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.

Circumcision was popularized in English-speaking nationns in the nineteeth century. The practice of non-therapeutic circumcision of boys now has greatly declined in [[Australia]], [[Canada]], [[New Zealand]] and the [[United Kingdom]]. It has been gradually declining since 1985 in the [[United States]]. It has ''never'' been a popular practice in other western nations. Circumcision is classified as a form of [[genital mutilation]].

In [[Judaism]], the tradition of [[Brit Milah| circumcision]] goes back to the [[Abrahamic covenant]] in a passage in the Book of Genesis (17:10-14). It is was seen as a covenant between God and man, dating back to the patriarch Abraham. The validity of this passage is increasingly being questioned.

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.

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

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]].

}}</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

* 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

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

|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.

Histology of the male circumcision scar shows [[amputation]] neuromas, Schwann cell proliferation and the bulbous collection of variably sized neurites. [[Amputation]] neuromas do not mediate normal sensation and are notorious for generating pain.<ref name="ColdCJ TaylorJR 1999"/>Cepeda-Emiliani et al. (2023) commented:<blockquote>Taking the sleve technique as an example of surgical flexibility during circumcision, to the extent that this technique is of such versatility that it allows highly variable quantities of cutaneous and subcutaneous tissue to be excised directly from the penile body, and to the extent that the prepuce is still conceived by segments of the medical community as "just a small piece of skin", we are concerned that aggressive circumcisions are intentionally or unintentionally being performed in pediatric and adult patients in the belief that "redundant" or " extra" tissue is being excised, or in the belief that "excesive sensitivity" is being reduced to augment ejaculatory latency time.<ref name="cepeda2023"/></blockquote>The un-anesthetized and un-sedated newborn infant is restrained by being strapped to a special plastic board called the [[circumstraint]]. The procedure is most often an elective, non-therapeutic surgery without [[medical indication]] performed on neonates and children for religious and cultural reasons in violation of the child's [[human rights]] to [[physical integrity]], but in older patients may be rarely indicated for therapeutic reasons. It is a radical treatment option for pathological [[phimosis]], refractory [[balanoposthitis]] and chronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health.  See [[Sexual effects of circumcision]] for more information. === Psychological effects ===[[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effects]] are also possible after a circumcision, especially if the operation was carried out in childhood. On this occasion a variety of [[trauma]] may occur, which depend, among others, on age and circumstances of the circumcision. For example, whether the circumcision took place with or without sufficient anaesthesia, if the individual has been informed about the operation beforehand, if he was [[circumcised]] against his will or without his consent, and also, in the case of infant circumcision, if he was told about it during childhood or had to find it out coincidentally on his own. The psychological late effects of circumcision are not yet fully researched, and many studies took place on rather a small scale. This situation needs to be rectified, because the available studies, as well as the histories of negatively affected men, suggest that these late effects may have more impact than previously assumed. * It was observed that infants, following circumcision without [[pain]] control, had a disturbed bond with their mother<ref>{{REFjournal |last=Cepeda-Emiliani |first=Marshall |init=A |author-link=Alfonso Cepeda-EmilianiRE |last2=Gándara-Cortés |first2=Porter |init2=MFL |author2-linklast3=Rogers |last3init3=Otero-AlénAG |first3etal=yes |init3title=M |author3Circumcision: II effects upon mother-link=infant interaction |last4journal=García Early Hum Dev |first4date=1982 |init4volume=H7 |author4-linkissue=4 |last5pages=Suárez367-Quintanilla74 |first5url=https://www.cirp.org/library/birth/marshall2/ |init5accessdate=J2020-02-01 |author5}}</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-link=REM sleep and increased waking.  |last6=García* 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-CaballeroIV criteria for PTSD following the operation.<ref>{{REFbook |first6last=Ramos |init6init=TS |author6-linklast2=Boyle |last7init2=GallegoGJ |first7year=2001 |init7title=R |author7Understanding circumcision: A Multi-Disciplinary Approach to a Multi-link=Dimensional Problem |last8url=Garcíahttps://link.springer.com/chapter/10.1007/978-1-Caballero4757-3351-8_14 |first8work= |init8editors=R[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |author8-linkedition= |etalvolume=no |titlechapter=Immunohistological study of the density Ritual and distribution medical circumcision among Filipino boys: evidence of human penile neural tissue: gradient hypothesis |transpost-title=traumatic stress disorder |journalpages= Int J Impot Res |date=2023-05253-02 |volume=35 |issue=3 |article= |page=70 |pageslocation=286-305New York |urlpublisher=https:/Kluwer Academic/www.nature.com/articles/s41443-022-00561-9Plenum Publishers |archivedisbn=

|pubmedIDaccessdate=35501394 |pubmedCIDnote=}}</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 name="GSoCH">{{REFweb |DOIurl=10http://www.circumcisionharm.1038org/s41443-022-00561-9 |title=Global Survey of Circumcision Harm |accessdate=20232019-1110-2312

</blockquote>The un-anesthetized and un-sedated newborn infant * It can frequently be found that the loss is restrained by being strapped denied, much as happens with the loss of other body parts. This denial can lead to a special plastic board called the fathers having their sons [[circumstraintcircumcised]]in order not to be reminded of their own loss. The procedure In this process, their own body is most often an elective, non-therapeutic surgery without [[medical indication]] performed on neonates defined as "normal" and children for religious and cultural reasons in violation of the child's [[human rights]] to [[physical integrityforeskin]]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, but in older patients may order to keep the positive emotion intact. The father wants to be rarely indicated for therapeutic reasons. It is a radical treatment option for pathological [[phimosis]]"good" father later in life as well, refractory [[balanoposthitis]] and chronic 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 [[urinary tract infectioncircumcised]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general healthas well. <ref>{{VanderKolkBA 1989}}</ref><ref>{{REFjournal |last=Goldman |init=R |author-link=Ronald Goldman |url=https://www.cirp.org/library/psych/goldman1/See [[Sexual effects |title=The psychological impact of circumcision]] for more information. |journal=BJU Int |date=1999 |volume=83 |issue= Psychological effects =Suppl. 1 |pages=93-103 |accessdate=2019-10-12}}</ref>* If the [[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effectscircumcised]] are also possible after a circumcisionmale feels incomplete, especially if or due to the operation was carried out in childhood. On this occasion a variety of missing [[foreskin]] disadvantaged compared to [[traumaintact]] may occurmales, which depend, among others, on age an inferiority complex 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 [[circumciseddepression]] against may occur. This can be accompanied by conscious recognition of his will own incompleteness, or without his consent, and also, in the case of infant deficiency may remain completely subconscious<ref>{{REFjournal |last=Rhinehart |init=J |url=https://www.cirp.org/library/psych/rhinehart1/ |title=Neonatal circumcision, if he was told about it during childhood or had to find it out coincidentally on his own.reconsidered |journal=Transactional Analysis J |date=1999 |volume=29 |issue=3 |pages=215-21 |accessdate=2019-10-12The psychological late effects of circumcision are not yet fully researched, and many studies took place on rather a small scale}}</ref>. This situation needs to be rectifiedIn an online study, because the available studies, as well as the histories 75% of negatively affected men, suggest those interviewed stated that these late effects may have more impact than previously assumed. * It was observed that infantsthey felt incomplete, following circumcision without and 66% said they felt inferior compared with [[painintact]] controlmales.<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 a disturbed bond with previously been prepared for their impending circumcision, that the children experienced the operation as an aggressive assault on their motherbodies.<ref>{{REFjournal |last=MarshallCansever |init=REG |last2date=Porter1965 |init2url=FLhttps://www.cirp.org/library/psych/cansever/ |last3title=RogersPsychological effects of circumcision |init3journal=AGBrit. J. Med. Psychol |etalvolume=yes38 |titlepages=Circumcision: II effects upon mother321-infant interaction31 |journalaccessdate=Early Hum Dev2019-10-12 |date}}</ref>* Fear of being alone or darkness.<ref name=1982"Levy1945">{{REFjournal |volumelast=7Levy |issuefirst=4David M. |pagesinit=367-74DM |url=https://www.cirp.org/library/birthpsych/marshall2levy1/ |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=20202019-0210-0112}}</ref>* Fear of doctors, as well as problems with nurturingclinics and also closed rooms.<ref name="Levy1945"/>* Relapse into the state of bed-wetting, up to even if the point of refusal to be fedchild was already dry before. The sleeping habits of these babies were also disturbed, with prolonged non-REM sleep and increased waking<ref name="Levy1945"/>* [[Circumcised]] males who become fathers frequently manifest [[adamant father syndrome]].

