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{{GraphicWarning}}"Male '''circumcision''' (from Latin ''circumcidere'', meaning "to cut around") is the surgical removal or [[amputation]] of the [[foreskin]] (prepuce) from , a major part of the human [[penis]]. The foreskin comprises ''more than fifty percent'' of the epithelium of the [[penis]]...] The procedure <ref name="taylor1996">{{TaylorJR LockwoodAP TaylorAJ 1996}}</ref> When the "cutting around" is most often an elective surgery performed on neonates and children for religious and cultural reasons, but in other cases may be indicated for both therapeutic the foreskin falls off, so [[amputation]] and prophylactic reasons[[mutilation]] is the result. It is a treatment option for pathological phimosisThe amputation destroys the [[Foreskin#Physiological_functions| many protective, immunological, sexual, refractory balanoposthitis and chronic urinary tract infections (UTIs); sensory physiological functions]] of the foreskin, so it is contraindicated in cases of certain genital structure abnormalities or poor general health." (Source: a very harmful and [[http://en.wikipediaPain| painful]] surgery.org/wiki/Circumcision Wikipedia])

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

''The following text Circumcision is taken from the classified as a form of [[Circumpendiumgenital mutilation]].''

== Non-medical indications for circumcision Historical background ==

Apart from The [[amputation]] of the [[foreskin]] is a very old ritual, whose exact origin cannot be verified beyond doubt. Circumcision is believed to have originated in east Africa near the Red Sea well before the dawn of recorded history.<ref name="demeo1997">{{REFbook |last=DeMeo |first= |author-link= |year=1997 |title=The geography of sexual mutilations |url=https://www.academia.edu/4212007/The_Geography_of_Male_and_Female_Genital_Mutilations |work=Sexual Mutilations: A Human Tragedy |editors=George C. Denniston, Marilyn Milos |edition= |volume= |chapter= |pages= |location=New York |publisher=Plenum |isbn=0-306-45589-7 |quote= |accessdate=2021-11-13 |note=}}</ref> Medical historians assume that circumcision already served in ancient history as a way to control the sexuality of slaves and members of the lower classes without compromising their ability to reproduce. In religious history circumcision may be seen as a substitute for human sacrifice. In prehistoric times it was not uncommon to placate the medical indication gods with human sacrifice. Castration of pathological phimosisslaves or conquered enemies was common as well. Following religious changes this sacrifice was altered, there also are other reasons and only a part of the very organ responsible for circumcisionthe creation of new life was sacrificed.

[[Image:Circumcision Sakkara 3.jpg|200px|right]] For the [[Aborigines]], the [[Australia| Australian]] natives, the tradition of circumcision is said to go back to 10,000 BC. On the African continent, the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of circumcision date back to the time around 3000-2000 BC. The oldest known depiction<ref>{{REFweb |url=https://commons.wikimedia.org/wiki/File:Circumcision_Sakkara_3.jpg |title=File:Circumcision Sakkara 3.jpg |accessdate= Aesthetic reasons ===2019-10-12}}</ref> is an Egyptian tomb relief from the 6th dynasty, approximately 2300-2000 BC. It is not known precisely who was circumcised and why in those times.

The visual appearance In many cultures circumcision during puberty serves as a rite of passage, bringing adolescents into the community. As with other painful or humiliating initiation rites, proof of courage and mastering of critical situations are the key motivations. From some African tribes it is also known that the [[penisamputation]] is changed radically after circumcision. In this case, personal taste is decisive whether an intact or a cut of the [[penisforeskin]] is more appealing. Since a circumcision cannot be undone, it is essential to be fully informed about seen as the risks and possible later complications before embarking on removal of an aesthetically motivated circumcisioninborn piece of femininity from the boys, to decide whether the appearance will justify such bodily modificationthus making them men.

With {{Citation |Text=10 This is my covenant with you and your descendants after you, the [[foreskin]]covenant you are to keep: Every male among you shall be circumcised. 11 You are to undergo circumcision, circumcision removes approximately 70% and it will be the sign of the sensitive tissue of covenant between me and you. 12 For the [[penis]]generations to come every male among you who is eight days old must be circumcised, including those born in your household or bought with money from a foreigner—those who are not your offspring. 13 Whether born in your household or bought with your money, lowering the potential for sexual stimulation accordinglythey must be circumcised. Due My covenant in your flesh is to the loss of around 50% of the entire penile skin, the be an everlasting covenant. 14 Any [[penisuncircumcised]] loses the reserve skin that provides cutaneous mobility male, who has not been circumcised in the erect [[penis]] and the gliding actionflesh, will be cut off from his people; he has broken my covenant.” |Author=Bible |Source=Gen 17, 10-14, NIV}}

In According to the anthropologist and sociologist Rabbi Nissan Rubin, the past[[Jewish circumcision| Jewish form of circumcision]], called ''[[Brit Milah| brit mila]]'', this circumstance was used to make it harder for boys to masturbateduring the first two millennia did not include the later customary ''[[periah]]'', as masturbation was viewed as immoral and was assumed to cause a variety namely the complete scraping of diseases. More on that can be found in the chapter "inner [[foreskin]] from the [[Circumcision#Historical_backgroundGlans penis|Historical backgroundglans]]". TodayThis was only added around 135 AD, to make it is known that masturbation has no negative health effects, but can contribute positively almost impossible to restore the child's sexual development. Sexuality is no longer a taboo nowadays[[foreskin]] by [[stretching]], while masturbation is considered to be a natural part which became popular in the wake of human sexuality and is no longer seen as immoralHellenic influence. ThereforeWhile originally only the tip of the [[foreskin]] was cut off, circumcision for moral reasons - which would only affect boys too young to give informed consent - is no longer justifiable nowadays''[[periah]]'' removes the entire [[foreskin]].

A common reason stated for circumcision is the assumption of hygienic benefits. This argument has to be viewed ===Christianity===Jesus was born into a Jewish family in [[Israel]], where [[Judaism]] was the context of prevailing religion, so He was [[circumcised]] on the environment the person in question grows up ineighth day.<ref>{{REFweb |url=https://www.biblegateway. It is commonly known that bad hygienic circumstancescom/passage/?search=Luke+2%3A21&version=NASB |title=Gospel of Luke |last=Luke |first= |publisher=NASB |website=Bible Gateway |date= |accessdate=2019-11-10 |format= |quote=And when eight days had passed, especially insufficient access to clean drinking waterbefore His circumcision, pose a serious problem. The situation in disaster areas or refugee camps His name was then called Jesus, the name given by the angel before He was conceived in the so-called third world keep reminding us of thatwomb.}}</ref>

In western industrial nationsThe first Christians had been born Jewish, 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 so a daily basis - and that may question arose whether one must be assumed - no pathogens can accumulate under the [[foreskincircumcised]]to be a Christian. Cleaning of When Christian leaders met at the [[Glans penis|glansCouncil at Jerusalem]] and in the area underneath First Century to decide what was required to be a Christian, a letter was written to explain the [[foreskin]] is easy - they are simply washed along with the rest of the bodyrequirements, just like but circumcision was omitted from the areas between the toesrequirements.<ref>{{REFweb |url=https://www.biblegateway.com/passage/?search=Acts+15%3A1-30&version=NASB |title=Acts 15:1-30 |last=Luke |first= |accessdate=2019-11-10}}</ref>

In small boysChristianity, where circumcision is practiced only in the [[foreskin]] cannot be retracted yet, cleaning Coptic denomination. There is not necessary, since the membrane no general belief that fuses the [[foreskin]] to the [[Glans penis|glans]] prevents the accumulation circumcision is a requirement of micro-organismsChristianity. The so-called <ref name="ballooninghill2004">{{REFweb |url=https://www.cirp.org/pages/cultural/christian.php |title=The Holy Bible, where the [[foreskin]] inflates during urinationCircumcision, False Prophets, and Christian Parents |last=Hill |first=George |author-link=George Hill |publisher=Circumcision Reference Library |website= |date=2004-08-29 |accessdate=2019-11-10 |format=HTML |quote=The falseness of those who advocate circumcision is not a serious problemrecurrent theme in the New Testament.}}</ref>

The opening Nevertheless, Christian moral notions had decisive influence on the spread of this practice. In the puritan influenced USA, circumcision of children was popular in the 19th century as a means to prevent [[foreskinmasturbation]] in small boys is often quite narrow and serves as a one. In those days, this so-called ‘self-way valve, allowing the urine to flow outabuse‘ was not only considered immoral, but preventing entry was supposedly responsible for a variety of microbesdiseases. Masturbation, however, is not mentioned anywhere in the Holy Bible, so there is no support for example from a dirty diaper. As long as the child belief that it is able to pass water, everything works as nature intendedsomehow immoral or sinful.

But even in areas where there are poorer hygienic conditions and an insufficient access to medical care, Even the benefits of easier cleaning mere existence of a circumcised [[penisforeskin]] are was falsoly linked to be viewed with a critical eyemany illnesses. Although even longer periods without personal hygiene will not result in an accumulation Among them one could find syphilis, epilepsy, paralysis of germs under the [[foreskin]]spine, bed wetting, scoliosis (spinal deformity), circumcision itself is not without risk paralysis of complications. If the operation is carried out without proper sterilitybladder, there is a high risk of an infection of club foot, nerve pain in the woundlower abdomen, tuberculosis and lazy eye. This also applies to One of the treatment best known advocates of common complications like postchild circumcision was [[John Harvey Kellogg]], co-operative bleedinginventor of the corn flakes bearing his name.In 1888, he wrote:

{{Citation |Text=A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of [[phimosis]]. The benefit of easier cleaning must operation should be balanced against performed by a surgeon without administering an anaesthetic, as the risk of promoting serious infections - among others HIV - during brief pain attending the operationwill have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. In parts females, the author has found the application of pure carbolic acid to the [[clitoris]] an excellent means of Africaallaying the abnormal excitement, several dozen and preventing the recurrence of one tribe's boys die each the practice in those whose will-power has become so weakened that the patient is unable to exercise entire self-control. |Author=[[John Harvey Kellogg]] |Source= |ref=<ref>{{REFbook |last=Kellogg |first=John Harvey |init=JH |author-link=John Harvey Kellogg |url=https://archive.org/details/plainfaorold00kell/page/290 |chapter=Treatment for Self-abuse and Its Effects |title=Plain Facts for Old and Young |location=Burlington, Iowa |publisher=F. Segner & Co. |year as a result of their circumcision.=1888 |page=107}}</ref>}}

=== Prophylactic reasons =Rationale ==

Some people claim that circumcision has prophylactic benefits. Especially in the USA those arguments have persisted Reasons for more then a 100 years, with ever changing diseases performing circumcision is said to protect against. At firstrange widely by culture, these were diseases where masturbation was believed to be the cause. After bacteria and viruses had been discoveredreligion, arguments changedlocation, and one after another miscellaneous diseases were citedage.

In conclusion, Many cultures perform circumcision does not provide any proven benefits as a rite of passage into manhood. This is common in preventive medicinethe Middle East and amongst some indigenous African and Southeast Asian peoples.

== Circumcision The [[United States]] and [[Israel]] are the only industrialized countries in detail: Stylesthe 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, techniques and instruments ==non-medical reasons. See [[History of circumcision]].

During ===Religious===The circumcision, of newborn boys is seen as a [[Abrahamic covenant| divine commandment]] in the [[foreskinJudaism| Jewish faith]] of . Though absent in the Koran, male circumcision is considered a religious requirement in [[penisIslam]] , and it is partly or completely removedperformed on male children of varying ages. The exact amount Converts to these faiths may also choose to undergo [[Adolescent and type of skin removed depends on the style and technique usedadult circumcision| circumcision]], and therefore also on the tools being usedbut it is not always required.

=== First, a look on the common styles: 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]].

==== High & Tight<ref>de.Wikipedia user Tinoel</ref> ====[[Image:Penis_unlabeled.jpg|200px|center]]This style is The form of circumcision adopted by the most common in the USA. In this style, medical community essentially was equivalent to the outer Jewish form with ''[[foreskinperiah]]'', parts of the inner [[foreskin]] and parts of so it inflicted the shaft skin are removedmaximum injury.

The remaining part 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 the inner [[foreskinphimosis]] . Overall, the actual medical necessity for circumcision is folded back and sewed extremely rare since many conditions respond to conservative treatment. All circumcisions injure the shaft skin. The scar is located closer to patient by amputating the body[[foreskin]] its with many protective, hence the term "high"immunological, sensory, and sexual [[Foreskin#Physiological_functions| functions]].

The inner [[# '''Deformed or malformed foreskin]], which originally faced inwards lying on the [[Glans penis|glans]], now faces outward; this causes the differently coloured section between [[Glans penis|glans]] and shaft skin which is characteristic for this style'''. A foreskin so deformed or malformed that it does not function properly may be removed by circumcision.

Of all styles, the tight ones remove the most skin# '''Traumatically injured foreskin'''. They already limit the mobility of the penile skin to a great extent when the [[penis]] A foreskin so traumatically damaged foreskin that cannot be surgically repaired is flaccid, and during an erection the skin is fully stretched and immobile. An insufficient amount of reserve skin can hamper a complete erection and lead to painful tension. Also, a skewed [[penis]] can occur due to an uneven distribution of the remaining skin, often caused by an inaccurately placed cut or a uneven growth during wound healing. Due to the extensive shortening of the inner [[foreskin]], this style also means the loss of large amounts of sensitive tissuevalid medical reason for circumcision.

==== Low & Tight<ref>David-matthias http://commons# '''Diseased foreskin.wikimedia''' A foreskin that is diseased is a valid indication for cirumcision.org/wiki/File:BeschneidungsstileSome diseases that qualify are malignancy, lichen sclerosis,_Styles_of_Circumcision.jpg</ref> ====[[Image:Low_and_tight.jpgBalanitis#Diabetic_males|200px|centeryeast infection in men with diabetes]]In this style, both the inner and outer [[foreskin]] are completely removed. The shaft skin is sewed just below the rim of the recurrent [[Glans penis|glansbalanoposthitis]]. The scar is located close the [[Glans penis|glans]], hence the term "low".

This style is the most radicalIn such cases, as it removes the entire sensitive tissue benefit of removing the [[problem foreskin]]. As in may exceed the high & tight style, large amounts maleficial harms of skin are removed. In a flaccid state, the skin is barely movable, tissue and in an erect state it is totally immobilefunction destruction.

An insufficient amount ====Arguments of reserve skin can hamper an erection prophylaxia====Though the practice of ritual circumcision of males, both consenting and lead non-consenting, has existed for millenia, the search for "potential medical benefits" began relatively recently. {''Potential'' means to painful tension and exist in possibility, but not in actuality, so a "''potential'' benefit" is not a skewed [[penis]] genuine proven benefit.) The discussion of circumcision in this style as wellthe Ninth Edition of the ''Encyclopǽdia Britannica'' (1876) made no mention of any prophylactic, medical, or therapeutic value or function.<ref>{{REFweb |url=https://www.cirp.org/library/history/encyclopaediabritannica1876/ |title=Circumcision |last=Cheyne |first=T. K. |author-link= |publisher=Encyclopǽdia Brittanica |website=Circumcision Reference Library |date=1876 |accessdate=2019-11-10 |format= |quote=}}</ref>

==== High & Loose<ref>David-matthias http://commons.wikimedia.org/wiki/File:BeschneidungsstileInitially, circumcision was adopted in the 19th century as a way to stop boys and men from masturbating,_Styles_of_Circumcision.jpg</ref> ====when [[image:High_and_loose.jpg|200px|centermasturbation]]The outer foreskin is completely removed, as well as parts of the shaft skin. The inner foreskin is folded back and sewed was claimed to be the shaft skincause for many diseases. The scar is located towards As the bodymyth that circumcision prevented masturbation became debunked, hence advocates of circumcision began the great search to find the term "highmedical benefits". Unlike the high & tight style, the inner [[foreskin]] is less reduced, and lies in folds behind the [[Glans penis|glans]]of circumcision.

