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]] and [[mutilation]] is the result. The amputation destroys the [[Foreskin#Physiological_functions| many protective, immunological, sexual, and sensory physiological functions]] of the foreskin, so it is a very harmful and [[Pain| painfdulpainful]] surgery.

The procedure is most often an elective, non-therapeutic surgery without [[medical indication]] performed on neonates and children for religious and cultural reasons in violation of the child's [[human rights]] to [[physical integrity]], but in older patients may be rarely indicated for therapeutic reasons. It is a radical treatment option for pathological [[phimosis]], refractory [[Balanitis| balanoposthitis]] and chronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health.  '''Posthectomy''' is a the more accurate medical term that more accurately reflects the injury and loss of functional body tissue, but the Biblical [[euphemism]], ''circumcision'', is more commonly used.  With reference to involuntary, non-therapeutic circumcision of children, [[Child Genital Cutting (CGC)]] is a newer term that has been introduced to avoid issues associated with more traditional terms.Bollinger (2023) identifed CGC as an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]].<ref name="bollinger2023">{{REFjournal |last=Bollinger |init=D |author-link=Dan Bollinger |last2= |init2= |author2-link= |url=https://kindredmedia.org/2023/02/adverse-childhood-experiences-dysfunctional-households-and-circumcision/ |title=Adverse Childhood Experiences, Dysfunctional Households, And Circumcision. |journal=Kindred |date=2023-02-28 |volume= |issue= |pages= |accessdate=2023-03-01}}</ref>

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

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:

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]].

=== [[Medical indication]] ===There are no [[medical indication| medical indications ]] for circumcision of the newborn. The [[circumcision industry]] offers circumcision of the newborn to the public because of the [[financial incentive]].

The form of circumcision adopted by the medical community essentially was equivalent to the Jewish form with ''[[periah]]'', so it inflicted the maximum injury.

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/

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.

|url=httphttps://www.cirp.org/library/complications/blalock1/

|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">{{FleissP HodgesF VanHoweRS 1998}}</ref> According to the [[AAP]], the general sexual behaviour of the male - — such as frequent change in partners and the use of condoms - — has a much higher impact on sexually transmitted diseases then the circumcision status.<ref>{{REFjournal

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

|url=httphttps://www.cirp.org/library/general/laumann/

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

|url=httphttps://www.cirp.org/library/disease/UTI/mccracken/

}}</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

* 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

* It can be concluded that circumcision is ineffective as a preventive measure against UTIs[[UTI]].

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]].

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.

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 surgery, circumcision is a surgical intervention and brings In the usual risks related to surgical operationspast, alongside several specific risks advocates of complications and late effects. Uberoi et al. (2022) report "some men are experiencing circumcision claimed that a complex negative constellation of psychological, physicalnewborn child's nerve system was not yet fully developed, and sexual associations that lead to significant emotional distress directed both internally and externally. The posts also reveal as a discovery phenomenon wherein men discover result, the physical and psychological manifestations of child felt no [[pain]] during the decisions made by others to modify their genitals." === Possible operative and postoperative complications === Circumcision is surgerycircumcision procedure. Surgical complications of circumcision generally may be classified as [[BleedingKanwaljeet J. Singh Anand| hemorrhageAnand]], & Hickey (1987) have shown that newborn children do in fact feel [[infectionpain]], or surgical misadventure up to and including loss of the penis and [[death]]more acutely than adults.<ref name="deacon2022" /><ref name="williamsanand-kapilla1993hickey1987">{{REFjournal |last=WilliamsAnand |initfirst=NKJS |author-link=Kanwaljeet J. Singh Anand |last2=KapillaHickey |init2first2=LPR |author2-link= |etal=no |title=Complications of circumcisionPain and its effects in the human neonate and fetus |trans-title=

|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>{{REFjournalREFweb |lasttitle=GarryCircumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed |initwebsite=TOfficial American Academy of Family Physicians Website |titleurl=Circumcisionhttp: a survey of fees and practices//www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html |journalaccessdate=OBG Management2011-05-02}}</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. |date=1994 |volume=OctoberPenile 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>{{REFweb |issuetitle=Report 10 of the Council on Scientific Affairs (I-99): Neonatal Circumcision |pageswebsite=34-6American Medical Association Official Website |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>{{REFjournalREFweb |lasttitle=HowardWhere We Stand: Circumcision |initpublisher=CR[[AAP]] |last2date=Howard2011-03-23 |init2url=FMhttp://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx |last3accessdate=Garfunkel2019-10-12 |init3=LC}}</ref> Be that as it may, few forms of analgesia are recommended. There are basically two types of injections to choose from, and the website does not go into the difference between a 'dorsal nerve block' and a 'ring block' injection. |last4=de Blieck |init4=EAGiven 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 local anesthesia, and make sure your baby is given an injection. This is your responsibility, because your doctor may or may not be up to date on the latest understandings of infant sensitivity to [[pain]] during circumcision."'' The AAP may be holding back, however, perhaps because this would upset the doctor/parent power relationship, and may cause too much questioning of doctors in general. One may not expect to find this kind of advice on such a website, and yet, anything less than this is a dangerously weak statement. |last5=Weitzman |init5=MTo control [[pain]], some physicians that circumcise use Tylenol, sugar,<ref>{{REFweb |titlequote=Neonatal circumcision To calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, and pain relief: current training practicessoothing music is played in the room. |journalurl=Pediatricshttp://www.pollockclinics.com/circumcision/circumcision-guide.html |datetitle=1998Parents' Guide to Circumcision |volumelast=101 |issuefirst= |pagespublisher=423-8 |urldate= |accessdate=2011-04-08}}</ref><ref>{{REFjournalREFweb |lastquote=StangDuring the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |initurl=HJ |last2=Snellman |init2=LWhttp://www.pollockclinics.com/circumcision/circumcision-before.html |title=Before the Circumcision practice patterns in the United States |journallast=Pediatrics |datefirst=1998 |volumepublisher=101 |issue=e5 |pages= |urldate=2011-04-08 |accessdate= |note=Link to [[AAP]] website2011-04-08}}</ref>. During procedures which take several minutes, babies tend to fall into a state of stuportopical cream, which in the past was falsely interpreted as peaceful sleep, nurturing the belief that babies felt no pain. Measurements taken in those cases revealed a typically 3- to 4-fold increase in cortisol levels, which equals a state of severe [[shock]].<ref>{{REFjournalREFweb |lastquote=GunnarThen in our office, he will have topical anesthetic applied to his penis. |initurl=MRhttp://www.pollockclinics.com/circumcision/circumcision-before.html |last2title=FischBefore the Circumcision |init2last=RO |last3first=Korsvik |init3publisher=S |last4date=Donhowe2011-04-08 |init4accessdate=JM2011-04-08 |title=The effects of circumcision on serum cortisol }}</ref> and behavior/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb |journalquote=Psychoneuroendocrinology |date=1981 |volume=6 |issue=3 |pages=269-75We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection. |url=http://www.cirppollockclinics.orgcom/library/pain/gunnarcircumcision/circumcision-guide.html |accessdatetitle=2019-11-26}}</ref>* Postoperative wound pain, in the case of childrenParents's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions.* Postoperative pain from the exposure of the sensitive glans penis Guide to clothing. This pain will endure for several weeks or even longer in some cases.* Postoperative [[bleeding]] of the wound. This can have severe consequences especially for very young infants, if they are not treated promptly. Their blood volume is only about 85 ml per kilogram of body weight, and even moderate blood loss can lead to hypovolaemia, hypovolaemic [[shock]] and even death.<ref>{{REFbookCircumcision