* In boys [[circumcisedIntact America]] in childhood, (2019) called circumcision an [[post-traumatic stress disorder]] Adverse Childhood Experiences ([[PTSD]]ACEs) could be diagnosed. In a study on Philippine boys, in whom no [[PTSD| adverse childhood experience]] 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.<refname-"bollinger2019">{{REFbook |last=Ramos |init=S |last2=Boyle |init2=GJ |year=2001REFdocument |title=Understanding circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional ProblemChild genital cutting as an adverse childhood experience |url=httpshttp://linkadversechildhoodexperiences.springer.com/chapternet/10CGC_as_an_ACE.1007/978-1-4757-3351-8_14pdf |worklast=Bollinger |editorsfirst=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]Dan |editionauthor-link=Dan Bollinger |volumelast2=Chapin |chapterfirst2=Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorderGeorganne |pages=253author2-70 |locationlink=New YorkGeorganne Chapin |publisher=Kluwer Academic/Plenum PublishersIntact America |isbnlocation=Tarrytown |quoteformat=PDF |accessdatedate=2019-08 |noteaccessdate=2021-11-02

* Circumcisions, especially those that happen without consent, can spark feelings == Complications ===== Possible operative and postoperative complications ===Circumcision is surgery. Surgical complications of helplessness and alienation, which can persist circumcision generally may be classified as [[traumaBleeding| hemorrhage]]. These feeling can also be triggered later, when someone [[circumcisedinfection]] 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, or surgical misadventure up to and 58% by including loss of the doctor, penis and 73% felt that their [[human rightsdeath]] had been violated.<ref name="GSoCHdeacon2022" /><ref name="williams-kapilla1993">{{REFwebREFjournal |last=Williams |init=N |author-link= |last2=Kapilla |init2=L |author2-link= |etal=no |title=Complications of circumcision |trans-title= |language= |journal=Brit J Surg |location= |date=1993-10 |volume=80 |issue=10 |pages=1231-6 |url=httphttps://www.circumcisionharmcirp.org/library/complications/williams-kapila/ |quote= |pubmedID=8242285 |pubmedCID= |titleDOI=Global Survey of Circumcision Harm10.1002/bjs.1800801005 |accessdate=2019-1011-1227

 * It can frequently be found that Intolerance or allergic reactions to the narcotics used.* Especially in newborns, where the loss bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is denied, much as happens with often insufficient for the loss of other body partsoperation. This denial can lead to fathers having their sons [[circumcised]] Even in order not to be reminded conjunction with regional anaesthesia of the dorsal nerve of their own loss. In this process, their own body is defined as "normal" and the [[foreskinpenis]] 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 rate of failure to keep the positive emotion intactprovide sufficient anaesthetic even for experienced anaesthetists is still 5-10%. The father wants to general anaesthesia that would be a "good" father later in life as wellneeded for newborns, and sohowever, following an idealised image of his own parentsposes significant risks for the child, circumcisionand, which has been redefined as a "good thing"therefore, is passed on only likely to his son by having him be used in emergencies. A surgical operation without proper [[circumcisedpain]] as well.control can lead to the development of a specific pain memory<ref>{{VanderKolkBA 1989}}</ref><ref>{{REFjournal |last=Goldman |init=R |author-link=Ronald GoldmanREFweb |url=httpshttp://www.cirpspiegel.orgde/libraryspiegel/psych/goldman1vorab/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=The psychological impact Children's pain expert warns: Ritual circumcision changes the brain of circumcisionchildren |journallanguage=BJU IntGerman |datelast=Prof. Dr. med. Boris Zernikow |first=1999 |volumepublisher=83Spiegel Online |issuewebsite=Suppl. 1 |pagesdate=932012-10308-12 |accessdate=2019-10-1211 |format= |quote=}}</ref>* If . In unsedated and partially sedated infants increased secretion of the [[circumcised]] male feels incomplete, or due to stress hormone cortisol could be observed for months after the missing [[foreskin]] disadvantaged compared to [[intact]] malesoperation. Overall, an inferiority complex their pain threshold was lower and depression may occurthe risk of chronic pain increased. This can be accompanied by conscious recognition Regardless of his own incompletenessthese findings, infant circumcisions with insufficient or the deficiency may remain completely subconsciousno anaesthetic are still common practice<ref>{{REFjournal |last=RhinehartGarry |init=JT |title=Circumcision: a survey of fees and practices |journal=OBG Management |date=1994 |volume=October |issue= |pages=34-6 |url=https://www.cirp.org/library/psych/rhinehart1 |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 reconsideredand pain relief: current training practices |journal=Transactional Analysis JPediatrics |date=19991998 |volume=29101 |issue=3 |pages=215423-218 |url= |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=CanseverStang |init=GHJ |datelast2=1965Snellman |urlinit2=https://www.cirp.org/library/psych/cansever/LW |title=Psychological effects of circumcisionCircumcision practice patterns in the United States |journal=Brit. J. Med. PsycholPediatrics |date=1998 |volume=38101 |issue=e5 |pages=321-31 |url= |accessdate=2019-10-12 |note=Link to [[AAP]] website}}</ref>* Fear . 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 being alone or darknesssevere [[shock]].<ref name="Levy1945">{{REFjournal |last=LevyGunnar |init=MR |last2=Fisch |firstinit2=RO |last3=Korsvik |init3=David M.S |initlast4=DMDonhowe |urlinit4=https://www.cirp.org/library/psych/levy1/JM |title=Psychic trauma The effects of operations in children; circumcision on serum cortisol and a note on combat neurosisbehavior |journal=American Journal of Diseases of ChildrenPsychoneuroendocrinology |date=1981 |volume=696 |dateissue=19453 |pages=7269-2575 |url=https://www.cirp.org/library/pain/gunnar/ |accessdate=2019-1011-1226

