation, 69% of the boys [[foreskincircumcised]] disadvantaged compared to intact males, an inferiority complex in the traditional ritual and depression may occur. This can be accompanied 51% of those [[circumcised]] by conscious recognition of his own incompleteness, or standard medical procedures (including anaesthesia) fulfilled the DSM-IV criteria for PTSD following the deficiency may remain completely subconsciousoperation.<ref>{{REFjournalREFbook |last=RhinehartRamos |init=JS |last2=Boyle |init2=GJ |year=2001 |title=Understanding circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem |url=httphttps://wwwlink.cirpspringer.orgcom/librarychapter/psych/rhinehart110.1007/978-1-4757-3351-8_14 |titlework=Neonatal circumcision reconsidered |journaleditors=Transactional Analysis J[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |dateedition=1999 |volume=29 |issuechapter=3Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder |pages=215253-22170 |location=New York |publisher=Kluwer Academic/Plenum Publishers |isbn= |quote= |accessdate=2019-10-12 |note=}}</ref>* Circumcisions, especially those that happen without consent, can spark feelings of helplessness and alienation, which can persist as [[trauma]]. These feeling can also be triggered later, when someone [[circumcised]] as an infant becomes aware of his circumcision. In an online study, 75% of those interviewed men stated that they felt incompletebetrayed - 55% by the mother, 50% by the father, and 6658% by the doctor, and 73% said they felt inferior compared with intact malesthat their [[human rights]] had been violated.<ref name="GSoCH"/>* Cases in which children felt ill treated or punished have been documented as well. G. Cansever found in her study on 12 boys aged between 4 and 7 years, who had previously been prepared for their impending circumcision, that the children experienced the operation as an aggressive assault on their bodies.<ref>{{REFjournal |last=Cansever |init=G |date=1965REFweb |url=http://www.cirpcircumcisionharm.org/library/psych/cansever/ |title=Psychological effects Global Survey of circumcision |journal=Brit. J. Med. Psychol |volume=38 |pages=321-331Circumcision Harm

* It can frequently be found that the loss is denied, much as happens with the loss of other body parts. This denial can lead to fathers having their sons [[circumcised]] in order not to be reminded of their own loss. In this process, their own body is defined as "normal" and the [[foreskin]] redefined as a foreign object. Their own parents are seen as "good", so that this image is projected onto the circumcision their parents carried out as well, in order to keep the positive emotion intact. The father wants to be a "good" father later in life as well, and so, following an idealised image of his own parents, circumcision, which has been redefined as a "good thing", is passed on to his son by having him [[circumcised]] as well.<ref>{{VanderKolkBA 1989}}</ref><ref>{{REFjournal |last=Goldman |init=R |author-link=Ronald Goldman |url=https://www.cirp.org/library/psych/goldman1/ |title=The psychological impact of circumcision |journal=BJU Int |date=1999 |volume=83 |issue=Suppl. 1 |pages=93-103 |accessdate=2019-10-12}}</ref>* If the [[circumcised]] male feels incomplete, or due to the missing [[foreskin]] disadvantaged compared to [[intact]] males, an inferiority complex and [[depression]] may occur. This can be accompanied by conscious recognition of his own incompleteness, or the deficiency may remain completely subconscious<ref>{{REFjournal |last=Rhinehart |init=J |url=https://www.cirp.org/library/psych/rhinehart1/ |title=Neonatal circumcision reconsidered |journal=Transactional Analysis J |date=1999 |volume=29 |issue=3 |pages=215-21 |accessdate=2019-10-12}}</ref>. In an online study, 75% of those interviewed stated that they felt incomplete, and 66% said they felt inferior compared with [[intact]] males.<ref name="GSoCH"/>* Cases in which children felt ill treated or punished have been documented as well. G. Cansever found in her study on 12 boys aged between 4 and 7 years, who had previously been prepared for their impending circumcision, that the children experienced the operation as an aggressive assault on their bodies.<ref>{{REFjournal |last=Cansever |init=G |date=1965 |url=https://www.cirp.org/library/psych/cansever/ |title=Psychological effects of circumcision |journal=Brit. J. Med. Psychol |volume=38 |pages=321-31 |accessdate=2019-10-12}}</ref>* Fear of being alone or darkness.<ref name="Levy1945">{{REFjournal |last=Levy

|url=httphttps://www.cirp.org/library/psych/levy1/

* [[Circumcised ]] males who become fathers frequently manifest [[adamant father syndrome]].