|yearpublisher= |date=2000 |titleaccessdate=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]].<ref name="Journal of Perinatology April/May 2002">{{REFjournal |last=Taeusch |first=Paediatric HandbookH. William |urlinit=HW |worklast2=Martinez |editorsfirst2=Smart J, Nolan TAlma M. |editioninit2=6AM |last3=Partridge |volumefirst3=J. Colin |chapterinit3=JC |pagelast4=82Sniderman |locationfirst4={{AUSCSusan |VIC}}, Australiainit4=S |publisherlast5=Blackwell Science AsiaArmstrong-Wells |isbnfirst5=Jennifer |quoteinit5=J |accessdatelast6=Fuentes-Afflick |notefirst6=Elena}}</ref><ref>{{REFdocument |init6=E |title=Autopsy Pain During Mogen or Plastibell Circumcision |journal=Journal of Demetrius MankerPerinatology |volume=22 |issue=3 |pages=214-8 |url=http://www.nature.com/jp/journal/v22/n3/full/7210653a.html |contributionquote=Case 93-1711...more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure. |lastpubmedID=Wetli |firstpubmedCID=CV |publisherDOI=Miami: Dade County Medical Examiner Department |formatnote=April/May 2002 |date=19932002-06-2304 |accessdate=2011-04-08}}</ref> <refname="Clinical Pediatrics August 1986">{{REFjournal |last=HissWilliamson |initfirst=JPaul S. |last2init=HorowitzPS |init2last2=AEvans |last3first2=KahanaNolan Donovan |init3init2=TND |title=Fatal haemorrhage following male ritual circumcisionNeonatal Cortisol Response to Circumcision with Anesthesia |journal=J Clin Forensic Med |date=2000Clinical Pediatrics |volume=725 |issue=8 |pages=32412-46 |url=http://wwwcpj.cirpsagepub.orgcom/librarycontent/death25/hiss18/412.abstract |quote=The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine. |pubmedID= |pubmedCID= |DOI= |date=1986-08 |accessdate=20192011-1104-0608}}</ref>During circumcision, somp physicians give children sugar pacifiers to "reduce the perception of pain",<ref>{{REFdocumentREFweb |titlequote=Judgement of inquiry into During the death of McWilliscircumcision, Ryleigh Roman Bryanyour son will receive sugar pacifiers to suck on which reduce his pain perceptions. |url=http://www.circumstitionspollockclinics.com/deathcircumcision/circumcision-exsangbefore.html |contributiontitle=Before the Circumcision |last=Newell |first=TEC |publisher=Burnaby, B.C.: B.C. Coroner's Service |format= |date=20042011-0104-1908 |accessdate=20192011-1104-2608}}</ref>* Post operative [[lymphoedema]].* Postoperative [[Infection| infections]]. This includes both local infectionsbut in at least one study, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatmentdata shows that giving sugar to a child doesn't help to reduce the perception of pain in the child.<refname="Lancet, The 2010-10-09">{{REFconferenceREFjournal |last=Dr. med. HartmannSlater |first=WolfgangRebeccah |urlinit=R |placefirst2=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German)Laura |titleinit2=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German)L |datelast2=2012-11-26Cornelissen |accessdatefirst3=Lorenzo}}</ref> |init3=L* [[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>{{REFjournallast3=Fabrizi |lastfirst4=BlalockDebbie |initinit4=HJD |last2last4=VemulakondaPatten |init2first5=VJan |last3init5=RitcheyJ |init3last5=MLYoxen |last4first6=RibbeckAlan |init4init6=MA |titlelast6=Outpatient management of [[phimosis]] Following newborn circumcisionWorley |journalfirst7=J UrolStewart |dateinit7=2003S |volumelast7=169Boyd |issuefirst8=6Judith |pagesinit8=2332-4J |urllast8=http://www.cirp.org/library/complications/blalock1/Meek |accessdatefirst9=2019-11-26}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournalMaria |lastinit9=LeitchM |initlast9=IOWProf. Fitzgerald |title=Circumcision - Oral sucrose as an analgesic drug for procedural pain in newborn infants: a continuing enigmarandomised controlled trial |journal=Aust Paediatr J |date=1970The Lancet |volume=6376 |issue=9748 |pages=591225-6532 |url=http://www.cirpthelancet.orgcom/libraryjournals/generallancet/leitch1article/PIIS0140-6736%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>Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals.

{{Box|Boxtext=<big><b>However, none of the above three procedures totally eliminate pain. A baby boy will still experience some pain despite any of those analgesic procedures. Prevention of [[pain]] requires protecting a boy from elective neonatal non-therapeutic circumcision. Only boys who are protected from the medically unnecessary circumcision surgery experience no [[pain]] or [[trauma]].</b></big>}} == Risks and effects ==Just like tonsil or appendix surgery, circumcision is a surgical intervention and brings the usual risks related to surgical operations, alongside several specific risks of complications and late effects. Uberoi et al. (2022) report "some men are experiencing a complex negative constellation of psychological, physical, and sexual associations that lead to significant emotional distress directed both internally and externally. The posts also reveal a discovery phenomenon wherein men discover the physical and psychological manifestations of the decisions made by others to modify their genitals."<ref name ="uberoi2022">{{REFjournal |last=Uberoi |first= |init=M |author-link= |last2=Abdulcadir |first2= |init2=J |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=Potentially under-recognized late-stage physical and psychosexual complications of non-therapeutic neonatal penile circumcision: a qualitative and quantitative analysis of self-reports from an online community forum |trans-title= |language= |journal=Int J Impot Res |location= |date=2022-10-23 |volume= |issue= |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 late effect of any circumcision is the permanent loss of sexual sensitivity. This is partly due to the removal of sensory tissue. The [[foreskin]] contains very many nerve endings and touch receptors, which account for the major part of male sexual sensation. If the [[foreskin]] is removed, they can no longer provide sexual stimulation. It is also partly due to the fact that the surface of the [[Glans penis|glans]] reacts to the missing protection from friction and drying out by developing a callus layer. This reduces the sensitivity of the remaining nerves in the [[Glans penis|glans]] gradually over the years. The study conducted by Sorrells et al.<ref>{{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.