* Fear Postoperative wound pain, in the case of doctors, clinics and also closed roomschildren's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions.<ref name="Levy1945"/>* Relapse into Postoperative pain from the state exposure of bed-wetting, the sensitive glans penis to clothing. This pain will endure for several weeks or even if the child was already dry beforelonger in some cases.<ref name="Levy1945"/>* Circumcised males who become fathers frequently manifest Postoperative [[adamant father syndromebleeding]]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 [[Intact Americashock]] (2019) called circumcision an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]],and even death.<ref name-"bollinger2019">{{REFdocumentREFbook |last= |first= |year=2000 |title=Child genital cutting as an adverse childhood experiencePaediatric Handbook |url=http://adversechildhoodexperiences.net/CGC_as_an_ACE.pdf |lastwork=Bollinger |firsteditors=Smart J, Nolan T. |edition=Dan6 |author-linkvolume=Dan Bollinger |last2chapter=Chapin |first2page=Georganne82 |author2-linklocation=Georganne Chapin{{AUSC|VIC}}, Australia |publisher=Intact AmericaBlackwell Science Asia |locationisbn=Tarrytown |formatquote=PDF |dateaccessdate=2019-08 |accessdatenote=2021-11-02}}</ref><ref>{{REFdocument |title=Autopsy of Demetrius Manker |url= Complications |contribution=Case 93-1711 |last=Wetli |first=CV |publisher=Miami: Dade County Medical Examiner Department |format= Possible operative and postoperative complications == |date=1993-06-23Circumcision is surgery. Surgical complications of circumcision generally may be classified as [[Bleeding| hemorrhage]], [[infection]], or surgical misadventure up to and including loss of the penis and [[death]].accessdate=}}</ref name="deacon2022" /><ref name="williams-kapilla1993">{{REFjournal |last=WilliamsHiss |init=N |author-link=J |last2=KapillaHorowitz |init2=LA |author2-linklast3=Kahana |etalinit3=noT |title=Complications of Fatal haemorrhage following male ritual circumcision |trans-title= |language= |journal=Brit J Surg |location=Clin Forensic Med |date=1993-102000 |volume=807 |issue=10 |pages=123132-64 |url=https://www.cirp.org/library/complicationsdeath/williams-kapila/ |quote= |pubmedID=8242285 |pubmedCID= |DOI=10.1002hiss1/bjs.1800801005 |accessdate=2019-11-2706}}</ref><ref>{{REFdocument * 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 |title=Judgement of inquiry into the dorsal nerve death of the [[penis]]McWillis, 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>{{REFwebRyleigh Roman Bryan |url=http://www.spiegelcircumstitions.decom/spiegel/vorab/expertedeath-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-849534exsang.html |titlecontribution=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder |trans-titlelast=Children's pain expert warns: Ritual circumcision changes the brain of childrenNewell |languagefirst=GermanTEC |lastpublisher=ProfBurnaby, B.C. Dr: B. medC. Boris Zernikow |first= |publisher=Spiegel Online |website= |date=2012-08-12 |accessdate=2019-10-11Coroner's Service

|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 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 fees and practices |journal=OBG Management |date=1994 |volume=October |issue= |pages=342004-01-6 |url=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>{{REFjournalREFconference |last=Howard |init=CR |last2=Howard |init2=FMDr. med. Hartmann |last3first=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=423-8Wolfgang

}}</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=StangBlalock

|last2=SnellmanVemulakonda |init2=LWV |last3=Ritchey |init3=ML |last4=Ribbeck |init4=M |title=Circumcision practice patterns in the United StatesOutpatient management of [[phimosis]] Following newborn circumcision |journal=PediatricsJ Urol |date=19982003 |volume=101169 |issue=e56 |pages=2332-4 |url=https://www.cirp.org/library/complications/blalock1/ |accessdate= |note=Link to [[AAP]] website2019-11-26}}</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 sleepprevalence is 2.9%, nurturing the belief that babies felt no pain. Measurements taken in those cases revealed a typically 3- according to 4-fold increase in cortisol levels, which equals a state of severe [[shock]].Leitch<ref>{{REFjournal |last=GunnarLeitch |init=MR |last2=Fisch |init2=RO |last3=Korsvik |init3=S |last4=Donhowe |init4=JMIOW |title=The effects of circumcision on serum cortisol and behaviorCircumcision - a continuing enigma |journal=PsychoneuroendocrinologyAust Paediatr J |date=19811970

|issue=3 |pages=26959-7565 |url=https://www.cirp.org/library/paingeneral/gunnarleitch1/ |accessdate=2019-12-15}}</ref> 5.5%.* [[Sudden Infant Death Syndrome]] (SIDS).* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], is cut during circumcision without being clamped and sutured at its origin separately, it starts to develop new branches over time, which can lead to the development of knots.* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro-penis) and induratio [[penis]] plastica (skewed penis).* Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis|glans]] or the [[penis]] can occur.* In rare cases, [[necrosis]], gangrene, ischaemia, keloid formation, and circulatory problems may also occur.* When the circumcision is followed by the ultra-orthodox Jewish ritual of Metzitzah B'Peh (which consists of sucking blood from the wound with the mouth), there is a risk of infection with [[herpes]] simplex type 1, which can lead to brain damage or [[death]].<ref>{{REFweb |url=http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritual.html?_r=0 |title=Baby’s Death Renews Debate Over a Circumcision Ritual |last=Robbins |first=Liz |date=2012-03-07 |accessdate=2019-10-11-26

* Postoperative wound pain, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions.=== Death ===* Postoperative pain from the exposure of the sensitive glans penis to clothing. This pain will endure for several weeks or even longer A study in some cases.* Postoperative 2010 estimated approximately 117 neonatal circumcision-related [[bleedingDeath| deaths]] of occur annually in the wound. This can have severe consequences especially for very young infants[[United States]], if they are not treated promptly. Their blood volume is only about 85 ml per kilogram one out of body weightevery 77 male neonatal deaths, and more than suffocation, auto accidents, or even moderate blood loss can lead to hypovolaemia, hypovolaemic [[shockSIDS]] and even death.<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>{{REFbookREFweb |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

|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=20002005 |title=Paediatric HandbookOn Circumcision |url=https://books.google.de/books?id=-zUhdvSt7cgC |work= |editorseditor=Smart J, Nolan T.Dianne Yeakey |edition=6

|pagepages=8272-3 |location={{AUSC|VIC}}Georgetown, AustraliaCanada |publisher=Blackwell Science AsiaRDR Books |isbn=1-157143-123-3 |quote=For a critical view, see Sorrells, "The History of Circumcision," p. 333

