Changes

{{Construction SiteGraphicWarning}}"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.

"Male '''circumcisionPosthectomy''' (from Latin is the more accurate medical term that more accurately reflects the injury and loss of functional body tissue, but the Biblical [[euphemism]], ''circumciderecircumcision'', meaning "is more commonly used.With reference to cut around") is the surgical removal involuntary, non-therapeutic circumcision of the children, [[foreskinChild Genital Cutting (CGC)]] is a newer term that has been introduced to avoid issues associated with more traditional terms. Bollinger (prepuce2023) from the human identifed CGC as an [[penisAdverse Childhood Experiences (ACEs)| adverse childhood experience]]. [...] The procedure is most often an elective surgery performed on neonates and children for religious and cultural reasons, but in other cases may be indicated for both therapeutic and prophylactic reasons. <ref name="bollinger2023">{{REFjournal |last=Bollinger |init=D |author-link=Dan Bollinger |last2= |init2= |author2-link= It is a treatment option for pathological phimosis, refractory balanoposthitis and chronic urinary tract infections (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health." (Source: [http|url=https://en.wikipediakindredmedia.org/wiki2023/02/adverse-childhood-experiences-dysfunctional-households-and-circumcision/ |title=Adverse Childhood Experiences, Dysfunctional Households, And Circumcision Wikipedia]). |journal=Kindred |date=2023-02-28 |volume= |issue= |pages= |accessdate=2023-03-01}}</ref>

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.

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

Apart from [[Image:Circumcision Sakkara 3.jpg|200px|right]] For the [[Aborigines]], the [[Australia| Australian]] natives, the medical indication tradition of pathological phimosiscircumcision is said to go back to 10,000 BC. On the African continent, there also the first circumcisions are other reasons for assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of circumcisiondate 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 the 6th dynasty, approximately 2300-2000 BC. It is not known precisely who was circumcised and why in those times.

Since this modification and its possible late effects will be In [[Judaism]], the lifelong burden tradition of the person who undertakes an aesthetically motivated [[Brit Milah| circumcision ]] goes back to suit his personal preferences, the [[Abrahamic covenant]] in a valid decision to proceed can only be made by passage in the person Book of Genesis (17:10-14). It was seen as a covenant between God and man, dating back to be circumcised himself, once he has reached the necessary age and level patriarch Abraham. The validity of maturity to make that decision. This should normally be the case when adulthood this passage is reachedincreasingly 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= Moral reasons ===Gen 17, 10-14, NIV}}

With According to the anthropologist and sociologist Rabbi Nissan Rubin, the [[foreskinJewish circumcision| Jewish form of circumcision]], called ''[[Brit Milah| brit mila]]'', circumcision removes approximately 70% of during the sensitive tissue of first two millennia did not include the later customary ''[[penisperiah]]'', lowering the potential for sexual stimulation accordingly. Due to namely the loss of around 50% complete scraping of the entire penile skin, inner [[foreskin]] from the [[Glans penis|glans]] loses . This was only added around 135 AD, to make it almost impossible to restore the reserve skin that provides cutaneous mobility [[foreskin]] by [[stretching]], which became popular in the erect wake of Hellenic influence. While originally only the tip of the [[penisforeskin]] was cut off, ''[[periah]] and '' removes the entire [[gliding actionforeskin]].

In the pastGreek society of the day, this circumstance a denuded [[Glans penis|glans]] was used to make it harder for boys to masturbate, as masturbation was viewed as immoral considered obscene and was assumed to cause a variety of diseasesrisible. More on that can be found in In ultra-orthodox communities, circumcision is followed by the chapter "''[[Circumcision#Historical_background|Historical backgroundmohel]]"'', the ritual circumciser, sucking blood from the wound with his mouth. TodayThis practice is highly controversial, as it is known that masturbation has no negative health effects, but can contribute positively to the child's sexual developmentresult in an [[infection]] with [[herpes]] simplex type 1. Sexuality is no longer a taboo nowadaysIn New York City, between 2000 and 2011 eleven children were infected with [[herpes]], while masturbation is considered 10 of whom had to be a natural part treated in hospital. Two of human sexuality and is no longer seen as immoralthem suffered permanent brain damage, two others died. ThereforeIn 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 moral reasons - which would only affect boys too young to give informed consent - is no longer justifiable nowadaysmere reproduction.