There is enough remaining reserve skin Male and female circumcision involves the removal and disruption of normal anatomical structures that are primary areas of sexual sensation.<ref name="taylor1996"/> In the past, some advocates of mass circumcision have considered the [[prepuce]] to ensure be a complete "mistake of nature,"<!--{{Cold and unhindered erectionWiswell (1995)}} | [[Template:Cold and Wiswell (1995)|see more]]--> but this notion has no validity because the prepuce is ubiquitous in primates and because it provides functional advantages. Of all variants<ref name="cold-mcgrath1995">{{REFbook |last=Cold |first=Christopher |init=C |last2=McGrath |first2=Kenneth |init2=K |author2-link=Ken McGrath |year=1999 |title=Male and female circumcision: medical, this one removes legal, and ethical considerations in pediatric practice |url=https://www.cirp.org/library/anatomy/cold-mcgrath/ |work= |editor= |edition= |volume= |chapter=Anatomy and histology of the smallest amount of sensitive tissue.penile and clitoral prepuce in primates |pages= |location=New York |publisher= |isbn=0306461315 |quote= |accessdate=2019-10-12 |note=}}</ref>

==== Low & LooseAll claims that circumcision prevents future disease are false.<ref>David-matthias http{{REFweb |url=https://commonswww.wikimediadoctorsopposingcircumcision.org/wikifor-professionals/alleged-medical-benefits/File:Beschneidungsstile,_Styles_of_Circumcision.jpg<conclusions-and-references/ref> |title=Conclusions |last=Anonymous |first= |init=[[image:Low_and_loose.jpg |200pxpublisher=Doctors Opposing Circumcision |center]]date=2016The inner [[foreskin]] is removed, the outer [[foreskin]] is sewed on below the [[Glans penis |glans]]. The scar is therefore located close accessdate=2023-10-22}}</ref> They are made to the [[Glans penis|glans]], hence the term "low". The outer [[foreskin]] lies in folds behind the [[Glans penis|glans]]. Enough skin is left in place enable a physician to ensure perform circumcision and collect a complete and unhindered erectionfee.<!--===Search for prophylactic reasons===

Since, The practice of finding prophylactic reasons for infant circumcision started in Germany in contrast to the high & loose stylenineteenth century, when non-Jewish Germans criticized the inner instead Jewish practice of the outer [[foreskin]] is removedinfant circumcision as being barbaric, this style results in Jewish doctors sprang to the loss defense of almost all the religious practice by claiming health benefits.<ref name="ephron2001">{{REFbook |last=Ephron |first=John M. |init=JM |author-link= |year=2001 |title=Medicine and the German Jews |url=https://www.cirp.org/library/history/ephron1/ |work= |editor= |edition= |volume= |chapter=6 |pages=222-33 |location=New Haven |publisher={{UNI|Yale University|Yale}} Press |isbn=0-300-08377-7 |quote= |accessdate=2019-11-20 |note=}}</ref> And so started the long tradition of the sensitive tissueJewish doctors inventing reasons for circumcision (and deceving gentile doctors).

Over time, a vast variety of methods has been developed to remove In 1870 the prominent Dr. [[foreskinLewis Albert Sayre|Lewis A. Sayre]]of NYC’s famed Bellevue Hospital<ref>https://nypost. A multitude com/2016/12/03/bellevues-doctors-invented-the-procedures-you-take-for-granted/</ref> claimed to cure a boy’s paralyzed legs with circumcision. Sayre's wild advocacy of clamps circumcision exemplified how some [https://intaction.org/circumcision-facts-and tools is available -myths/ circumcision facts and myths] originated. He also claimed to cure epilepsy, mental disorders, hip-joint pain, & hernias with circumcision. “Genital irritations” & masturbation were deemed to ease be the work cause of these issues. Sayre was later elected as the circumciser, to improve President of the chance for visually symmetrical results and to prevent injuries to the [[Glans penis|glans]] from inexpert cutsAmerican Medical Association. <ref>American Medical Association. I will introduce some Transactions of the most widely spread variantsAmerican Medical Association.1870;21:205–11</ref>

In the 1920s it was penile cancer. [[Abraham L. Wolbarst]] (1926) claims that circumcision can prevent penile cancer.<ref name="wolbarst1926">{{REFjournal |last=Wolbarst |first=Abraham L. |init= FreehandAL |author-techniques link=Abraham L. Wolbarst |title=Is circumcision a prophylactic against penis cancer? |journal=Cancer |date=Jul 1926[[File:Circumpendium-6-2-1.jpg |volume=3 |centerissue=4 |thumb]]pages=301-10The oldest method of removing the [[foreskin]] uses just a few instruments. In the simplest case, the [[foreskin]] is pulled out with a cord, a knife is placed directly above the [[Glans penis|glans]], and the skin finally cut with a hit on the blunt edge of the knife. No stitches are placed and the skin is left to grow together naturally.}}</ref>

In the 1940s, prostate and tongue cancer as well as STDs. [[FileEugene H. Hand]] (1949) falsely explains that circumcision somehow protects against venereal diseases and tongue cancer.<ref name="hand1949">{{REFjournal |last=Hand |first=Eugene H. |init=EH |author-link=Eugene H. Hand |url=https:Circumpendium//pubmed.ncbi.nlm.nih.gov/18135844/ |title=Circumcision and venereal disease |journal=Archives of Dermatology and Syphilology |date=1949-6-2-1-b.jpg09 |volume=60 |issue=3 |centerpages341-6 |thumb]]pubmedID=18135844In modern operating theatres the [[foreskin]] is first grasped with forceps, pulled out and clamped above the [[Glans penis |glans]] for a while to reduce bleedingDOI=10. Next, the skin is cut along the forceps with a scalpel1001/archderm. Following that, the remaining skin is manually trimmed according to the desired style and finally sutured1949.01530030037004 |accessdate=2021-10-08}}</ref>

In the 1950s it was cervical cancer. [[File:Circumpendium-6-2-1-c.jpg||center|thumbAbraham Ravich]]Completely freehand techniques are also common. The penile skin is first cut in two places along (1951) invents the circumference, in myth that circumcision reduces the area risk of the shaft skin and [[foreskin]]. After that the skin area between the cuts is removed and the remaining skin suturedwomen getting cervical cancer.<ref name="ravich1951">{{Ravich1951}}</ref>

Also among In the freehand techniques are the shield variantslate 1960s it was neuroses. [[Morris Fishbein]] (1969) calls for circumcision to prevent nervousness and, of course, [[masturbation]].<ref>{{Fishbein1969}}</ref>

[[File:CircumpendiumIn the 1970s bladder-6-2-1-Jewish-clampand rectal cancer.jpg||center|thumb|Jewish clamp]]In ritual Jewish circumcision the [[foreskinAbraham Ravich]] in inserted into the slit of the shield (left1971) claims that circumcision would prevent bladder cancer and then cut on the upper side of the shieldrectal cancer.<ref>{{Ravich1971}}</ref>

In the 1980s, UTIs. [[File:Circumpendium-6-2-1-Mogen-clampThomas E.jpg||center|thumb|Mogen-clampWiswell]]The Mogen-Clamp works in a similar way (middle1985), with the difference claims that it is locked shut after the [[foreskin]] is insertedcircumcision, thus clamping it. After using a few minutes methodologically flawed report, reduces the [[foreskin]] is cut in the same fashion as with the simple shieldrisk of urinary tract infections.<ref name="wiswell1985">{{REFjournal |last=Wiswell |first=Thomas E. |init=TE |author-link=Thomas E. Wiswell |url=https://pediatrics. The clamping is meant to reduce or prevent bleeding from the woundaappublications.org/content/75/5/901 |title=Decreased incidence of urinary tract infections in circumcised male infants |journal=Pediatrics |date=May 1985 |volume=75 |issue=5 |pages=901-3 |accessdate=2019-10-12}}</ref>

[[File:Circumpendium-6-2-1-Sheldon-clampAaron J.jpg||center|thumb|Sheldon-ClampFink]]The Sheldon-Clamp (right1986) works in a similar way. The inner clamp grasps the tip of the , with no evidence whatsoever, claims that circumcision protects against [[foreskinAIDS]], pulling it into the outer clamp which is closedfollowed. The outer clamp then grips the skin<ref name="fink1986">{{REFjournal |last=Fink |first=Aaron J. After a few minutes |init=AJ |author-link=Aaron J. Fink |title=A possible explanation for heterosexual male infection with AIDS |journal=New England Journal of pressure, the [[foreskin]] is cut between the two clampsMedicine |date=1986-10-30 |volume=31 |issue=18 |page=1167 |url=https://www.nejm.org/doi/full/10.1056/NEJM198610303151818 |DOI=10.1056/NEJM198610303151818 |accessdate=2019-11-20}}</ref>

The use of a shield, rather than forcepsRetrospectively, is meant to provide circumcision was always advertised as a better protection of cure for whatever disease was in the public spotlight at the time. [[Glans penis|glansDoctors Opposing Circumcision (D.O.C.)]] (2016) state:<blockquote>These claims date originally from cutting injuries. However, if used improperly both the Mogen and before the Sheldon clamp are subject to the risk advent of evidence-based medicine, when doctors relied on the tip opinions of the other clinicians to inform their practice, rather than on scientifically collected evidence.<ref name="doc2016">{{REFweb |url=https://www.doctorsopposingcircumcision.org/for-professionals/alleged-medical-benefits/ |title=Alleged Medical Benefits |publisher=[[Glans penis|glansDoctors Opposing Circumcision (D.O.C.)]] being accidentally clamped and being cut into or severed. |website= |date=2016-05 |accessdate=2019-11-20 |format= |quote=}}</ref></blockquote>

==== Complex clamps ====[[File:Circumpendium-6-2-2-Gomco-clamp.jpg|center|thumb|Gomco clamp]]One The sheer mass of studies and publications that were released during those almost 180 years on this topic are the most widely used clamps in the USA is the Gomco clamp. First, a cut is placed into the [[foreskin]], then the metal bell is placed over the [[Glans penis|glans]]. After reason that even arguments thathave been disproved multiple times, the bell, together with the [[foreskin]], is pulled through the opening in the base plate and hung into the lever. By fastening the screw the lever pulls the bell upwards, jamming the [[foreskin]] between bell especially regarding infant and base plate. After several minutes of clampingchild circumcision, the skin is cut off with a scalpel along the upper side of the base plate and the clamp removedtenaciously persist up until today.

[[File:CircumpendiumAn ever-6-2-2-plastibell.jpg|center|thumb|plastibell method]]In the plastibell method, the skin recurring element of initiation rites found in many different cultures is first cut lengthwise, then a plastic ring is placed over the [[Glans penis|glans]] and the [[foreskin]] pulled over it. A tightly tied string is used to fix the [[foreskin]] to a rim in fixation upon the ring, thereby strangulating itgenitalia.

The tissue beyond It reflects the string is cut off and fascination that emerges from the bell's handle cracked offability to create new life. The strangulated tissue dies off in In most cultures, fertility is seen as the following daysmost precious good, and the ring falls off on its ownbody parts involved frequently find themselves in the focus of ritual acts. Since this form of circumcision means part In many parts of the process goes on without medical supervisionworld, those rites take place when the boy reaches puberty, it may not be possible and are meant to intervene promptly symbolize his transition from boy to man. The removal of the male [[foreskin]] is just one of many phenomena that developed in this context. They range from the event removal of swelling; also there is a risk the frenulum in boys and men through partial or complete removal of the ring being [[foreskin]] up to radical operations. Australian [[Aborigines]], as mentioned above, have their [[foreskin]]s removed prematurely due to external influence. This may cause the healing wound to burst It is also usual that, a few weeks later, young men have their [[penis]]es sliced openin a [[subincision]], necessitating additional suturingresulting in a partly or completely divided [[urethra]].

[[File:Circumpendium-6-2-2-Smartclamp.jpg|center|thumb|Smartclamp]]The Smartclamp and a couple of similar designs are one way clampsAnother known, particularly massive, representing a mixture intervention is the stripping of the Gomco and Plastibell methods. The entire [[Glans penis|glansskin]] is inserted into the plastic tube, off the [[foreskinpenis]] pulled over it. The base plate of the outer clamping mechanism is pushed over the [[foreskin]] and cocked shutIn Indonesia, jamming the boys have metal or bamboo balls inserted into their [[foreskinpenis]] between the bulging lower rim of the tube and the lower base plate. The shaft or [[foreskinGlans penis|glans]] is now cut off along at the upper side beginning of the base plate. The entire clamping mechanism remains on the [[penis]]puberty, until it - like the plastibell - falls off by itself after the clamped skin dies off in the following dayswhich form little "humps".

All of these methods have in For many cultures it is also common that the [[foreskin]] has to be separated perform similar rituals on girls. This can range from relatively small interventions such as piercing or cutting the [[Glans penis|glans]] first. In case of the circumcision of a childclitoral hood, it is in most cases (see chart above) necessary to forcibly tear apart the balanopreputial membrane, which fuses the [[foreskin]] its complete removal and up to the [[Glans penis|glans]]radical removal of clitoral hood, either by violently retracting the [[foreskin]] or separating it by pushing a blunt instrument underneath the [[foreskinclitoris]], both of which can result in injuries inner and inflammations of outer labia followed by sewing up the [[Glans penis|glans]]vagina.