[[Intact America]] (2019) called circumcision as an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]],<ref name-"bollinger2019">{{REFdocument

=== 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

|last2=HickeyKapilla |first2init2=L

|title=Pain and its effects in the human neonate and fetusComplications of circumcision

|journal=New Engl Brit J MedSurg

|date=19871993-11-1910 |volume=31780 |issue=2110 |pages=13211231-96 |url=httphttps://www.cirp.org/library/paincomplications/anandwilliams-kapila/

|pubmedID=33170378242285

|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 [http://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 are circumcised without analgesia experience pain and physiologic stress"''. Furthermore, where the bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is quite severe, and requires injections often insufficient for proper pain managementthe operation. Sucrose and Acetaminophen ''"cannot be recommended as Even in conjunction with regional anaesthesia of the dorsal nerve of the [[penis]], the sole method rate of analgesia"''failure to provide sufficient anaesthetic even for experienced anaesthetists is still 5-10%. Topical cream is no longer thought sufficient as ''"The general anaesthesia that would be needed for newborns, however, poses significant risks for the analgesic effect child, and, therefore, is limited during only likely to be used in emergencies. 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 |url=http://www.spiegel.de/spiegel/vorab/experte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-849534.html |title=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder |trans-title=Children's pain expert warns: Ritual circumcision changes the brain of children |language=German |last=Prof. Dr. med. Boris Zernikow

|titlepublisher=American Academy of Pediatrics: Circumcision Policy Statement; Task Force on CircumcisionSpiegel Online |journalwebsite=Pediatrics |date=19992012-0308-12 |volumeaccessdate=103 |issue=3 |pages=6862019-693 |url=https://pediatrics.aappublications.org/content/103/3/686#sec10-911 |accessdateformat=2019-11-26 |notequote=Statement Reaffirmed Sept. 1, 2005}}</ref> The [[AAFP]] (2002) states quite simply in their [http://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 statementstate of severe [[shock]]. To control pain, some physicians that circumcise use Tylenol, sugar,<ref>{{REFwebREFjournal |quotelast=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.Gunnar |urlinit=http://www.pollockclinics.com/circumcision/circumcision-guide.htmlMR |titlelast2=Parents' Guide to CircumcisionFisch |lastinit2=RO |firstlast3=Korsvik |publisherinit3=S |datelast4=Donhowe |accessdateinit4=2011-04-08}}</ref><ref>{{REFwebJM |quotetitle=During the The effects of circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.serum cortisol and behavior |urljournal=http://www.pollockclinics.com/circumcision/circumcision-before.htmlPsychoneuroendocrinology |titledate=Before the Circumcision1981 |lastvolume=6 |firstissue=3 |publisherpages=269-75 |dateurl=2011-04-08https://www.cirp.org/library/pain/gunnar/ |accessdate=20112019-0411-0826}}</ref> a topical cream* Postoperative wound pain,<ref>{{REFwebin the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions. |quote=Then * Postoperative pain from the exposure of the sensitive glans penis to clothing. This pain will endure for several weeks or even longer in our office, he will have topical anesthetic applied to his penissome cases. |url=http://www* Postoperative [[bleeding]] of the wound.pollockclinicsThis can have severe consequences especially for very young infants, if they are not treated promptly.com/circumcision/circumcision-beforeTheir 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.html |title=Before the Circumcision<ref>{{REFbook

|year=2000 |title=Paediatric Handbook |url= |work= |editors=Smart J, Nolan T. |edition=6 |volume= |chapter= |page=82 |location={{AUSC|VIC}}, Australia |publisher=Blackwell Science Asia |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=2142019-21811-26 |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=Vemulakonda |init2=Paul S.V |initlast3=PSRitchey |last2init3=EvansML |first2last4=Nolan DonovanRibbeck |init2init4=NDM |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=4122332-4164 |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 |pubmedIDlast=Leitch |pubmedCIDinit=IOW |DOItitle=Circumcision - a continuing enigma |journal=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 pain"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 |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 2010 estimated approximately 117 neonatal circumcision-related [[Death| deaths]] occur annually in at least 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=122578-123290 |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.

|DOI=10.3149/thy.0401.78 |date=2010-1004-0926 |accessdate=20112019-0410-0812}}</ref> Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals. It has been shown that an infant's response to [[pain]] can be altered for years as a consequence of circumcision.<ref>{{REFjournal |last=Taddio |first=Anna |init=A |first2=Morton |init2=M |last2=Goldbach |first3=Moshe |init3=M |last3=Ipp |first4=Bonnie |init4=B |last4=Stevens |first5=Gideon |init5=G |last5=Koren |title=Effect of neonatal circumcision on pain responses during vaccination in boys |journal=The Lancet |volume=345 |issue=8945 |pages=291-2REFweb |url=http://www.cirpicgi.org/library2010/pain/taddio04/infant-circumcision-causes-100-deaths-each-year-in-us |title=Infant circumcision causes 100 deaths each year in US |quotelast= |pubmedIDfirst=7837863 |pubmedCIDpublisher=ICGI |DOIwebsite=[[International Coalition for Genital Integrity]] |date=19952010-04-26