=== Hygiene reasons 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 |first= |publisher=NASB |website=Bible Gateway |date= |accessdate=2019-11-10 |format= |quote=And when eight days had passed, before His circumcision, His name was then called Jesus, the name given by the angel before He was conceived in the womb.}}</ref>

A common reason stated for circumcision is the assumption of hygienic benefits. This argument has The first Christians had been born Jewish, so a question arose whether one must be [[circumcised]] to be viewed a Christian. When Christian leaders met at the [[Council at Jerusalem]] in the context of First Century to decide what was required to be a Christian, a letter was written to explain the environment requirements, but circumcision was omitted from the person in question grows up inrequirements.<ref>{{REFweb |url=https://www. It is commonly known that bad hygienic circumstances, especially insufficient access to clean drinking water, pose a serious problembiblegateway. The situation in disaster areas or refugee camps in the socom/passage/?search=Acts+15%3A1-30&version=NASB |title=Acts 15:1-30 |last=Luke |first= |accessdate=2019-11-called third world keep reminding us of that.10}}</ref>

In western industrial nations, however, this problem does not existChristianity, circumcision is practiced only in view of the availability of clean water for daily personal hygieneCoptic denomination. If the cleaning of the genitals There is no general belief that circumcision is performed on a daily basis requirement of Christianity.<ref name="hill2004">{{REFweb |url=https://www.cirp.org/pages/cultural/christian.php |title=The Holy Bible, Circumcision, False Prophets, and Christian Parents |last=Hill |first=George |author-link=George Hill |publisher=Circumcision Reference Library |website= |date=2004- and that may be assumed 08- no pathogens can accumulate under the [[foreskin]]. Cleaning of the [[Glans penis29 |glans]] and the area underneath the [[foreskin]] is easy accessdate=2019-11- they are simply washed along with the rest 10 |format=HTML |quote=The falseness of those who advocate circumcision is a recurrent theme in the body, just like the areas between the toesNew Testament.}}</ref>

Nevertheless, Christian moral notions had decisive influence on the spread of this practice. In small boys, where the [[foreskin]] cannot be retracted yetpuritan influenced USA, cleaning is not necessary, since circumcision of children was popular in the membrane that fuses the [[foreskin]] 19th century as a means to the prevent [[Glans penis|glansmasturbation]] prevents the accumulation of micro-organisms. The In those days, this so-called "ballooning"‘self-abuse‘ was not only considered immoral, where but was supposedly responsible for a variety of diseases. Masturbation, however, is not mentioned anywhere in the [[foreskin]] inflates during urinationHoly Bible, so there is not a serious problemno support for the belief that it is somehow immoral or sinful.

The opening Even the mere existence of the a [[foreskin]] in small boys is often quite narrow and serves as a was falsoly linked to many illnesses. Among them one-way valvecould find syphilis, epilepsy, allowing paralysis of the urine to flow outspine, bed wetting, scoliosis (spinal deformity), but preventing entry paralysis of microbesthe bladder, club foot, nerve pain in the lower abdomen, for example from a dirty diapertuberculosis and lazy eye. As long as One of the best known advocates of child is able to pass watercircumcision was [[John Harvey Kellogg]], everything works as nature intendedco-inventor of the corn flakes bearing his name.In 1888, he wrote:

But even {{Citation |Text=A remedy which is almost always successful in areas where small boys is circumcision, especially when there are poorer hygienic conditions and an insufficient access to medical care, the benefits is any degree of easier cleaning of a circumcised [[penisphimosis]] are to . The operation should be viewed with performed by a critical eye. Although even longer periods surgeon without personal hygiene administering an anaesthetic, as the brief pain attending the operation will not result have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in an accumulation some cases. In females, the author has found the application of germs under pure carbolic acid to the [[foreskinclitoris]], circumcision itself is not without risk an excellent means of complications. If allaying the operation is carried out without proper sterilityabnormal excitement, there is a high risk of an infection and preventing the recurrence of the woundpractice in those whose will-power has become so weakened that the patient is unable to exercise entire self-control. |Author=[[John Harvey Kellogg]] |Source= |ref=<ref>{{REFbook |last=Kellogg |first=John Harvey |init=JH |author-link=John Harvey Kellogg |url=https://archive. This also applies to the treatment of common complications like postorg/details/plainfaorold00kell/page/290 |chapter=Treatment for Self-operative bleedingabuse and Its Effects |title=Plain Facts for Old and Young |location=Burlington, Iowa |publisher=F. Segner & Co. |year=1888 |page=107}}</ref>}}