Some people claim that circumcision has prophylactic benefits. Especially in the [[USA]] those arguments have persisted for more then a 100 years, with ever changing diseases circumcision is said to protect against. At first, these were diseases where [[masturbation]] was believed to be the cause. After bacteria and viruses had been discovered, arguments changed, and one after another miscellaneous diseases were cited. * [[Phimosis]]: as mentioned earlier, true [[phimosis]] is rare and can be treated effectively without surgery. According to a study by Blalock et al. (2003)<ref name="blalock2003">{{REFjournal |last=Blalock |init=HJ |last2=Vemulakonda |init2=V |last3=Ritchey |init3=ML |last4=Ribbeck |init4=M |title= Possible Outpatient management of [[phimosis]] Following newborn circumcision |journal=J Urol |date=2003 |volume=169 |issue=6 |pages=2332-4 |url=https://www.cirp.org/library/complications/blalock1/ |accessdate=2019-11-07}}</ref>, 2.9% of those circumcised develop a post-operative [[phimosis]], in which the circumcision scar constricts. In [[intact]] patients, the rate of [[phimosis]] is only 1% (see also the study by [[Jakob Øster]]). Therefore, circumcision is not a preventive measure for [[phimosis]].* Sexually Transmitted Diseases (STDs): a vast number of studies has been conducted on the subject of transmission of STDs.* First, it has to be noted that any form of protection against these diseases only affects people who are sexually active. Circumcision in childhood cannot be justified on these grounds, since any assumed protective effect will not occur before the boy is already old enough to decide about circumcision for himself.* As mentioned above, the [[foreskin]] keeps the [[Glans penis|glans]] moist. This subpreputial moisture contains, among other substances, the enzyme lysozyme, which breaks up the cell wall of bacteria, thereby providing a natural antibacterial screen. This explains the results of several studies, such as Laumann et al.<ref>{{REFjournal |last=Laumann |init=EO |last2=Masi |init2=CM |last3=Zuckerman |init3=EW |title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice |journal=JAMA |date=1997 |volume=277 |issue= |pages=1052-7 |url=https://www.cirp.org/library/general/laumann/ |accessdate=2019-11-06}}</ref>, which found a higher rate of infection with bacterial venereal diseases in [[circumcised]] than in [[intact]] men.* The studies by Fleiss et al. (1998) support this.<ref name="fleiss-hodges-vanhowe1998">{{FleissP HodgesF VanHoweRS 1998}}</ref> According to the [[AAP]], the general sexual behaviour of the male — such as frequent change in partners and postoperative complications the use of condoms — has a much higher impact on sexually transmitted diseases then the circumcision status.<ref>{{REFjournal |last=Task Force on Circumcision |first= |title=Circumcision policy statement |journal=Pediatrics |date=1999 |volume=103 |issue=3 |pages=686-93 |url=https://www.cirp.org/library/statements/aap1999/ |accessdate=2019-11-15}}</ref>* [[HIV]] / [[AIDS]]: in the recent past, the argument that circumcision could help to contain the spread of [[HIV]] has been stated numerous times.*:First, two notes: for one, the use of condoms is still by far the most effective protection against an infection. During intercourse with that preventive measure, circumcision status does not make a difference.*:Secondly, the assumed protection would only affect healthy men who have intercourse with an infected woman. An infected man can infect a women by transmission of his bodily fluids, so that his circumcision status is irrelevant. Therefore, the use of condoms remains vital in containing the spread of [[HIV]], which in return renders circumcision unnecessary* Due to the inevitable loss of sensitivity as a result of circumcision, there is also the temptation to go without condoms, in order not to lose even more sensitivity.<ref>{{REFjournal |last=Hooykaas |init=C |last2=van der Velde |init2=FW |last3=van der Linden |init3=MM |etal=yes |title=The importance of ethnicity as a risk factor for STDs and sexual behaviour among heterosexuals |journal=Genitourin Med |date=1991 |volume=67 |issue=5 |pages=378-83 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1194736/pdf/genitmed00041-0022.pdf |accessdate=2019-11-15}}</ref><ref>{{REFjournal |last=Michael |init=RT |last2=Wadsworth |init2=J |last3=Feinleib |init3=J |etal=yes |title=Private sexual behavior, public opinion, and public health policy related to sexually transmitted diseases: a US-British comparison |journal=Am J Public Health |date=1998 |volume=88 |issue=5 |pages=749-54 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1508929/pdf/amjph00017-0039.pdf |accessdate=2019-11-15}}</ref><ref>{{REFjournal |last=Laumann |init=EO |last2=Masi |init2=CM |last3=Zuckerman |init3=EW |title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice |journal=JAMA |date=1997 |volume=277 |issue= |pages=1052-7 |url=https://www.cirp.org/library/general/laumann/ |accessdate=2019-11-06}}</ref>* Two studies that have been published in early 2007<ref>{{RCT Gray et al 2007}}</ref><ref>{{RCT Bailey et al 2007}}</ref>, which investigated the effectiveness of circumcision as a means of reducing the spread of [[HIV]] from infected women to heterosexual men in African high risk areas, have been repeatedly subjected to strong criticism. Both studies were ended prematurely, which distorted the results. The men who had been [[circumcised]] for the study had to stay sexually inactive during the wound healing, which gave the intact control group more relative opportunity to become infected. These African randomized clinical trials have been demonstrated to have very serious methodological and statistical errors that distort the results in favor of circumcision.<ref name="boyle-hill2011">{{BoyleGJ HillG 2011}}</ref>

* Intolerance or allergic reactions to The fact that the [[USA]] has both the narcotics used.* Especially highest percentage of [[circumcised]] males in newborns, where the bodily pain reduction mechanisms are not yet fully developedwestern world, local anaesthesia is often insufficient for the operation. Even in conjunction with regional anaesthesia of the dorsal nerve of as well as the highest [[penisHIV]]infection rate, makes the rate of failure to provide sufficient anaesthetic even for experienced anaesthetists is still 5-10%studies look dubious. The general anaesthesia Besides that would be needed for newborns, however, poses several other studies concluded that circumcision does not have a significant risks for impact on the child, and, therefore, is only likely to be used in emergenciesrisk of infection with [[HIV]]. <ref>{{REFjournal |last=Grosskurth |init=H |last2=Mosha |init2=F |last3=Todd |init3=J |etal=yes |title=A surgical operation without proper pain control can lead to community trial of the development impact of a specific pain memory<ref>Profimproved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Dr. med. Boris Zernikow httpBaseline survey results |journal=AIDS |date=1995 |volume=9 |issue=8 |pages=927-34 |url=https://wwwinsights.spiegelovid.decom/aids/aids/spiegel1995/08/vorab000/expertecommunity-warnttrial-rituelleimpact-beschneidungimproved-veraendertsexually/15/00002030 |accessdate=2019-das11-gehirn-der-kinder-a-849534.html15}}</ref>. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation. Overall, their pain threshold was lower and the risk of chronic pain increased. Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>Garry T. Circumcision: a survey {{REFjournal |last=Barongo |init=LR |last2=Borgdorff |init2=MW |last3=Mosha |init3=FF |etal=yes |title=The epidemiology of fees HIV-1 infection in urban areas, roadside settlements and practices. OBG Management 1994. (October): 34rural villages in Mwanza Region, Tanzania |journal=AIDS |date=1992 |volume=6 |issue=12 |pages=1521-6.8 |url= |accessdate=}}</ref><ref>Howard CR{{REFconference |last=Changedia SM, Howard FM, Garfunkel LC, de Blieck EA, Weitzman M. Neonatal Gilada IS |first= |title=Role of male circumcision and pain relief: current training practicesin HIV transmission insignificant in conjugal relationship (abstract no. Pediatrics 1998; 101:423ThPeC7420) |url= |place=Barcelona, Spain |source=Presented at the Fourteenth International AIDS Conference |datefrom=2002-07-07 |dateto=2002-07-428.12 |accessdate=}}</ref><ref>Stang HJ{{REFconference |last=Connolly CA, Snellman LW. Circumcision practice patterns in the United States. Pediatrics 1998; 101: e5. Link to [[AAP]] website</ref>. During procedures which take several minutesShishana O, babies tend to fall into a state of stuporSimbayi L, which Colvin M |first= |title=HIV and circumcision in the past was falsely interpreted as peaceful sleepSouth Africa (Abstract No. MoPeC3491) |url= |place=Bangkok, nurturing Thailand |source=Presented at the belief that babies felt no pain. Measurements taken in those cases revealed a typically 315th International AIDS Conference |datefrom=2004-07-11 |dateto=2004- to 407-fold increase in cortisol levels, which equals a state of severe shock.16 |accessdate=}}</ref><ref>Gunnar MR{{REFconference |last=Thomas AG, Fisch ROBakhireva LN, Korsvik SBrodine SK, Donhowe JM. The effects Shaffer RA |first= |title=Prevalence of male circumcision on serum cortisol and behaviorits association with HIV and sexually transmitted infections in a U.S. Psychoneuroendocrinology 1981; 6navy population (3Abstract no. TuPeC4861) |url=https:269//apps.dtic.mil/dtic/tr/fulltext/u2/a458066.pdf |place=Bangkok, Thailand |source=Presented at the 15th International AIDS Conference |datefrom=2004-07-11 |dateto=2004-07-16 |accessdate=2019-75.11-15}}</ref>* Postoperative wound painUrinary tract infections (UTI): a [[UTI]] can be effectively treated with antibiotics, in the case of children's circumcisions conceivably worsened this was also proven by the forceful breaking of the preputial adhesionsstudies.<ref>{{REFjournal* Postoperative bleeding |last=McCracken |init=G |title=Options in antimicrobial management of the wound. This can have severe consequences especially for very young urinary tract infections in 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>Smart children |journal=Pediatr Infect Dis J, Nolan T |date=1989 |volume=8 |issue=8 |pages=552-5 |url=https://www. (Editors)cirp. Paediatric Handbook, Sixth Edition. Victoria, Australia: Blackwell Science Asia, 2000: p. 82org/library/disease/UTI/mccracken/ |accessdate=2019-11-19}}</ref><ref>Wetli CV. Case 93{{REFjournal |last=Larcombe |init=J |title=Urinary tract infection in children |journal=BMJ |date=1999 |volume=319 |issue= |pages=1173-1711. Autopsy of Demetrius Manker. Miami: Dade County Medical Examiner Department, June 23, 1993.5 |url= |accessdate=}}</ref>A Swedish study<ref>Hiss J, Horowitz A, Kahana T. Fatal haemorrhage following male ritual circumcision. J Clin Forensic Med 2000;7:32{{REFjournal |last=Mårild |init=S |last2=Jodal |init2=U |title=Incidence rate of first–time symptomatic urinary tract infection in children under 6 years of age |journal=Acta Paediatr |date=1998 |volume=87 |issue=5 |pages=549-4.52 |url= |accessdate=}}</ref><ref>Newell TEC. Judgement found that, during the first 6 years of inquiry into life, the death incidence of McWillis, Ryleigh Roman Bryan[[UTI]]s in boys was 1. Burnaby8%, Bbut in girls was 6.C6%.: BUTIs are less common in boys after the first year of life.CMueller et al. Coroner's Service, Monday, 19 January 2004</ref>{{REFjournal |last=Mueller |init=ER |last2=Steinhardt |init2=G |last3=Naseer |init3=S* Postoperative infections. This includes both local infections, which can be treated |title=The incidence of genitourinary abnormalities in [[circumcised]] and [[uncircumcised]] boys presenting with local therapy, and systemic infections, requiring systemic antibiotic treatment.<ref>Dr.med Wolfram Hartmann, Stellungnahme zur Anhörung am 26. November 2012 im Rechtsausschuss des Bundestagesan initial urinary tract infection by 6 months of age |journal=Pediatrics |date=1997 |volume=100 (Supplement) |issue= |page=580 |url= |accessdate=}}</ref>* Wound dehiscence, meaning the separation of the edges of the wound or the tissue after suturing.* Adhesion did not find a significant difference in UTI rates between the surface or rim of the [[Glans penis|glanscircumcised]] and [[intact]] boys with the neighbouring penile skin, causing skin pockets and bridges, as well as visually unpleasant results like uneven scars, which make a re-circumcision necessarynormal urinary tract anatomy.* Postoperative Other studies suggest that circumcision is more likely to raise than to lower the generally low risk of acquiring UTI: multiple studies from [[phimosisIsrael]]: showed a phimotic ring can develop during scarring, which makes a re-strong correlation between ritual circumcision necessary. According to a study by Blalock et.alon the 8th day of life and postoperative UTI.<ref>Blalock HJ, Vemulakonda V, Ritchey ML, Ribbeck M. Outpatient management of [[phimosis]] Following newborn {{REFjournal |last=Menahem |init=S |title=Complications arising from ritual circumcision. : pathogenesis and possible prevention |journal=Isr J Urol 2003;169(Med Sci |date=1981 |volume=17 |issue=1 |pages=45-8 |url= |accessdate=}}</ref><ref>{{REFjournal |last=Cohen |init=HA |last2=Drucker |init2=MM |last3=Vainer |init3=S |etal=yes |title=Postcircumcision urinary tract infection |journal=Clin Pediatr |date=1992 |volume=31 |issue=6):2332 |pages=322-4. |url= |accessdate=}}</ref>, the prevalence is 2.9%, according to Leitch<ref>Leitch IOW. Circumcision - a continuing enigma. Aust Paediatr {{REFjournal |last=Goldman |init=M |last2=Barr |init2=J |last3=Bistritzer |init3=T |last4=Aladjem |init4=M |title=Urinary tract infection following ritual Jewish circumcision |journal=Isr J 1970;6:59Med Sci |date=1996 |volume=32 |issue= |pages=1098-651102 |url= |accessdate=}}</ref> 5.5%* It can be concluded that circumcision is ineffective as a preventive measure against [[UTI]].* Meatal stenosisPenile and cervical cancer / HPV: first studies on those diseases and their assumed prevention by circumcision date back to 1932, a pathological narrowing of time when the opening of the urethra, which mostly occurs in infancy and early childhood. It is one of the most common complications of infant circumcision. A study from 2006 found meatal stenosis exclusively in previously circumcised boys. The incidence rate after a circumcision is at approximately 10%cause for those illnesses was not yet fully understood.<ref>Van Howe RS. Incidence of meatal stenosis following neonatal circumcision in a primary care setting. Clin Pediatr (Phila). Jan-Feb 2006;45(1):49-54.{{Wolbarst1932}}</ref>Today, it is known that sexually transmitted human papillomavirus (HPV) is a major risk factor<ref>Stenram, {{REFjournal |last=McCance |init=DJ |last2=Kalache |init2=A., Malmfors, G., & Okmian, L. ( |last3=Ashdown |init3=K |etal=yes |title=Human papillomavirus types 16 and 18 in carcinomas of the penis from Brazil |journal=Int J Cancer |date=1986): Circumcision for [[phimosis]]: a follow |volume=37 |issue=1 |pages=55-up study. Scandinavian journal of urology and nephrology, 20(2), 89 PMID 3749823.9 |url= |accessdate=}}</ref>, as well as smoking<ref>http://emedicine.medscape.com/article/1016016{{REFjournal |last=Harish |init=K |last2=Ravi |init2=R |title=The role of tobacco in penile carcinoma |journal=Brit J Urol |date=1995 |volume=75 |issue=3 |pages=375-overview7 |url= |accessdate=}}</ref>* Knot formation of the veins. If the dorsal vein, which originates Studies have shown that there is no significant difference in the tip risk of the getting penile cancer between [[foreskincircumcised]], is cut during circumcision without being clamped and sutured at its origin separately[[intact]] men. To prevent a single case of penile cancer, it starts would statistically take 600 to develop new branches over time, which can lead to the development of knots.900 circumcisions<ref>{{REFdocument |title=Position Paper on Neonatal Circumcision |url= |contribution= |last= |first=* Possible deformities due to circumcision include hypoplasia |publisher=American Academy of the [[penis]] Family Physicians (microLeawood, Kansas) |format= |date=2002-02-penis) and induratio [[penis]] plastica (skewed penis).14* Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis |glans]] or the [[penis]] can occur.accessdate=* In rare cases, necrosis, gangrene, ischaemia, keloid formation and circulatory problems may also occur}}</ref>.* When the The influence of circumcision is followed by on the ultra-orthodox Jewish ritual of Metzitzah B'Peh (which consists infection risk of sucking blood from the wound female partner with the mouth), there cervical cancer has been refuted several times as well. HPV vaccination is a risk an effective measure against carcinoma of infection with herpes simplex type 1, which can lead to brain damage or death.<ref>http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritualthe cervix.html?_r=0</ref>