}}</ref><ref>{{REFjournal |last=Taddio |first=Anna |init=A |last2=Katz |init2=J |last3=Ilersich |init3=AL |last4=Koren |init4=G |title=Effects See also the list of neonatal circumcision on pain response during subsequent routine vaccination |journal=The Lancet |volume=349 |issue=9052 |pages=599-603 |url=http://www[[fatalities]].thelancet.com/journals/lancet/article/PIIS0140-6736(96)10316-0/fulltext |quote= |pubmedID=9057731 |pubmedCID= |DOI=10.1016/S0140-6736(96)10316-0 |date=1997-03 |accessdate=}}</ref>

{{Box|Boxtext== Forced circumcision ==<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>}} === Sexual effects United States military === Circumcision and frenectomy remove tissues with heightened erogenous sensitivityAmerican soldiers serving in World War II were subjected to regular inspections of their genitals. Boyle et al. (2002) wroteIf intact, "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings&mdash;many of which are lost soldiers risked being ordered to undergo immediate circumcision."<ref>{{REFjournalREFbook |last=BoyleSchoen |first=Gregory J.Ed |init=GJE |author-link=Gregory BoyleEdgar J. Schoen |first2year=Gillian A.2005 |init2title=GAOn Circumcision |last2url=Bensley |titlehttps://books.google.de/books?id=Adverse Sexual and Psychological Effects of Male Infant Circumcision-zUhdvSt7cgC |journalwork=Psychological reports |volumeeditor=88Dianne Yeakey |issueedition=3, Part 2 |pagesvolume=1105–1106 |urlchapter=http://www.cirp.org/library/psych/boyle5/ |quotepages=72-3 |pubmedIDlocation=11597060Georgetown, Canada |pubmedCIDpublisher=RDR Books |DOIisbn=10.1046/j.14641-157143-123-410x.1999.0830s1085.x3 |datequote=July 2001For a critical view, see Sorrells, "The History of Circumcision," p. 333

|note=}}</ref> They concluded, "Evidence has also started to accumulate that This practice was discontinued at least six decades ago.-->=== Non-therapeutic circumcision of male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well."children ===

The Human babies, because they are not yet in possession of language, are incapable of giving or refusing consent to be [[amputationcircumcised]] . The element of force has led some scholars to view the prepuce results in circumcision of baby boys as a category of forced circumcision.<ref>For example, Frederick M. Hodges, a medical historian, writes: "In the late 1970s, as the loss Americans were growing increasingly aware of the majority abuses of fine-touch neuroreceptors found in power rampant throughout the penisnation's social institutions, leaving only influential grass-roots movements protesting the uninhibited protopathic sensibility forced circumcision of the artificially externalized glans penisAmerican children sprang up nationwide." F. Hodges, "A Short History," p. 31; see also [[Leonard B. Glick|Glick]], ''Marked in Your Flesh'', pp. 273-281. The imbalance caused by not having </ref> There are, however, physicians in the input from the now ablated fineUnited States who argue strongly for non-touch receptors may be therapeutic circumcision of newborn babies; and circumcision is widely accepted as a leading cause of the changes postnatal procedure in sexual behavior noted in circumcised human malesAmerican hospitals.<ref>{{REFjournalREFbook |last=Van HoweFletcher |first=Christopher R. |init=RSCR |author-linkyear=Robert Van Howe1999 |last2title=ColdCircumcision in America in 1998: Attitudes, Beliefs, and Charges of American Physicians |init2url=CJhttp://www.springerlink.com/content/h2150v731233m177/ |titlework=Advantages Male and Disadvantages of Neonatal Female Circumcision |journaleditors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |edition=The Journal of the American Medical Association |volume=277 |issuechapter=13Section 5 |pages=1052259-771 |location=New York |urlpublisher=http:Kluwer Academic//www.ncbi.nlm.nih.gov/pubmed/9218663Plenum Publishers |isbn=

|pubmedIDaccessdate=92186632019-10-12 |pubmedCIDnote= |DOI= |date=1997ID 10.1007/978-0-585-0439937-02 |accessdate=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.