The benefit ===Islam===In [[Islam]], circumcision is also religiously founded, even though there is no mention of easier cleaning must be balanced against it in the Koran itself. According to tradition, the Prophet Mohammed was born without a [[foreskin]]. It is seen as a sign of prophets that they are born without a [[foreskin]] already. It is considered an honour to "resemble the risk example of promoting serious infections - among others HIV - during the operationProphet", meaning to be [[circumcised]]. In parts of AfricaIslam, unlike [[Judaism]], several dozen of one tribe's boys die each year as a result of their there is no specific age at which the circumcisionshould be performed. Most circumcisions take place at ages between 6 and 10 years, but the range goes from birth to adulthood.

* [[Phimosis]]: Many cultures perform circumcision as mentioned earlier, true [[phimosis]] is rare and can be treated effectively without surgery. According to a study by Blalock et.al. (2003)<ref>Blalock HJ, Vemulakonda V, Ritchey ML, Ribbeck M. Outpatient management of [[phimosis]] Following newborn circumcision. ''J Urol'' 2003;169(6):2332-4.</ref>, 2.9% of those circumcised develop a post-operative [[phimosis]], in which the circumcision scar constricts. In intact patients, the rate of [[phimosis]] is only 1% (see also the study by Jakob Øster above). Therefore, circumcision is not a preventive measure for [[phimosis]].* Sexually Transmitted Diseases (STDs): a vast number of studies has been conducted on the subject of transmission of STDs.* First, it has to be noted that any form rite of protection against these diseases only affects people who are sexually active. Circumcision in childhood cannot be justified on these grounds, since any assumed protective effect will not occur before the boy is already old enough to decide about circumcision for himself.* As mentioned above, the [[foreskin]] keeps the [[Glans penis|glans]] moistpassage into manhood. This subpreputial moisture contains, among other substances, the enzyme lysozyme, which breaks up the cell wall of bacteria, thereby providing a natural antibacterial screen. This explains the results of several studies, such as Laumann et.al.<ref>Laumann EO, Masi CM, Zuckerman EW. Circumcision in the United States: prevalence, prophylactic effects, and sexual practice. ''JAMA'' 1997;277:1052-7.</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<ref>Fleiss PM, Hodges FM, Van Howe RS. Immunological functions of the human prepuce. ''Sex Transm Inf'' 1998;74:364-7.</ref> support this. 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>Task Force on Circumcision. Circumcision policy statement. ''Pediatrics'' 1999;103(3):686-93.</ref>* HIV / AIDS: in the recent past, the argument that circumcision could help to contain the spread of HIV has been stated numerous times.*:First, two notes: for one, the use of condoms is still by far the most effective protection against an infection. During intercourse with that preventive measure, circumcision status does not make a difference.*:Secondly, the assumed protection would only affect healthy men who have intercourse with an infected woman. An infected man can infect a women by transmission of his bodily fluids, so that his circumcision status is irrelevant. Therefore, the use of condoms remains vital in containing the spread of HIV, which in return renders circumcision unnecessary* Due to the inevitable loss of sensitivity as a result of circumcision, there is also the temptation to go without condoms, in order not to lose even more sensitivity.<ref>Hooykaas C, van der Velde FW, van der Linden MM. et al. The importance of ethnicity as a risk factor for STDs and sexual behaviour among heterosexuals. ''Genitourin Med'' 1991; 67(5): 378-83.</ref><ref>Michael RT, Wadsworth J, Feinleib J, ''et al''. Private sexual behavior, public opinion, and public health policy related to sexually transmitted diseases: a US-British comparison. ''Am J Public Health'' 1998;88(5):749-54.</ref><ref>Laumann EO, Masi CM, Zuckerman EW. Circumcision common in the United States: prevalence, prophylactic effects, and sexual practice. ''JAMA'' 1997;277:1052-7.</ref>* Two studies that have been published in early 2007<ref>Gray RH Middle East and colleagues. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007:369;657-666.</ref><ref>[[Robert C. Bailey|Bailey RC]] and colleagues. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. ''Lancet''. 2007:369;643-656.