* 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 ML, Snyder JL, Reiss MD, et al. Fine-touch pressure thresholds in the adult [[penis]]. BJU Int 2007;99:864-9.</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>Taylor, J.R., Lockwood, A.P., & Taylor, A.J. (1996). The prepuce: „Specialized mucosa of the [[penis]] and its loss to circumcision.“ British Journal of Urology, 77, 291-295.</ref>. This risk is partly dependent on the anatomy of the [[penis]]. While some [[penis]]es already have the majority of their full size when flaccid ([[Flesh Penis]], or "[[shower]]"), others are rather short when flaccid and double or more their size during an erection ([[Blood Penis]], or "[[grower]]"). Especially in children's circumcision, where the [[penis]] is not yet fully developed, the amount of reserve skin needed in adulthood cannot be estimated.* Erectile dysfunction: Both the damage inflicted to the blood vessels in the [[foreskin]] and the reduced sexual sensitivity can be causes for reduced erectile function with advancing age.<ref>Money, J., & Davison, J. (1983): Adult penile circumcision: Erotosexual and cosmetic sequelae. Journal of Sex Research, 19, 289-292</ref>* Orgasm problems: In the wake of reduced sexual sensitivity, due to the loss of sensory tissue and gradual keratinization of the surface of the [[Glans penis|glans]], orgasm problems may develop with increasing age. In this case, the sexual arousal created by intercourse or masturbation is not enough to achieve orgasm. A preliminary stage of this late effect is the prolonged time circumcised men need to reach an orgasm. This is often fielded as the "cut men have more endurance" argument for circumcision.* Vaginal dryness: Due to the loss of the natural gliding action, which comes from the mobility of the fore== Non- and shaft skin, a much increased friction between [[penis]] and vagina occurs during intercourse. This can make intercourse painful medical indications for both partners and lead to abrasions<ref>[[Morten Frisch]], Morten Lindholm, Morten Grønbæk: Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark. In: International Journal of Epidemiology Oktober 2011, 40(5), S. 1367-1381, doi:10.1093/ije/dyr104, PMID 21672947.</ref><ref>Cortés-González, J., Arratia-Maqueo, J., & Gómez-Guerra, L. (2008): Does circumcision has an effect on female's perception of sexual satisfaction? Rev Invest Clin, 60(3), 227 PMID 18807735.</ref> The prolonged time it takes circumcised men to reach orgasm, as well as the often longer and more vigorous thrusting movements - compared to intact men - play a part in this.<ref>Cold CJ, Taylor JR. The prepuce BJU Int 1999;83 Suppl. 1:34-44.</ref><ref>Fink KS, Carson CC, DeVellis RF. Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction. J Urol 2002;167(5):2113-2116.</ref>==

The psychological late effects visual appearance of the [[penis]] is changed radically after circumcision are not yet fully researched. In this case, and many studies took place on rather personal taste is decisive whether an [[intact]] or a small scale[[circumcised]] [[penis]] is more appealing. This situation needs Since a circumcision cannot be undone, it is essential to be rectified, because fully informed about the available studiesrisks and possible later complications before embarking on an aesthetically motivated circumcision, as well as to decide whether the histories of negatively affected men, suggest that these late effects may have more impact than previously assumedappearance will justify such bodily modification.

* It was observed should be noted that infants, following every circumcision without pain control, had a disturbed bond with their mother<ref>Marshall RE, Porter FL, Rogers AG, et al. Circumcision: II effects upon mother-infant interaction. Early Hum Dev 1982; 7(4):367-74.</ref>, as well as problems with nurturing, up to the point of refusal to be fed. The sleeping habits of these babies were also disturbed, with prolonged non-REM sleep and increased waking.* In boys circumcised in childhood, 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>Ramos S, Boyle GJ. Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder. In: Denniston GC, Hodges FM, Milos MF (eds) Understanding circumcision: A Multi-Disciplinary Approach to leaves a Multilife-Dimensional Problem. New York: Kluwer Academic/Plenum Publishers, 2001: pp. 253-70.</ref>* Circumcisions, especially those that happen without consent, can spark feelings of helplessness and alienation, which can persist as trauma. These feeling can also be triggered later, when someone circumcised as an infant becomes aware of his circumcision. In an online study, interviewed men stated they felt betrayed - 55% by the mother, 50% by the father, and 58% by the doctor, and 73% felt that their human rights had been violated.<ref>http://www.circumcisionharm.org/</ref>* It can frequently be found that the loss is denied, much as happens with the loss of other body parts. This denial can lead to fathers having their sons circumcised in order not to be reminded of their own loss. In this process, their own body is defined as "normal" and the long [[foreskincircumcision scar]] redefined as a foreign object. Their own parents are seen as "good", so that this image is projected onto the circumcision their parents carried out as well, in order to keep the positive emotion intact. The father wants to be a "good" father later in life as well, and so, following an idealised image of his own parents, circumcision, which has been redefined as a "good thing", is passed on to his son by having him circumcised as well.<ref>van der Kolk BA. The compulsion to repeat encircles the trauma: re-enactment, revictimization, and masochism. Psychiatr Clin North Am 1989;12(2):389-411.</ref><ref>Goldman R. The psychological impact shaft of circumcision. BJU Int 1999;83 Suppl. 1:93-103.</ref>* If the circumcised male feels incomplete, or due to the missing [[foreskinpenis]] disadvantaged compared to intact males, an inferiority complex and depression may occur. This can be accompanied by conscious recognition of his own incompletenessIn addition, or there frequently a a color change at the deficiency may remain completely subconscious<ref>Rhinehart J. Neonatal circumcision reconsidered. Transactional Analysis J 1999;29(3):215-21.</ref>. In an online study, 75% of those interviewed stated that they felt incomplete, and 66% said they felt inferior compared with intact males.<ref>http://www.circumcisionharm.org/</ref>* Cases in scar which children felt ill treated or punished have been documented as well. G. Cansever found results in her study on 12 boys aged between 4 and 7 years, who had previously been prepared for their impending circumcision, that the children experienced the operation as an aggressive assault on their bodies.<ref>Cansever, G. (1965). Psychological effects of circumcision. Brit. J. Med. Psychol. 38: 321-331.</ref>* Fear of being alone or darkness.<ref>David M. Levy, Psychic trauma of operations in children; and a note on combat neurosis, American Journal of Diseases of Children, Vol. 69, 1945, 7two-25</ref>* Fear of doctors, clinics and also closed roomstone appearance.<ref>David M. Levy, Psychic trauma of operations in children; and a note on combat neurosis, American Journal of Diseases of Children, Vol. 69, 1945, 7-25</ref>* Relapse into the state of bed-wetting, even if the child was already dry before.<ref>David M. Levy, Psychic trauma of operations in children; and a note on combat neurosis, American Journal of Diseases of Children, Vol. 69, 1945, 7-25</ref>

In the United States, payment for non-therapeutic circumcision is made by most [[Image:Circumcision Sakkara 3.jpgthird-party payment|200px|rightthird-party payers]] For the Aborigines, the Australian natives, the tradition without question of circumcision is said to go back to 10,000 BCnecessity. On the African continentDoctors frequently perform medically-unnecessary, the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints non-therapeutic circumcision of various forms of circumcision date back infants and children simply to collect a fee for the time around 3000-2000 BCsurgical operation. The oldest known depiction<ref>http://commons.wikimedia.org/wiki/File:Circumcision Sakkara 3.jpg</ref> only beneficiary of such surgery is an Egyptian tomb relief from the 6th dynasty, approximately 2300-2000 BC. It is not known precisely who was circumcised and why in those times[[Financial Incentive| bank account of the medical doctor]].

In With the Jewish religion[[foreskin]], the tradition of circumcision goes back to a passage in the Book removes approximately 70% of Genesis (17, 10-14). It is seen as a covenant between God and man, dating back to the patriarch Abraham.{{Citation| Text=10 This is my covenant with you and your descendants after you, the covenant you are to keep: Every male among you shall be circumcised. 11 You are to undergo circumcision, and it will be the sign sensitive tissue of the covenant between me and you. 12 For the generations to come every male among you who is eight days old must be circumcised, including those born in your household or bought with money from a foreigner—those who are not your offspring. 13 Whether born in your household or bought with your money, they must be circumcised. My covenant in your flesh is to be an everlasting covenant. 14 Any uncircumcised male, who has not been circumcised in the flesh, will be cut off from his people; he has broken my covenant.” | Author=Bible| Source=Gen 17, 10-14, NIV}}According to the anthropologist and sociologist Nissan Rubin, the Jewish form of circumcision, called brit mila, during the first two millennia did not include the later customary periah, namely the complete scraping of the inner [[foreskinpenis]] from , lowering the [[Glans penis|glans]]potential for sexual stimulation accordingly. This was only added around 135 AD, Due to make it impossible to restore the [[foreskin]] by stretching, which became popular in the wake loss of Hellenic influence. While originally only the tip around 50% of the entire [[foreskinpenile skin]] was cut off, periah removes the entire [[foreskinpenis]]. In loses the Greek society of reserve skin that provides cutaneous mobility in the day, a denuded erect [[Glans penis|glans]] was considered obscene and risible. In ultra-orthodox communities, circumcision is followed by the [[mohelgliding action]], the ritual circumciser, sucking blood from the wound with his mouth. This practice is highly controversial, as it can result in an infection with herpes simplex type 1. In New York City, between 2000 and 2011 eleven children were infected with herpes, 10 of whom had to be treated in hospital. Two of them suffered permanent brain damage, two others died. In the 12th century, the Jewish philosopher and doctor Maimonides pointed out that circumcision was necessary, as it diminished sexual desires and reduced the pleasure to a degree just sufficient for mere reproduction.

In Islamthe past, circumcision is also religiously founded, even though there is no mention of this circumstance was used to make it in the Koran itself. According harder for boys to traditionmasturbate and [[masturbation]] less fun, the Prophet Mohammed was born without a as [[foreskinmasturbation]]. It is seen was viewed as immoral and was assumed to cause a sign variety of prophets mental diseases, caused by the thinking of immoral thoughts! More on that they are born without a can be found in the chapter "[[foreskinCircumcision#Historical_background|Historical background]] already". It Today, it is considered an honour known that [[masturbation]] has no negative health effects, but can contribute positively to "resemble the example of the Prophet"child's sexual development. Sexuality is no longer a taboo nowadays, meaning while [[masturbation]] is considered to be circumcised. In Islam, unlike Judaism, there a natural part of human sexuality and is no specific age at which the circumcision should be performedlonger seen as immoral. Most circumcisions take place at ages between 6 and 10 yearsTherefore, but the range goes from birth circumcision for moral reasons - which would only affect boys too young to adulthoodgive [[informed consent]] - is no longer justifiable nowadays.

In Christianity, circumcision is only common in a few orthodox churches. Nevertheless, Christian moral notions had decisive influence on the spread of this practice. In the puritan influenced USA, circumcision of children was popular in the 19th century as a means to prevent masturbation. In those days, this so-called ‘self-abuse‘ was not only considered immoral, but was supposedly responsible for a variety of diseases. Even the mere existence of a [[foreskin]] was linked to many illnesses. Among them one could find syphilis, epilepsy, paralysis of the spine, bed wetting, scoliosis (spinal deformity), paralysis of the bladder, club foot, nerve pain in the lower abdomen, tuberculosis and lazy eye. One of the best known advocates of child circumcision was [[John Harvey Kellogg]], co-inventor of the Corn Flakes bearing his name. In 1888, he wrote:{{Citation| Text=A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of [[phimosis]]. The operation should be performed by a surgeon without administering an anaesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. In females, the author has found the application of pure carbolic acid to the clitoris an excellent means of allaying the abnormal excitement, and preventing the recurrence of the practice in those whose will-power has become so weakened that the patient is unable to exercise entire self-control.| Author=John Harvey Kellogg| Source=| refHygiene reasons ===<ref>Treatment for Self-abuse and Its Effects, Plain Facts for Old and Young, Burlington, Iowa, F. Segner & Co. (1888) p. 107</ref>}}Following the discovery of bacteria as a cause of many diseases – such as tuberculosis – the search began for other illnesses that could be prevented by circumcision.

In the 1920s it was penile cancer<ref>Abraham L. Wolbarst behauptet, die Beschneidung könne dem Peniskrebs vorbeugen. [Is circumcision a prophylactic against penis cancer? Cancer 1926 Jul;3(4):301-10]</ref>, in the 1940 prostate- ''Hygiene'' refers to health and tongue cancer as well as STDs<ref>Eugene H. Hand erklärt, dass die Beschneidung irgendwie gegen Geschlechtskrankheiten und Zungenkrebsschütze. [Circumcision and venereal disease. Archives of Dermatology and Syphilology 1949 Sep;60(3):341-6]</ref>, in the 1950s it was cervical cancer<ref>Abraham Ravich erfindet den Mythos, die Beschneidung verringere das Risiko von Frauen an Gebärmutterhalskrebs zu erkranken. [Prophylaxis of cancer of the prostate, penis, and cervix by circumcision. New York State Journal of Medicine 1951 Jun;51(12):1519-20</ref>, in the late 1960s it was neuroses<ref>Morris Fishbein fordert die Beschneidung zur Prävention von Nervosität und natürlich auch Masturbation. [Sex hygiene. Modern Home Medical Adviser. Garden City, New York: Doubleday & Co: 1969 pp 90, 119]</ref>, in the 1970s bladder- and rectal cancer<ref>Abraham Ravich behauptet, dass die Beschneidung Blasenkrebs und Rektumskrebs vorbeugen würde. [Viral carcinogenesis in venereally susceptible organs. Cancer 1971 Jun;27(6)1493-6]</ref>, nd in the 1980s UTIs<ref>Thomas E. Wiswell behauptet, eine Beschneidung verringere das Risiko für Harntraktinfektionen. [Decreased incidence of urinary tract infections in circumcised male infants. Pediatrics 1985 May;75(5):901-3]</ref> and AIDS<ref>Aaron J. Fink behauptet, dass die Beschneidung gegen AIDS schütze. [A possible explanation for heterosexual male infection with AIDS. New England Journal of Medicine 1986 Oct 30;31(18):1167]</ref> followed. Retrospectively, circumcision was always advertised as a cure for whatever disease was in the public spotlight at the timeonly secondarily to cleanliness.

One should note that the human [[foreskin]] is endowed by nature with [[Foreskin#Immunological_functions| immunological functions]] that serve to protect the human body from disease.<ref name="fleiss-hodges-vanhowe1998"/> The sheer mass [[glans penis]] receives blood through the frenular artery.<ref>{{REFjournal |last=Persad |init=R |author-link= |last2=Sharma |init2=S |author2-link= |last3=McTavish |init3=J |author3-link= |etal=yes |title=Clinical presentation and pathophysiology of studies and publications that were released during those almost 180 years on this topic meatal stenosis following circumcision |journal=Brit J Urol |date=1995 |volume=75 |issue=1 |pages=91-3 |url=https://www.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.1995.tb07242.x |quote= |pubmedID=7850308 |pubmedCID= |DOI=10.1111/j.1464-410x.1995.tb07242.x |accessdate=2019-11-26}}</ref> These facts are the reason that even generally overlooked in arguments that have been disproved multiple times, especially regarding infant and child for alleged hygienic benefits of circumcision, tenaciously persist up until today.

