Changes

"Male '''circumcision''' (from Latin ''circumcidere'', meaning "to cut around") is the surgical removal or [[amputation]] of the [[foreskin]] (prepuce) , a major part of the human [[penis]]. The foreskin comprises ''more than fifty percent'' of the epithelium of the [[penis]].<ref name="taylor1996">{{TaylorJR LockwoodAP TaylorAJ 1996}}</ref> When the "cutting around" is performed, the foreskin falls off, so [[amputation]] and [[mutilation]] is the result. The amputation destroys the [[Foreskin#Physiological_functions| many protective, immunological, sexual, and sensory physiological functions]] of the foreskin, so it is a very harmful and [[Pain| painful]] surgery.

Cepeda'''Posthectomy''' is the more accurate medical term that more accurately reflects the injury and loss of functional body tissue, but the Biblical [[euphemism]], ''circumcision'', is more commonly used.With reference to involuntary, non-Emiliani et altherapeutic circumcision of children, [[Child Genital Cutting (CGC)]] is a newer term that has been introduced to avoid issues associated with more traditional terms. Bollinger (2023) commentedidentifed CGC as an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]].<ref name="bollinger2023">{{REFjournal |last=Bollinger |init=D |author-link=Dan Bollinger |last2= |init2= |author2-link= |url=https://kindredmedia.org/2023/02/adverse-childhood-experiences-dysfunctional-households-and-circumcision/ |title=Adverse Childhood Experiences, Dysfunctional Households, And Circumcision. |journal=Kindred |date=2023-02-28 |volume= |issue= |pages= |accessdate=2023-03-01}}<blockquote/ref>Taking the sleve technique as an example of surgical flexibility during circumcision, to the extent that this technique is of such versatility that it allows highly variable quantities of cutaneous and subcutaneous tissue to be excised directly from Deacon & Muir (2022) have reviewed the penile body, evidence and to the extent concluded that the prepuce "there is still conceived by segments of the no medical community as "just justification for performing a small piece of skin", we are concerned circumcision prior to an age that aggressive circumcisions are intentionally or unintentionally being performed in pediatric he can assess the known risks and adult patients in the belief that "redundant" or " extra" tissue is being excisedpotential benefits, and choose to give or in the belief that "excesive sensitivitywithhold [[informed consent]] himself." is being reduced to augment ejaculatory latency time.<ref name="cepeda2023deacon2022">{{REFjournal |last=Cepeda-EmilianiDeacon |first=Matthew |init=AM |author-link=Alfonso Cepeda-Emiliani |last2=Gándara-Cortés Muir |first2=Gordon |init2=MG

|title=Immunohistological study of What is the density and distribution of human penile neural tissue: gradient hypothesis |transmedical evidence on non-title=therapeutic child circumcision?

|date=20232022-0501-02 |volume=35 |issue=3 |article= |page= |pages=286-30508 |url=https://www.nature.com/articles/s41443-022021-0056100502-9 |archived= |quote=y |pubmedID=35501394 |pubmedCID=34997197 |DOI=10.1038/s41443-022021-0056100502-9 y |accessdate=20232022-1101-2330

'''Posthectomy''' is a more accurate medical term that more accurately reflects Circumcision was popularized in English-speaking nationns in the injury and loss nineteeth century. The practice of non-therapeutic circumcision of functional body tissueboys now has greatly declined in [[Australia]], but [[Canada]], [[New Zealand]] and the Biblical [[euphemismUnited Kingdom]], . It has been gradually declining since 1985 in the [[United States]]. It has ''circumcisionnever'', been a popular practice in other western nations. Circumcision is more commonly usedclassified as a form of [[genital mutilation]].  == Historical background ==

With reference to involuntary, non-therapeutic circumcision The [[amputation]] of children, the [[Child Genital Cutting (CGC)foreskin]] is a newer term that has been introduced very old ritual, whose exact origin cannot be verified beyond doubt. Circumcision is believed to avoid issues associated with more traditional terms. Bollinger (2023) identifed CGC as an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]]have originated in east Africa near the Red Sea well before the dawn of recorded history.<ref name="bollinger2023demeo1997">{{REFjournalREFbook |last=BollingerDeMeo |initfirst=D |author-link=Dan Bollinger |last2year=1997 |init2= |author2-linktitle=The geography of sexual mutilations |url=https://kindredmediawww.org/2023academia.edu/02/adverse-childhood-experiences-dysfunctional-households-and-circumcision4212007/The_Geography_of_Male_and_Female_Genital_Mutilations |titlework=Adverse Childhood Experiences, Dysfunctional Households, And Circumcision.Sexual Mutilations: A Human Tragedy |journaleditors=KindredGeorge C. Denniston, Marilyn Milos |dateedition=2023-02-28

|issuechapter=

|location=New York |publisher=Plenum |isbn=0-306-45589-7 |quote= |accessdate=20232021-0311-0113 |note=}}</ref>Medical historians assume that circumcision already served in ancient history as a way to control the sexuality of slaves and members of the lower classes without compromising their ability to reproduce. In religious history circumcision may be seen as a substitute for human sacrifice. In prehistoric times it was not uncommon to placate the gods with human sacrifice. Castration of slaves or conquered enemies was common as well. Following religious changes this sacrifice was altered, and only a part of the very organ responsible for the creation of new life was sacrificed.

Deacon & Muir (2022) have reviewed [[Image:Circumcision Sakkara 3.jpg|200px|right]] For the [[Aborigines]], the [[Australia| Australian]] natives, the evidence and concluded that "there tradition of circumcision is no medical justification for performing a circumcision prior said to go back to an age that he can assess 10,000 BC. On the known risks and potential benefitsAfrican continent, and choose the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of circumcision date back to give or withhold [[informed consent]] himselfthe time around 3000-2000 BC."The oldest known depiction<ref name="deacon2022">{{REFjournal |last=Deacon |first=Matthew |init=M |author-link= |last2=Muir |first2=Gordon |init2=G |author2-link= |etal=no |title=What is the medical evidence on non-therapeutic child circumcision? |journal= Int J Impot Res |date=2022-01-08REFweb |url=https://wwwcommons.naturewikimedia.comorg/articleswiki/s41443-021-00502-yFile:Circumcision_Sakkara_3.jpg |pubmedIDtitle=34997197 |DOI=10File:Circumcision Sakkara 3.1038/s41443-021-00502-y jpg |accessdate=20222019-0110-3012}}</ref>is an Egyptian tomb relief from the 6th dynasty, approximately 2300-2000 BC. It is not known precisely who was circumcised and why in those times. In many cultures circumcision during puberty serves as a rite of passage, bringing adolescents into the community. As with other painful or humiliating initiation rites, proof of courage and mastering of critical situations are the key motivations. From some African tribes it is also known that the [[amputation]] of the [[foreskin]] is seen as the removal of an inborn piece of femininity from the boys, thus making them men.