</ref>, which investigated the effectiveness of circumcision as a means of reducing the spread of HIV from infected women to heterosexual men in amongst some indigenous African high risk areas, have been repeatedly subjected to strong criticism. Both studies were ended prematurely, which distorted the results. The men who had been circumcised for the study had to stay sexually inactive during the wound healing, which gave the intact control group more relative opportunity to become infected. The fact that the USA has both the highest rate 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>Grosskurth H, Mosha F, Todd J, et al. A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results. ''AIDS'' 1995;9(8):927-34.</ref><ref>Barongo LR, Borgdorff MW, Mosha FF, ''et al''. The epidemiology of HIV-1 infection in urban areas, roadside settlements and rural villages in Mwanza Region, Tanzania. ''AIDS'' 1992;6(12):1521-8.</ref><ref>Changedia SM, Gilada IS. Role of male circumcision in HIV transmission insignificant in conjugal relationship (abstract no. ThPeC7420). Presented at the Fourteenth International AIDS Conference, Barcelona, Spain, July 7-12, 2002.</ref><ref>Connolly CA, Shishana O, Simbayi L, Colvin M. HIV and circumcision in South Africa (Abstract No. MoPeC3491). Presented at the 15th International AIDS Conference, Bangkok, Thailand, July 11-16, 2004.</ref><ref>Thomas AG, Bakhireva LN, Brodine SK, Shaffer RA. Prevalence of male circumcision and its association with HIV and sexually transmitted infections in a U.S. navy population (Abstract no. TuPeC4861). Presented at the 15th International AIDS Conference, Bangkok, Thailand, July 11-16, 2004.</ref>* Urinary tract infections (UTI): a UTI can be effectively treated with antibiotics, this was also proven by studies<ref>McCracken G. Options in antimicrobial management of urinary tract infections in infants and children. ''Pediatr Infect Dis J'' 1989;8(8):552–55.</ref><ref>Larcombe J. Urinary tract infection in children. ''BMJ'' 1999;319:1173–5.</ref>. A Swedish study <ref>Mårild S, Jodal U. Incidence rate of first–time symptomatic urinary tract infection in children under 6 years of age. ''Acta Paediatr'' 1998;87(5):549–52.</ref> found that, during the first 6 years of life, the incidence of UTIs 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>Mueller ER, Steinhardt, G., Naseer S. The incidence of genitourinary abnormalities in circumcised and uncircumcised boys presenting with an initial urinary tract infection by 6 months of age. ''Pediatrics'' 1997;100 (Supplement): 580.</ref> did not find a significant difference in UTI rates between circumcised and intact boys with normal urinary tract anatomy.* Other studies suggest that circumcision is more likely to raise than to lower the generally low risk of acquiring UTI: multiple studies from Israel showed a strong correlation between ritual circumcision on the 8th day of life and postoperative UTI.<ref>Menahem S. Complications arising from ritual circumcision: pathogenesis and possible prevention. ''Isr J Med Sci'' 1981;17(1):45–8.</ref><ref>Cohen HA, Drucker MM, Vainer S, et al. Postcircumcision urinary tract infection. Clin Pediatr 1992;31(6):322–4.</ref><ref>Goldman M, Barr J, Bistritzer T, Aladjem M. Urinary tract infection following ritual Jewish circumcision ''Isr J Med Sci'' 1996;32:1098–102.</ref>* It can be concluded that circumcision is ineffective as a preventive measure against UTIs.* Penile and cervical cancer / HPV: first studies on those diseases and their assumed prevention by circumcision date back to 1932, a time when the cause for those illnesses was not yet fully understood<ref>Wolbarst A. Circumcision and penile cancer. ''Lancet'' 1932;1(5655):150–53.</ref>. Today, it is known that sexually transmitted human papillomavirus (HPV) is a major risk factor<ref>McCance DJ, Kalache A, Ashdown K, ''et al''. Human papillomavirus types 16 and 18 in carcinomas of the penis from Brazil. ''Int J Cancer'' 1986;37(1):55–9.</ref>, as well as smoking<ref>Harish K, Ravi R. The role of tobacco in penile carcinoma. ''Brit J Urol'' 1995;75(3):375–7.</ref>. Studies have shown that there is no significant difference in the risk of getting penile cancer between circumcised and intact men. To prevent a single case of penile cancer, it would statistically take 600 to 900 circumcisions<ref>American Academy of Family Physicians. Position Paper on Neonatal Circumcision. Leawood, Kansas, (February 14, 2002).</ref>. The influence of circumcision on the infection risk of the female partner with cervical cancer has been refuted several times as well. HPV vaccination is an effective measure against carcinoma of the cervixSoutheast Asian peoples.