An ever-recurring element A common reason stated for circumcision is the assumption of hygienic benefits. This argument has to be viewed in the context of initiation rites found the environment the person in question grows up in many different cultures . It is commonly known that bad hygienic circumstances, especially insufficient access to clean drinking water, pose a serious problem. The situation in disaster areas or refugee camps in the fixation upon the genitaliaso-called third world keep reminding us of that.

It reflects the fascination that emerges from the ability to create new life. In most cultureswestern industrial nations, however, fertility is seen as the most precious goodthis problem does not exist, and the body parts involved frequently find themselves in view of the focus availability of ritual actsclean water for daily personal hygiene. In many parts If the cleaning of the world, those rites take place when the boy reaches puberty, genitals is performed on a daily basis — and are meant to symbolize his transition from boy to man. The removal of that may be assumed — no pathogens can accumulate under the male [[foreskin]] is just one of many phenomena that developed in this context. They range from the removal Cleaning of the frenulum in boys [[Glans penis|glans]] and men through partial or complete removal of the [[foreskinpreputial sac]] up to radical operations. Australian Aborigines, as mentioned above, have their underneath the [[foreskin]]s removed. It is also usual that, a few weeks later, young men have their easy — they are simply [[penisPreputial_sac#Washing| washed with warm water along with the rest of the body]]es sliced open, resulting in a partly or completely divided urethrajust like the areas between the toes.

Another knownIn small boys, particularly massivewhere the [[foreskin]] cannot be retracted yet, intervention cleaning is the stripping of the entire skin off not necessary, since the [[penisSynechia| membrane]]. In Indonesia, boys have metal or bamboo balls inserted into their that fuses the [[penisforeskin]] shaft or to the [[Glans penis|glans]] at prevents the beginning accumulation of puberty, which form little micro-organisms. The so-called "humps[[Ballooning of the foreskin| ballooning]]", where the [[foreskin]] inflates during urination, is not a concern.

For many cultures it The opening of the [[foreskin]] in small boys is also common often quite narrow and serves as a one-way valve, allowing the [[urine]] to perform similar rituals on girlsflow out, but preventing entry of microbes, for example from a dirty diaper. This can range from relatively small interventions such As long as piercing or cutting the clitoral hood, child is able to its complete removal and up to radical removal of clitoral hoodpass water, clitoris, inner and outer labia followed by sewing up the vaginaeverything works as nature intended.

== Rights But even in areas where there are poorer hygienic conditions and Ethics ==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]].

Non-therapeutic circumcision The benefit of children is not only one easier cleaning must be balanced against the risk of promoting serious infections — among others [[HIV]] — during the most widespread surgical operations in the worldoperation. In parts of Africa, but also several dozen of one tribe's boys die each year as a result of the oldest. It is probably due to this long tradition, that despite its violating the common basic rights to bodily integrity and medical ethics in the western world, it is still widely tolerated there, even though there are barely any legal exemptions in place. The few regulations, which mostly emerged in the recent past, usually only deal with the basic conditions. They regulate how and under what conditions the operation should be carried out, while the general compatibility with basic human rights is rarely questioned, let alone taken into considerationtheir circumcision.

=== Examples of legal regulations<ref>http://de.wikipedia.org/wiki/Zirkumzision#Regelung_der_Beschneidung_Minderj.C3.A4hriger_in_einzelnen_Staaten</ref> =Circumcision methods ==

The [[Circumcision methods]] are discussed in a separate article.==Pain == Germany In the past, advocates of circumcision claimed that a newborn child's nerve system was not yet fully developed, and that as a result, the child felt no [[pain]] during the circumcision procedure. [[Kanwaljeet J. Singh Anand| Anand]] & Hickey (1987) have shown that newborn children do in fact feel [[pain]], and more acutely than adults.<ref name="anand-hickey1987">{{REFjournal |last=Anand |first=KJS |author-link=Kanwaljeet J. Singh Anand |last2=Hickey |first2=PR |author2-link= |etal=no |title=Pain and its effects in the human neonate and fetus |trans-title= |language= |journal=New Engl J Med |location= |date=1987-11-19 |volume=317 |issue=21 |pages=1321-9 |url=https://www.cirp.org/library/pain/anand/ |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=3317037 |pubmedCID= |DOI=10.1056/NEJM198711193172105 |accessdate=2019-11-08}}</ref> This has led American health associations to recommend doctors take measures to reduce the [[pain]] of circumcision in infants.

GenerallyThe [https://www.cirp.org/library/statements/aap1999/|AAP Circumcision Policy Statement] (1999) states quite clearly that ''"There is considerable evidence that newborns who are [[circumcised]] without analgesia experience pain and physiologic stress"''. Furthermore, circumcision of children met the criteria pain is quite severe, and requires injections for proper pain management. Sucrose and Acetaminophen ''"cannot be recommended as the sole method of bodily assault until December 2012analgesia"''. Practically, however, it was not legally pursued, since it was considered unclear whether parents had Topical cream is no longer thought sufficient as ''"the right to consent to analgesic effect is limited during the operation phases associated with extensive tissue trauma such as...tightening of the clamp"''.<ref>{{REFjournal |last= |first= |title=American Academy of Pediatrics: Circumcision Policy Statement; Task Force on behalf of their children (see §228 StGB)Circumcision |journal=Pediatrics |date=1999-03 |volume=103 |issue=3 |pages=686-93 |url=https://pediatrics.aappublications.org/content/103/3/686#sec-9 |accessdate=2019-11-26 |note=Statement Reaffirmed Sept.1, 2005}}</ref>

In 2004The [[AAFP]] (2002) states quite simply in their [https://www.cirp.org/library/statements/aafp2002/| position paper], the ''Landgericht"Newborns experience pain during circumcision".'' (regional court) <ref>{{REFweb |title=Circumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed |website=Official American Academy of Frankenthal ruled in Family Physicians Website |url=http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html |accessdate=2011-05-02}}</ref> This is not a case of a circumcision done debatable fact, and yet, it is not widely accepted, even by non-medical peoplesome doctors. It might be hard for some doctors to accept, as they may have been taught that parental consent was the infant does not legally validfeel [[pain]], and may have performed countless circumcisions with this idea. Usage of anesthesia for infant circumcision is still by no means the rule.

Penile injections of local anesthetic are now recommended by all of the major medical institutions if a circumcision is to be performed. In August 2007 their [http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml Report 10 of the Council on Scientific Affairs], the AMA states ''Oberlandesgericht"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, '' (upper regional court) Frankfurt/Main "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 decision about a use of local anesthesia". The AMA reports that "Of physicians performing circumcision, because 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, and 25% of the obstetricians"bodily modifications that cannot be reversed [''.<ref>{{REFweb |title=Report 10 of the Council on Scientific Affairs (I-99): Neonatal Circumcision |website=American Medical Association Official Website |url=http://www.ama-assn.] belongs to the core of a person's rights to decide upon for themselves"org/ama/no-index/about-ama/13585.shtml |accessdate=2011-05-04}}</ref>

The AAP''Landgerichts [http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx Heatlhy Children website] suggests '' "Your pediatrician (regional courtor your obstetrician) should discuss the forms of Cologne, in a second trial, ruled on May 7th, 2012analgesia that are available"''.<ref>{{REFweb |title=Where We Stand: Circumcision |publisher=[[AAP]] |date=2011-03-23 |url=http://dejurewww.healthychildren.org/diensteEnglish/ages-stages/prenatal/decisions-to-make/vernetzungpages/rechtsprechung?Gericht=LG%20K%F6ln&Datum=07Where-We-Stand-Circumcision.05.2012&Aktenzeichenaspx |accessdate=151%20Ns%20169/112019-10-12}}</ref>Be that as it may, that circumcision is a bodily assaultfew forms of analgesia are recommended. There are basically two types of injections to choose from, which is not justified by the religious motivation and wishes of the parents and is website does not in go into the interest of difference between a 'dorsal nerve block' and a child's well-beingring block' injection.

The ruling Given what is known from May 2012 sparked fierce protests by representatives 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 religious groupsanything short of local anesthesia, and make sure your baby is given an injection. This is your responsibility, which were instantly answered by politicians with because your doctor may or may not be up to date on the assurance that religiously motivated 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 underage Muslim advice on such a website, and Jewish boys in Germany would remain legalyet, anything less than this is a dangerously weak statement.

On August 23rdTo control [[pain]], some physicians that circumcise use Tylenol, sugar,<ref>{{REFweb |quote=To calm the baby during the procedure, 2012a sugar filled gauze pacifier soaked with sweet juice is used, and soothing music is played in the room. |url=http://www.pollockclinics.com/circumcision/circumcision-guide.html |title=Parents''Deutscher Ethikrat'' Guide to Circumcision |last= |first= |publisher= |date= |accessdate=2011-04-08}}</ref><ref>{{REFweb |quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |url=http://www.pollockclinics.com/circumcision/circumcision-before.html |title=Before the Circumcision |last= |first= |publisher= |date=2011-04-08 |accessdate=2011-04-08}}</ref> a topical cream,<ref>{{REFweb |quote=Then in our office, he will have topical anesthetic applied to his penis. |url=http://www.pollockclinics.com/circumcision/circumcision-before.html |title=Before the Circumcision |last= |first= |publisher= |date=2011-04-08 |accessdate=2011-04-08}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb |quote=We use extensive pain control methods including Tylenol, a sugar solution (German Council of Ethicsto reduce pain perceptions), during a publicly held plenary sessiontopical freezing cream, came and a local anesthetic injection. |url=http://www.pollockclinics.com/circumcision/circumcision-guide.html |title=Parents' Guide to Circumcision |last= |first= |publisher= |date= |accessdate=2011-04-08}}</ref> Topical anaesthetic only serves to numb the area to terms 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="despite profound differencesJournal of Perinatology April/May 2002" (!) upon four minimum requirements for legal regulation >{{REFjournal |last=Taeusch |first=H. William |init=HW |last2=Martinez |first2=Alma M. |init2=AM |last3=Partridge |first3=J. Colin |init3=JC |last4=Sniderman |first4=Susan |init4=S |last5=Armstrong-Wells |first5=Jennifer |init5=J |last6=Fuentes-Afflick |first6=Elena |init6=E |title=Pain During Mogen or Plastibell Circumcision |journal=Journal of Perinatology |volume=22 |issue=3 |pages=214-8 |url=http://www.nature.com/jp/journal/v22/n3/full/7210653a.html |quote=...more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure. |pubmedID= |pubmedCID= |DOI= |note=April/May 2002 |date=2002-04 |accessdate=2011-04-08}}</ref><ref name="Clinical Pediatrics August 1986">{{REFjournal |last=Williamson |first=Paul S. |init=PS |last2=Evans |first2=Nolan Donovan |init2=ND |title=Neonatal Cortisol Response to Circumcision with Anesthesia |journal=Clinical Pediatrics |volume=25 |issue=8 |pages=412-6 |url=http://cpj.sagepub.com/content/25/8/412.abstract |quote=The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine. |pubmedID= |pubmedCID= |DOI= |date=1986-08 |accessdate=2011-04-08}}</ref> During circumcision, somp physicians give children sugar pacifiers to "reduce the perception of pain",<ref>{{REFweb |quote=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |url=http://www.pollockclinics.com/circumcision/circumcision-before.html |title=Before the Circumcision |last= |first= |publisher= |date=2011-04-08 |accessdate=2011-04-08}}</ref> but in at least one study, data shows that giving sugar to a child doesn't help to reduce the perception of pain in the child.<ref name="Lancet, The 2010-10-09">{{REFjournal |last=Slater |first=Rebeccah |init=R |first2=Laura |init2=L |last2=Cornelissen |first3=Lorenzo |init3=L |last3=Fabrizi |first4=Debbie |init4=D |last4=Patten |first5=Jan |init5=J |last5=Yoxen |first6=Alan |init6=A |last6=Worley |first7=Stewart |init7=S |last7=Boyd |first8=Judith |init8=J |last8=Meek |first9=Maria |init9=M |last9=Prof. Fitzgerald |title=Oral sucrose as an analgesic drug for procedural pain in newborn infants:a randomised controlled trial |journal=The Lancet |volume=376 |issue=9748 |pages=1225-32 |url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2961303-7/fulltext |quote=Our data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuits, and therefore might not be an effective analgesic drug. The ability of sucrose to reduce clinical observational scores after noxious events in newborn infants should not be interpreted as pain relief. |pubmedID= |pubmedCID= |DOI= |date=2010-10-09 |accessdate=2011-04-08}}</ref> Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals.

* Fully informed consent by the legal guardians* Qualified It has been shown that an infant's response to [[pain management* The operation to ]] can be performed by altered for years as a professional and* Approval of a right of veto depending on the maturity consequence of the affected boycircumcision.<ref>{{TaddioA etal 1995}}</ref><ref>{{TaddioA KatzJ IlersichAL KorenG 1997}}</ref>

The explicitly mentioned profound differences point out the difficulty {{Box|Boxtext=<big><b>However, none of legally regulating the circumcision above three procedures totally eliminate pain. A baby boy will still experience some pain despite any of underaged boysthose analgesic procedures. The legislative procedure led to Prevention of [[pain]] requires protecting a broad public debate over boy from elective neonatal non-therapeutic circumcision. Only boys who are protected from the legitimacy and legality of medically unnecessary circumcision of minors in German societysurgery experience no [[pain]] or [[trauma]]. Despite the fierce resistance of medical associations, jurists, constitution experts, child and human rights activists as well as 100 Members of Parliament, the following Act was adopted in December 2012:</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."<blockquoteref 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=''§ 1631d BGB'' |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 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 child''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).

''(1) Personal Care also includes the right to consent * 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 circumcision anatomy of the male child who lacks competence [[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 understandingdouble or more their size during an [[erection]] ([[Blood Penis]], if it is to be performed according to proper medical standardsor "[[grower]]"). This does not apply when the Especially in children's circumcision, also considering where the motivation[[penis]] is not yet fully developed, endangers the child's well-beingamount of reserve [[skin]] needed in adulthood cannot be estimated.''