}}</ref>This practice was discontinued at least six decades ago.-->=== Non-therapeutic circumcision of male children === Human babies, because they are not yet in possession of language, are incapable of giving or refusing consent to be [[circumcised]]. The element of force has led some scholars to view the circumcision of baby boys as a category of forced circumcision.<ref>For example, Frederick M. Hodges, a medical historian, writes: "In the late 1970s, as the Americans were growing increasingly aware of the abuses of power rampant throughout the nation's social institutions, influential grass-roots movements protesting the forced circumcision of American children sprang up nationwide." F. Hodges, "A Short History," p. 31; see also [[Leonard B. Glick|Glick]], ''Marked in Your Flesh'', pp. 273-281.</ref> There are, however, physicians in the United States who argue strongly for non-therapeutic circumcision of newborn babies; and circumcision is widely accepted as a postnatal procedure in American hospitals.<ref>{{REFdocumentREFbook |last=Fletcher |first=Christopher R. |init=CR |year=1999 |title=Autopsy Circumcision in America in 1998: Attitudes, Beliefs, and Charges of Demetrius MankerAmerican Physicians |url=http://www.springerlink.com/content/h2150v731233m177/ |contributionwork=Case 93-1711Male and Female Circumcision |lasteditors=Wetli[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |firstedition=CV |publishervolume=Miami: Dade County Medical Examiner Department |formatchapter=Section 5 |datepages=1993259-06-2371 |accessdatelocation=New York}}< |publisher=Kluwer Academic/ref> <ref>{{REFjournalPlenum Publishers |lastisbn=Hiss |initquote=J |last2accessdate=Horowitz2019-10-12 |init2note=ID 10.1007/978-0-585-39937-9_19}}</ref> Parental consent is required.<ref>See, e.g., Shephard and Shephard, ''The Complete Guide'', p. 125.</ref> Astatement published by the [[American Academy of Pediatrics]] in 1999 claimed that "parents should determine what is in the best interest of the child... It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in additions to the medical factors, when making a decision."<ref>Lannon and Bailey, "Circumcision Policy Statement," p. 691.</ref> however surrogate consent for non-therapeutic circumcision is now viewed as unethical. 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 |last3last=Kahana |init3first=T |title=Fatal haemorrhage following male ritual Re J (child's religious upbringing and circumcision) |journal=J Clin Forensic MedFamily Court Reports

|volume=71

|pages=32307-414 |url=https://www.cirp.org/library/deathlegal/hiss1Re_J/2000.html |accessdate=2019-1110-0612}}</ref>(The National Health Service does not provide non-therapeutic circumcision.) In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<ref>{{REFdocument See, e.g., [[Margaret A. Somerville|Somerville]], "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; [[Abbie Chessler|title=Judgement Chessler]], "Justifying the Unjustifiable"; Smith, "Male Circumcision."</ref> For example, critics have pointed out that, in the [[United States]], more than 1.3% of inquiry into male neonatal deaths are attributable to the death complications of McWillis, Ryleigh Roman Bryannon-therapeutic circumcision surgery.<ref name="Bollinger 2010"/>==Video=====Is circumcision healthy?===The video ''Is Circumcision Healthy'' is recommended for parental viewing.<br><br> <youtube>D_3LQjZgdbQ</youtube> ===Dr. Christopher Guest discusses circumcision===<br><youtube>v=TQIp9f4krVQ</youtube> ===Plastibel circumcision=== {{UNI|Stanford University|url=httpSU}} has published a video of an actual non-therapeutic plastibell circumcision. The infant has received two injections of local anesthesia to deaden the dorsal nerves. The ventral nerves were not deadened so the infant still feels pain. One can his cries on the soundtrack.* [https://wwwmed.circumstitionsstanford.comedu/newborns/professional-education/circumcision/deathplastibell-exsangtechnique.htmlPlastibell Technique] |contribution===Gomco clamp circumcision=== |last=Newell |first=TEC'''Not for the squeamish:'''  |publisher=Burnaby, BThis is a video of an actual circumcision with a Gomco clamp.CThe infant boy received two dorsal penile nerve block (DPNB) analgesic injections but they did not seem to work. * [https: B//www.Creddit. Coroner's Servicecom/r/Intactivism/comments/qbpzqr/trained_medical_professionals_restrain_infant_to/ Circumcision video]  |format= |date=2004-01-19Recommendations of medical authorities== * [[George Hill|accessdate=2019-11-26Hill]] (2007) said:}}</refblockquote>* Post operative Male circumcision is harmful because it excises healthy tissue and permanently impairs beneficial physiological functions. Male circumcision also causes psychological problems that tend to perpetuate the cycle of abuse. Male circumcision is a costly diversion of medical resources away from beneficial services. Male circumcision violates legal rights, [[lymphoedemahuman rights]], and ethical standards. Finally, we must remember that males are the more vulnerable and sensitive of the two genders and, therefore, deserve the greater degree of protection from traumatic, invasive, injurious,and unnecessary surgery.* Postoperative For all of these reasons the non-therapeutic circumcision of boys should not be performed and the [[Infection| infectionsgenital integrity]]. This includes both local infections, which can of all children should be treated with local therapy, respected and systemic infections, requiring systemic antibiotic treatmentprotected.<refname="hill2007">{{REFconferenceREFjournal |last=Dr. med. HartmannHill |first=WolfgangGeorge |urlinit=G |placeauthor-link=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German)George Hill |title=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German)The case against circumcision |journal=Journal of Men's Health and Gender |date=20122007 |volume=4 |issue=3 |pages=318-11-2623 |url=https://www.academia.edu/8367383/The_Case_Against_Circumcision |quote= |pubmedID= |pubmedCID= |DOI= |accessdate=2021-05-30

</blockquote>* [[Wound dehiscence]]Andrew E. MacNeiiy, Head, Division of Pediatric Urology, Department of Urological Sciences, meaning the separation {{UNI|University of the edges British Columbia|UBC}}, Vancouver, BC, (2008) said:<blockquote>Newborn circumcision remains an area of controversy. Social, cultural, aesthetic and religious pressures form the wound or most common reasons for non-therapeutic circumcision. Although penile cancer and UTIs are reduced compared with uncircumcised males, the tissue after suturingincidence of such illness is so low that circumcision cannot be justified as prophylaxis.* Adhesion between the surface or rim The role of the foreskin in [[Glans penis|glans]] with the neighbouring [[penile skinHIV]]transmission in developed countries is unclear, causing [[skin]] pockets and bridges, as well as visually unpleasant results like uneven scars, which make safe sexual practice remains the cornerstone of prevention. There remains a re-circumcision necessarylack of knowledge regarding what constitutes the normal foreskin both among parents and among primary care providers.* Postoperative [[phimosis]]: This lack of knowledge results in a phimotic ring can develop during scarringburden of costs to our health care system in the form of unnecessary urological referrals, which makes expansion of wait times and circumcisions. Routine circumcision of all infants is not justified from a rehealth or cost-circumcision necessary. According to a study by Blalock et albenefit perspective.<ref>{{REFjournal |last=BlalockMacNeily |initfirst=HJAndrew |last2init=Vemulakonda |init2author-link=V |last3etal=Ritchey |init3=ML |last4=Ribbeck |init4=Mno |title=Outpatient management of [[phimosis]] Following newborn Routine circumcision |journal=J Urol |date=2003 |volume=169 |issue=6 |pages=2332-4 |url=https://www.cirp.org/library/complications/blalock1/the opposing view |accessdate=2019trans-11-26}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal |lasttitle=Leitch |initlanguage=IOW |titlejournal=Circumcision - a continuing enigmaCan Urol Assoc J |journallocation=Aust Paediatr J |date=19702007-11 |volume=61 |issue=4 |pagesarticle=59-65 |urlpage=https://www.cirp.org/library/general/leitch1/ |accessdatepages=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 ultra395-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>{{REFweb7 |url=http://wwweuropepmc.nytimes.comorg/2012article/03PMC/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritual.html?_r=02422979 |titlepubmedID=Baby’s Death Renews Debate Over a Circumcision Ritual18542825 |lastpubmedCID=Robbins |firstDOI=Liz |date=2012-03-0710.5489/cuaj.455 |accessdate=20192021-1011-1108