In conclusionThe [[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 does not provide any proven benefits in preventive medicine]].

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

During circumcision, the === Medical indication ===There are no [[foreskinmedical indication| medical indications]] for circumcision of the newborn. The [[peniscircumcision industry]] is partly or completely removed. The exact amount and type offers circumcision of skin removed depends on the style and technique used, and therefore also on newborn to the public because of the tools being used[[financial incentive]].

=== FirstThe form of circumcision adopted by the medical community essentially was equivalent to the Jewish form with ''[[periah]]'', a look on so it inflicted the common styles: ===maximum injury.

==== High & Tight<ref>deIn a few cases with older patients, circumcision is legitimately indicated; a patient may be suffering recurring infections, and other methods of treatment have failed.Wikipedia user Tinoel</ref> ====In other cases, a patient may be suffering from a severe case of [[Image:Penis_unlabeled.jpg|200px|centerphimosis]]This style . Overall, the actual medical necessity for circumcision is extremely rare since many conditions respond to conservative treatment. All circumcisions injure the most common in the USA. In this style, patient by amputating the outer [[foreskin]]its with many protective, immunological, sensory, parts of the inner and sexual [[foreskinForeskin#Physiological_functions| functions]] and parts of the shaft skin are removed.

The remaining part of the inner [[# '''Deformed or malformed foreskin]] is folded back and sewed to the shaft skin'''. The scar is located closer to the body, hence the term "high"A foreskin so deformed or malformed that it does not function properly may be removed by circumcision.

The inner [[# '''Traumatically injured foreskin]], which originally faced inwards lying on the [[Glans penis|glans]], now faces outward; this causes the differently coloured section between [[Glans penis|glans]] and shaft skin which '''. A foreskin so traumatically damaged foreskin that cannot be surgically repaired is characteristic a valid medical reason for this stylecircumcision.

Of all styles, the tight ones remove the most skin# '''Diseased foreskin. They already limit the mobility of the penile skin to a great extent when the [[penis]] ''' A foreskin that is flaccid, and during an erection the skin diseased is fully stretched and immobile. An insufficient amount of reserve skin can hamper a complete erection and lead to painful tensionvalid indication for cirumcision. AlsoSome diseases that qualify are malignancy, lichen sclerosis, a skewed [[penisBalanitis#Diabetic_males| yeast infection in men with diabetes]] can occur due to an uneven distribution of the remaining skin, often caused by an inaccurately placed cut or a uneven growth during wound healing. Due to the extensive shortening of the inner and recurrent [[foreskinbalanoposthitis]], this style also means the loss of large amounts of sensitive tissue.

==== Low & Tight<ref>David-matthias http://commons.wikimedia.org/wiki/File:Beschneidungsstile,_Styles_of_Circumcision.jpg</ref> ====[[Image:Low_and_tight.jpg|200px|center]]In this stylesuch cases, both the inner and outer [[benefit of removing the problem foreskin]] are completely removed. The shaft skin is sewed just below may exceed the rim maleficial harms of the [[Glans penis|glans]]. The scar is located close the [[Glans penis|glans]], hence the term "low"tissue and function destruction.

This style is ====Arguments of prophylaxia====Though the most radicalpractice of ritual circumcision of males, both consenting and non-consenting, has existed for millenia, as it removes the entire sensitive tissue search for "potential medical benefits" began relatively recently. {''Potential'' means to exist in possibility, but not in actuality, so a "''potential'' benefit" is not a genuine proven benefit.) The discussion of circumcision in the [[foreskin]]. As in Ninth Edition of the high & tight style, large amounts ''Encyclopǽdia Britannica'' (1876) made no mention of skin are removed. In a flaccid stateany prophylactic, the skin is barely movablemedical, and in an erect state it is totally immobileor therapeutic value or function.<ref>{{REFweb |url=https://www.cirp.org/library/history/encyclopaediabritannica1876/ |title=Circumcision |last=Cheyne |first=T. K. |author-link= |publisher=Encyclopǽdia Brittanica |website=Circumcision Reference Library |date=1876 |accessdate=2019-11-10 |format= |quote=}}</ref>

An insufficient amount of reserve skin can hamper an erection and lead Initially, circumcision was adopted in the 19th century as a way to painful tension stop boys and a skewed men from masturbating, when [[penismasturbation]] in this style as wellwas claimed to be the cause for many diseases. As the myth that circumcision prevented masturbation became debunked, advocates of circumcision began the great search to find the "medical benefits" of circumcision.