''(2) During * Erectile dysfunction: Both the first 6 months of life, persons appointed by a religious group may perform circumcisions according damage inflicted to paragraph 1, if they are specially trained the blood vessels in the [[foreskin]] and, without being a medical doctor, are similarly competent to perform the reduced sexual sensitivity can be causes for reduced erectile function with advancing age.<ref>{{REFjournal |last=Money |init=J |last2=Davison |init2=J |title=Adult penile circumcision.'': Erotosexual and cosmetic sequelae |journal=Journal of Sex Research |date=1983 |volume=19 |issue= |pages=289-92 |url= |accessdate=}}</blockquoteref>

Therefore* Orgasm problems: In the wake of reduced sexual sensitivity, a non-therapeutic circumcision due to the loss of a male child lacking competence sensory tissue and understanding for whatever reason gradual [[keratinization]] of the surface of the [[Glans penis|glans]], orgasm problems may develop with increasing age. In this case, the sexual arousal created by intercourse or [[masturbation]] is generally legalnot enough to achieve orgasm. A right preliminary stage of veto for this late effect is the affected boys was turned down in parliament, prolonged time [[circumcised]]] men need to reach an orgasm. This is often fielded as well as a proposed change destined the "cut men have more endurance" argument for circumcision.* Vaginal dryness: Due to introduce an evaluation the loss of the regulations after five years. Giving natural [[gliding action]], which comes from the Ministry mobility of Heath the right [[foreskin]] and [[shaft skin]], a much increased friction between [[penis]] and [[vagina]] occurs during intercourse. This can make intercourse painful for both partners and lead to determine more specific guidance abrasions<ref>{{FrischM LindholmM GroenbaekM 2011}}</ref><ref>{{REFjournal |last=Cortés- for example regarding pain management and the qualification and training of nonGonzález |init=J |last2=Arratia-medical circumcisers Maqueo |init2=J |last3=Gómez- by issuing additional regulations was also rejected. A call for mandatory documentation Guerra |init3=L |title=Does circumcision has an effect on female's perception of non-therapeutic circumcisions was ignored. Merely stating the intent sexual satisfaction? |journal=Rev Invest Clin |date=2008 |volume=60 |issue=3 |page=227 |url= |pubmedID=18807735 |accessdate=}}</ref> The prolonged time it takes [[circumcised]] men to have reach orgasm, as well as the operation performed according often longer and more vigorous thrusting movements - compared to proper medical standards was considered sufficient[[intact]] men - play a part in this.<ref name="ColdCJ TaylorJR 1999">{{ColdCJ TaylorJR 1999}}</ref><ref>{{REFjournal |last=Fink |init=KS |last2=Carson |init2=CC |last3=DeVellis |init3=RF |title=Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction |journal=J Urol |date=2002 |volume=167 |issue=5 |pages=2113-6 |url= |accessdate=}}</ref>

In December 2012, a representative poll done by Infratest dimap revealed that only 24 percent * [[Lymphoedema]] of the interviewed citizens were in favour of the law, while 70 percent explicitly disapproved penis is a normal and expected complication of it.<ref>http://die-betroffenen.de/blog/mehrheit-der-bevoelkerung-lehnt-beschneidungsgesetz-ab/ und http://www.infratest-dimapmale circumcision.de/umfragen-analysen/bundesweit/umfragen/aktuell/bewertung-der-gesetzlichen-regelung-zu-beschneidungen/</ref>

* [[Meatal stenosis]], a pathological narrowing of the opening of the [[urethra]], which mostly occurs in infancy and early childhood. It is one of the most common complications of infant circumcision. A study from 2006 found meatal stenosis exclusively in previously [[circumcised]] boys. The incidence rate after a circumcision is approximately 10 to 20 percent.<ref name="vanhowe2006">{{REFjournal |last=Van Howe |init=RS |author-link= Austria Robert S. Van Howe |title=Incidence of meatal stenosis following neonatal circumcision in a primary care setting |journal=Clin Pediatr (Phila) |note=Jan-Feb 2006 |date=2006-01 |volume=45 |issue=1 |pages=49-54 |url=https://www.academia.edu/6992015/Incidence_of_Meatal_Stenosis_following_Neonatal_Circumcision_in_a_Primary_Care_Setting |accessdate=2019-12-15}}</ref><ref>{{REFjournal |last=Stenram |init=A |last2=Malmfors |init2=G |last3=Okmian |init3=L |title=Circumcision for [[phimosis]]: a follow-up study |journal=Scandinavian journal of urology and nephrology |date=1986 |volume=20 |issue=2 |page=89 |url= |pubmedID=3749823 |accessdate=}}</ref><ref>{{REFweb |url=http://emedicine.medscape.com/article/1016016-overview |title=Meatal Stenosis |publisher=Medscape |accessdate=2019-10-11}}</ref>

In Austria, bodily assault is, as in Germany, punishable, without any specific regulations regarding circumcision. There is, however – unlike in Germany - no specific basic right to an unharmed body in the constitution. It is regulated in §146a ABGB that "the application of bodily violence and the infliction of bodily or mental suffering" * Shorter adult penile length was reported by the parents is unlawfulPark et al. According to §90 (32016) StGB it is impossible to consent to "as a mutilation or other injuring result of the genitalsNMC (newborn male circumcision).{{Citation |Title= |Text=In conclusion, that is able second to inflict a lasting impairment fourth digit ratio, flaccid penile length, and age of the sexual sensitivity" even circumcision were significant predictive factors for adultserectile penile length. On the other handFurthermore, the ''"Israelitengesetz"'' (Law for penile lengths of the Israelites) entitles NMC group were shorter than those of the Jewish religious non-NMC group and their members to "bring their children and juveniles, also outside . |Author=Park et al. |Source= |ref=<ref>{{REFjournal |last=Park |first= |init=JK |author-link= |last2=Doo |first2= |init2=AR |author2-link= |last3=Kim |first3= |init3=JH |author3-link= |last4=Park |first4= |init4=HS |author4-link= |etal=yes |title=Prospective investigation of school, through all traditional rites penile length with newborn male circumcision and second to educate them according to their religious commandments"fourth digit ratio. |trans-title= |language= |journal=Can Urol Assoc J |location= |date=2016-09 |season= |volume=10 |issue=9-10 |article= |page= |pages= |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028213/ |archived= |quote= |pubmedID=27695583 |pubmedCID=5028213 |DOI=10. Circumcision of boys for religious reasons is not considered punishable by the Austrian Ministry of Justice, and is justified by the parental rights5489/cuaj.3590 |accessdate=2022-09-04}}</ref>}}

===Sexual effects = France ==Cepeda-Emiliani et al (2023) cited six reports in the literature of detrimental effects of circumcision, including erectile function, sensation, masturbatory pleasure, orgasm, and sexual satisfaction. The authors also cited three studies of severe distress in [[circumcised]] men, due to their infant circumcision, with complaints of [[glans]] insensitivity, delayed [[ejaculation]], and 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 density and distribution of human 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>

In France, there is no specific regulation for circumcisionCircumcision and frenectomy remove tissues with heightened erogenous sensitivity. The question of parental consent is neither debated under religious aspects nor by the parenting laws. Article 16.3 of the civil code states that <ref name="cepeda2023" /> <ref name="the integrity of the human body may not be harmed, other then in cases of medical necessity for those affectedwinkleman1959". However>{{WinkelmannRK 1959}}</ref> They concluded, there is a "silent toleration" of the Evidence has also started to accumulate that male circumcision of minorsmay result in lifelong physical, sexual, and sometimes psychological harm as well."

The [[amputation]] of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the [[penis]], leaving only the uninhibited protopathic sensibility of the artificially externalized [[glans penis]]. The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of the changes in sexual behavior noted in [[circumcised]] human males.<ref>{{REFjournal |last=Van Howe |init=RS |author-link=Robert S. Van Howe |last2= Italy 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>

In ItalyHistology 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, there to the extent that this technique is a basic agreement between of such versatility that it allows highly variable quantities of cutaneous and subcutaneous tissue to be excised directly from the State penile body, and to the extent that the Jewish communities prepuce is still conceived by segments of the medical community as "just a small piece of skin", we are concerned that was formulated aggressive circumcisions are intentionally or unintentionally being performed in 1987 pediatric and secured adult patients in the law in 1989. It implies belief that the Jewish way of circumcision "redundant" or " extra" tissue is being excised, or in accord with the Italian system of lawsbelief that "excesive sensitivity" is being reduced to augment ejaculatory latency time. According <ref name="cepeda2023" /></blockquote>The un-anesthetized and un-sedated newborn infant is restrained by being strapped to Article 19 of a special plastic board called the Italian constitution[[circumstraint]]. The procedure is most often an elective, non-therapeutic surgery without [[medical indication]] performed on neonates and children for religious freedom is and cultural reasons in violation of the child's [[human rights]] to [[physical integrity]], but in older patients may be respectedrarely indicated for therapeutic reasons. It is a radical treatment option for pathological [[phimosis]], as long as no acts are performed that contradict good mannersrefractory [[balanoposthitis]] and chronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health.

In a ruling by the "High Court See [[Sexual effects of Cassation" from Nov. 24th, 2011, a mother was found not guilty, whose son almost bled to death after being circumcised by a medically unqualified laymancircumcision]] for more information.

==== Finland =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.

At the end The psychological late effects of 1999circumcision are not yet fully researched, the Finnish parliament issued and many studies took place on rather a declaration regarding ritual circumcisionsmall scale. Ombudsman Riita-Leena Paunio statedThis situation needs to be rectified, that because the operation could not be recommended without a medical indicationavailable studies, and that as well as the histories of negatively affected children should be consulted and give consent. She saidmen, the Finnish parliament had to weigh the religious rights of the parents against the responsibility of the society to protect their children from ritual operations suggest that these late effects may have no immediate benefit for them. Since then, the written consent of both parents is mandatorymore 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= Sweden FL |last3=Rogers |init3=AG |etal=yes |title=Circumcision: II effects upon mother-infant interaction |journal=Early Hum Dev |date=1982 |volume=7 |issue=4 |pages=367-74 |url=https://www.cirp.org/library/birth/marshall2/ |accessdate=2020-02-01}}</ref>, as well as problems with nurturing, up to the point of refusal to be fed. The sleeping habits of these babies were also disturbed, with prolonged non-REM sleep and increased waking.

* In Swedenboys [[circumcised]] in childhood, non[[post-therapeutic circumcision 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 under 18 years [[circumcised]] in the traditional ritual and 51% of age is regulated since 2001 those [[circumcised]] by standard medical procedures (including anaesthesia) fulfilled the DSM-IV criteria for PTSD following the ''"Lag (operation.<ref>{{REFbook |last=Ramos |init=S |last2=Boyle |init2=GJ |year=2001 |title=Understanding circumcision:499) om omskärelse av pojkar"'' (Law regarding A Multi-Disciplinary Approach to a Multi-Dimensional Problem |url=https://link.springer.com/chapter/10.1007/978-1-4757-3351-8_14 |work= |editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |edition= |volume= |chapter=Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder |pages=253-70 |location=New York |publisher=Kluwer Academic/Plenum Publishers |isbn= |quote= |accessdate= |note=}}</ref>* Circumcisions, especially those that happen without consent, can spark feelings of helplessness and alienation, which can persist as [[trauma]]. These feeling can also be triggered later, when someone [[circumcised]] as an infant becomes aware of boys)his circumcision. According to itIn an online study, interviewed men stated they felt betrayed - 55% by the mother, 50% by the father, such circumcisions are a surgical procedure and have to be carried out 58% by a qualified the doctor , and under anaesthesia73% felt that their [[human rights]] had been violated.<ref name="GSoCH">{{REFweb |url=http://www.circumcisionharm. For boys under 2 month org/ |title=Global Survey of ageCircumcision Harm |accessdate=2019-10-12}}</ref>* It can frequently be found that the loss is denied, circumcision may also be carried out by another competent person much as happens with a government licensethe loss of other body parts. This applies denial can lead to persons that have been nominated by religious groups fathers having their sons [[circumcised]] in which circumcision order not to be reminded of their own loss. In this process, their own body is part of defined as "normal" and the religious tradition[[foreskin]] redefined as a foreign object. Persons who perform a Their own parents are seen as "good", so that this image is projected onto the circumcision without their parents carried out as well, in order to keep the necessary qualification or license face positive emotion intact. The father wants to be a fine or prison sentence "good" father later in life as well, and so, following an idealised image of up his own parents, circumcision, which has been redefined as a "good thing", is passed on to six monthshis son by having him [[circumcised]] as well. <ref>{{VanderKolkBA 1989}}</ref><ref>{{REFjournal |last=Goldman |init=R |author-link=Ronald Goldman |url=https://www.cirp.org/library/psych/goldman1/ |title=The psychological impact of circumcision requires |journal=BJU Int |date=1999 |volume=83 |issue=Suppl. 1 |pages=93-103 |accessdate=2019-10-12}}</ref>* If the consent of [[circumcised]] male feels incomplete, or due to the legal guardiansmissing [[foreskin]] disadvantaged compared to [[intact]] males, an inferiority complex and [[depression]] may occur. It may not This can be carried out against accompanied by conscious recognition of his own incompleteness, or the child's willdeficiency may remain completely subconscious<ref>{{REFjournal |last=Rhinehart |init=J |url=https://www.cirp.org/library/psych/rhinehart1/ |title=Neonatal circumcision reconsidered |journal=Transactional Analysis J |date=1999 |volume=29 |issue=3 |pages=215-21 |accessdate=2019-10-12}}</ref>. In an online study, 75% of those interviewed stated that they felt incomplete, and 66% said they felt inferior compared with [[intact]] males.<ref name="GSoCH"/>* Cases in which children felt ill treated or punished have been documented as well. G. Cansever found in her study on 12 boys aged between 4 and 7 years, who had previously been prepared for their impending circumcision, if he has that the children experienced the age operation as an aggressive assault on their bodies.<ref>{{REFjournal |last=Cansever |init=G |date=1965 |url=https://www.cirp.org/library/psych/cansever/ |title=Psychological effects of circumcision |journal=Brit. J. Med. Psychol |volume=38 |pages=321-31 |accessdate=2019-10-12}}</ref>* Fear of being alone or darkness.<ref name="Levy1945">{{REFjournal |last=Levy |first=David M. |init=DM |url=https://www.cirp.org/library/psych/levy1/ |title=Psychic trauma of operations in children; and a note on combat neurosis |journal=American Journal of Diseases of Children |volume=69 |date=1945 |pages=7-25 |accessdate=2019-10-12}}</ref>* Fear of doctors, clinics and level also closed rooms.<ref name="Levy1945"/>* Relapse into the state of maturity for such a statementbed-wetting, even if the child was already dry before.<ref name="Levy1945"/>* [[Circumcised]] males who become fathers frequently manifest [[adamant father syndrome]].