=== Death ===</blockquote> A study in * The [[Royal Dutch Medical Association]] (KNMG) (2010 estimated approximately 117 neonatal ) said: <blockquote>The official viewpoint of KNMG and other related medical/scientific organisations is that non-therapeutic circumcision-related deaths occur annually in the United States, about one out of every 77 male neonatal deathsminors is a violation of children’s rights to autonomy and physical integrity. Contrary to popular belief, more than suffocationcircumcision can cause complications – [[bleeding]], auto accidentsinfection, or even [[SIDSurethra]]l stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications.<ref name="Bollinger 2010">{{REFjournal |last=Bollinger |first=Dan |init=D |author-link=Dan Bollinger |last2=Boy's Health AdvisoryREFdocument |title=Lost Boys: An Estimate of U.S. CircumcisionNon-Related Infant Deaths |journal=Thymos: Journal therapeutic circumcision of Boyhood Studies |volume=4 |issue=1 |pages=78-90male minors |url=httphttps://www.mensstudiesdoctorsopposingcircumcision.comorg/wp-content/b64n267w47m333x0uploads/?p=7ebbd6b446d940cbbd4274c095754b12π=5 |quote= |pubmedID= |pubmedCID= |DOI=10.31492016/09/thy.0401.78 |date=2010knmg-04non-26 |accessdate=2019-10-12}}</ref><ref>{{REFweb |url=http://www.icgi.org/2010/04/infanttherapeutic-circumcision-causesof-100male-deathsminors-each27-year05-in-us2010.pdf |titlecontribution=Infant circumcision causes 100 deaths each year in US

|publisher=ICGIRoyal Dutch Medical Association |websiteformat=[[International Coalition for Genital Integrity]]PDF |date=2010-04-26 |accessdate=2021-11-08}}</ref> See also the list </blockquote> * The [[Royal Australasian College of Physicians]] (2010) said: <blockquote>Ethical and [[fatalitieshuman rights]].concerns have been raised regarding elective infant male == Forced circumcision ==because it is recognised that the foreskin has a functional role, the operation <!is non--=== United States military ===therapeutic and the infant 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 American soldiers serving complication rates of circumcision do not warrant routine infant circumcision in World War II were subjected Australia and New Zealand. However it is reasonable for parents to regular inspections weigh the benefits and risks of their genitals. If intact, circumcision and to make the soldiers risked being ordered decision whether or not to undergo immediate circumcisioncircumcise their sons.<refname="racp2010">{{REFbook |last=Schoen |first=Ed |init=E |author-link=Edgar J. Schoen |year=2005REFdocument |title=On Circumcisionof Infant Males |url=https://bookswww.racp.googleedu.deau//docs/default-source/advocacy-library/books?id=circumcision-of-infant-zUhdvSt7cgCmales.pdf |workcontribution= |editorlast=Dianne Yeakey |editionfirst= |volumepublisher=The Royal Australasian College of Physicians |chapterformat=PDF |pagesdate=722010-309-01 |location=Georgetown, Canada |publisher=RDR Books |isbnaccessdate=12021-15714311-123-3 |quote=For a critical view, see Sorrells, "The History of Circumcision," p. 333 |accessdate= |note=08}}</ref> This practice was discontinued at least six decades ago.--</blockquote>=== Non* The [[American Academy of Pediatrics]] (AAP) has not re-therapeutic affirmed its disastrous, failed 2012 Circumcision Policy Statement, which expired in 2017, so currently has no position on child circumcision of male children ===.

Human babies, because they are not yet in possession of language, are incapable of giving or refusing consent to be [[circumcised]]. The element of force has led some scholars to view the circumcision of baby boys as a category of forced circumcision.<ref>For example, Frederick M. Hodges, a medical * Medical historian, writes: "In the late 1970s, as the Americans were growing increasingly aware of the abuses of power rampant throughout the nation's social institutions, influential grass-roots movements protesting the forced circumcision of American children sprang up nationwide." F. Hodges, "A Short History," p. 31; see also [[Leonard B. Glick|GlickRobert Darby]], ''Marked in Your Flesh'', pp. 273-281.</ref> There are, however, physicians in the United States who argue strongly for non-therapeutic circumcision of newborn babies; and 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(2014) wrote simply://www.springerlink.com/content/h2150v731233m177/ |work=Male and Female Circumcision |editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |edition= |volume= |chapter=Section 5 |pages=259-71 |location=New York |publisher=Kluwer Academic/Plenum Publishers |isbn= |quote= |accessdate=2019-10-12 |note=ID 10.1007/978-0-585-39937-9_19}}</ref> Parental consent is required.<refblockquote>See, e.g., Shephard and Shephard, ''The Complete Guide'', p. 125.</ref> A statement published by the [[American Academy of Pediatrics]] in 1999 claimed that "parents should determine what is in the best interest of the child... It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in additions to the medical factors, when making a decision."<ref>Lannon and Bailey, "Circumcision Policy Statement," p. 691.</ref> however surrogate consent for non-therapeutic To avoid 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]]complications, the written consent of both parents is required, if a physician is to perform a non-therapeutic avoid circumcision of a child."<ref>{{REFjournal |last=Darby

|init=R |author-link=Robert Darby |etal=no |title=Re J (child's religious upbringing and To avoid circumcision complications, avoid circumcision) |trans-title= |language= |journal=Family Court ReportsCan Urol Assoc J |location= |date=20002014-08-14 |volume=18 |issue=7-8 |article= |page=231 |pages=307-14 |url=https://wwwcuaj.cirpca/index.orgphp/journal/libraryarticle/legalview/Re_J1709/1823 |archived= |quote= |pubmedID= |pubmedCID= |DOI=10.5489/2000cuaj.html1709 |accessdate=20192022-1012-1216}}</ref> </blockquote>* The [[Canadian Paediatric Society]] (The National Health Service does not provide non-therapeutic circumcision.CPS) (2015)said:

<blockquote>In recent yearsmost jurisdictions, legal writers in several English-speaking countries have been questioning the practice of acceding authority is limited only to interventions deemed to parental wishesbe medically necessary.<ref>See, e.g., [[Margaret A. Somerville|Somerville]], "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; [[Abbie Chessler|Chessler]]In cases in which medical necessity is not established or a proposed treatment is based on personal preference, "Justifying interventions should be deferred until the Unjustifiable"; Smith, "Male Circumcision."</ref> For example, critics have pointed out that, in the [[United States]], more than 1.3% of male neonatal deaths are attributable individual concerned is able to the complications of non-therapeutic circumcision surgerymake their own choices.<ref name="Bollinger 2010CPS2015"/>{{REFjournal |last=Sorokin |first=S. Todd |init=ST |author-link=Video |last2=Finlay |first2=JC |author2-link= |last3=Jeffries |first3=Is AL |author3-link= |etal=yes |title=Newborn male circumcision healthy? |journal=Paediatr Child Health |location= |date=2015-08 |volume=20 |issue=6 |pages=311-20The video ''Is Circumcision Healthy'' is recommended for parental viewing |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4578472/ |quote= |pubmedID=26435672 |pubmedCID=4578472<br><br> |DOI=10.1093/pch/20.6.311 |accessdate=2019-10-27}}<youtube/ref>D_3LQjZgdbQ</youtubeblockquote> * The [[Canadian Urological Association]] (CUA) considered the matter of circumcision and issued a statement in February 2018. The CUA concluded:

<blockquote>"Given the socioeconomic, educational status, and health demographics of our population, universal neonatal circumcision cannot be justified based on the current evidence available.<ref name="cua2018">{{REFjournal |last=Dave |first=DrSumit |init=S |author-link= |etal=yes |title=Canadian Urological Association guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants (abridged version) |journal=Can Urol Assoc J |location= |date=2018-02 |volume=12 |issue=2 |pages=18-28 |url=https://cuaj.ca/index. Christopher Guest discusses circumcisionphp/journal/article/view/5034/3470 |quote= |pubmedID= |pubmedCID= |DOI=<br> |accessdate=2021-11-09}}<youtube/ref>v=TQIp9f4krVQ</youtubeblockquote>==British family court opinion==The issue of non-therapeutic circumcision of male children came before the court in the case of ''[[Re B and G (children) (No 2) EWFC 3]] (2015)'' . In that case, Judge Sir James Munby ruled that circumcision of male children caused ''significant harm''. == Rights and ethics ==

===Plastibel The [[Rights situation on circumcision===|rights situation]] is discussed in a separate article.

{{UNI[[Image:Intact vs circumcised.JPG |thumbnail|right|Stanford University300px|SU}} has published a video of an actual non-therapeutic plastibell circumcision. The infant has received two injections of local anesthesia to deaden the dorsal nerves. The ventral nerves were not deadened so the infant still feels pain. One can his cries on the soundtrack.* [https://med.stanford.edu/newborns/professional-education/circumcision/plastibell-techniqueintact and circumcised human penis, side by side.html Plastibell Technique]]

===Gomco clamp The term "circumcision===" without a gender qualifier refers specifically to male circumcision. It means "to cut around," and it refers to the [[excision]] of the [[foreskin]] from the penis. The term is inaccurate and a euphemism because the operation actually cuts off or [[amputation| amputates]] the [[foreskin]], which in adults comprises about fifteen square inches of highly functional erogenous tissue.

'''Not Circumcision is most often performed in healthy males for the squeamish:''' This is a video of an actual circumcision with a Gomco clamp. The infant boy received two dorsal penile nerve block (DPNB) analgesic injections but they did not seem to work. * [https://www.reddit.com/r/Intactivism/comments/qbpzqr/trained_medical_professionals_restrain_infant_to/ Circumcision video] ==Recommendations of medical authorities==* [[George HillReligion and Culture| Hillreligious or cultural]] (2007) said:<blockquote>Male circumcision 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 harmful because it excises healthy tissue and permanently impairs beneficial physiological functionsso controversial. Male Opponents of circumcision also causes psychological problems that tend to perpetuate consider the cycle circumcision of abuse. Male circumcision is non-consenting minors to be unethical and a costly diversion of medical resources away from beneficial services. Male circumcision violates legal rights, [[human rights]]violation, and ethical standards. Finally, we must remember that males are the more vulnerable and sensitive of the two genders and, therefore, deserve the greater degree of protection from traumatic, invasive, injurious,and unnecessary surgery. For all of these reasons the non-therapeutic circumcision of boys should not be performed and the unless there is concrete [[genital integritymedical indication]] .=== Consent by surrogates ===Medical ethics has long recognized limitations on the power of all children should be respected and protectedconsent by surrogates.<ref name="hill2007">{{REFjournal |last=HillCommittee on Bioethics, American Academy of Pediatrics |firstetal=Georgeno |inittitle=GInformed consent, parental permission, and assent in pediatric practice |authortrans-linktitle=George Hill |titlelanguage=The case against circumcision |journal=Journal of Men's Health and GenderPediatrics |location= |date=20071995 |volume=495 |issue=32 |article= |page= |pages=318314-2317 |url=https://www.academiacirp.eduorg/library/ethics/8367383AAP/The_Case_Against_Circumcision |archived=

|pubmedID=7478854

|accessdate=20212023-05-3021}}</ref></blockquote>* Andrew E. MacNeiiy, Head, Division of Pediatric Urology, Department of Urological Sciences, {{UNI|University of British Columbia|UBC}}, Vancouver, BC, (2008) said:<blockquote>Newborn circumcision remains an area of controversy. Social, cultural, aesthetic and religious pressures form the most common reasons for non-therapeutic circumcision. Although penile cancer and UTIs are reduced compared with uncircumcised males, the incidence of such illness is so low that circumcision cannot be justified as prophylaxis. The role of the foreskin in [[HIV]] transmission in developed countries is unclear, and safe sexual practice remains the cornerstone of prevention. There remains a lack of knowledge regarding what constitutes the normal foreskin both among parents and among primary care providers. This lack of knowledge results in a burden of costs to our health care system in the form of unnecessary urological referrals, expansion of wait times and circumcisions. Routine circumcision of all infants is not justified from a health or cost-benefit perspective.<ref>{{REFjournal |last=MacNeily |first=Andrew |init= |author-link=Committee on Bioethics

|title=Routine circumcision: the opposing viewInformed Consent in Decision-Making in Pediatric Practice

|journal=Can Urol Assoc JPediatrics

|date=20072016-1108 |volume=1138 |issue=42

|page=e20161485 |pages=395-7 |url=httphttps://europepmcwatermark.silverchair.orgcom/article/PMC/2422979peds_20161485.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQM8zYHFd0Ylu9Annq_AgEQgIICT24ikc839aJMYOiypqC2G9f7_yKGAGkAekzzbCtck5TElALWVCGNoVSOaA6rDA_dOkQ_LyJnxYlZ88J9-uk15tvlIBbE82_aNyYfq5e9xmEfqD2vh374q3Naz57dxZaUbgxUkKX4PqsiLmYHLvVrr7bQK2MZuuUOKiQU8JZy7lLjkp-PjJO1U9cyIplTAgs_EdvgK8MWWoIsj-X-ZUDImAG63-rlj_qLsy5dYwytmxfCuVa47RdZseLSr2_bdDpwKAKGhq_Ly9rlHZeW_f7fYktVfF_sFTgcJziAlvEQmdyWIw0qf-hlO31Qb3sH6kDdcvHAbm7llY5xa34XLYIt8QR0YFIimgDGFliN4-ce2vjvvrwS85WeeNFhpn-Ywn4Qjpy06hPuLDL-MtI2Z3BZbBsKq4dp8qGu1q9GlXaKw193riTFG9G5bF5GCKmxmt0nCQTthrb_CcK2UhKjZwPekC9zkIUHPZ9BXJt0SM03F_g-GgqbE0hTYKMqNdJ3sHDQu2luFrJ9JEiMzxtP28gJoYh20d2APA0xrRbXBYsFdAlr50gb1BSAbNJhTyx-Kh3geoSHsAYMjPaG7cIbh0jd42pWCUx30vjlAGK8zXTuf7-31oi81CLbHTAJLuzK3NT4Whi17jVq1SbXsIXlWpKc_d-HujCvlb74rkZQ6RG9wkxW7gAKaDqtKv5zTOTMBD9vLVxgp8lDmVA8PFB59Bqd6w-fi86tW132oWQM-mTfwdIBXFbUFXkeTUC5RYyqJQIXAEwLJSRm1RX-LRbKRzgaRQ |archived= |quote= |pubmedID=1854282527456510