Male and female circumcision involves the removal and disruption of normal anatomical structures that are primary areas of sexual sensation.<ref name="taylor1996"/> In the past, some advocates of mass circumcision have considered the [[prepuce]] to be a "mistake of nature,"<!--{{Cold and Wiswell (1995)}} | [[Template:Cold and Wiswell (1995)|see more]]--> but this notion has no validity because the prepuce is ubiquitous in primates and because it provides functional advantages.<ref name="cold-mcgrath1995">{{REFbook |last=Cold |first=Christopher |init=C |last2= High & Loose<ref>DavidMcGrath |first2=Kenneth |init2=K |author2-matthias httplink=Ken McGrath |year=1999 |title=Male and female circumcision: medical, legal, and ethical considerations in pediatric practice |url=https://commonswww.wikimediacirp.org/wikilibrary/anatomy/File:Beschneidungsstile,_Styles_of_Circumcision.jpg<cold-mcgrath/ref> |work= |editor= |edition= |volume=[[image:High_and_loose.jpg |200px|center]]The outer foreskin is completely removed, as well as parts chapter=Anatomy and histology of the shaft skin. The inner foreskin is folded back penile and sewed to the shaft skin. The scar is located towards the body, hence the term "high". Unlike the high & tight style, the inner [[foreskin]] is less reduced, and lies clitoral prepuce in folds behind the [[Glans penisprimates |pages= |location=New York |publisher= |isbn=0306461315 |quote= |accessdate=2019-10-12 |glans]].note=}}</ref>

There is enough remaining reserve skin All claims that circumcision prevents future disease are false.<ref>{{REFweb |url=https://www.doctorsopposingcircumcision.org/for-professionals/alleged-medical-benefits/conclusions-and-references/ |title=Conclusions |last=Anonymous |first= |init= |publisher=Doctors Opposing Circumcision |date=2016 |accessdate=2023-10-22}}</ref> They are made to ensure enable a complete physician to perform circumcision and unhindered erection. Of all variants, this one removes the smallest amount of sensitive tissuecollect a fee.<!--===Search for prophylactic reasons===

The practice of finding prophylactic reasons for infant circumcision started in Germany in the nineteenth century, when non-Jewish Germans criticized the Jewish practice of infant circumcision as being barbaric, Jewish doctors sprang to the defense of the religious practice by claiming health benefits.<ref name="ephron2001">{{REFbook |last=Ephron |first=John M. |init= Low & Loose<ref>DavidJM |author-matthias httplink= |year=2001 |title=Medicine and the German Jews |url=https://commonswww.wikimediacirp.org/wikilibrary/File:Beschneidungsstile,_Styles_of_Circumcision.jpg<history/ephron1/ref> |work= |editor= |edition= |volume= |chapter=6 |pages=222-33 |location=New Haven[[image:Low_and_loose.jpg |publisher={{UNI|200pxYale University|center]]Yale}} PressThe inner [[foreskin]] is removed, the outer [[foreskin]] is sewed on below the [[Glans penis |isbn=0-300-08377-7 |quote= |glans]]. The scar is therefore located close to the [[Glans penisaccessdate=2019-11-20 |glans]], hence note=}}</ref> And so started the term "low". The outer [[foreskin]] lies in folds behind the [[Glans penis|glans]]. Enough skin is left in place to ensure a complete long tradition of Jewish doctors inventing reasons for circumcision (and unhindered erectiondeceving gentile doctors).

Since, in contrast to Following the high & loose style, the inner instead of the outer [[foreskin]] is removed, this style results in the loss discovery of almost all bacteria as a cause of many diseases – such as tuberculosis – the sensitive tissuesearch began for other illnesses that could be prevented by circumcision.