[[Intact America]] (2019) called circumcision an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]],<ref name-"bollinger2019">{{REFdocument |title=Child genital cutting as an adverse childhood experience |url=http://adversechildhoodexperiences.net/CGC_as_an_ACE.pdf |last=Bollinger |first= USA Dan |author-link=Dan Bollinger |last2=Chapin |first2=Georganne |author2-link=Georganne Chapin |publisher=Intact America |location=Tarrytown |format=PDF |date=2019-08 |accessdate=2021-11-02}}</ref>

The USA have by far the highest rate == Complications ===== Possible operative and postoperative complications ===Circumcision is surgery. Surgical complications of circumcision among the western nations. In many maternity wards the routine circumcision of newborn boys is common. The US paediatric societygenerally may be classified as [[Bleeding| hemorrhage]], [[AAPinfection]], is or surgical misadventure up to and including loss of the only major medical society in the world still advocating the nonpenis and [[death]].<ref name="deacon2022" /><ref name="williams-kapilla1993">{{REFjournal |last=Williams |init=N |author-link= |last2=Kapilla |init2=L |author2-therapeutic link= |etal=no |title=Complications of circumcision of newborns and children |trans-title= |language= |journal=Brit J Surg |location= |date=1993-10 |volume=80 |issue=10 |pages=1231-6 |url=https://www.cirp.org/library/complications/williams-kapila/ |quote= |pubmedID=8242285 |pubmedCID= |DOI=10.1002/bjs.1800801005 |accessdate=2019-11-27}}</ref>

* Intolerance or allergic reactions to the narcotics used.* Especially in newborns, 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 [[penis]], the rate of failure to provide sufficient anaesthetic even for experienced anaesthetists is still 5-10%. The general anaesthesia that would be needed for newborns, however, poses significant risks for the child, and, therefore, is only likely to be used in emergencies. A surgical operation without proper [[pain]] control can lead to the development of a specific pain memory<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=German |last=Prof. Dr. med. Boris Zernikow |first= |publisher=Spiegel Online |website= |date=2012-08-12 |accessdate=2019-10-11 |format= |quote=}}</ref>. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation. Overall, their pain threshold was lower and the autumn risk of chronic pain increased. Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFjournal |last=Garry |init=T |title=Circumcision: a survey of 2010fees and practices |journal=OBG Management |date=1994 |volume=October |issue= |pages=34-6 |url= |accessdate=}}</ref><ref>{{REFjournal |last=Howard |init=CR |last2=Howard |init2=FM |last3=Garfunkel |init3=LC |last4=de Blieck |init4=EA |last5=Weitzman |init5=M |title=Neonatal circumcision and pain relief: current training practices |journal=Pediatrics |date=1998 |volume=101 |issue= |pages=423-8 |url= |accessdate=}}</ref><ref>{{REFjournal |last=Stang |init=HJ |last2=Snellman |init2=LW |title=Circumcision practice patterns in the United States |journal=Pediatrics |date=1998 |volume=101 |issue=e5 |pages= |url= |accessdate= |note=Link to [[AAP]] website}}</ref>. During procedures which take several minutes, babies tend to fall into a state of stupor, which in the past was falsely interpreted as peaceful sleep, nurturing the belief that babies felt no pain. Measurements taken in those cases revealed a typically 3- to 4-fold increase in cortisol levels, which equals a state of severe [[shock]].<ref>{{REFjournal |last=Gunnar |init=MR |last2=Fisch |init2=RO |last3=Korsvik |init3=S |last4=Donhowe |init4=JM |title=The effects of circumcision on serum cortisol and behavior |journal=Psychoneuroendocrinology |date=1981 |volume=6 |issue=3 |pages=269-75 |url=https://www.cirp.org/library/pain/gunnar/ |accessdate=2019-11-26}}</ref>* Postoperative wound pain, Californian intactivists called in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions.* Postoperative pain from the exposure of the sensitive glans penis to clothing. This pain will endure for several weeks or even longer in some cases.* Postoperative [[bleeding]] of the wound. This can have severe consequences especially for very young infants, if they are not treated promptly. Their blood volume is only about 85 ml per kilogram of body weight, and even moderate blood loss can lead to hypovolaemia, hypovolaemic [[shock]] and even death.<ref>{{REFbook |last= |first= |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 |isbn= |quote= |accessdate= |note=}}</ref><ref>{{REFdocument |title=Autopsy of Demetrius Manker |url= |contribution=Case 93-1711 |last=Wetli |first=CV |publisher=Miami: Dade County Medical Examiner Department |format= |date=1993-06-23 |accessdate=}}</ref> <ref>{{REFjournal |last=Hiss |init=J |last2=Horowitz |init2=A |last3=Kahana |init3=T |title=Fatal haemorrhage following male ritual circumcision |journal=J Clin Forensic Med |date=2000 |volume=7 |issue= |pages=32-4 |url=https://www.cirp.org/library/death/hiss1/ |accessdate=2019-11-06}}</ref><ref>{{REFdocument |title=Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan |url=http://www.circumstitions.com/death-exsang.html |contribution= |last=Newell |first=TEC |publisher=Burnaby, B.C.: B.C. Coroner's Service |format= |date=2004-01-19 |accessdate=2019-11-26}}</ref>* Post operative [[lymphoedema]].* Postoperative [[Infection| infections]]. This includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.<ref>{{REFconference |last=Dr. med. Hartmann |first=Wolfgang |url= |place=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German) |title=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German) |date=2012-11-26 |accessdate=}}</ref>* [[Wound dehiscence]], meaning the separation of the edges of the wound or the tissue after suturing.* Adhesion between the surface or rim of the [[Glans penis|glans]] with the neighbouring [[penile skin]], causing [[skin]] pockets and bridges, as well as visually unpleasant results like uneven scars, which make a re-circumcision necessary.* Postoperative [[phimosis]]: a phimotic ring can develop during scarring, which makes a re-circumcision necessary. According to a study by Blalock et al.<ref>{{REFjournal |last=Blalock |init=HJ |last2=Vemulakonda |init2=V |last3=Ritchey |init3=ML |last4=Ribbeck |init4=M |title=Outpatient management of [[phimosis]] Following newborn circumcision |journal=J Urol |date=2003 |volume=169 |issue=6 |pages=2332-4 |url=https://www.cirp.org/library/complications/blalock1/ |accessdate=2019-11-26}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal |last=Leitch |init=IOW |title=Circumcision - a ban continuing enigma |journal=Aust Paediatr J |date=1970 |volume=6 |issue= |pages=59-65 |url=https://www.cirp.org/library/general/leitch1/ |accessdate=2019-12-15}}</ref> 5.5%.* [[Sudden Infant Death Syndrome]] (SIDS).* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], is cut during circumcision without being clamped and sutured at its origin separately, it starts to develop new branches over time, which can lead to the development of routine infant knots.* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro-penis) and thereby sparked induratio [[penis]] plastica (skewed penis).* Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis|glans]] or the [[penis]] can occur.* In rare cases, [[necrosis]], gangrene, ischaemia, keloid formation, and circulatory problems may also occur.* When the circumcision is followed by the ultra-orthodox Jewish ritual of Metzitzah B'Peh (which consists of sucking blood from the wound with the mouth), there is a risk of infection with [[herpes]] simplex type 1, which can lead to brain damage or [[death]].<ref>{{REFweb |url=http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritual.html?_r=0 |title=Baby’s Death Renews Debate Over a nationCircumcision Ritual |last=Robbins |first=Liz |date=2012-03-07 |accessdate=2019-10-11}}</ref>=== Death ===A study in 2010 estimated approximately 117 neonatal circumcision-wide discussion related [[Death| deaths]] occur annually in the [[United States]], about one out of every 77 male neonatal deaths, more than suffocation, auto accidents, or even [[SIDS]].<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 of U.S. Circumcision-Related Infant Deaths |journal=Thymos: Journal of Boyhood Studies |volume=4 |issue=1 |pages=78-90 |url=http://www.mensstudies.com/content/b64n267w47m333x0/?p=7ebbd6b446d940cbbd4274c095754b12π=5 |quote= |pubmedID= |pubmedCID= |DOI=10.3149/thy.0401.78 |date=2010-04-26 |accessdate=2019-10-12}}</ref><ref>{{REFweb |url=http://www.icgi.org/2010/04/infant-circumcision-causes-100-deaths-each-year-in-us |title=Infant circumcision causes 100 deaths each year in US |last= |first= |publisher=ICGI |website=[[International Coalition for Genital Integrity]] |date=2010-04-26 |accessdate=}}</ref> See also the topiclist of [[fatalities]].

It is noteworthy thatHuman 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 abuses of power rampant throughout the nation's social institutions, despite influential grass-roots movements protesting the wide spread forced circumcision of American children sprang up nationwide." F. Hodges, "A Short History," p. 31; see also [[Leonard B. Glick|Glick]], ''Marked in Your Flesh'', pp. 273-281.</ref> There are, however, physicians in the United States who argue strongly for non-therapeutic circumcision of children newborn babies; and circumcision is widely accepted as a postnatal procedure in American hospitals.<ref>{{REFbook |last=Fletcher |first=Christopher R. |init=CR |year=1999 |title=Circumcision in America in 1998: Attitudes, Beliefs, and Charges of American Physicians |url=http://www.springerlink.com/content/h2150v731233m177/ |work=Male and the fact that it contradicts many national lawsFemale Circumcision |editors=[[George C. Denniston]], [[Frederick M. Hodges]], there [[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 barely a country that has issued explicit exemptionsrequired.<ref>See, e.g. , Shephard and Shephard, ''The principle Complete Guide'', p. 125.</ref> A statement published by the [[American Academy of Pediatrics]] in 1999 claimed that "silent toleration" parents should determine what is in the best interest of the child... It islegitimate for parents to take into account cultural, religious, regardless of and ethnic traditions, in additions to the medical factors, when making a possible illegalitydecision."<ref>Lannon and Bailey, common practice"Circumcision Policy Statement," p. 691.</ref> however surrogate consent for non-therapeutic circumcision is now viewed as unethical.

In the [[United Kingdom]], where non-therapeutic circumcision has now become far less prevalent than in the [[United States]], the written consent of both parents is required, if a physician is to perform a non-therapeutic circumcision of a child.<ref>{{REFjournal |last= |first= |title= Legal Re J (child's religious upbringing and ethical issues circumcision) |journal=Family Court Reports |date=2000 |volume=1 |issue= |pages=307-14 |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.)

Considering In recent years, legal writers in several English-speaking countries have been questioning the severity practice of acceding to parental wishes.<ref>See, e.g., [[Margaret A. Somerville|Somerville]], "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; [[Abbie Chessler|Chessler]], "Justifying the intrusion into the body of the affected personUnjustifiable"; Smith, "Male Circumcision."</ref> For example, critics have pointed out that, in the question arises[[United States]], whether it is both legally and morally acceptable more than 1.3% of male neonatal deaths are attributable to leave the decision about a complications of non-therapeutic operation on a child too young to understand or give valid consent, to the parents alonecircumcision surgery.<ref name="Bollinger 2010"/>==Video=====Is circumcision healthy?===The video ''Is Circumcision Healthy'' is recommended for parental viewing. In Germany, several basic rights are concerned:<br><br> <youtube>D_3LQjZgdbQ</youtube>

* the right to bodily integrity===Dr. Christopher Guest discusses circumcision===* the right to sexual self-determination<br>* the right to equal treatment of genders (circumcision<youtube>v=TQIp9f4krVQ</FGM of females is illegal)* the right to religious freedom (where the circumcision has a religious motive) These four basic rights are relevant from the legal as well as the ethical point of view. Let us begin with the most obvious intrusion - the one into the bodily integrity. Under German law, children enjoy far-reaching protection, that limits the parental rights and the powers delegated to third persons overseeing the upbringing (such as kindergarten staff or teachers). Methods of upbringing that may cause physical or mental harm are prohibited. This is not only corporal punishment, which was common in families, schools and vocational training for ages, which may cause direct (and sometimes severe) bodily harm - it also covers spanking, which is included under degrading treatment. It is assumed that not only does the immediate injury harm the child, but also the feeling of helplessness and of being at someone's mercy at the time of punishment by an authority figure. This also applies to other treatment that harms the dignity of a child - for example being forced to publicly change clothes in front of the kindergarten group after wetting his pants.youtube>

There are also ethical problems. Can {{UNI|Stanford University|SU}} has published a child be denied the right to determine the visible appearance and degree video of functionality of his body? Should a circumcised boy later in life decide that he would prefer to have an intact [[penis]], he actual non-therapeutic plastibell circumcision. The infant has no means received two injections of reversing local anesthesia to deaden the decision his parents madedorsal nerves. Other people's ideas about his body‘s appearance and functionality are imposed upon him irreversiblyThe ventral nerves were not deadened so the infant still feels pain. He is denied the possibility of deciding upon that according to One can his own preferences, which can lead to inferiority complexes and depression - regardless of cries on the parents‘ reasons or their idea of what would be best for their childsoundtrack.* [https://med.stanford. So great a level of paternalism regarding such a severe intrusion, especially in the most intimate area of the child, cannot be justified by the parents‘ willedu/newborns/professional-education/circumcision/plastibell-technique.html Plastibell Technique]

It is not much different with the right to sexual self-determination. Here, the consequences that ===Gomco clamp circumcision has and can have for the body, play a significant role. Normally, a man has free choice as to how he wants to experience his sexuality. It is solely up to him to decide in which way he wants to be stimulated, and he can - if he so desires - limit his sexual experience without a problem. A circumcised man does not have these options. The full range of his sexual experience and sensation is not available to him due the to bodily modification.===

An intact [[penis]] enables many men to reach orgasm just by manipulation of '''Not for the [[foreskin]]. During masturbation, the man can choose whether he wants to stimulate the [[Glans penis|glans]] directly or indirectly through the movement of the [[foreskin]]. Since he has the full, naturally given potential of sensitivity at his disposal, he can use it to according to his own preferences. The circumcised man, however, does not have that freedom of choice. He has neither the opportunity to include the [[foreskin]] into the stimulation, nor can he utilize its nerves and touch receptors. He also only has access to 15-50% of the potential sensitivity of an intact man, depending on the amount and kind of tissue that was removed, and the degree of keratinization of the [[Glans penis|glans]]. In some cases, the limitation can be even more severe. On a heavily desensitized [[penis]], condoms can limit the sexual stimulation to the point where not enough arousal can be built up to reach an orgasm - which means that fulfilling safer sex is not possible.squeamish:'''

In particular, the tight styles of circumcision bear the risk, that the loss of the friction-reducing gliding effect leads to unpleasant feelings or even pain for both partners during intercourse. The ability to masturbate without aid - for example, from lubricants - can be significantly reduced or even be lost in such a case. In a study<ref>DaiSik Kim, Myung-Geol Pang: The effect of male circumcision on sexuality. In: BJU international, Volume 99, Issue 3, März 2007, S. 619-622. doi:10.1111/j.1464-410X.2006.06646.x, PMID 17155977</ref>, 63% of the men interviewed reported problems with masturbation after being circumcised. If a boy or man is circumcised, without him making that decision for himself after thorough consideration and in full knowledge and understanding of all possible consequences, he is denied his constitutionally guaranteed freedom to experience his sexuality according to his own preferences. This is much like parental interference to promote a prohibition video of masturbation, or to inhibit a homosexual relationship - an actual circumcision with the key difference that the parental intervention in form of a circumcision, unlike prohibitions during childhood, will have an irreversible, lifelong effectGomco clamp. Both do The infant boy received two dorsal penile nerve block (DPNB) analgesic injections but they did not comply with modern views of children's well-being and accepting the child as an autonomous individual, and are, therefore, not ethically justifiableseem to work.