Histology of In the male circumcision scar shows [[amputationUnited Kingdom]] neuromas, Schwann cell proliferation and where non-therapeutic circumcision has now become far less prevalent than in the bulbous collection of variably sized neurites. [[AmputationUnited States]] neuromas do not mediate normal sensation and are notorious for generating pain.<ref name="ColdCJ TaylorJR 1999"/> === Death ===A study in 2010 estimated approximately 117 neonatal circumcision-related deaths occur annually in , the United States, about one out written consent of every 77 male neonatal deathsboth parents is required, more than suffocation, auto accidents, or even [[SIDS]].<ref name="Bollinger 2010">{{REFjournal |last=Bollinger |first=Dan |init=D |authorif a physician is to perform a non-link=Dan Bollinger |last2=Boy's Health Advisory |title=Lost Boys: An Estimate therapeutic circumcision of Ua child.S. Circumcision-Related Infant Deaths |journal=Thymos: Journal of Boyhood Studies |volume=4 |issue=1 |pages=78-90 |url=http://www.mensstudies.com/content/b64n267w47m333x0/?p=7ebbd6b446d940cbbd4274c095754b12π=5 |quote= |pubmedID= |pubmedCID= |DOI=10.3149/thy.0401.78 |date=2010-04-26 |accessdate=2019-10-12}}</ref><ref>{{REFweb |url=http://www.icgi.org/2010/04/infant-circumcision-causes-100-deaths-each-year-in-us |title=Infant circumcision causes 100 deaths each year in USREFjournal

|publishertitle=ICGIRe J (child's religious upbringing and circumcision) |websitejournal=International Coalition for Genital IntegrityFamily Court Reports |date=20102000 |volume=1 |issue= |pages=307-04-2614 |url=https://www.cirp.org/library/legal/Re_J/2000.html |accessdate=2019-10-12}}</ref> (The National Health Service does not provide non-therapeutic circumcision.) In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<ref> See also , e.g., [[Margaret A. Somerville|Somerville]], "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; [[Abbie Chessler|Chessler]], "Justifying the Unjustifiable"; Smith, "Male Circumcision."</ref> For example, critics have pointed out that, in the list of [[fatalitiesUnited States]], more than 1.3% of male neonatal deaths are attributable to the complications of non-therapeutic circumcision surgery.<ref name="Bollinger 2010"/>==Video=====Is circumcision healthy?===The video ''Is Circumcision Healthy'' is recommended for parental viewing.<br><br> <youtube>D_3LQjZgdbQ</youtube> ===Dr. Christopher Guest discusses circumcision===<br><youtube>v=TQIp9f4krVQ</youtube> ===Plastibel circumcision=== {{UNI|Stanford University|SU}} has published a video of an actual non-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.* [https://med.stanford.edu/newborns/professional-education/circumcision/plastibell-technique.html Plastibell Technique] ===Gomco clamp circumcision===

American soldiers serving in World War II were subjected to regular inspections of their genitals. If intact, the soldiers risked being ordered to undergo immediate circumcision.<ref>{{REFbook |last=Schoen |first=Ed |author-link=Edgar J. Schoen |year=2005 |title=On Circumcision |url=* [https://bookswww.googlereddit.decom/r/Intactivism/comments/qbpzqr/trained_medical_professionals_restrain_infant_to/books?id=-zUhdvSt7cgC |work= |editor=Dianne Yeakey |edition= |volume= |chapter= |pages=72-73 |location=Georgetown, Canada |publisher=RDR Books |isbn=1-157143-123-3 |quote=For a critical view, see Sorrells, "The History of Circumcision," p. 333 |accessdate= |note=}}</ref> This practice was discontinued at least six decades ago.-->video]

=== Non-therapeutic circumcision Recommendations of male children =medical authorities==* [[George Hill| Hill]] (2007) said:<blockquote>Human babies, Male circumcision is harmful because they are not yet in possession of language, are incapable of giving or refusing consent for being circumcisedit excises healthy tissue and permanently impairs beneficial physiological functions. The element of force has led some scholars Male circumcision also causes psychological problems that tend to view perpetuate the cycle of abuse. Male circumcision of baby boys as is a category costly diversion of forced medical resources away from beneficial services. Male circumcision.<ref>For exampleviolates legal rights, [[human rights]], Frederick Mand ethical standards. HodgesFinally, a medical historian, writes: "In we must remember that males are the late 1970s, as the Americans were growing increasingly aware more vulnerable and sensitive of the abuses of power rampant throughout the nation's social institutionstwo genders and, therefore, influential grass-roots movements protesting deserve the forced circumcision greater degree of American children sprang up nationwide." F. Hodgesprotection from traumatic, "A Short History," p. 31; see also [[Leonard B. Glick|Glick]]invasive, ''Marked in Your Flesh''injurious, ppand unnecessary surgery. 273-281.</ref> There are, however, physicians in For all of these reasons the United States who argue strongly for non-therapeutic circumcision of newborn babies; boys should not be performed and circumcision is widely accepted as a postnatal procedure in American hospitalsthe [[genital integrity]] of all children should be respected and protected.<refname="hill2007">{{REFbookREFjournal |last=FletcherHill |first=Christopher R.George |yearinit=1999G |titleauthor-link=Circumcision in America in 1998: Attitudes, Beliefs, and Charges of American PhysiciansGeorge Hill |urltitle=http://www.springerlink.com/content/h2150v731233m177/The case against circumcision |workjournal=Male Journal of Men's Health and Female CircumcisionGender |editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |editiondate=2007 |volume=4 |chapterissue=Section 53 |pages=259318-27123 |locationurl=New York |publisher=Kluwer Academichttps://www.academia.edu/8367383/Plenum Publishers |isbn=The_Case_Against_Circumcision