The [[amputation]] {{Citation |Text=10 This is my covenant with you and your descendants after you, the covenant you are to keep: Every male among you shall be circumcised. 11 You are to undergo circumcision, and it will be the sign of the [[foreskin]] 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 very old ritualforeigner—those who are not your offspring. 13 Whether born in your household or bought with your money, whose exact origin cannot they must be verified beyond doubtcircumcised. Circumcision My covenant in your flesh is believed to have originated be an everlasting covenant. 14 Any [[uncircumcised]] male, who has not been circumcised in east Africa near the Red Sea well before the dawn of recorded historyflesh, will be cut off from his people; he has broken my covenant.<ref name="demeo1997">{{REFbook” |lastAuthor=DeMeoBible |firstSource= |authorGen 17, 10-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. Denniston14, Marilyn Milos |edition= |volume= |chapter= |pages= |location=New York |publisher=Plenum |isbn=0-306-45589-7 |quote= |accessdate=2021-11-13 |note=NIV}}</ref> Medical historians assume that circumcision already served in ancient history as a way to control the sexuality of slaves and members of the lower classes without compromising their ability to reproduce. In religious history circumcision may be seen as a substitute for human sacrifice. In prehistoric times it was not uncommon to placate the gods with human sacrifice. Castration of slaves or conquered enemies was common as well. Following religious changes this sacrifice was altered, and only a part of the very organ responsible for the creation of new life was sacrificed.

According to the anthropologist and sociologist Rabbi Nissan Rubin, the [[Image:Circumcision Sakkara 3.jpgJewish circumcision|200pxJewish form of circumcision]], called ''[[Brit Milah|rightbrit mila]] For '', during the first two millennia did not include the later customary ''[[Aboriginesperiah]]'', namely the complete scraping of the inner [[Australiaforeskin]] from the [[Glans penis| Australianglans]] natives. This was only added around 135 AD, the tradition of circumcision is said to go back make it almost impossible to 10,000 BC. On restore the African continent[[foreskin]] by [[stretching]], which became popular in the first circumcisions are assumed to have emerged around 6000 BCwake of Hellenic influence. From ancient Egypt hints While originally only the tip of various forms of circumcision date back to the time around 3000-2000 BC. The oldest known depiction<ref>{{REFweb |url=https://commons.wikimedia.org/wiki/File:Circumcision_Sakkara_3.jpg |title=File:Circumcision Sakkara 3.jpg |accessdate=2019-10-12}}</ref> is an Egyptian tomb relief from [[foreskin]] was cut off, ''[[periah]]'' removes the 6th dynasty, approximately 2300-2000 BC. It is not known precisely who was circumcised and why in those timesentire [[foreskin]].

In many cultures circumcision during puberty serves as a rite the Greek society of passage, bringing adolescents into the community. As with other painful or humiliating initiation ritesday, proof of courage a denuded [[Glans penis|glans]] was considered obscene and mastering of critical situations are the key motivationsrisible. From some African tribes it In ultra-orthodox communities, circumcision is also known that followed by the ''[[amputationmohel]] of '', the ritual circumciser, sucking blood from the wound with his mouth. This practice is highly controversial, as it can result in an [[foreskininfection]]with [[herpes] is seen as the removal ] simplex type 1. In New York City, between 2000 and 2011 eleven children were infected with [[herpes]], 10 of an inborn piece whom had to be treated in hospital. Two of femininity from them suffered permanent brain damage, two others died. In the boys12th century, thus making them menthe Jewish philosopher and doctor [[Moses Maimonides| Maimonides]] claimed that circumcision was necessary, as it diminished sexual desires and reduced the pleasure to a degree just sufficient for mere reproduction.

===Judaism=== In [[Judaism]], the tradition of [[Brit Milah| circumcision]] goes back to the [[Abrahamic covenant]] in a passage in the Book of Genesis (17:10-14). It is seen as a covenant between God and man, dating back to the patriarch Abraham. The validity of this passage is increasingly being questioned. {{Citation |Text=10 This is my covenant with you and your descendants after you, the covenant you are to keep: Every male among you shall be circumcised. 11 You are to undergo circumcision, and it will be the sign of the covenant between me and you. 12 For the generations to come every male among you who is eight days old must be circumcised, including those born in your household or bought with money from a foreigner—those who are not your offspring. 13 Whether born in your household or bought with your money, they must be circumcised. My covenant in your flesh is to be an everlasting covenant. 14 Any [[uncircumcised]] male, who has not been circumcised in the flesh, will be cut off from his people; he has broken my covenant.” |Author=Bible |Source=Gen 17, 10-14, NIV}} According to the anthropologist and sociologist Rabbi Nissan Rubin, the [[Jewish circumcision| Jewish form of circumcision]], called ''[[Brit Milah| brit mila]]'', during the first two millennia did not include the later customary ''[[periah]]'', namely the complete scraping of the inner [[foreskin]] from the [[Glans penis|glans]]. This was only added around 135 AD, to make it almost impossible to restore the [[foreskin]] by [[stretching]], which became popular in the wake of Hellenic influence. While originally only the tip of the [[foreskin]] was cut off, ''[[periah]]'' removes the entire [[foreskin]].  In the Greek society of the day, a denuded [[Glans penis|glans]] was considered obscene and risible. In ultra-orthodox communities, circumcision is followed by the ''[[mohel]]'', the ritual circumciser, sucking blood from the wound with his mouth. This practice is highly controversial, as it can result in an infection with [[herpes]] simplex type 1. In New York City, between 2000 and 2011 eleven children were infected with [[herpes]], 10 of whom had to be treated in hospital. Two of them suffered permanent brain damage, two others died. In the 12th century, the Jewish philosopher and doctor [[Moses Maimonides| Maimonides]] claimed that circumcision was necessary, as it diminished sexual desires and reduced the pleasure to a degree just sufficient for mere reproduction. ===Christianity===Jesus was born into a Jewish family in [[Israel]], where [[Judaism]] was the prevailing religion, so He was [[circumcised]] on the eighth day.<ref>{{REFweb |url=https://www.biblegateway.com/passage/?search=Luke+2%3A21&version=NASB |title=Gospel of Luke |last=Luke

In Christianity, circumcision is practiced only in the Coptic churchesdenomination. There is no general belief that circumcision is a requirement of Christianity.<ref name="hill2004">{{REFweb

Even the mere existence of a [[foreskin]] was falsoly linked to many illnesses. Among them one could find syphilis, epilepsy, paralysis of the spine, bed wetting, scoliosis (spinal deformity), paralysis of the bladder, club foot, nerve pain in the lower abdomen, tuberculosis and lazy eye. One of the best known advocates of child circumcision was [[John Harvey Kellogg]], co-inventor of the corn flakes bearing his name. In 1888, he wrote:

The [[United States]] and [[Israel ]] are the only industrialized countries in the world to have a high incidence of non-therapeutic infant male circumcision. The vast majority of infant circumcisions performed in the United States are for non-religious, non-medical reasons. See [[History of circumcision]].