The basic right to equal treatment of the sexes is also breached, since girls are legally protected from violations of their genital integrity, while boys are not* [https://www. This not only contradicts the constitution, but also is contrary to all efforts of equal treatment. Because in this case, decisions are made during childhood that will affect the entire later life, it equals the attempt to have certain educational grades open to one gender unconditionally, while giving parents the right to deny them to the other gender for life. That such an unequal treatment of genders is not justifiable, neither legally nor morally, is obviousreddit.com/r/Intactivism/comments/qbpzqr/trained_medical_professionals_restrain_infant_to/ Circumcision video]

Last not least, religious freedom ==Recommendations of medical authorities==* [[George Hill| Hill]] (2007) said:<blockquote>Male circumcision is impairedharmful because it excises healthy tissue and permanently impairs beneficial physiological functions. Male circumcision also causes psychological problems that tend to perpetuate the cycle of abuse. If a boy Male circumcision is circumcised for religious reasons as a child before he reaches costly diversion of medical resources away from beneficial services. Male circumcision violates legal rights, [[human rights]], and ethical standards. Finally, we must remember that males are the age more vulnerable and sensitive of competencethe two genders and, he will carry therefore, deserve the sign greater degree of protection from traumatic, invasive, injurious,and unnecessary surgery. For all of these reasons the non-therapeutic circumcision of boys should not be performed and the [[genital integrity]] of all children should be respected and protected.<ref name="hill2007">{{REFjournal |last=Hill |first=George |init=G |author-link=George Hill |title=The case against circumcision |journal=Journal of Men's Health and Gender |date=2007 |volume=4 |issue=3 |pages=318-23 |url=https://www.academia.edu/8367383/The_Case_Against_Circumcision |quote= |pubmedID= |pubmedCID= |DOI= |accessdate=2021-05-30}}</ref></blockquote>* Andrew E. MacNeiiy, Head, Division of Pediatric Urology, Department of Urological Sciences, {{UNI|University of British Columbia|UBC}}, Vancouver, BC, (2008) said:<blockquote>Newborn circumcision remains an area of that religion on his body controversy. Social, cultural, aesthetic and religious pressures form the most common reasons for his entire life non- even if he decides therapeutic circumcision. Although penile cancer and UTIs are reduced compared with uncircumcised males, the incidence of such illness is so low that circumcision cannot be justified as prophylaxis. The role of the foreskin in [[HIV]] transmission in developed countries is unclear, and safe sexual practice remains the cornerstone of prevention. There remains a lack of knowledge regarding what constitutes the normal foreskin both among parents and among primary care providers. This lack of knowledge results in a burden of costs to abjure that religion our health care system in the course form of unnecessary urological referrals, expansion of wait times and circumcisions. Routine circumcision of his lifeall infants is not justified from a health or cost-benefit perspective.<ref>{{REFjournal |last=MacNeily |first=Andrew |init= |author-link= |etal=no |title=Routine circumcision: the opposing view |trans-title= |language= |journal=Can Urol Assoc J |location= |date=2007-11 |volume=1 |issue=4 |article= |page= |pages=395-7 |url=http://europepmc.org/article/PMC/2422979 |pubmedID=18542825 |pubmedCID= |DOI=10.5489/cuaj.455 |accessdate=2021-11-08}}</ref></blockquote>

Therefore <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 does not impair the ability to change religioncan cause complications – [[bleeding]], infection, but it makes it impossible to discard one's old religion entirely[[urethra]]l stricture and panic attacks are particularly common. This KNMG is not only therefore urging a violation strong policy of the basic law, it deterrence. KNMG is also ethically unjustifiable calling upon doctors to force someone to carry a religious symbol for his entire life actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications.<ref>{{REFdocument |title=Non-therapeutic circumcision of male minors |url=https://www.doctorsopposingcircumcision.org/wp-content/uploads/2016/09/knmg-non-therapeutic-circumcision-of-male-minors-27-05- especially in his most private body area2010.pdf |contribution= |last= |first= |publisher=Royal Dutch Medical Association |format=PDF |date=2010 |accessdate=2021-11-08}}</ref></blockquote>

So why is circumcision tolerated as a means * The [[Royal Australasian College of upbringing, and even explicitly legalized? In Germany, this stems from - although it is not stated in the law for legal reasons - the belief that a ban would impair the religious freedom of the parents. Even though it is stated in Art.140 GG Physicians]] (German basic law2010)said:

''(1) Civic Ethical and [[human rights ]] concerns have been raised regarding elective infant male circumcision because it is recognised that the foreskin has a functional role, the operation is non-therapeutic and duties are neither dependant on, nor impaired by, the exercise of religious freedominfant is unable to consent.''

''[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=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>

''* The [[American Academy of Pediatrics]] (4AAP) No one may be forced to take part has not re-affirmed its disastrous, failed 2012 Circumcision Policy Statement, which expired in a religious act or ceremony2017, so currently has no position on child circumcision. * 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, or to participation in religious rites or to the use of a religious oathavoid circumcision |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>

Still<blockquote>"Given the socioeconomic, educational status, it was considered intolerable for and health demographics of our population, universal neonatal circumcision cannot be justified based on the parents to be unable to perform a religious rite that involved interference with current evidence available.<ref name="cua2018">{{REFjournal |last=Dave |first=Sumit |init=S |author-link= |etal=yes |title=Canadian Urological Association guideline on the care of the body normal foreskin and neonatal circumcision in Canadian infants (abridged version) |journal=Can Urol Assoc J |location= |date=2018-02 |volume=12 |issue=2 |pages=18-28 |url=https://cuaj.ca/index.php/journal/article/view/5034/3470 |quote= |pubmedID= |pubmedCID= |DOI= |accessdate=2021-11-09}}</ref></blockquote>==British family court opinion==The issue of another person 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 person being their son. While normally the religious freedom ends "at someone else‘s nose", an exemption was legalized to enable parents to comply with their own, personalcase, religious duties, even if Judge Sir James Munby ruled that means that several circumcision of their sonmale children caused ''significant harm''s basic rights are impaired. This does, however, not apply for other religious traditions, so that a ritual beating - no matter how religiously important it may be to the parents - is still considered child abuse == Rights and would likely result in the loss of child custody here.ethics ==

Only very few will supposedly know that circumcision has become a lucrative business[[Image:Intact vs circumcised. Not only the operation itselfJPG |thumbnail|right|300px| The intact and circumcised human penis, but also the potentially needed aftercare, bring profits. But while this is still obvious, there are also other trades that make money from itside by side.]]

Baby [[foreskin]]s are The term "circumcision" without a coveted resourcegender qualifier refers specifically to male circumcision. Under the name It means "Apligrafto cut around," an artificial skin product is marketed worldwide, which is used - among other uses - as an alternative and it refers to skin grafts using the patient’s own skin. It is grown from the [[foreskinexcision]]s of children as young as possible. Since they are also mostly free of pathogenic organisms, they are also used as the basis for collagen, which is, among other purposes, used for anti wrinkle therapy and for lip augmentation. The manufacturer of the british product "Vavelta" advertised with the use of "freshly harvested (!) [[foreskin]]s". It is ''inter alia'' used as a replacement for animal experiments testing the compatibility of cosmetic products. In the face of the falling numbers of routine infant circumcisions in from the USA, manufacturers have already expressed concerns that they might not "bring in enough harvest" more than 10 years agopenis. The parents of the circumcised boys, however, very rarely know of the "secondary use" of their son's "donated" body parts. While preimplantation genetic diagnosis, stem cell research term is inaccurate and genetic engineering are time and again critically questioned and discussed, a euphemism because the lifelong, significant modification of infant bodies for the good of operation actually cuts off or [[amputation| amputates]] the cosmetic industry is still common practice - supposedly partly because many women do not know what their augmented lips and wrinkle-free cheeks are made of - baby [[foreskin]]. An ethical justification cannot be valid here, which in adults comprises about fifteen square inches of highly functional erogenous tissue.

Circumcision is most often performed in healthy males for [[Religion and Culture|religious or cultural]] reasons. The procedure may be performed on consenting adults, but it is most often performed on non-consenting minors, particularly newborn children, which is why the ritual is so controversial. Opponents of circumcision consider the circumcision of non-consenting minors to be unethical and a [[human rights]] violation, unless there is concrete [[medical indication]].=== Consent by surrogates ===Medical ethics has long recognized limitations on the power of consent by surrogates.<ref>{{REFjournal |last=Committee on Bioethics, American Academy of Pediatrics |etal=no |title= Informed consent, parental permission, and assent in pediatric practice |trans-title= |language= |journal=Pediatrics |location= |date=1995 |volume=95 |issue=2 |article= |page= |pages=314-17 |url=https://www.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://watermark.silverchair.com/peds_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=27456510 |pubmedCID= |DOI=10.1542/peds.2016-1485 |format=PDF |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=e20161484 |pages= |url=https://watermark.silverchair.com/peds_20161484.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMYv3coRY-UCYMgTaqAgEQgIICT4di03qn2Hbho3i8Li_78lod0lNMunch25nx1rKvaM_aeFerz5eN6_k8VVeNv-DLocZp28whQr1x4WYDVwSs4uF73vZpYZYuDphYQkwxV1HHgMbZAbHBFuE8QyCHyDvSY-fhQcUl-JrYxa3TbhYgd4bKiU9zfIyXUsCnItroCc9iNrMicPg0v_A0AJJlhxioOlAU-im6OPI06OcCBj78yqkPO0J4nMTN1FLochsOyvZZdtFQQzLhrnM_Gey8K75lFYIBJHA7uzMmP2o5KZ-FTGUkEA_eSpEIpwv2WI4SbtrA8WYk3cQqXOmLIWjkSs9CTELD7CQP29xarr1ANrF_id4CiCX7zIomC2Ciz9lHBEgz8EH2i9Woke_YuZeLax52_6JpdhH1qdMQyF1bByjP8mU98V5_B4BPPiBpKt4pVA_UgtaABRHL8oPv6SwOUQZ2Bc-0_E2tod0VIF1FJBwZRZJm2ZkJPgBSKUo8VBe5Pz_6Vpt2DqLzwqVUYscPsIJMvxl09mMtvJrsBa8yVoTRWj4Rd0OBTMV7zhZskDnYYyrAZ6sHMk0MzvbHilPNbNgU5o7mXmcbFGDgGgWbqrIdT6sVSSfPJm4TnR0HSWbc_EnHhhyye7tVlFGjAsR0R46_DSwEMz8M5DkSln8xfKtX_so9rjCvYeq45wqn09g8DqtV-WHEA9PIrcw5kTcz5I0JkNuW4-vKVU1Xz9XHiYi4Zqbq0vx9NWLdNSYHQSOGMZ1MCAxT152evQdipQB5wokR8Q4rICoJYII5bsmRMYd7JQ |archived= |quote= |pubmedID=27456514 |pubmedCID= |DOI=10.1542/peds.2016-1484 |format=PDF |accessdate=2023-05-21}}</ref>

Two ethicists, Myers & Earp (2020), have conducted a detailed review and analysis of the claimed medical benefits of ''non-therapeutic'' [[circumcision]]. They have determined than the alleged benefits are not material, so they do not support granting of consent by a surrogate. In other words, ''Non-therapeutic'' circumcision is not truly healthcare. Moreover, they comment that even the most perfectly executed surgery produces [[trauma]] and harm to the patient. Circumcision also produces tissue loss and loss of function, therefore, circumcision should be performed only after the individual reaches the age of consent. <u>Consent by a surrogate for a ''non-therapeutic'' circumcision of a minor child is an unethical practice.</u><ref name="myers2020">{{REFjournal |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= |language= |journal=J Biosoc Sci |location= |date=2020-09 |volume=34 |issue=7 |pages=560-72 |url=https://onlinelibrary.wiley.com/doi/abs/10.1111/bioe.12714 |archived= |quote= |pubmedID=32068898 |pubmedCID= |DOI=10.1111/bioe.12714 |accessdate=2023-05-18}}</ref> ==Tipping point = See also =[[Intact America]] (2024) argues that public opinion regarding non-therapeutic [[circumcision]] of children is approaching or at a "tipping point" at which [[intact]] genitals would be preferred over the [[circumcised]] variety.<ref>{{REFweb |url=https://intactamerica.org/public-opinion-on-circumcision/ |title=Public Opinion on Circumcision: Can Intactivists Hit A Tipping Point? |last=Anonymous |first= |init= |publisher=Intact America |date=2024-03-23 |accessdate=2024-04-09}}</ref>{{SEEALSO}}* [[Adolescent and adult circumcision]]* [[Bodily harm]]* [[Breastfeeding]]* [[Case Histories]]* [[Circumcision maps]]* [[Circumcision methods]]* [[Circumcision scar]]* [[Circumpendium]]* [[Circumstraint]]* [[Documented severe complications of circumcision]]* [[Ethics of non-therapeutic child circumcision]]

* [[CircumpendiumPain]]* [[Psychological issues of male circumcision]]* [[Rights situation on circumcision]]* [[Risks and complications]]* [[Sexual effects of circumcision]]* [[Sudden Infant Death Syndrome]] (SIDS)* [[Trauma]]{{LINKS}} * {{REFweb |url=https://www.cirp.org/library/anatomy/garcia/ |title=What exactly is circumcision and what is it not? |last=Garcia |first=Francisco |date=1995-12-11 |accessdate=2020-09-08}}* {{REFjournal |last=Fleiss |first=Paul |init=P |author-link=Paul M. Fleiss |title=The foreskin is necessary |journal=Mothering |date=1997-01 |volume= |issue= |pages=36-45 |url=http://www.noharmm.org/mothering.htm |accessdate=2020-06-29}}*{{REFweb |url=https://15square.org.uk/losses-from-circumcision/ |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 the USA: A Human Rights Primer |last=Winkel |first=Rich |author-link=Rich Winkel |date=2005-05-12 |accessdate=2021-01-27}} * {{REFjournal |last=Testa |first=Patrick |init= |author-link= |last2=Block |first2=Walter E. |init2= |author2-link= |etal=no |title=Libertarianism and circumcision |trans-title= |language= |journal=Int J Health Poiicy Manag |location= |date=2014-05-26 |volume=3 |issue= |article= |page= |pages=33-40 |url=https://www.academia.edu/7587653/Libertarianism_and_Circumcision?email_work_card=view-paper |pubmedID=24987720 |pubmedCID=4075101 |DOI=10.15171/ijhpm.2014.51 |accessdate=}} * {{REFweb |url=https://intaction.org/what-is-circumcision/ |title=What is circumcision? |last=Simone |first=Judy |author-link= |publisher=Intaction |website=https://intaction.org/ |date=2020-07-26 |accessdate=2020-10-04 |format= |quote=}}* {{REFjournal |last=Deacon |first= |init=M |author-link= |last2=Muir |first2= |init2=G |author2-link= |etal=no |title=What is the medical evidence on non-therapeutic child circumcision? |trans-title= |language= |journal= Int J Impot Res |location= |date=2022-01-08 |volume= |issue= |article= |page= |pages= |url=https://www.nature.com/articles/s41443-021-00502-y |archived= |quote= |pubmedID=34997197 |pubmedCID= |DOI=10.1038/s41443-021-00502-y |accessdate=2023-04-30}}* {{REFweb |url=https://intactamerica.org/pros-and-cons-of-circumcision/ |title=Pros and Cons of Circumcision (Spoiler: You’ve Been Lied to) |last=Garrett |first= |init=CJ |publisher=Intact America |date=2023-11-10 |accessdate=2024-03-22}}* {{REFweb |url=https://intactamerica.org/groups-who-pressure-you-to-circumcise/ |title=The 4 Authority Figures and Groups Who Will Pressure You to Circumcise (and What You Can Do) |last=Anonymous |first= |init= |publisher=Intact America |date=2024-01-24 |accessdate=2024-01-27}}* {{REFweb |url=https://intactamerica.org/keeping-your-sons-penis-intact/ |title=Keeping Your Son’s Penis Intact: A Guide for Parents |last=Anonymous |first= |init= |publisher=Intact America |date=2024-01-24 |accessdate=2024-01-29}}* {{REFweb |url=https://intactamerica.org/timeline-of-circumcision-suffering/ |title=A Timeline of Circumcision Suffering: A Detailed Look |last=Anonymous |first= |init= |publisher=Intact America |date=2024-02-02 |accessdate=2024-02-09}}{{REF}}  

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