|DOI=10.54891542/cuajpeds.455 |accessdate=2021-11-08}}</ref></blockquote> * The [[Royal Dutch Medical Association]] (KNMG) (2010) said: <blockquote>The official viewpoint of KNMG and other related medical/scientific organisations is that non-therapeutic circumcision of male minors is a violation of children’s rights to autonomy and physical integrity. Contrary to popular belief, circumcision can cause complications – [[bleeding]], infection, [[urethra]]l stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications.<ref>{{REFdocument |title=Non-therapeutic circumcision of male minors |url=https://www.doctorsopposingcircumcision.org/wp-content/uploads/2016/09/knmg-non-therapeutic-circumcision-of-male-minors-27-05-2010.pdf |contribution= |last= |first= |publisher=Royal Dutch Medical Association1485

|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=20102016-08 |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=20212023-1105-0821

* The [[Royal Australasian College of Physicians]] Two ethicists, Myers & Earp (20102020) said: <blockquote>Ethical , have conducted a detailed review and analysis of the claimed medical benefits of ''non-therapeutic'' [[human rightscircumcision]] concerns . They have been raised regarding elective infant male circumcision because it is recognised that determined than the foreskin has alleged benefits are not material, so they do not support granting of consent by a functional rolesurrogate. In other words, the operation is non''Non-therapeutic and the infant '' circumcision is unable to consentnot truly healthcare.  After reviewing the currently available evidenceMoreover, they comment that even the RACP believes that most perfectly executed surgery produces [[trauma]] and harm to the frequency patient. Circumcision also produces tissue loss and loss of diseases modifiable by function, therefore, circumcision, should be performed only after the individual reaches the level age of protection offered consent. <u>Consent by a surrogate for a ''non-therapeutic'' circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand. However it a minor child is reasonable for parents to weigh the benefits and risks of circumcision and to make the decision whether or not to circumcise their sonsan unethical practice.</u><ref name="racp2010myers2020">{{REFdocument |title=Circumcision of Infant Males |url=https://www.racp.edu.au//docs/default-source/advocacy-library/circumcision-of-infant-males.pdf |contribution=REFjournal |last=Myers |first= |publisherinit=The Royal Australasian College of PhysiciansA |format=PDF |date=2010author-09-01 |accessdatelink=2021-11-08}}</ref></blockquote> * The [[American Academy of Pediatrics]] (AAP) has not re-affirmed its disastrous, failed 2012 Circumcision Policy Statement, which expired in 2017, so currently has no position on child circumcision. * Medical historian [[Robert Darby]] (2014) wrote simply:<blockquote>"To avoid circumcision complications, avoid circumcision."<ref>{{REFjournal |lastlast2=DarbyEarp |firstfirst2= |initinit2=RBD |authorauthor2-link=Robert DarbyBrian D. Earp |etal=no |title=To avoid circumcision complications, avoid circumcisionWhat is the best age to circumcise? A medical and ethical analysis |trans-title= |language= |journal=Can Urol Assoc JBiosoc Sci |location= |date=20142020-08-1409 |volume=834 |issue=7-8 |article= |page=231 |pages=560-72 |url=https://cuajonlinelibrary.ca/indexwiley.phpcom/journaldoi/articleabs/view10.1111/1709/1823bioe.12714

|pubmedID=32068898

|DOI=10.54891111/cuajbioe.1709 12714 |accessdate=20222023-1205-1618}}</ref> == Tipping point ==[[Intact America]] (2024) argues that public opinion regarding non-therapeutic [[circumcision]] of children is approaching or at a "tipping point" at which [[intact]] genitals would be preferred over the [[circumcised]] variety.<ref>{{REFweb |url=https://intactamerica.org/public-opinion-on-circumcision/ |title=Public Opinion on Circumcision: Can Intactivists Hit A Tipping Point? |last=Anonymous |first= |init= |publisher=Intact America |date=2024-03-23 |accessdate=2024-04-09

</blockquote>{{SEEALSO}}* The [[Canadian Paediatric SocietyAdolescent and adult circumcision]] (CPS) (2015) said:* [[Bodily harm]]<blockquote>In most jurisdictions, authority is limited only to interventions deemed to be medically necessary. In cases in which medical necessity is not established or a proposed treatment is based on personal preference, interventions should be deferred until the individual concerned is able to make their own choices.<ref name="CPS2015">{{REFjournal* [[Breastfeeding]] |last=Sorokin* [[Case Histories]] |first=S. Todd* [[Circumcision maps]] |init=ST* [[Circumcision methods]] |author-link=* [[Circumcision scar]] |last2=Finlay* [[Circumpendium]] |first2=JC* [[Circumstraint]] |author2-link=* [[Documented severe complications of circumcision]] |last3=Jeffries |first3=AL |author3* [[Ethics of non-link= |etal=yes |title=Newborn male therapeutic child circumcision]] |journal=Paediatr Child Health* [[FGM]] |location=* [[Human rights]] |date=2015-08* [[Lymphoedema]] |volume=20* [[MGM]] |issue=6* [[Pain]] |pages=311-20* [[Psychological issues of male circumcision]] |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4578472/* [[Rights situation on circumcision]] |quote=* [[Risks and complications]] |pubmedID=26435672* [[Sexual effects of circumcision]] |pubmedCID=4578472* [[Sudden Infant Death Syndrome]] (SIDS) |DOI=10.1093/pch/20.6.311 |accessdate=2019-10-27* [[Trauma]]{{LINKS}}</ref></blockquote>

* The [[Canadian Urological Association]] (CUA) considered the matter of {{REFweb |url=https://www.cirp.org/library/anatomy/garcia/ |title=What exactly is circumcision and issued a statement in February 2018. The CUA concluded:what is it not? |last=Garcia |first=Francisco<blockquote>"Given the socioeconomic, educational status, and health demographics of our population, universal neonatal circumcision cannot be justified based on the current evidence available.<ref name |date=1995-12-11 |accessdate="cua2018">2020-09-08}}* {{REFjournal |last=DaveFleiss |first=SumitPaul |init=SP |author-link= |etal=yesPaul M. Fleiss |title=Canadian Urological Association guideline on the care of the normal The foreskin and neonatal circumcision in Canadian infants (abridged version)is necessary |journal=Can Urol Assoc J |location=Mothering |date=20181997-0201 |volume=12 |issue=2 |pages=1836-2845 |url=httpshttp://cuajwww.canoharmm.org/indexmothering.phphtm |accessdate=2020-06-29}}*{{REFweb |url=https:/journal/article15square.org.uk/viewlosses-from-circumcision/5034/3470 |quotetitle=Losses from Circumcision |last=Ball |pubmedIDfirst=Peter |pubmedCIDpublisher=15 Square |DOIdate=2003-08-09 |accessdate=20212023-1102-0923}}<* {{REFweb |url=http://members.tranquility.net/ref><~rwinkel/blockquote>MGM/primer.html |title==British family court opinion==The issue of non-therapeutic circumcision of male children came before the court Male Circumcision in the case of ''[[Re B and G (children) (No 2) EWFC 3]] (2015)'' . In that case, Judge Sir James Munby ruled that circumcision of male children caused ''significant harm''. USA: A Human Rights Primer |last=Winkel |first= Rights and ethics =Rich |author-link=Rich Winkel The [[Rights situation on circumcision |rights situation]] is discussed in a separate article.date=2005-05-12 [[Image:Intact vs circumcised.JPG |thumbnail|right|300px| The intact and circumcised human penis, side by side.]]accessdate=2021-01-27 The term "circumcision" without a gender qualifier refers specifically to male circumcision. It means "to cut around," and it refers to the [[excision]] of the [[foreskin]] from the penis. The term is inaccurate and a euphemism because the operation actually cuts off or [[amputation| amputates]] the [[foreskin]], which in adults comprises about fifteen square inches of highly functional erogenous tissue. }}