|accessdatepubmedID= |pubmedCID=2019-10-12 |noteDOI=ID 10.1007/978-0-585 |accessdate=2021-3993705-9_1930}}</ref> Parental consent is required.<ref/blockquote>See, e.g* Andrew E.MacNeiiy, Shephard and ShephardHead, ''The Complete Guide''Division of Pediatric Urology, p. 125.</ref> A statement published by the American Academy Department of Pediatrics in 1999 declares that "parents should determine what is in the best interest Urological Sciences, {{UNI|University of the child... It is legitimate for parents to take into account culturalBritish Columbia|UBC}}, religiousVancouver, and ethnic traditionsBC, in additions to the medical factors, when making a decision."(2008) said:<refblockquote>Lannon and BaileyNewborn circumcision remains an area of controversy. Social, "Circumcision Policy Statementcultural," p. 691.</ref> In aesthetic and religious pressures form the United Kingdom, where most common reasons for non-therapeutic circumcision has now become far less prevalent than . 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 United States, cornerstone of prevention. There remains a written consent lack of knowledge regarding what constitutes the normal foreskin both among parents is required, if and among primary care providers. This lack of knowledge results in a physician is burden of costs to perform a non-therapeutic 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 childhealth or cost-benefit perspective.<ref>{{REFjournal |last=MacNeily |first=Andrew |init= |author-link= |etal=no |title=Re J (child's religious upbringing and Routine circumcision): the opposing view |trans-title= |language= |journal=Family Court ReportsCan Urol Assoc J |location= |date=20002007-11

|issue=4 |article= |page= |pages=307395-3147 |url=http://www.cirpeuropepmc.org/libraryarticle/legalPMC/Re_J2422979 |pubmedID=18542825 |pubmedCID= |DOI=10.5489/2000cuaj.html455 |accessdate=20192021-1011-1208}}</ref> (The National Health Service does not provide non-therapeutic circumcision.)</blockquote>

In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<ref>See, e.g., * The [[Margaret A. Somerville|SomervilleRoyal Dutch Medical Association]], "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; Chessler, "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-therapeutic circumcision surgery.<ref name="Bollinger (KNMG) (2010"/>) said:

==Video==<blockquote>Stanford University has published a video The official viewpoint of an actual KNMG and other related medical/scientific organisations is that non-therapeutic plastibell circumcisionof male minors is a violation of children’s rights to autonomy and physical integrity. The infant has received two injections Contrary to popular belief, circumcision can cause complications – [[bleeding]], infection, [[urethra]]l stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of local anesthesia deterrence. KNMG is calling upon doctors to deaden actively and insistently inform parents who are considering the dorsal nerves. The ventral nerves were not deadened so procedure of the infant still feels pain. One can his cries on absence of medical benefits and the soundtrackdanger of complications.<ref>{{REFdocument |title=Non-therapeutic circumcision of male minors* [ |url=https://medwww.stanforddoctorsopposingcircumcision.eduorg/wp-content/uploads/2016/newborns09/professionalknmg-non-therapeutic-education/circumcision/plastibell-techniqueof-male-minors-27-05-2010.html Plastibell Technique]pdf |contribution= |last= |first= |publisher=Royal Dutch Medical Association |format=PDF |date=2010 |accessdate=2021-11-08}}</ref></blockquote>

Not for <blockquote>Ethical and [[human rights]] concerns have been raised regarding elective infant male circumcision because it is recognised that the squeamish:foreskin has a functional role, the operation is non-therapeutic and the infant is unable to consent.

This After reviewing the currently available evidence, the RACP believes that the frequency of diseases 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 a video reasonable for parents to weigh the benefits and risks of an actual circumcision with a Gomco clamp. The infant boy received two dorsal penile nerve block (DPNB) analgesic injections but they did and to make the decision whether or not seem to workcircumcise their sons.<ref name="racp2010">{{REFdocument |title=Circumcision of Infant Males* [ |url=https://www.redditracp.comedu.au/r/Intactivismdocs/commentsdefault-source/qbpzqradvocacy-library/trained_medical_professionals_restrain_infant_to/ Circumcision video]circumcision-of-infant-males.pdf |contribution= |last= |first= |publisher=Recommendations The Royal Australasian College of medical authoritiesPhysicians |format=PDF |date=2010-09-01 |accessdate=2021-11-08}}</ref></blockquote> * 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 [[George Hill| HillRobert Darby]] (20072014) saidwrote simply:

Male circumcision is harmful because it excises healthy tissue and permanently impairs beneficial physiological functions. Male circumcision also causes psychological problems that tend to perpetuate the cycle of abuse. Male circumcision is a costly diversion of medical resources away from beneficial services. Male "To avoid 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, injuriouscomplications,and unnecessary surgery. For all of these reasons the non-therapeutic avoid circumcision of boys should not be performed and the genital integrity of all children should be respected and protected."<ref name="hill2007">{{REFjournal |last=HillDarby |first=George |init=GR |author-link=George HillRobert Darby |etal=no |title=The case against To avoid circumcision complications, avoid circumcision |trans-title= |language= |journal=Journal of Men's Health and GenderCan Urol Assoc J |location= |date=20072014-08-14 |volume=48 |issue=37-8 |article= |page=231 |pages=318-323 |url=https://wwwcuaj.academiaca/index.eduphp/8367383journal/The_Case_Against_Circumcisionarticle/view/1709/1823 |archived=

|DOI=10.5489/cuaj.1709 |accessdate=20212022-0512-3016

* Andrew E. MacNeiiy, Head, Division of Pediatric Urology, Department of Urological Sciences, University of British Columbia, Vancouver, BC, The [[Canadian Paediatric Society]] (CPS) (20082015) said: <blockquote>Newborn circumcision remains an area of controversy. Social, cultural, aesthetic and religious pressures form the In most common reasons for non-therapeutic circumcision. Although penile cancer and UTIs are reduced compared with uncircumcised malesjurisdictions, the incidence of such illness authority is so low that circumcision cannot limited only to interventions deemed to be justified as prophylaxismedically necessary. The role of the foreskin In cases in HIV transmission in developed countries which medical necessity is not established or a proposed treatment is unclearbased on personal preference, and safe sexual practice remains interventions should be deferred until 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 individual concerned is able 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 perspectivemake their own choices.<refname="CPS2015">{{REFjournal |last=MacNeilySorokin |first=AndrewS. Todd |init=ST

|etallast2=Finlay |first2=JC |author2-link= |last3=noJeffries |titlefirst3=Routine circumcision: the opposing viewAL |transauthor3-titlelink= |etal=yes |languagetitle=Newborn male circumcision |journal=Can Urol Assoc JPaediatr Child Health

|date=20072015-1108 |volume=120 |issue=4 |article= |page=6 |pages=395311-720 |url=httphttps://europepmcwww.ncbi.nlm.nih.orggov/pmc/articlearticles/PMCPMC4578472/2422979 |archived=

|pubmedID=1854282526435672 |pubmedCID=4578472 |DOI=10.54891093/cuajpch/20.4556.311 |accessdate=20212019-1110-0827}}</ref></blockquote>

* The [[Royal Dutch Medical Canadian Urological Association]] (KNMGCUA) (2010) said:<blockquote>The official viewpoint of KNMG and other related medical/scientific organisations is that non-therapeutic circumcision of male minors is a violation considered the matter of children’s rights to autonomy and physical integrity. Contrary to popular belief, circumcision can cause complications – bleeding, infection, urethral stricture and panic attacks are particularly common. KNMG is therefore urging issued a strong policy of deterrencestatement in February 2018. 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=httpsThe CUA concluded://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 <blockquote>"Given the socioeconomic, educational status, and health demographics of our population, universal neonatal circumcision cannot be justified based on the current evidence available.<ref name="cua2018">{{REFjournal |last=Dave |first=Sumit |init=S |author-link= |etal=yes |title=Canadian Urological Association guideline on the care of Physicians]] the normal foreskin and neonatal circumcision in Canadian infants (2010abridged version) said |journal=Can Urol Assoc J |location= |date=2018-02 |volume=12 |issue=2 |pages=18-28 |url=https://cuaj.ca/index.php/journal/article/view/5034/3470 |quote= |pubmedID= |pubmedCID= |DOI= |accessdate=2021-11-09}}</ref></blockquote>Ethical and human rights concerns have been raised regarding elective infant male ==British family court opinion==The issue of non-therapeutic circumcision because it is recognised of male children came before the court in the case of ''[[Re B and G (children) (No 2) EWFC 3]] (2015)'' . In that the foreskin has a functional rolecase, the operation Judge Sir James Munby ruled that circumcision of male children caused ''significant harm''. is non-therapeutic == Rights and the infant ethics == The [[Rights situation on circumcision|rights situation]] is unable to consentdiscussed in a separate article.