=== Psychological late Sexual effects === [[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late Cepeda-Emiliani et al (2023) cited six reports in the literature of detrimental effects]] are also possible after a of circumcision, especially if the operation was carried out in childhoodincluding erectile function, sensation, masturbatory pleasure, orgasm, and sexual satisfaction. On this occasion a variety The authors also cited three studies of severe distress in [[traumacircumcised]] may occurmen, which depend, among others, on age and circumstances of the due to their infant circumcision. For example, whether the circumcision took place with or without sufficient anaesthesia, if the individual has been informed about the operation beforehandcomplaints of [[glans]] insensitivity, if he was delayed [[circumcisedejaculation]] against his will or without his consent, and also, in unpleasant sensation.<ref name="cepeda2023">{{REFjournal |last=Cepe da-Emiliani |first= |init=A |author-link=Alfonso Cepeda-Emiliani |last2=Gándara-Cortés |first2= |init2=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=García-Caballero |first8= |init8=R |author8-link= |etal=no |title=Immunohistological study of the case density and distribution of infant circumcision, if he was told about it during childhood or had to find it out coincidentally on his ownhuman penile neural tissue: gradient hypothesis |trans-title= |language= |journal= Int J Impot Res |location= |date=2023-05-02 |volume=35 |issue=3 |article= |page= |pages=286-305 |url=https://www.nature.com/articles/s41443-022-00561-9 |archived= |quote= |pubmedID=35501394 |pubmedCID= |DOI=10.1038/s41443-022-00561-9 |accessdate=2023-11-26}}</ref>

The psychological late effects of circumcision are not yet fully researched, Circumcision and many studies took place on rather a small scalefrenectomy remove tissues with heightened erogenous sensitivity. This situation needs <ref name="cepeda2023" /> <ref name="winkleman1959">{{WinkelmannRK 1959}}</ref> They concluded, "Evidence has also started to be rectifiedaccumulate that male circumcision may result in lifelong physical, because the available studiessexual, and sometimes psychological harm as well as the histories of negatively affected men, suggest that these late effects may have more impact than previously assumed."

The [[amputation]] of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the [[penis]], leaving only the uninhibited protopathic sensibility of the artificially externalized [[glans penis]]. The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of the changes in sexual behavior noted in [[circumcised]] human males.<ref>{{REFjournal |last=Van Howe |init=RS |author-link=Robert S. Van Howe |last2=Cold |init2=CJ |title=Advantages and Disadvantages of Neonatal Circumcision |journal=The Journal of the American Medical Association |volume=277 |issue=13 |pages=1052-7 |url=http://www.ncbi.nlm.nih.gov/pubmed/9218663 |quote= |pubmedID=9218663 |pubmedCID= |DOI= |date=1997-04-02 |accessdate=}}</ref> Histology of the male circumcision scar shows [[amputation]] neuromas, Schwann cell proliferation and the bulbous collection of variably sized neurites. [[Amputation]] neuromas do not mediate normal sensation and are notorious for generating pain.<ref name="ColdCJ TaylorJR 1999"/> Cepeda-Emiliani et al. (2023) commented:<blockquote> Taking the sleve technique as an example of surgical flexibility during circumcision, to the extent that this technique is of such versatility that it allows highly variable quantities of cutaneous and subcutaneous tissue to be excised directly from the penile body, and to the extent that the prepuce is still conceived by segments of the medical community as "just a small piece of skin", we are concerned that aggressive circumcisions are intentionally or unintentionally being performed in pediatric and adult patients in the belief that "redundant" or " extra" tissue is being excised, or in the belief that "excesive sensitivity" is being reduced to augment ejaculatory latency time.<ref name="cepeda2023" /></blockquote>The un-anesthetized and un-sedated newborn infant is restrained by being strapped to a special plastic board called the [[circumstraint]]. The procedure is most often an elective, non-therapeutic surgery without [[medical indication]] performed on neonates and children for religious and cultural reasons in violation of the child's [[human rights]] to [[physical integrity]], but in older patients may be rarely indicated for therapeutic reasons. It is a radical treatment option for pathological [[phimosis]], refractory [[balanoposthitis]] and chronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health.  See [[Sexual effects of circumcision]] for more information. === Psychological effects ===[[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effects]] are also possible after a circumcision, especially if the operation was carried out in childhood. On this occasion a variety of [[trauma]] may occur, which depend, among others, on age and circumstances of the circumcision. For example, whether the circumcision took place with or without sufficient anaesthesia, if the individual has been informed about the operation beforehand, if he was [[circumcised]] against his will or without his consent, and also, in the case of infant circumcision, if he was told about it during childhood or had to find it out coincidentally on his own. 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. * It was observed that infants, following circumcision without [[pain ]] control, had a disturbed bond with their mother<ref>{{REFjournal |last=Marshall |init=RE |last2=Porter |init2=FL

|url=httphttps://www.cirp.org/library/birth/marshall2/

* In boys [[circumcised]] in childhood, [[posttraumatic post-traumatic stress disorder]] ([[PTSD]]) could be diagnosed. In a study on Philippine boys, in whom no [[PTSD]] 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 operation.<ref>{{REFbook