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]].

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.

}}</ref>, which found a higher rate of infection with bacterial venereal diseases in [[circumcised ]] than in [[intact ]] men.* The studies by Fleiss et al. (1998) support this.<ref name="fleiss-hodges-vanhowe1998">{{FleissP HodgesF VanHoweRS 1998}}</ref> According to the [[AAP]], the general sexual behaviour of the male - — such as frequent change in partners and the use of condoms - — has a much higher impact on sexually transmitted diseases then the circumcision status.<ref>{{REFjournal

The fact that the [[USA ]] has both the highest rate percentage of [[circumcised]] males in the western world, as well as the highest [[HIV]] infection rate, makes the studies look dubious. Besides that, several other studies concluded that circumcision does not have a significant impact on the risk of infection with [[HIV]].<ref>{{REFjournal

}}</ref> found that, during the first 6 years of life, the incidence of UTIs [[UTI]]s in boys was 1.8%, but in girls was 6.6%. UTIs are less common in boys after the first year of life. Mueller et al. <ref>{{REFjournal

* Other studies suggest that circumcision is more likely to raise than to lower the generally low risk of acquiring UTI: multiple studies from [[Israel ]] showed a strong correlation between ritual circumcision on the 8th day of life and postoperative UTI.<ref>{{REFjournal

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

One should note that the human [[foreskin ]] is endowed by nature with [[Foreskin#Immunological_functions| immunological functions]] that serve to protect the human body from disease.<ref name="fleiss-hodges-vanhowe1998"/> The [[glans penis ]] receives blood through the frenular artery.<ref>{{REFjournal

In western industrial nations, however, this problem does not exist, in view of the availability of clean water for daily personal hygiene. If the cleaning of the genitals is performed on a daily basis - — and that may be assumed - — no pathogens can accumulate under the [[foreskin]]. Cleaning of the [[Glans penis|glans]] and the area [[preputial sac]] underneath the [[foreskin]] is easy - — they are simply [[Preputial_sac#Washing| washed with warm water along with the rest of the body]], just like the areas between the toes.

In small boys, where the [[foreskin]] cannot be retracted yet, cleaning is not necessary, since the [[Synechia| membrane]] that fuses the [[foreskin]] to the [[Glans penis|glans]] prevents the accumulation of micro-organisms. The so-called "[[Ballooning of the foreskin| ballooning]]", where the [[foreskin]] inflates during urination, is not a serious problemconcern.

But even in areas where there are poorer hygienic conditions and an insufficient access to medical care, the benefits of easier cleaning of a [[circumcised ]] [[penis]] are to be viewed with a critical eye. Although even longer periods without personal hygiene will not result in an accumulation of germs under the [[foreskin]], circumcision itself is not without risk of complications. If the operation is carried out without proper sterility, there is a high risk of an [[infection]] of the wound. This also applies to the treatment of common complications like post-operative [[bleeding]].

The benefit of easier cleaning must be balanced against the risk of promoting serious infections - — among others [[HIV]] - — during the operation. In parts of Africa, several dozen of one tribe's boys die each year as a result of their circumcision.

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

|first=KJS |author-link=Kanwaljeet J. Singh Anand

|first2=PR

|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.

|DOI=10.1056/NEJM198711193172105

}}</ref> This has led American health associations to recommend doctors take measures to reduce the [[pain ]] of circumcision in infants.

Penile injections of local anesthetic are now recommended by all of the major medical institutionsif a circumcision is to be performed. In their [http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml Report 10 of the Council on Scientific Affairs], the AMA states ''"When the decision is made to proceed with circumcision, local anesthesia should be provided for the procedure. [[Ring block ]] or [[dorsal penile blocks nerve block]] [injections] are most effective. [[EMLA]] cream has limited utility"''. Alarmingly, ''"Despite the clear evidence that newborn males generate brisk pain responses during circumcision, a recent survey of residency training programs found that 26% of programs that taught circumcision provided no instruction on the use of local anesthesia". The AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of family practitioners, and 25% of obstetricians"''.<ref>{{REFweb

Given what is known from aforementioned official documents, the AAP website may be more informative and effective if it would say ''"Make sure your doctor knows of the ineffectiveness of anything short of local anesthesia, and make sure your baby is given an injection. This is your responsibility, because your doctor may or may not be up to date on the latest understandings of infant sensitivity to [[pain ]] during circumcision."'' The AAP may be holding back, however, perhaps because this would upset the doctor/parent power relationship, and may cause too much questioning of doctors in general. One may not expect to find this kind of advice on such a website, and yet, anything less than this is a dangerously weak statement.

}}</ref> Topical anaesthetic only serves to numb the area to lessen the pain of the injection, but studies have shown that a [[dorsal penile ring nerve block ]] is not always only partially effective in stopping the [[Pain| pain of circumcision]].<ref name="Journal of Perinatology April/May 2002">{{REFjournal