After reviewing the currently available evidence[[Image:Intact vs circumcised.JPG |thumbnail|right|300px| The intact and circumcised human penis, the RACP believes that the frequency of side by side.]] diseases modifiable by The term "circumcision" without a gender qualifier refers specifically to male circumcision. It means "to cut around, " and it refers to the level [[excision]] of protection offered by circumcision 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.  complication rates of circumcision do not warrant routine infant circumcision Circumcision is most often performed in Australia healthy males for [[Religion and New ZealandCulture|religious or cultural]] reasons. However The procedure may be performed on consenting adults, but it is reasonable for parents to weigh most often performed on non-consenting minors, particularly newborn children, which is why the benefits and risks ritual is so controversial. Opponents of circumcision consider the circumcision of non-consenting minors to be unethical and to make a [[human rights]] violation, unless there is concrete [[medical indication]].=== Consent by surrogates ===Medical ethics has long recognized limitations on the decision whether or not to circumcise their sonspower of consent by surrogates.<ref name="racp2010">{{REFdocumentREFjournal |titlelast=Circumcision Committee on Bioethics, American Academy of Infant MalesPediatrics |urletal=https://www.racp.edu.au//docs/default-source/advocacy-library/circumcision-of-infant-males.pdfno |contributiontitle=Informed consent, parental permission, and assent in pediatric practice |lasttrans-title= |firstlanguage= |publisherjournal=The Royal Australasian College of PhysiciansPediatrics |formatlocation=PDF |date=2010-09-011995 |accessdatevolume=2021-11-0895}}</ref> |issue=2</blockquote> |article= |page=* The [[American Academy of Pediatrics]] (AAP) has not re |pages=314-affirmed its disastrous, failed 2012 Circumcision Policy Statement, which expired in 2017, so currently has no position on child circumcision.17 * The [[Canadian Paediatric Society]] (CPS) (2015) said |url=https:<blockquote>In most jurisdictions, authority is limited only to interventions deemed to be medically necessary//www. 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 choicescirp.<ref name="CPS2015">{{REFjournalorg/library/ethics/AAP/ |lastarchived=Sorokin |firstquote=S. Todd |initpubmedID=ST7478854 |author-linkpubmedCID= |last2DOI=Finlay |first2accessdate=JC2023-05-21}}</ref> <ref>{{REFjournal |author2-linklast=Committee on Bioethics |last3etal=Jeffriesno |first3title=ALInformed Consent in Decision-Making in Pediatric Practice |author3trans-link= |etaltitle=yes |titlelanguage=Newborn male circumcision |journal=Paediatr Child HealthPediatrics

|date=20152016-08 |volume=20138 |issue=62 |article= |page=e20161485 |pages=311-20 |url=https://wwwwatermark.ncbisilverchair.nlmcom/peds_20161485.nihpdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQM8zYHFd0Ylu9Annq_AgEQgIICT24ikc839aJMYOiypqC2G9f7_yKGAGkAekzzbCtck5TElALWVCGNoVSOaA6rDA_dOkQ_LyJnxYlZ88J9-uk15tvlIBbE82_aNyYfq5e9xmEfqD2vh374q3Naz57dxZaUbgxUkKX4PqsiLmYHLvVrr7bQK2MZuuUOKiQU8JZy7lLjkp-PjJO1U9cyIplTAgs_EdvgK8MWWoIsj-X-ZUDImAG63-rlj_qLsy5dYwytmxfCuVa47RdZseLSr2_bdDpwKAKGhq_Ly9rlHZeW_f7fYktVfF_sFTgcJziAlvEQmdyWIw0qf-hlO31Qb3sH6kDdcvHAbm7llY5xa34XLYIt8QR0YFIimgDGFliN4-ce2vjvvrwS85WeeNFhpn-Ywn4Qjpy06hPuLDL-MtI2Z3BZbBsKq4dp8qGu1q9GlXaKw193riTFG9G5bF5GCKmxmt0nCQTthrb_CcK2UhKjZwPekC9zkIUHPZ9BXJt0SM03F_g-GgqbE0hTYKMqNdJ3sHDQu2luFrJ9JEiMzxtP28gJoYh20d2APA0xrRbXBYsFdAlr50gb1BSAbNJhTyx-Kh3geoSHsAYMjPaG7cIbh0jd42pWCUx30vjlAGK8zXTuf7-31oi81CLbHTAJLuzK3NT4Whi17jVq1SbXsIXlWpKc_d-HujCvlb74rkZQ6RG9wkxW7gAKaDqtKv5zTOTMBD9vLVxgp8lDmVA8PFB59Bqd6w-fi86tW132oWQM-mTfwdIBXFbUFXkeTUC5RYyqJQIXAEwLJSRm1RX-LRbKRzgaRQ |archived= |quote= |pubmedID=27456510 |pubmedCID= |DOI=10.gov1542/pmcpeds.2016-1485 |format=PDF |accessdate=2023-05-21}}</articlesref> <ref>{{REFjournal |last=Committee on Bioethics ||etal=no |title=Informed Consent in Decision-Making in Pediatric Practice |trans-title= |language= |journal=Pediatrics |location= |date=2016-08 |volume=138 |issue=2 |article= |page=e20161484 |pages= |url=https:/PMC4578472/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=

|pubmedID=2643567227456514 |pubmedCID=4578472 |DOI=10.10931542/pch/20peds.6.3112016-1484 |format=PDF |accessdate=20192023-1005-2721}}</ref></blockquote>