|url=httphttps://www.cirp.org/library/psych/goldman1/

* 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

|url=httphttps://www.cirp.org/library/psych/rhinehart1/

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

|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 , where the bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is often insufficient for the operation. Even in conjunction with regional anaesthesia of the dorsal nerve of the [[circumcisedpenis]] without analgesia experience pain and physiologic stress"''. Furthermore, the pain rate of failure to provide sufficient anaesthetic even for experienced anaesthetists is quite severestill 5-10%. The general anaesthesia that would be needed for newborns, however, and requires injections poses significant risks for proper pain management. Sucrose the child, and Acetaminophen ''"cannot , therefore, is only likely to be recommended as the sole method of analgesia"''used in emergencies. Topical cream is no longer thought sufficient as ''"A surgical operation without proper [[pain]] control can lead to the analgesic effect is limited during 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=6862019-93 |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=2142019-11-826 |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=20022012-11-0426 |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=4122332-64 |url=httphttps://cpjwww.sagepubcirp.comorg/contentlibrary/25complications/8blalock1/412.abstract |quoteaccessdate=The adrenal cortisol response to surgery was not significantly reduced by 2019-11-26}}</ref>, the administration of lidocaineprevalence is 2.9%, according to Leitch<ref>{{REFjournal |last=Leitch |pubmedIDinit=IOW |pubmedCIDtitle=Circumcision - a continuing enigma |DOIjournal=Aust Paediatr J |date=19861970 |volume=6 |issue= |pages=59-0865 |url=https://www.cirp.org/library/general/leitch1/ |accessdate=20112019-0412-0815}}</ref> During 5.5%.* [[Sudden Infant Death Syndrome]] (SIDS).* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], is cut during circumcisionwithout being clamped and sutured at its origin separately, somp physicians give children sugar pacifiers it starts to "reduce develop new branches over time, which can lead to the development of knots.* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro-penis) and induratio [[penis]] plastica (skewed penis).* Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis|glans]] or the [[penis]] can occur.* In rare cases, [[necrosis]], gangrene, ischaemia, keloid formation, and circulatory problems may also occur.* When the circumcision is followed by the perception 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=122578-3290 |url=http://www.thelancetmensstudies.com/journalscontent/lancetb64n267w47m333x0/article/PIIS0140-6736%2810%2961303-7/fulltext?p=7ebbd6b446d940cbbd4274c095754b12π=5 |quote=Our data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuits, and therefore might not be an effective analgesic drug. The ability of sucrose to reduce clinical observational scores after noxious events in newborn infants should not be interpreted as pain relief.

|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>{{TaddioA etal 1995}}</ref><ref>{{TaddioA KatzJ IlersichAL KorenG 1997}}</ref> {{Box|Boxtext=<big><b>However, none of the above three procedures totally eliminate pain. A baby boy will still experience some pain despite any of those analgesic procedures. Prevention of [[pain]] requires protecting a boy from elective neonatal non-therapeutic circumcision. Only boys who are protected from the medically unnecessary circumcision surgery experience no pain or [[trauma]].</b></big>}} === Sexual effects === Circumcision and frenectomy remove tissues with heightened erogenous sensitivity. Boyle et al. (2002) wrote, "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings&mdash;many of which are lost to circumcision."<ref>{{REFjournal |last=Boyle |first=Gregory J. |init=GJ |author-link=Gregory Boyle |first2=Gillian A. |init2=GA |last2=Bensley |title=Adverse Sexual and Psychological Effects of Male Infant Circumcision |journal=Psychological reports |volume=88 |issue=3, Part 2 |pages=1105–6REFweb |url=http://www.cirpicgi.org/library2010/psych/boyle504/infant-circumcision-causes-100-deaths-each-year-in-us |title=Infant circumcision causes 100 deaths each year in US |quotelast= |pubmedIDfirst=11597060 |pubmedCIDpublisher=ICGI |DOIwebsite=10.1046/j.1464-410x.1999.0830s1085.x[[International Coalition for Genital Integrity]] |date=July 20012010-04-26

}}</ref> They concluded, "Evidence has See also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as wellthe list of [[fatalities]]."

The [[amputation]] of the prepuce results in the loss of the majority of fine== Forced circumcision ==<!--touch neuroreceptors found === United States military ===American soldiers serving in the [[penis]], leaving only the uninhibited protopathic sensibility World War II were subjected to regular inspections of the artificially externalized [[glans penis]]their genitals. The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of If intact, the changes in sexual behavior noted in [[circumcised]] human malessoldiers risked being ordered to undergo immediate circumcision.<ref>{{REFjournalREFbook |last=Van HoweSchoen |first=Ed |init=RSE |author-link=Robert SEdgar J. Van HoweSchoen |last2year=Cold2005 |init2title=CJOn Circumcision |titleurl=https://books.google.de/books?id=Advantages and Disadvantages of Neonatal Circumcision-zUhdvSt7cgC |journalwork=The Journal of the American Medical Association |volumeeditor=277Dianne Yeakey |issueedition=13 |pagesvolume=1052-7 |urlchapter=http://www.ncbi.nlm.nih.gov/pubmed/9218663 |quotepages=72-3 |pubmedIDlocation=9218663Georgetown, Canada |pubmedCIDpublisher=RDR Books |DOIisbn=1-157143-123-3 |datequote=1997-04-02For a critical view, see Sorrells, "The History of Circumcision," p. 333

|note=}}</ref>This practice was discontinued at least six decades ago.-->=== Non-therapeutic circumcision of male children ===

Histology Human babies, because they are not yet in possession of language, are incapable of giving or refusing consent to be [[circumcised]]. The element of force has led some scholars to view the circumcision of baby boys as a category of forced circumcision.<ref>For example, Frederick M. Hodges, a medical historian, writes: "In the late 1970s, as the Americans were growing increasingly aware of the male abuses of power rampant throughout the nation's social institutions, influential grass-roots movements protesting the forced circumcision scar shows of American children sprang up nationwide." F. Hodges, "A Short History," p. 31; see also [[amputationLeonard B. Glick|Glick]] neuromas, Schwann cell proliferation ''Marked in Your Flesh'', pp. 273-281.</ref> There are, however, physicians in the United States who argue strongly for non-therapeutic circumcision of newborn babies; and the bulbous collection circumcision is widely accepted as a postnatal procedure in American hospitals.<ref>{{REFbook |last=Fletcher |first=Christopher R. |init=CR |year=1999 |title=Circumcision in America in 1998: Attitudes, Beliefs, and Charges of variably sized neuritesAmerican Physicians |url=http://www.springerlink. com/content/h2150v731233m177/ |work=Male and Female Circumcision |editors=[[AmputationGeorge C. Denniston]] neuromas do not mediate normal sensation , [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |edition= |volume= |chapter=Section 5 |pages=259-71 |location=New York |publisher=Kluwer Academic/Plenum Publishers |isbn= |quote= |accessdate=2019-10-12 |note=ID 10.1007/978-0-585-39937-9_19}}</ref> Parental consent is required.<ref>See, e.g., Shephard and are notorious 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 generating painparents to take into account cultural, religious, and ethnic traditions, in additions to the medical factors, when making a decision."<ref name=>Lannon and Bailey, "ColdCJ TaylorJR 1999Circumcision Policy Statement,"p. 691.</ref>however surrogate consent for non-therapeutic circumcision is now viewed as unethical.