=== Physical effects ===* [[Bodily harm]]* [[Circumcision scar]] is surgeryan invariable effect. Surgical complications * An unavoidable effect of any circumcision generally may be classified as is the permanent loss of sexual sensitivity. This is partly due to the removal of sensory tissue. The [[Bleeding| hemorrhageforeskin]]contains very many nerve endings and touch receptors, which account for the major part of male sexual sensation. If the [[infectionforeskin]]is removed, or surgical misadventure up 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 including loss 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 and ]]es in adult males. Other studies revealed that [[circumcised]] men use condoms significantly less often than [[deathintact]]men, since they further limit the sexual sensitivity (see above). * Painful tension can occur when there is too little reserve [[skin]] left to support a full [[erection]]<ref name="deacon2022taylor1996" />. 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 name="williams-kapilla1993">{{REFjournal |last=WilliamsMoney |init=N |author-link=J |last2=KapillaDavison |init2=L |author2-link= |etal=noJ |title=Complications of Adult penile circumcision |trans-title= |language=: Erotosexual and cosmetic sequelae |journal=Brit J Surg |location=Journal of Sex Research |date=1993-101983 |volume=8019 |issue=10 |pages=1231289-692 |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 Orgasm problems: In the wake of reduced sexual sensitivity, due to the narcotics usedloss of sensory tissue and gradual [[keratinization]] of the surface of the [[Glans penis|glans]], orgasm problems may develop with increasing age.* Especially in newbornsIn this case, where the bodily pain reduction mechanisms are sexual arousal created by intercourse or [[masturbation]] is not yet fully developed, local anaesthesia 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 insufficient fielded as the "cut men have more endurance" argument for the operationcircumcision. Even in conjunction with regional anaesthesia of * Vaginal dryness: Due to the dorsal nerve loss of the natural [[penisgliding action]], which comes from the rate mobility 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[[foreskin]] and [[shaft skin]], a much increased friction between [[penis]] and, therefore, is only likely to be used in emergencies. A surgical operation without proper [[painvagina]] control occurs during intercourse. This can make intercourse painful for both partners and lead to the development of a specific pain memoryabrasions<ref>{{FrischM LindholmM GroenbaekM 2011}}</ref><ref>{{REFwebREFjournal |urllast=http://www.spiegel.de/spiegel/vorab/experteCortés-warntGonzález |init=J |last2=Arratia-rituelleMaqueo |init2=J |last3=Gómez-beschneidung-veraendert-das-gehirn-der-kinder-a-849534.htmlGuerra |titleinit3=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der KinderL |trans-title=ChildrenDoes circumcision has an effect on female's pain expert warns: Ritual circumcision changes the brain perception of childrensexual satisfaction? |languagejournal=GermanRev Invest Clin |lastdate=Prof. Dr. med. Boris Zernikow2008 |firstvolume=60 |publisherissue=Spiegel Online3 |websitepage=227 |dateurl=2012-08-12 |accessdatepubmedID=2019-10-1118807735 |format= |quoteaccessdate=}}</ref>. In unsedated and partially sedated infants increased secretion of The prolonged time it takes [[circumcised]] men to reach orgasm, as well as the stress hormone cortisol could be observed for months after the operation. Overall, their pain threshold was lower often longer and the risk of chronic pain increasedmore vigorous thrusting movements - compared to [[intact]] men - play a part in this. Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref name="ColdCJ TaylorJR 1999">{{ColdCJ TaylorJR 1999}}</ref><ref>{{REFjournal |last=GarryFink |init=TKS |last2=Carson |init2=CC |last3=DeVellis |init3=RF |title=Adult CircumcisionOutcomes Study: a survey of fees Effect on Erectile Function, Penile Sensitivity, Sexual Activity and practicesSatisfaction |journal=OBG ManagementJ Urol |date=19942002 |volume=October167 |issue=5 |pages=342113-6

|last=HowardStenram |init=CRA |last2=HowardMalmfors |init2=FMG |last3=GarfunkelOkmian |init3=LC |last4=de Blieck |init4=EA |last5=Weitzman |init5=ML |title=Neonatal circumcision and pain reliefCircumcision for [[phimosis]]: current training practicesa follow-up study |journal=PediatricsScandinavian journal of urology and nephrology |date=19981986 |volume=10120 |issue=2 |pagespage=423-889

}}</ref><ref>{{REFjournalREFweb |lasturl=Stanghttp://emedicine.medscape.com/article/1016016-overview |inittitle=HJMeatal Stenosis |last2publisher=SnellmanMedscape |init2accessdate=LW2019-10-11 |title=Circumcision practice patterns in the United States}}</ref> |journal=Pediatrics |date=1998* Shorter adult penile length was reported by Park et al. (2016) as a result of NMC (newborn male circumcision). |volume=101{{Citation |issueTitle=e5 |pagesText=In conclusion, second to fourth digit ratio, flaccid penile length, and age of circumcision were significant predictive factors for erectile penile length. Furthermore, the penile lengths of the NMC group were shorter than those of the non-NMC group. |urlAuthor=Park et al. |accessdateSource= |noteref=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=GunnarPark |first= |init=MRJK |author-link= |last2=FischDoo |init2first2=RO |last3init2=KorsvikAR |init3author2-link=S |last4last3=DonhoweKim |init4first3=JM |titleinit3=The effects of circumcision on serum cortisol and behaviorJH |journalauthor3-link=Psychoneuroendocrinology |datelast4=1981Park |volumefirst4=6 |issueinit4=3HS |pagesauthor4-link=269-75 |urletal=https://www.cirp.org/library/pain/gunnar/yes |accessdatetitle=2019-11-26}}</ref>* Postoperative wound pain, in the case Prospective investigation 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, penile length with newborn male circumcision and even moderate blood loss can lead second to hypovolaemia, hypovolaemic [[shock]] and even deathfourth digit ratio.<ref>{{REFbook |lasttrans-title= |firstlanguage= |yearjournal=2000Can Urol Assoc J |titlelocation=Paediatric Handbook |urldate=2016-09 |workseason= |editors=Smart J, Nolan T. |editionvolume=610 |volumeissue=9-10 |chapterarticle= |page=82 |locationpages={{AUSC|VIC}}, Australia |publisherurl=Blackwell Science Asiahttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028213/ |isbnarchived=

|accessdatepubmedID=27695583 |pubmedCID=5028213 |DOI=10.5489/cuaj.3590 |noteaccessdate=2022-09-04}}</ref>}} === Sexual effects ===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.<refname="cepeda2023">{{REFdocumentREFjournal |titlelast=Autopsy of Demetrius MankerCepe da-Emiliani |urlfirst= |contributioninit=Case 93A |author-1711link=Alfonso Cepeda-Emiliani |lastlast2=WetliGándara-Cortés |firstfirst2=CV |publisherinit2=Miami: Dade County Medical Examiner DepartmentM |formatauthor2-link= |datelast3=1993Otero-06Alén |first3= |init3=M |author3-23link= |accessdatelast4=García |first4= |init4=H |author4-link=}}</ref> <ref>{{REFjournal |last5=Suárez-Quintanilla |lastfirst5=Hiss |initinit5=J |last2author5-link=Horowitz |init2last6=AGarcía-Caballero |last3first6=Kahana |init3init6=T |titleauthor6-link=Fatal haemorrhage following male ritual circumcision |journallast7=J Clin Forensic MedGallego |datefirst7=2000 |volumeinit7=7R |issueauthor7-link= |pageslast8=32García-4Caballero |urlfirst8=https://www.cirp.org/library/death/hiss1/ |accessdateinit8=2019R |author8-11-06link=}}</ref><ref>{{REFdocument |etal=no |title=Judgement Immunohistological study of inquiry into the death density and distribution of McWillis, Ryleigh Roman Bryanhuman 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=httphttps://www.circumstitionsnature.com/deatharticles/s41443-022-exsang.html00561-9 |contributionarchived= |lastquote=Newell |firstpubmedID=TEC35501394 |publisherpubmedCID=Burnaby, B.C.: B.C. Coroner's Service |formatDOI= |date=200410.1038/s41443-022-0100561-199 |accessdate=20192023-11-26