* The [http://www.cua.org/en Canadian Urological Association] Two ethicists, Myers & Earp (CUA2020) considered , have conducted a detailed review and analysis of the matter claimed medical benefits of ''non-therapeutic'' [[circumcision and issued a statement in February 2018]]. The CUA concluded: <blockquote>"Given They have determined than the socioeconomicalleged benefits are not material, educational statusso 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 health demographics loss of our populationfunction, therefore, universal neonatal circumcision cannot should be justified based on performed only after the individual reaches the current evidence availableage of consent. <u>Consent by a surrogate for a ''non-therapeutic'' circumcision of a minor child is an unethical practice.</u><ref name="cua2018myers2020">{{REFjournal |last=DaveMyers |first=Sumit |init=SA

|last2=Earp |first2= |init2=BD |author2-link=Brian D. Earp |etal=yesno |title=Canadian Urological Association guideline on What is the care of the normal foreskin best age to circumcise? A medical and neonatal circumcision in Canadian infants (abridged version)ethical analysis |trans-title= |language= |journal=Can Urol Assoc JBiosoc Sci

|date=20182020-0209 |volume=1234 |issue=27 |pages=18560-2872 |url=https://cuajonlinelibrary.ca/indexwiley.phpcom/journaldoi/articleabs/view10.1111/5034/3470bioe.12714 |archived=

|pubmedID=32068898

|DOI=10.1111/bioe.12714 |accessdate=20212023-1105-0918}}</ref>== Tipping point ==[[Intact America]] (2024) argues that public opinion regarding non-therapeutic [[circumcision]] of children is approaching or at a "tipping point" at which [[intact]] genitals would be preferred over the [[circumcised]] variety.<ref>{{REFweb |url=https://intactamerica.org/public-opinion-on-circumcision/ |title=Public Opinion on Circumcision: Can Intactivists Hit A Tipping Point? |last=Anonymous |first= |init= |publisher=Intact America |date=2024-03-23 |accessdate=2024-04-09}}</blockquoteref> 

* [[Sudden Infant Death Syndrome]] (SIDS).* [[Trauma]]

|url=httphttps://www.cirp.org/library/anatomy/garcia/

|article= |page= |pages=33-40 |url=https://www.academia.edu/7587653/Libertarianism_and_Circumcision?email_work_card=view-paper |pubmedID=24987720 |pubmedCID=4075101 |DOI=10.15171/ijhpm.2014.51 |accessdate=}} * {{REFweb |url=https://intaction.org/what-is-circumcision/ |title=What is circumcision? |last=Simone |first=Judy |author-link= |publisher=Intaction |website=https://intaction.org/ |date=2020-07-26 |accessdate=2020-10-04 |format= |quote=}}* {{REFjournal |last=Deacon |first= |init=M |author-link= |last2=Muir |first2= |init2=G |author2-link= |etal=no |title=What is the medical evidence on non-therapeutic child circumcision? |trans-title= |language= |journal= Int J Impot Res |location= |date=2022-01-08 |volume= |issue= |article= |page= |pages= |url=https://www.nature.com/articles/s41443-021-00502-y |archived= |quote= |pubmedID=2498772034997197 |pubmedCID=4075101 |DOI=10.151711038/s41443-021-00502-y |accessdate=2023-04-30}}* {{REFweb |url=https://intactamerica.org/pros-and-cons-of-circumcision/ |title=Pros and Cons of Circumcision (Spoiler: You’ve Been Lied to) |last=Garrett |first= |init=CJ |publisher=Intact America |date=2023-11-10 |accessdate=2024-03-22}}* {{REFweb |url=https://intactamerica.org/groups-who-pressure-you-to-circumcise/ |title=The 4 Authority Figures and Groups Who Will Pressure You to Circumcise (and What You Can Do) |last=Anonymous |first= |init= |publisher=Intact America |date=2024-01-24 |accessdate=2024-01-27}}* {{REFweb |url=https://ijhpmintactamerica.2014org/keeping-your-sons-penis-intact/ |title=Keeping Your Son’s Penis Intact: A Guide for Parents |last=Anonymous |first= |init= |publisher=Intact America |date=2024-01-24 |accessdate=2024-01-29}}* {{REFweb |url=https://intactamerica.51org/timeline-of-circumcision-suffering/ |title=A Timeline of Circumcision Suffering: A Detailed Look |last=Anonymous |first= |init= |publisher=Intact America |date=2024-02-02 |accessdate=2024-02-09}}{{REF}}

[[Category:TermPenile surgery]][[Category:Medical term]][[Category:Male genital mutilation]]