=== Death ===A study in 2010 estimated approximately 117 neonatal circumcision-related deaths occur annually in In the [[United StatesKingdom]], about one out of every 77 male neonatal deaths, more where non-therapeutic circumcision has now become far less prevalent than suffocation, auto accidents, or even in the [[SIDSUnited States]].<ref name="Bollinger 2010">{{REFjournal |last=Bollinger |first=Dan |init=D |author-link=Dan Bollinger |last2=Boy's Health Advisory |title=Lost Boys: An Estimate , the written consent of U.S. Circumcisionboth parents is required, if a physician is to perform a non-Related Infant Deaths |journal=Thymos: Journal therapeutic circumcision 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/thya child.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 |last=

|publishertitle=ICGIRe J (child's religious upbringing and circumcision) |websitejournal=[[International Coalition for Genital Integrity]]Family 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===

== Forced {{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]

<!--=== United States military Gomco clamp circumcision===

American soldiers serving in World War II were subjected to regular inspections of their genitals. If intact, '''Not for the soldiers risked being ordered to undergo immediate circumcision.<ref>{{REFbook |last=Schoen |first=Ed |init=E |author-link=Edgar J. Schoen |year=2005 |title=On Circumcision |url=httpssqueamish://books.google.de/books?id=-zUhdvSt7cgC''' |work= |editor=Dianne Yeakey |edition= |volume= |chapter= |pages=72-3 |location=Georgetown, Canada |publisher=RDR Books |isbn=1-157143-123-3 |quote=For This is a critical view, see Sorrells, "The History video of Circumcision," pan actual circumcision with a Gomco clamp. 333 |accessdate= |note=}}</ref> This practice was discontinued at least six decades agoThe infant boy received two dorsal penile nerve block (DPNB) analgesic injections but they did not seem to work.-->

Human babies, ==Recommendations of medical authorities==* [[George Hill| Hill]] (2007) said:<blockquote>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 Historyinvasive," p. 31; see also [[Leonard B. Glick|Glick]]injurious, ''Marked in Your Flesh'', 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 |init=CRG |yearauthor-link=1999George Hill |title=Circumcision in America in 1998: Attitudes, Beliefs, and Charges of American PhysiciansThe case against circumcision |urljournal=http://www.springerlink.com/content/h2150v731233m177/ |work=Male Journal of Men's Health and Female Circumcision |editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]Gender |editiondate=2007 |volume=4 |chapterissue=Section 53 |pages=259318-7123 |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=307395-147 |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.) In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<ref>See, e.g., [[Margaret A. Somerville|Somerville]], "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 2010"/blockquote>

==Video=====Is circumcision healthy?===* The video ''Is Circumcision Healthy'' is recommended for parental viewing.<br><br> <youtube>D_3LQjZgdbQ</youtube>[[Royal Dutch Medical Association]] (KNMG) (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 of children’s rights to autonomy and physical integrity. 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 deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications.<ref>{{REFdocument |title=Non-therapeutic circumcision of male minors |url==Drhttps://www.doctorsopposingcircumcision. Christopher Guest discusses 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}}<br/ref><youtube>v=TQIp9f4krVQ</youtubeblockquote>

{{UNI|Stanford University|SU}} <blockquote>Ethical and [[human rights]] concerns have been raised regarding elective infant male circumcision because it is recognised that the foreskin has published a video of an actual functional role, the operation is non-therapeutic plastibell circumcision. The and the infant has received two injections of local anesthesia is unable to deaden the dorsal nerves. The ventral nerves were not deadened so the infant still feels pain. One can his cries on the soundtrackconsent.* [https://med.stanford.edu/newborns/professional-education/circumcision/plastibell-technique.html Plastibell Technique]

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 reasonable for parents to weigh the benefits and risks of circumcision and to make the decision whether or not to circumcise their sons.<ref name="racp2010">{{REFdocument |title=Circumcision of Infant Males |url=Gomco clamp https://www.racp.edu.au//docs/default-source/advocacy-library/circumcision-of-infant-males.pdf |contribution= |last= |first= |publisher=The Royal Australasian College of Physicians |format=PDF |date=2010-09-01 |accessdate=2021-11-08}}</ref></blockquote>

This is a video of an actual * Medical historian [[Robert Darby]] (2014) wrote simply:<blockquote>"To avoid circumcision complications, avoid circumcision."<ref>{{REFjournal |last=Darby |first= |init=R |author-link=Robert Darby |etal=no |title=To avoid circumcision complications, avoid circumcision with a Gomco clamp |trans-title= |language= |journal=Can Urol Assoc J |location= |date=2014-08-14 |volume=8 |issue=7-8 |article= |page=231 |pages= |url=https://cuaj.ca/index.php/journal/article/view/1709/1823 |archived= |quote= |pubmedID= |pubmedCID= |DOI=10.5489/cuaj. 1709 |accessdate=2022-12-16}}</ref></blockquote>* The infant boy received two dorsal penile nerve block [[Canadian Paediatric Society]] (CPS) (DPNB2015) analgesic injections but they did not seem to work.said:

* [<blockquote>In most jurisdictions, authority is limited only to interventions deemed to be medically necessary. In cases in which medical necessity is not established or a proposed treatment is based on personal preference, interventions should be deferred until the individual concerned is able to make their own choices.<ref name="CPS2015">{{REFjournal |last=Sorokin |first=S. Todd |init=ST |author-link= |last2=Finlay |first2=JC |author2-link= |last3=Jeffries |first3=AL |author3-link= |etal=yes |title=Newborn male circumcision |journal=Paediatr Child Health |location= |date=2015-08 |volume=20 |issue=6 |pages=311-20 |url=https://www.redditncbi.nlm.nih.comgov/pmc/rarticles/IntactivismPMC4578472/comments |quote= |pubmedID=26435672 |pubmedCID=4578472 |DOI=10.1093/qbpzqrpch/20.6.311 |accessdate=2019-10-27}}</trained_medical_professionals_restrain_infant_toref></ Circumcision video]blockquote>

==Recommendations of medical authorities==* The [[George Hill| HillCanadian Urological Association]] (2007CUA) saidconsidered the matter of circumcision and issued a statement in February 2018. The CUA concluded: <blockquote>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 "Given the cycle of abuse. Male circumcision is a costly diversion of medical resources away from beneficial services. Male circumcision violates legal rights, [[human rights]]socioeconomic, and ethical standards. Finallyeducational status, we must remember that males are the more vulnerable and sensitive of the two genders and, therefore, deserve the greater degree health demographics of protection from traumatic, invasive, injuriousour population,and unnecessary surgery. For all of these reasons the non-therapeutic universal neonatal circumcision of boys should not cannot be performed and justified based on the [[genital integrity]] of all children should be respected and protectedcurrent evidence available.<ref name="hill2007cua2018">{{REFjournal |last=HillDave |first=GeorgeSumit |init=GS |author-link=George Hill |etal=yes |title=The case against Canadian Urological Association guideline on the care of the normal foreskin and neonatal circumcisionin Canadian infants (abridged version) |journal=Journal of Men's Health and GenderCan Urol Assoc J |location= |date=20072018-02 |volume=412 |issue=32 |pages=31818-2328 |url=https://wwwcuaj.academiaca/index.eduphp/journal/article/view/83673835034/The_Case_Against_Circumcision3470