* Post operative Circumcision and frenectomy remove tissues with heightened erogenous sensitivity.<ref name="cepeda2023" /> <ref name="winkleman1959">{{WinkelmannRK 1959}}</ref> They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well." The [[amputation]] of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the [[lymphoedemapenis]].* Postoperative , leaving only the uninhibited protopathic sensibility of the artificially externalized [[Infection| infectionsglans penis]]. This includes both local infections, which can The imbalance caused by not having the input from the now ablated fine-touch receptors may be treated with local therapy, and systemic infections, requiring systemic antibiotic treatmenta leading cause of the changes in sexual behavior noted in [[circumcised]] human males.<ref>{{REFconferenceREFjournal |last=DrVan Howe |init=RS |author-link=Robert S. med. HartmannVan Howe |last2=Cold |firstinit2=WolfgangCJ |urltitle=Advantages and Disadvantages of Neonatal Circumcision |placejournal=Rechtsausschuss des Bundestages [Legal Committee The Journal of the Bundestag] (German)American Medical Association |volume=277 |issue=13 |pages=1052-7 |titleurl=Stellungnahme zur Anhörung am 26http://www.ncbi.nlm.nih. November 2012 [Opinion on the hearing on 26 November 2012] (German)gov/pubmed/9218663 |quote= |pubmedID=9218663 |pubmedCID= |DOI= |date=20121997-1104-2602

* Histology of the male circumcision scar shows [[amputation]] neuromas, Schwann cell proliferation and the bulbous collection of variably sized neurites. [[Wound dehiscenceAmputation]]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, meaning to the separation extent that this technique is of such versatility that it allows highly variable quantities of cutaneous and subcutaneous tissue to be excised directly from the edges penile body, and to the extent that the prepuce is still conceived by segments of the wound medical community as "just a small piece of skin", we are concerned that aggressive circumcisions are intentionally or unintentionally being performed in pediatric and adult patients in the belief that "redundant" or " extra" tissue after suturingis being excised, or in the belief that "excesive sensitivity" is being reduced to augment ejaculatory latency time.<ref name="cepeda2023" />* Adhesion between </blockquote>The un-anesthetized and un-sedated newborn infant is restrained by being strapped to a special plastic board called the [[circumstraint]]. The procedure is most often an elective, non-therapeutic surgery without [[medical indication]] performed on neonates and children for religious and cultural reasons in violation of the surface child's [[human rights]] to [[physical integrity]], but in older patients may be rarely indicated for therapeutic reasons. It is a radical treatment option for pathological [[phimosis]], refractory [[balanoposthitis]] and chronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or rim poor general health.  See [[Sexual effects of the circumcision]] for more information. === Psychological effects ===[[Glans penisPsychological_issues_of_male_circumcision#Circumcision_trauma_in_adults|glansPsychological late effects]] with are also possible after a circumcision, especially if the neighbouring operation was carried out in childhood. On this occasion a variety of [[penile skintrauma]]may occur, causing 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 [[skincircumcised]] pockets against his will or without his consent, and also, in the case of infant circumcision, if he was told about it during childhood or had to find it out coincidentally on his own. The psychological late effects of circumcision are not yet fully researched, and bridgesmany studies took place on rather a small scale. This situation needs to be rectified, because the available studies, as well as visually unpleasant results like uneven scarsthe histories of negatively affected men, which make a re-circumcision necessarysuggest that these late effects may have more impact than previously assumed. * Postoperative It was observed that infants, following circumcision without [[phimosispain]]: a phimotic ring can develop during scarringcontrol, which makes had a re-circumcision necessary. According to a study by Blalock et al.disturbed bond with their mother<ref>{{REFjournal |last=BlalockMarshall |init=HJRE |last2=VemulakondaPorter |init2=VFL |last3=RitcheyRogers |init3=ML |last4=RibbeckAG |init4etal=Myes |title=Outpatient management of [[phimosis]] Following newborn circumcisionCircumcision: II effects upon mother-infant interaction |journal=J UrolEarly Hum Dev |date=20031982 |volume=1697 |issue=64 |pages=2332367-474 |url=https://www.cirp.org/library/complicationsbirth/blalock1marshall2/ |accessdate=20192020-1102-2601}}</ref>, as well as problems with nurturing, up to the prevalence is 2point 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.9%In a study on Philippine boys, according in whom no [[PTSD]] was found prior to Leitchthe 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>{{REFjournalREFbook |last=LeitchRamos |init=IOWS |titlelast2=Circumcision - a continuing enigmaBoyle |journalinit2=Aust Paediatr JGJ |dateyear=19702001 |volumetitle=6 |issue= |pages=59Understanding circumcision: A Multi-Disciplinary Approach to a Multi-65Dimensional Problem |url=https://wwwlink.cirpspringer.orgcom/librarychapter/general/leitch110.1007/978-1-4757-3351-8_14 |accessdatework=2019-12-15}}</ref> 5.5%.* |editors=[[Sudden Infant Death SyndromeGeorge C. Denniston]] (SIDS).* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskinFrederick M. Hodges]], is cut during circumcision without being clamped and sutured at its origin separately, it starts to develop new branches over time, which can lead to the development of knots.* Possible deformities due to circumcision include hypoplasia of the [[penisMarilyn Fayre Milos]] (micro-penis) and induratio [[penis]] plastica (skewed penis).* Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis |edition= |glans]] or the [[penis]] can occur.volume=* In rare cases, [[necrosis]], gangrene, ischaemia, keloid formation, |chapter=Ritual and circulatory problems may also occur.* When the medical circumcision is followed by the ultraamong Filipino boys: evidence of post-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>{{REFwebtraumatic stress disorder |urlpages=http://www.nytimes.com/2012/03/08/nyregion/infants253-death-renews-debate-over-a-circumcision-ritual.html?_r70 |location=0New York |titlepublisher=Baby’s Death Renews Debate Over a Circumcision RitualKluwer Academic/Plenum Publishers |lastisbn=Robbins |firstquote=Liz |dateaccessdate=2012-03-07 |accessdatenote=2019-10-11