Circumcision is most often performed in healthy males for [[Religion and Culture* {{REFjournal |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]].last=Testa |first=Patrick |init= |author-link= Consent by surrogates |last2=Block |first2=Walter E. |init2=Medical ethics has long recognized limitations on the power of consent by surrogates.<ref>{{REFjournal |lastauthor2-link=Committee on Bioethics, American Academy of Pediatrics

|title= Informed consent, parental permission, Libertarianism and assent in pediatric practicecircumcision

|journal=PediatricsInt J Health Poiicy Manag

|date=19952014-05-26 |volume=953 |issue=2

|pages=31433-1740 |url=https://www.cirpacademia.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/librarywhat-is-circumcision/ethics |title=What is circumcision? |last=Simone |first=Judy |author-link= |publisher=Intaction |website=https:/AAP/intaction.org/ |date=2020-07-26 |accessdate=2020-10-04 |archivedformat=

}}* {{REFjournal |pubmedIDlast=7478854Deacon |pubmedCIDfirst= |DOIinit=M |accessdateauthor-link= |last2=Muir |first2=2023-05-21}}</ref> <ref>{{REFjournal |init2=G |lastauthor2-link=Committee on Bioethics

|title=Informed Consent in DecisionWhat is the medical evidence on non-Making in Pediatric Practice therapeutic child circumcision?

|journal=PediatricsInt J Impot Res

|date=20162022-01-08 |volume=138 |issue=2

|page=e20161485

|url=https://watermarkwww.silverchairnature.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-HujCvlb74rkZQ6RG9wkxW7gAKaDqtKv5zTOTMBD9vLVxgp8lDmVA8PFB59Bqd6warticles/s41443-fi86tW132oWQM021-mTfwdIBXFbUFXkeTUC5RYyqJQIXAEwLJSRm1RX00502-LRbKRzgaRQy

|pubmedID=2745651034997197

|DOI=10.15421038/peds.2016s41443-021-00502-1485 |format=PDFy |accessdate=2023-0504-2130}}</ref> <ref>* {{REFjournal |last=Committee on Bioethics ||etal=no |title=Informed Consent in Decision-Making in Pediatric Practice |trans-title= |language= |journal=Pediatrics |location= |date=2016-08 |volume=138 |issue=2 |article= |page=e20161484 |pages=REFweb |url=https://watermarkintactamerica.silverchair.comorg/peds_20161484.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMYv3coRYpros-UCYMgTaqAgEQgIICT4di03qn2Hbho3i8Li_78lod0lNMunch25nx1rKvaM_aeFerz5eN6_k8VVeNvand-DLocZp28whQr1x4WYDVwSs4uF73vZpYZYuDphYQkwxV1HHgMbZAbHBFuE8QyCHyDvSYcons-fhQcUlof-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=10.1542circumcision/peds.2016-1484 |formattitle=PDF |accessdate=2023-05-21}}</ref> Two ethicists, Myers & Earp (2020), have conducted a detailed review Pros and analysis Cons 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 Circumcision (Spoiler: You’ve Been Lied 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=MyersGarrett

|init=ACJ |author-linkpublisher=Intact America |last2date=Earp |first2= |init2=BD |author22023-11-link=Brian D. Earp10 |etalaccessdate=no |title=What is the best age to circumcise? A medical and ethical analysis |trans2024-title= |language= |journal=J Biosoc Sci |location= |date=202003-0922 |volume=34}} |issue=7 |pages=560-72* {{REFweb |url=https://onlinelibraryintactamerica.wiley.comorg/doigroups-who-pressure-you-to-circumcise/abs/10.1111/bioe.12714 |archivedtitle=The 4 Authority Figures and Groups Who Will Pressure You to Circumcise (and What You Can Do) |quotelast=Anonymous |pubmedIDfirst=32068898 |pubmedCIDinit= |DOIpublisher=10.1111/bioe.12714Intact America |accessdatedate=20232024-0501-1824}}</ref> {{SEEALSO}}* [[Adolescent and adult circumcision]]* [[Breastfeeding]]* [[Case Histories]]* [[Circumcision maps]]* [[Circumcision methods]]* [[Circumcision scar]]* [[Circumpendium]]* [[Circumstraint]]* [[Documented severe complications of circumcision]]* [[Ethics of non |accessdate=2024-01-therapeutic child circumcision]]* [[FGM]]* [[Human rights]]* [[Lymphoedema]]* [[MGM]]* [[Pain]]* [[Psychological issues of male circumcision]]* [[Rights situation on circumcision]]27* [[Risks and complications]]* [[Sexual effects of circumcision]]* [[Sudden Infant Death Syndrome]] (SIDS)* [[Trauma]]{{LINKS}} 

|url=https://www.cirpintactamerica.org/library/anatomy/garciakeeping-your-sons-penis-intact/ |title=What exactly is circumcision and what is it not?Keeping Your Son’s Penis Intact: A Guide for Parents |last=GarciaAnonymous |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 |journalpublisher=MotheringIntact America |date=19972024-01 |volume= |issue= |pages=36-45 |url=http://www.noharmm.org/mothering.htm24 |accessdate=20202024-0601-29}}*{{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

|url=httphttps://membersintactamerica.tranquility.netorg/~rwinkel/MGMtimeline-of-circumcision-suffering/primer.html |title=Male A Timeline of Circumcision in the USASuffering: A Human Rights Primer |last=Winkel |first=Rich |author-link=Rich Winkel |date=2005-05-12 |accessdate=2021-01-27}} * {{REFjournalDetailed Look |last=TestaAnonymous |first=Patrick |init= |author-link= |last2=Block |first2=Walter E. |init2= |author2-link= |etal=no |title=Libertarianism and circumcision |trans-title= |language= |journal=Int J Health Poiicy Manag |locationpublisher=Intact America |date=20142024-0502-2602 |volumeaccessdate=3 |issue= |article= |page= |pages=332024-40 |url=https://www.academia.edu/7587653/Libertarianism_and_Circumcision?email_work_card=view02-paper |pubmedID=24987720 |pubmedCID=4075101 |DOI=10.15171/ijhpm.2014.51 |accessdate=09