|accessdate=2021-0511-3009}}</ref></blockquote>* Andrew E==British family court opinion==The issue of non-therapeutic circumcision of male children came before the court in the case of ''[[Re B and G (children) (No 2) EWFC 3]] (2015)'' . MacNeiiyIn that case, Head, Division Judge Sir James Munby ruled that circumcision of Pediatric Urologymale children caused ''significant harm''. == Rights and ethics == The [[Rights situation on circumcision|rights situation]] is discussed in a separate article. [[Image:Intact vs circumcised.JPG |thumbnail|right|300px| The intact and circumcised human penis, Department of Urological Sciencesside by side.]] The term "circumcision" without a gender qualifier refers specifically to male circumcision. It means "to cut around, {{UNI|University " and it refers to the [[excision]] of British Columbiathe [[foreskin]] from the penis. The term is inaccurate and a euphemism because the operation actually cuts off or [[amputation|UBC}}amputates]] the [[foreskin]], Vancouver, BC, (2008) said:which in adults comprises about fifteen square inches of highly functional erogenous tissue.

<blockquote>Newborn circumcision remains an area of controversyCircumcision is most often performed in healthy males for [[Religion and Culture|religious or cultural]] reasons. SocialThe procedure may be performed on consenting adults, cultural, aesthetic and religious pressures form the but it is most common reasons for often performed on non-therapeutic circumcision. Although penile cancer and UTIs are reduced compared with uncircumcised malesconsenting minors, particularly newborn children, which is why the incidence of such illness ritual is so low that circumcision cannot be justified as prophylaxiscontroversial. The role Opponents of circumcision consider the foreskin in circumcision of non-consenting minors to be unethical and a [[HIVhuman rights]] transmission in developed countries violation, unless there is unclear, and safe sexual practice remains the cornerstone of preventionconcrete [[medical indication]]. There remains a lack of knowledge regarding what constitutes the normal foreskin both among parents and among primary care providers. This lack of knowledge results in a burden of costs to our health care system in === Consent by surrogates ===Medical ethics has long recognized limitations on the form of unnecessary urological referrals, expansion power of wait times and circumcisions. Routine circumcision of all infants is not justified from a health or cost-benefit perspectiveconsent by surrogates.<ref>{{REFjournal |last=MacNeily |first=Andrew |init= |author-link=Committee on Bioethics, American Academy of Pediatrics

|title=Routine circumcision: the opposing viewInformed consent, parental permission, and assent in pediatric practice

|journal=Can Urol Assoc JPediatrics

|date=2007-111995 |volume=195 |issue=42

|pages=395314-717 |url=httphttps://europepmcwww.cirp.org/library/ethics/AAP/ |archived= |quote= |pubmedID=7478854 |pubmedCID= |DOI= |accessdate=2023-05-21}}</ref> <ref>{{REFjournal |last=Committee on Bioethics |etal=no |title=Informed Consent in Decision-Making in Pediatric Practice |trans-title= |language= |journal=Pediatrics |location= |date=2016-08 |volume=138 |issue=2 |article= |page=e20161485 |pages= |url=https://PMCwatermark.silverchair.com/2422979peds_20161485.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQM8zYHFd0Ylu9Annq_AgEQgIICT24ikc839aJMYOiypqC2G9f7_yKGAGkAekzzbCtck5TElALWVCGNoVSOaA6rDA_dOkQ_LyJnxYlZ88J9-uk15tvlIBbE82_aNyYfq5e9xmEfqD2vh374q3Naz57dxZaUbgxUkKX4PqsiLmYHLvVrr7bQK2MZuuUOKiQU8JZy7lLjkp-PjJO1U9cyIplTAgs_EdvgK8MWWoIsj-X-ZUDImAG63-rlj_qLsy5dYwytmxfCuVa47RdZseLSr2_bdDpwKAKGhq_Ly9rlHZeW_f7fYktVfF_sFTgcJziAlvEQmdyWIw0qf-hlO31Qb3sH6kDdcvHAbm7llY5xa34XLYIt8QR0YFIimgDGFliN4-ce2vjvvrwS85WeeNFhpn-Ywn4Qjpy06hPuLDL-MtI2Z3BZbBsKq4dp8qGu1q9GlXaKw193riTFG9G5bF5GCKmxmt0nCQTthrb_CcK2UhKjZwPekC9zkIUHPZ9BXJt0SM03F_g-GgqbE0hTYKMqNdJ3sHDQu2luFrJ9JEiMzxtP28gJoYh20d2APA0xrRbXBYsFdAlr50gb1BSAbNJhTyx-Kh3geoSHsAYMjPaG7cIbh0jd42pWCUx30vjlAGK8zXTuf7-31oi81CLbHTAJLuzK3NT4Whi17jVq1SbXsIXlWpKc_d-HujCvlb74rkZQ6RG9wkxW7gAKaDqtKv5zTOTMBD9vLVxgp8lDmVA8PFB59Bqd6w-fi86tW132oWQM-mTfwdIBXFbUFXkeTUC5RYyqJQIXAEwLJSRm1RX-LRbKRzgaRQ |archived= |quote= |pubmedID=1854282527456510