 === Physical late effects === * An unavoidable late effect of any circumcision is the permanent loss Circumcisions, especially those that happen without consent, can spark feelings of sexual sensitivity. This is partly due to the removal of sensory tissue. The [[foreskin]] contains very many nerve endings helplessness and touch receptorsalienation, which account for the major part of male sexual sensation. If the can persist as [[foreskintrauma]] is removed, they . These feeling can no longer provide sexual stimulation. It is also partly due to the fact that the surface of the be triggered later, when someone [[Glans penis|glanscircumcised]] reacts to 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 missing protection from friction father, and drying out 58% by developing a callus layer. This reduces the sensitivity of the remaining nerves in the doctor, and 73% felt that their [[Glans penis|glanshuman rights]] gradually over the years. The study conducted by Sorrells et alhad been violated.<refname="GSoCH">{{Sorrells etal 2007REFweb |url=http://www.circumcisionharm.org/ |title=Global Survey of Circumcision Harm |accessdate=2019-10-12}}</ref> * It can frequently be found a significant reduction that the loss is denied, much as happens with the loss of sensitivity other body parts. This denial can lead to touch for fathers having their sons [[circumcised]] compared in order not to [[intact]] [[penis]]es in adult malesbe reminded of their own loss. Other studies revealed that [[circumcised]] men use condoms significantly less often than [[intact]] menIn this process, since they further limit their own body is defined as "normal" and the sexual sensitivity (see above). * Painful tension can occur when there is too little reserve [[skinforeskin]] left to support redefined as a full [[erection]]<ref name=foreign object. Their own parents are seen as "taylor1996good"/>. This risk , so that this image is partly dependent on projected onto the anatomy of circumcision their parents carried out as well, in order to keep the [[penis]]positive emotion intact. While some [[penis]]es already have the majority of their full size when flaccid ([[Flesh Penis]], or The father wants to be a "[[shower]]good")father later in life as well, others are rather short when flaccid and double or more their size during so, following an [[erection]] ([[Blood Penis]]idealised image of his own parents, circumcision, or which has been redefined as a "[[grower]]good thing"). 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 passed on to the blood vessels in the his son by having him [[foreskincircumcised]] and the reduced sexual sensitivity can be causes for reduced erectile function with advancing ageas well.<ref>{{VanderKolkBA 1989}}</ref><ref>{{REFjournal |last=MoneyGoldman |init=JR |last2author-link=DavisonRonald Goldman |init2url=Jhttps://www.cirp.org/library/psych/goldman1/ |title=Adult penile The psychological impact of circumcision: Erotosexual and cosmetic sequelae |journal=Journal of Sex ResearchBJU Int |date=19831999 |volume=1983 |issue=Suppl. 1 |pages=28993-92 |url=103 |accessdate=2019-10-12

 * Orgasm problems: In the wake of reduced sexual sensitivity, due to If the loss of sensory tissue and gradual [[keratinization]] of the surface of the [[Glans penis|glanscircumcised]]male feels incomplete, orgasm problems may develop with increasing age. In this case, the sexual arousal created by intercourse or [[masturbation]] is not enough due to achieve orgasm. A preliminary stage of this late effect is the prolonged time missing [[circumcisedforeskin]]] men need to reach an orgasm. This is often fielded as the "cut men have more endurance" argument for circumcision.* Vaginal dryness: Due disadvantaged compared to the loss of the natural [[gliding actionintact]]males, which comes from the mobility of the [[foreskin]] an inferiority complex and [[shaft skindepression]], a much increased friction between [[penis]] and [[vagina]] occurs during intercoursemay occur. This can make intercourse painful for both partners and lead to abrasions<ref>{{FrischM LindholmM GroenbaekM 2011}}</ref>be accompanied by conscious recognition of his own incompleteness, or the deficiency may remain completely subconscious<ref>{{REFjournal |last=Cortés-GonzálezRhinehart

|last2url=Arratia-Maqueo |init2=J |last3=Gómez-Guerra |init3=Lhttps://www.cirp.org/library/psych/rhinehart1/ |title=Does Neonatal circumcision has an effect on female's perception of sexual satisfaction?reconsidered |journal=Rev Invest ClinTransactional Analysis J |date=20081999 |volume=6029

|pagepages=227 |url= |pubmedID=18807735215-21 |accessdate=2019-10-12}}</ref> The prolonged time it takes [[circumcised]] men to reach orgasm. In an online study, 75% of those interviewed stated that they felt incomplete, as well as the often longer and more vigorous thrusting movements - 66% said they felt inferior compared to with [[intact]] men - play a part in thismales.<ref name="ColdCJ TaylorJR 1999GSoCH">{{ColdCJ TaylorJR 1999}}</ref>* Cases in which children felt ill treated or punished have been documented as well. G. Cansever found in her study on 12 boys aged between 4 and 7 years, who had previously been prepared for their impending circumcision, that the children experienced the operation as an aggressive assault on their bodies.<ref>{{REFjournal |last=FinkCansever |init=KSG |last2date=Carson1965 |init2url=CC |last3=DeVellis |init3=RFhttps://www.cirp.org/library/psych/cansever/ |title=Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and SatisfactionPsychological effects of circumcision |journal=Brit. J Urol |date=2002. Med. Psychol |volume=167 |issue=538 |pages=2113321-6 |url=31 |accessdate=2019-10-12

 * [[Lymphoedema]] of the penis is a normal and expected complication of male circumcision. * [[Meatal stenosis]], a pathological narrowing of the opening Fear 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 percentbeing alone or darkness.<ref name="vanhowe2006Levy1945">{{REFjournal |last=Van HoweLevy |first=David M. |init=RSDM |author-linkurl=Robert Shttps://www. Van Howecirp.org/library/psych/levy1/ |title=Incidence Psychic trauma of meatal stenosis following neonatal circumcision operations in children; and a primary care settingnote on combat neurosis |journal=Clin Pediatr (Phila)American Journal of Diseases of Children |notevolume=Jan-Feb 200669 |date=2006-01 |volume=45 |issue=11945 |pages=497-54 |url=https://www.academia.edu/6992015/Incidence_of_Meatal_Stenosis_following_Neonatal_Circumcision_in_a_Primary_Care_Setting25 |accessdate=2019-10-12-15}}</ref>* Fear of doctors, clinics and also closed rooms.<refname="Levy1945"/>{{REFjournal |last* Relapse into the state of bed-wetting, even if the child was already dry before.<ref name=Stenram"Levy1945"/> |init=A* [[Circumcised]] males who become fathers frequently manifest [[adamant father syndrome]]. |last2=Malmfors [[Intact America]] (2019) called circumcision an [[Adverse Childhood Experiences (ACEs)|init2=Gadverse childhood experience]],<ref name-"bollinger2019">{{REFdocument |last3title=OkmianChild genital cutting as an adverse childhood experience |init3url=Lhttp://adversechildhoodexperiences.net/CGC_as_an_ACE.pdf |titlelast=Circumcision for [[phimosis]]: a follow-up studyBollinger |journalfirst=Scandinavian journal of urology and nephrologyDan |dateauthor-link=1986Dan Bollinger |volumelast2=20Chapin |issuefirst2=2Georganne |pageauthor2-link=89Georganne Chapin |urlpublisher=Intact America |pubmedIDlocation=3749823Tarrytown |accessdateformat=}}</ref><ref>{{REFwebPDF |urldate=http://emedicine.medscape.com/article/10160162019-overview |title=Meatal Stenosis |publisher=Medscape08 |accessdate=20192021-1011-1102