|DOI=10.54891542/cuajpeds.4552016-1485 |format=PDF |accessdate=20212023-1105-0821}}</ref></blockquoteref>{{REFjournal |last=Committee on Bioethics* The [[Royal Dutch Medical Association]] (KNMG) (2010) said: ||etal=no |title=Informed Consent in Decision-Making in Pediatric Practice |trans-title= |language=<blockquote> |journal=Pediatrics |location=The official viewpoint of KNMG and other related medical/scientific organisations is that non |date=2016-therapeutic circumcision of male minors is a violation of children’s rights to autonomy and physical integrity. Contrary to popular belief, circumcision can cause complications – [[bleeding]], infection, [[urethra]]l stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications.<ref>{{REFdocument08 |volume=138 |issue=2 |article= |page=e20161484 |titlepages=Non-therapeutic circumcision of male minors |url=https://wwwwatermark.doctorsopposingcircumcisionsilverchair.orgcom/wppeds_20161484.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMYv3coRY-content/uploads/2016/09/knmgUCYMgTaqAgEQgIICT4di03qn2Hbho3i8Li_78lod0lNMunch25nx1rKvaM_aeFerz5eN6_k8VVeNv-nonDLocZp28whQr1x4WYDVwSs4uF73vZpYZYuDphYQkwxV1HHgMbZAbHBFuE8QyCHyDvSY-therapeuticfhQcUl-circumcisionJrYxa3TbhYgd4bKiU9zfIyXUsCnItroCc9iNrMicPg0v_A0AJJlhxioOlAU-ofim6OPI06OcCBj78yqkPO0J4nMTN1FLochsOyvZZdtFQQzLhrnM_Gey8K75lFYIBJHA7uzMmP2o5KZ-maleFTGUkEA_eSpEIpwv2WI4SbtrA8WYk3cQqXOmLIWjkSs9CTELD7CQP29xarr1ANrF_id4CiCX7zIomC2Ciz9lHBEgz8EH2i9Woke_YuZeLax52_6JpdhH1qdMQyF1bByjP8mU98V5_B4BPPiBpKt4pVA_UgtaABRHL8oPv6SwOUQZ2Bc-minors0_E2tod0VIF1FJBwZRZJm2ZkJPgBSKUo8VBe5Pz_6Vpt2DqLzwqVUYscPsIJMvxl09mMtvJrsBa8yVoTRWj4Rd0OBTMV7zhZskDnYYyrAZ6sHMk0MzvbHilPNbNgU5o7mXmcbFGDgGgWbqrIdT6sVSSfPJm4TnR0HSWbc_EnHhhyye7tVlFGjAsR0R46_DSwEMz8M5DkSln8xfKtX_so9rjCvYeq45wqn09g8DqtV-27WHEA9PIrcw5kTcz5I0JkNuW4-05-2010.pdfvKVU1Xz9XHiYi4Zqbq0vx9NWLdNSYHQSOGMZ1MCAxT152evQdipQB5wokR8Q4rICoJYII5bsmRMYd7JQ |archived= |contributionquote= |lastpubmedID=27456514 |firstpubmedCID= |publisherDOI=Royal Dutch Medical Association10.1542/peds.2016-1484

|date=2010 |accessdate=20212023-1105-0821

* The [[Royal Australasian College of Physicians]] Two ethicists, Myers & Earp (20102020) said: <blockquote>Ethical , have conducted a detailed review and analysis of the claimed medical benefits of ''non-therapeutic'' [[human rightscircumcision]] concerns . They have been raised regarding elective infant male circumcision because it is recognised that determined than the foreskin has alleged benefits are not material, so they do not support granting of consent by a functional rolesurrogate. In other words, the operation is non''Non-therapeutic and the infant '' circumcision is unable to consentnot truly healthcare.  After reviewing the currently available evidenceMoreover, they comment that even the RACP believes that most perfectly executed surgery produces [[trauma]] and harm to the frequency patient. Circumcision also produces tissue loss and loss of diseases modifiable by function, therefore, circumcision, should be performed only after the individual reaches the level age of protection offered consent. <u>Consent by a surrogate for a ''non-therapeutic'' circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand. However it a minor child is reasonable for parents to weigh the benefits and risks of circumcision and to make the decision whether or not to circumcise their sonsan unethical practice.</u><ref name="racp2010myers2020">{{REFdocumentREFjournal |last=Myers |first= |init=A |author-link= |last2=Earp |first2= |init2=BD |author2-link=Brian D. Earp |etal=no |title=What is the best age to circumcise? A medical and ethical analysis |trans-title=Circumcision of Infant Males |language= |journal=J Biosoc Sci |location= |date=2020-09 |volume=34 |issue=7 |pages=560-72 |url=https://wwwonlinelibrary.racpwiley.educom/doi/abs/10.au1111/bioe.12714 |archived= |quote= |pubmedID=32068898 |pubmedCID= |DOI=10.1111/docsbioe.12714 |accessdate=2023-05-18}}</defaultref> == Tipping point ==[[Intact America]] (2024) argues that public opinion regarding non-sourcetherapeutic [[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://advocacy-libraryintactamerica.org/circumcisionpublic-ofopinion-infanton-males.pdfcircumcision/ |contributiontitle=Public Opinion on Circumcision: Can Intactivists Hit A Tipping Point? |last=Anonymous

|publisherinit=The Royal Australasian College of Physicians |formatpublisher=PDFIntact America |date=20102024-0903-0123 |accessdate=20212024-1104-0809

</blockquote>{{SEEALSO}}* [[Adolescent and adult circumcision]]* The [[American Academy of PediatricsBodily harm]] (AAP) has not re-affirmed its disastrous, failed 2012 Circumcision Policy Statement, which expired in 2017, so currently has no position on child circumcision.* [[Breastfeeding]]* Medical historian [[Robert DarbyCase Histories]] (2014) wrote simply:<blockquote>* [[Circumcision maps]]"To avoid circumcision complications, avoid circumcision."<ref>{{REFjournal* [[Circumcision methods]] |last=Darby* [[Circumcision scar]] |first=* [[Circumpendium]] |init=R* [[Circumstraint]] |author-link=Robert Darby |etal=no |title=To avoid circumcision * [[Documented severe complications, avoid of circumcision]] |trans* [[Ethics of non-title=therapeutic child circumcision]] |language=* [[FGM]] |journal=Can Urol Assoc J* [[Human rights]] |location=* [[Lymphoedema]] |date=2014-08-14* [[MGM]] |volume=8* [[Pain]] |issue=7-8* [[Psychological issues of male circumcision]] |article=* [[Rights situation on circumcision]] |page=231* [[Risks and complications]] |pages= |url=https://cuaj.ca/index.php/journal/article/view/1709/1823 |archived= |quote= |pubmedID= |pubmedCID= |DOI=10.5489/cuaj.1709 |accessdate=2022-12-16}}</ref></blockquote>* [[Sexual effects of circumcision]]* The [[Canadian Paediatric SocietySudden Infant Death Syndrome]] (CPSSIDS) (2015) said:* [[Trauma]]{{LINKS}}

<blockquote>In most jurisdictions, authority is limited only to interventions deemed to be medically necessary. In cases in which medical necessity is not established or a proposed treatment is based on personal preference, interventions should be deferred until the individual concerned is able to make their own choices.<ref name="CPS2015">* {{REFjournal |last=Sorokin |first=S. Todd |init=ST |author-link= |last2=Finlay |first2=JC |author2-link= |last3=Jeffries |first3=AL |author3-link= |etal=yes |title=Newborn male circumcision |journal=Paediatr Child Health |location= |date=2015-08 |volume=20 |issue=6 |pages=311-20REFweb |url=https://www.ncbi.nlmcirp.nih.govorg/pmclibrary/articlesanatomy/PMC4578472garcia/ |quotetitle=What exactly is circumcision and what is it not? |pubmedIDlast=26435672Garcia |pubmedCIDfirst=4578472Francisco |DOIdate=10.1093/pch/20.6.3111995-12-11 |accessdate=20192020-1009-2708