* Shorter adult penile length was reported by Park et al. (2016) as a result of NMC (newborn male circumcision).== Complications =={{Citation |Title=== Possible operative and postoperative complications ===Circumcision is surgery. Surgical complications of circumcision generally may be classified as [[Bleeding|Text=In conclusionhemorrhage]], [[infection]], second or surgical misadventure up to fourth digit ratio, flaccid penile length, and age including loss of circumcision were significant predictive factors for erectile penile length. Furthermore, the penile lengths of the NMC group were shorter than those of the non-NMC grouppenis and [[death]]. |Author=Park et al. |Source= |<refname="deacon2022" /><refname="williams-kapilla1993">{{REFjournal |last=Park |first=Williams |init=JKN

|last2=Doo |first2=Kapilla |init2=ARL

|last3=Kim |first3= |init3=JH |author3-link= |last4=Park |first4= |init4=HS |author4-link= |etal=yesno |title=Prospective investigation Complications of penile length with newborn male circumcision and second to fourth digit ratio.

|journal=Can Urol Assoc Brit JSurg

|date=20161993-09 |season=10 |volume=1080 |issue=9-10 |article= |page= |pages=1231-6 |url=https://www.ncbicirp.nlm.nih.govorg/pmclibrary/articlescomplications/PMC5028213williams-kapila/ |archived=

|pubmedID=276955838242285 |pubmedCID=5028213 |DOI=10.54891002/cuajbjs.3590 1800801005 |accessdate=20222019-0911-0427

Circumcision and frenectomy remove tissues with heightened erogenous sensitivity.<ref name="cepeda2023" /> <ref name="winkleman1959">{{WinkelmannRK 1959}}</ref> They concluded, "Evidence has also started * Intolerance or allergic reactions to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as wellthe narcotics used." The [[amputation]] of the prepuce results * Especially in newborns, where the loss of the majority of fine-touch neuroreceptors found in the [[penis]]bodily pain reduction mechanisms are not yet fully developed, leaving only local anaesthesia is often insufficient for the uninhibited protopathic sensibility of the artificially externalized [[glans penis]]operation. The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of the changes Even in sexual behavior noted in [[circumcised]] human males.<ref>{{REFjournal |last=Van Howe |init=RS |author-link=Robert S. Van Howe |last2=Cold |init2=CJ |title=Advantages and Disadvantages of Neonatal Circumcision |journal=The Journal conjunction with regional anaesthesia of the American Medical Association |volume=277 |issue=13 |pages=1052-7 |url=http://www.ncbi.nlm.nih.gov/pubmed/9218663 |quote= |pubmedID=9218663 |pubmedCID= |DOI= |date=1997-04-02 |accessdate=}}</ref> Histology dorsal nerve of the male circumcision scar shows [[amputationpenis]] neuromas, Schwann cell proliferation and the bulbous collection rate of variably sized neurites. [[Amputation]] neuromas do not mediate normal sensation and are notorious failure to provide sufficient anaesthetic even for generating painexperienced anaesthetists is still 5-10%.<ref name="ColdCJ TaylorJR 1999"/> See [[Sexual effects of circumcision]] The general anaesthesia that would be needed for more information. === Psychological effects === [[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effects]] are also possible after a circumcisionnewborns, especially if the operation was carried out in childhood. On this occasion a variety of [[trauma]] may occurhowever, which depend, among others, on age and circumstances of the circumcision. For example, whether poses significant risks for 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 consentchild, and also, in the case of infant circumcisiontherefore, if he was told about it during childhood or had to find it out coincidentally on his own. The psychological late effects of circumcision are not yet fully researched, and many studies took place on rather a small scale. This situation needs is only likely to be rectified, because the available studies, as well as the histories of negatively affected men, suggest that these late effects may have more impact than previously assumedused in emergencies. * It was observed that infants, following circumcision A surgical operation without proper [[pain]] control, had can lead to the development of a disturbed bond with their motherspecific pain memory<ref>{{REFjournal |last=Marshall |init=RE |last2=Porter |init2=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=367-74REFweb |url=httpshttp://www.cirpspiegel.orgde/libraryspiegel/birthvorab/marshall2/ |accessdate=2020experte-warnt-rituelle-beschneidung-veraendert-das-02gehirn-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 nonder-REM sleep and increased waking. * In boys [[circumcised]] in childhood, [[postkinder-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 operation849534.<ref>{{REFbook |last=Ramos |init=S |last2=Boyle |init2=GJ |year=2001html |title=Understanding circumcisionKinderschmerz-Experte warnt: A Multi-Disciplinary Approach to a Multi-Dimensional ProblemRituelle Beschneidung verändert das Gehirn der Kinder |urltrans-title=httpsChildren's pain expert warns://link.springer.com/chapter/10.1007/978-1-4757-3351-8_14Ritual circumcision changes the brain of children |worklanguage=German |editorslast=[[George CProf. Dr. Denniston]], [[Frederick Mmed. Hodges]], [[Marilyn Fayre Milos]]Boris Zernikow |editionfirst= |volumepublisher=Spiegel Online |chapterwebsite=Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder |pagesdate=2532012-08-7012 |locationaccessdate=New York |publisher=Kluwer Academic/Plenum Publishers2019-10-11 |isbnformat=

|note=Link to [[AAP]] website}}</ref>* Circumcisions. During procedures which take several minutes, especially those that happen without consent, can spark feelings babies tend to fall into a state of helplessness and alienationstupor, which can persist in the past was falsely interpreted as [[trauma]]. These feeling can also be triggered laterpeaceful sleep, when someone [[circumcised]] as an infant becomes aware of his circumcisionnurturing the belief that babies felt no pain. In an online study, interviewed men stated they felt betrayed Measurements taken in those cases revealed a typically 3- to 4- 55% by the motherfold increase in cortisol levels, 50% by the father, and 58% by the doctor, and 73% felt that their which equals a state of severe [[human rightsshock]] had been violated.<ref name="GSoCH">{{REFwebREFjournal |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=httphttps://www.circumcisionharmcirp.org/ |title=Global Survey of Circumcision Harmlibrary/pain/gunnar/ |accessdate=2019-1011-1226

* It can frequently be found that Postoperative wound pain, in the case of children's circumcisions conceivably worsened by the forceful breaking of the loss is denied, much as happens with preputial adhesions.* Postoperative pain from the loss exposure of other body partsthe sensitive glans penis to clothing. This denial can lead to fathers having their sons pain will endure for several weeks or even longer in some cases.* Postoperative [[circumcisedbleeding]] in order not to be reminded of their own lossthe wound. In this processThis can have severe consequences especially for very young infants, their own body is defined as "normal" and the [[foreskin]] redefined as a foreign objectif they are not treated promptly. Their own parents are seen as "good", so that this image blood volume is projected onto the circumcision their parents carried out as wellonly about 85 ml per kilogram of body weight, in order to keep the positive emotion intact. The father wants and even moderate blood loss can lead 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"hypovolaemia, is passed on to his son by having him hypovolaemic [[circumcisedshock]] as welland even death.<ref>{{VanderKolkBA 1989}}</ref><ref>{{REFjournalREFbook |last=Goldman |initfirst= |year=R2000 |author-linktitle=Ronald GoldmanPaediatric Handbook |url=https://www |work= |editors=Smart J, Nolan T.cirp.org/library/psych/goldman1/ |titleedition=6 |volume= |chapter=The psychological impact of circumcision |journalpage=BJU Int82 |datelocation=1999{{AUSC|VIC}}, Australia |volumepublisher=83Blackwell Science Asia |issueisbn=Suppl. 1 |pagesquote=93-103 |accessdate=2019-10-12 |note=}}</ref>* If the [[circumcised]] male feels incomplete, or due to the missing [[foreskin]] disadvantaged compared to [[intact]] males, an inferiority complex and depression may occur. This can be accompanied by conscious recognition of his own incompleteness, or the deficiency may remain completely subconscious<ref>{{REFjournalREFdocument |lasttitle=Rhinehart |init=JAutopsy of Demetrius Manker |url=https://www.cirp.org/library/psych/rhinehart1/ |titlecontribution=Neonatal circumcision reconsideredCase 93-1711 |journallast=Transactional Analysis JWetli |datefirst=1999CV |volumepublisher=29Miami: Dade County Medical Examiner Department |issueformat=3 |pagesdate=2151993-2106-23 |accessdate=2019-10-12}}</ref>. In an online study, 75% of those interviewed stated that they felt incomplete, and 66% said they felt inferior compared with [[intact]] males.<ref name="GSoCH"/>* Cases in which children felt ill treated or punished have been documented as well. G. Cansever found in her study on 12 boys aged between 4 and 7 years, who had previously been prepared for their impending circumcision, that the children experienced the operation as an aggressive assault on their bodies.<ref>{{REFjournal |last=CanseverHiss |init=GJ |last2=Horowitz |init2=A |datelast3=1965Kahana |urlinit3=https://www.cirp.org/library/psych/cansever/T |title=Psychological effects of Fatal haemorrhage following male ritual circumcision |journal=Brit. J. Clin Forensic Med. Psychol |date=2000 |volume=387 |issue= |pages=32132-314 |url=https://www.cirp.org/library/death/hiss1/ |accessdate=2019-1011-1206}}</ref>* Fear of being alone or darkness.<ref name="Levy1945">{{REFjournalREFdocument |lasttitle=Levy |first=David M. |init=DMJudgement of inquiry into the death of McWillis, Ryleigh Roman Bryan |url=httpshttp://www.cirpcircumstitions.org/library/psych/levy1com/death-exsang.html |contribution= |titlelast=Psychic trauma of operations in children; and a note on combat neurosisNewell |journalfirst=American Journal of Diseases of ChildrenTEC |volumepublisher=69Burnaby, B.C.: B.C. Coroner's Service |dateformat=1945 |pagesdate=72004-01-2519 |accessdate=2019-1011-1226

* Fear of doctors, clinics and also closed rooms.<ref name="Levy1945"/>* Relapse into the state of bed-wetting, even if the child was already dry before.<ref name="Levy1945"/>* Circumcised males who become fathers frequently manifest Post operative [[adamant father syndromelymphoedema]]. * Postoperative [[Intact America]] (2019) called circumcision an [[Adverse Childhood Experiences (ACEs)Infection| adverse childhood experienceinfections]]. This includes both local infections, which can be treated with local therapy, and systemic infections,requiring systemic antibiotic treatment.<ref name-"bollinger2019">{{REFdocumentREFconference |titlelast=Child genital cutting as an adverse childhood experience |url=http://adversechildhoodexperiencesDr.net/CGC_as_an_ACEmed.pdf |last=BollingerHartmann |first=DanWolfgang |author-linkurl=Dan Bollinger |last2place=ChapinRechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German) |first2title=Georganne |author2-link=Georganne Chapin |publisher=Intact America |location=Tarrytown |format=PDFStellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German) |date=20192012-11-0826 |accessdate=2021-11-02

* [[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 continuing enigma |journal=Aust Paediatr J |date=1970 |volume=6 |issue= |pages=59-65 |url=https://www.cirp.org/library/general/leitch1/ |accessdate=2019-12-15}}</ref> 5.5%.* [[Sudden Infant Death Syndrome]] (SIDS).* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], is cut during circumcision without being clamped and sutured at its origin separately, it starts to develop new branches over time, which can lead to the development of knots.* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro-penis) and induratio [[penis]] plastica (skewed penis).* Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis|glans]] or the [[penis]] can occur.* In rare cases, [[necrosis]], gangrene, ischaemia, keloid formation, and circulatory problems may also occur.* When the circumcision is followed by the ultra-orthodox Jewish ritual of Metzitzah B'Peh (which consists of sucking blood from the wound with the mouth), there is a risk of infection with [[herpes]] simplex type 1, which can lead to brain damage or [[death]].<ref>{{REFweb |url=http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritual.html?_r= Complications 0 |title=Baby’s Death Renews Debate Over a Circumcision Ritual |last=Robbins |first=Liz |date=2012-03-07 |accessdate=2019-10-11}}</ref>=== Death ===A study in 2010 estimated approximately 117 neonatal circumcision-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 list of [[fatalities]]. == Forced circumcision == <!--=== United States military === American soldiers serving in World War II were subjected to regular inspections of their genitals. If intact, the soldiers risked being ordered to undergo immediate circumcision.<ref>{{REFbook |last=Schoen |first=Ed |init=E |author-link=Edgar J. Schoen |year=2005 |title=On Circumcision |url=https://books.google.de/books?id=-zUhdvSt7cgC |work= |editor=Dianne Yeakey |edition= |volume= |chapter= |pages=72-3 |location=Georgetown, Canada |publisher=RDR Books |isbn=1-157143-123-3 |quote=For a critical view, see Sorrells, "The History of Circumcision," p. 333

}}</ref> See also the list of [[fatalities]]. == Forced circumcision ==<!--=== United States military ===American soldiers serving in World War II were subjected to regular inspections of their genitals. If intact, the soldiers risked being ordered to undergo immediate circumcision.<ref>{{REFbook |last=Schoen |first=Ed |init=E |author-link=Edgar J. Schoen |year=2005 |title=On Circumcision |url=https://books.google.de/books?id=-zUhdvSt7cgC |work= |editor=Dianne Yeakey |edition= |volume= |chapter= |pages=72-3 |location=Georgetown, Canada |publisher=RDR Books |isbn=1-157143-123-3 |quote=For a critical view, see Sorrells, "The History of Circumcision," p. 333 |accessdate= |note=

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

|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}}