<* {{REFjournal |last=Fleiss |first=Paul |init=P |author-link=Paul M. Fleiss |title=The foreskin is necessary |journal=Mothering |date=1997-01 |volume= |issue= |pages=36-45 |url=http:/ref></blockquote>www.noharmm.org/mothering.htm |accessdate=2020-06-29}}* The [[Canadian Urological Association]] (CUA) considered the matter of {{REFweb |url=https://15square.org.uk/losses-from-circumcision and issued a statement / |title=Losses from Circumcision |last=Ball |first=Peter |publisher=15 Square |date=2003-08-09 |accessdate=2023-02-23}}* {{REFweb |url=http://members.tranquility.net/~rwinkel/MGM/primer.html |title=Male Circumcision in February 2018. The CUA concludedthe USA:A Human Rights Primer |last=Winkel |first=Rich |author-link=Rich Winkel |date=2005-05-12<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 |accessdate="cua2018">2021-01-27}} * {{REFjournal |last=DaveTesta |first=SumitPatrick |init=S

|last2=Block |first2=Walter E. |init2= |author2-link= |etal=yesno |title=Canadian Urological Association guideline on the care of the normal foreskin Libertarianism and neonatal circumcision in Canadian infants (abridged version) |trans-title= |language= |journal=Can Urol Assoc Int JHealth Poiicy Manag

|date=20182014-0205-26 |volume=123 |issue=2 |article= |page= |pages=1833-2840 |url=https://cuajwww.ca/indexacademia.phpedu/journal/article7587653/Libertarianism_and_Circumcision?email_work_card=view/5034/3470 |quote=-paper |pubmedID=24987720 |pubmedCID=4075101 |DOI=10.15171/ijhpm.2014.51 |accessdate=2021-11-09}}</ref></blockquote>

== Rights and ethics == The [[Rights situation on circumcision|rights situation]] is discussed in a separate article. [[Image:Intact vs circumcised.JPG |thumbnail|right|300px| The intact and circumcised human penis, side by side.]] The term "circumcision" without a gender qualifier refers specifically to male circumcision. It means "to cut around," and it refers to the [[excision]] of the [[foreskin]] from the penis. The term is inaccurate and a euphemism because the operation actually cuts off or [[amputates]] the [[foreskin]], which in adults comprises about fifteen square inches of highly functional tissue.  Circumcision is most often performed in healthy males for [[Religion and Culture|religious or cultural]] reasons. The procedure may be performed on consenting adults, but it is most often performed on non-consenting minors, particularly newborn children, which is why the ritual is so controversial. Opponents of circumcision consider the circumcision of non-consenting minors to be unethical and a [[human rights]] violation, unless there is concrete [[medical indication]]. Proponents of circumcision consider the circumcision of non-consenting minors to be a "religious freedom" and a "parental right." ==British family court opinion==The issue of non-therapeutic circumcision of male children came before the court in the case of ''[[Re B and G (children) (No 2) EWFC 3]] (2015)'' . In that case, Judge Sir James Munby ruled that circumcision of male children caused ''significant harm''. {{SEEALSO}}* [[Adolescent and adult circumcision]]* [[Breastfeeding]]* [[Case Histories]]* [[Circumcision maps]]* [[Circumcision methods]]* [[Circumcision scar]]* [[Circumpendium]]* [[Circumstraint]]* [[Documented severe complications of circumcision]]* [[Ethics of non-therapeutic child circumcision]]* [[FGM]]* [[Human rights]]* [[Lymphoedema]]* [[MGM]]* [[Pain]]* [[Psychological issues of male circumcision]]* [[Rights situation on circumcision]]* [[Risks and complications]]* [[Sexual effects of circumcision]]* [[Sudden Infant Death Syndrome]] (SIDS)* [[Trauma]]{{LINKS}} * {{REFweb |url=httphttps://www.cirpintaction.org/library/anatomy/garciawhat-is-circumcision/ |title=What exactly is circumcision and what is it not? |last=GarciaSimone |first=FranciscoJudy |author-link= |publisher=Intaction |website=https://intaction.org/ |date=19952020-1207-1126 |accessdate=2020-0910-0804 |format= |quote=

|last=FleissDeacon |first=Paul |init=PM |author-link=Paul M. Fleiss |last2=Muir |first2= |init2=G |author2-link= |etal=no |title=The foreskin What is necessarythe medical evidence on non-therapeutic child circumcision? |trans-title= |language= |journal=MotheringInt J Impot Res |location= |date=19972022-01-08

|article= |page= |pages=36-45 |url=httphttps://www.noharmmnature.orgcom/motheringarticles/s41443-021-00502-y |archived= |quote= |pubmedID=34997197 |pubmedCID= |DOI=10.htm1038/s41443-021-00502-y |accessdate=20202023-0604-2930}}

|url=httphttps://membersintactamerica.tranquility.netorg/~rwinkelpros-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:/MGM/primerintactamerica.htmlorg/groups-who-pressure-you-to-circumcise/ |title=Male Circumcision in the USA: A Human Rights Primer The 4 Authority Figures and Groups Who Will Pressure You to Circumcise (and What You Can Do) |last=WinkelAnonymous |first=Rich |init= |publisher=Intact America |date=20052024-0501-1224 |accessdate=20212024-01-27

 * {{REFjournalREFweb |url=https://intactamerica.org/keeping-your-sons-penis-intact/ |title=Keeping Your Son’s Penis Intact: A Guide for Parents |last=TestaAnonymous |first=Patrick

|author-linkpublisher=Intact America |last2date=Block2024-01-24 |first2accessdate=Walter E.2024-01-29 |init2=}} |author2-link=* {{REFweb |etalurl=nohttps://intactamerica.org/timeline-of-circumcision-suffering/ |title=Libertarianism and circumcisionA Timeline of Circumcision Suffering: A Detailed Look |trans-titlelast=Anonymous |languagefirst= |journalinit=Int J Health Poiicy Manag |locationpublisher=Intact America |date=20142024-0502-2602 |volumeaccessdate=32024-02-09 |issue=}}{{REF}}   [[Category:Circumcision]][[Category:Genital mutilation]] |article=[[Category:Body modification]] |page=[[Category:Genital surgery]] |pages=33-40[[Category:Islam]] |url=https[[Category://www.academia.edu/7587653/Libertarianism_and_Circumcision?email_work_card=view-paperJudaism]] |pubmedID=24987720[[Category:Male circumcision]] |pubmedCID=4075101[[Category:Parental information]] |DOI=10.15171/ijhpm.2014.51[[Category:Penile surgery]] |accessdate=[[Category:Medical term]]}}[[Category:Male genital mutilation]]