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

Over time, a vast variety of methods has been developed to remove In the 1920s it was penile cancer. [[foreskinAbraham L. Wolbarst]](1926) claims that circumcision can prevent penile cancer. A multitude of clamps and tools is available to ease the work of the circumciser, to improve the chance for visually symmetrical results and to prevent injuries to the [[Glans penis<ref name="wolbarst1926">{{REFjournal |last=Wolbarst |glans]] from inexpert cutsfirst=Abraham L. I will introduce some of the most widely spread variants |init=AL |author-link=Abraham L.Wolbarst |title=Is circumcision a prophylactic against penis cancer? |journal=Cancer |date=Jul 1926 |volume=3 |issue=4 |pages=301-10}}</ref>

In the 1940s, prostate and tongue cancer as well as STDs. [[Eugene H. Hand]] (1949) falsely explains that circumcision somehow protects against venereal diseases and tongue cancer.<ref name="hand1949">{{REFjournal |last=Hand |first=Eugene H. |init= FreehandEH |author-techniques link=Eugene H. Hand |url=https://pubmed.ncbi.nlm.nih.gov/18135844/ |title=Circumcision and venereal disease |journal=Archives of Dermatology and Syphilology[[File:Circumpendium |date=1949-6-2-1.jpg09 |volume=60 |issue=3 |centerpages341-6 |thumb]]pubmedID=18135844The oldest method of removing the [[foreskin]] uses just a few instruments |DOI=10. In the simplest case, the [[foreskin]] is pulled out with a cord, a knife is placed directly above the [[Glans penis|glans]], and the skin finally cut with a hit on the blunt edge of the knife1001/archderm. No stitches are placed and the skin is left to grow together naturally1949.01530030037004 |accessdate=2021-10-08}}</ref>

[[File:Circumpendium-6-2-1-b.jpg||center|thumb]]In modern operating theatres the 1950s it was cervical cancer. [[foreskinAbraham Ravich]] is first grasped with forceps, pulled out and clamped above (1951) invents the [[Glans penis|glans]] for a while to reduce bleeding. Next, the skin is cut along the forceps with a scalpel. Following myth that, the remaining skin is manually trimmed according to circumcision reduces the desired style and finally suturedrisk of women getting cervical cancer.<ref name="ravich1951">{{Ravich1951}}</ref>

In the late 1960s it was neuroses. [[File:Circumpendium-6-2-1-c.jpg||center|thumbMorris Fishbein]]Completely freehand techniques are also common. The penile skin is first cut in two places along the circumference(1969) calls for circumcision to prevent nervousness and, in the area of the shaft skin and course, [[foreskinmasturbation]]. After that the skin area between the cuts is removed and the remaining skin sutured.<ref>{{Fishbein1969}}</ref>

Also among In the freehand techniques are the shield variants1970s bladder- and rectal cancer. [[Abraham Ravich]] (1971) claims that circumcision would prevent bladder cancer and rectal cancer.<ref>{{Ravich1971}}</ref>

[[File:Circumpendium-6-2-1-Jewish-clamp.jpg||center|thumb|Jewish clamp]]In ritual Jewish circumcision the 1980s, UTIs. [[foreskinThomas E. Wiswell]] in inserted into the slit of the shield (left1985) and then cut on claims that circumcision, using a methodologically flawed report, reduces the upper side risk of the shieldurinary tract infections.<ref name="wiswell1985">{{REFjournal |last=Wiswell |first=Thomas E. |init=TE |author-link=Thomas E. Wiswell |url=https://pediatrics.aappublications.org/content/75/5/901 |title=Decreased incidence of urinary tract infections in circumcised male infants |journal=Pediatrics |date=May 1985 |volume=75 |issue=5 |pages=901-3 |accessdate=2019-10-12}}</ref>

[[File:Circumpendium-6-2-1-Mogen-clampAaron J.jpg||center|thumb|Mogen-clampFink]]The Mogen-Clamp works in a similar way (middle1986), with the difference no evidence whatsoever, claims that it is locked shut after the circumcision protects against [[foreskinAIDS]] is inserted, thus clamping itfollowed.<ref name="fink1986">{{REFjournal |last=Fink |first=Aaron J. |init=AJ |author-link=Aaron J. After a few minutes the [[foreskin]] is cut in the same fashion as Fink |title=A possible explanation for heterosexual male infection with the simple shieldAIDS |journal=New England Journal of Medicine |date=1986-10-30 |volume=31 |issue=18 |page=1167 |url=https://www.nejm.org/doi/full/10. The clamping is meant to reduce or prevent bleeding from the wound1056/NEJM198610303151818 |DOI=10.1056/NEJM198610303151818 |accessdate=2019-11-20}}</ref>

Retrospectively, circumcision was always advertised as a cure for whatever disease was in the public spotlight at the time. [[File:Circumpendium-6-2-1-Sheldon-clampDoctors Opposing Circumcision (D.O.C.jpg||center|thumb|Sheldon-Clamp)]]The Sheldon-Clamp (right2016) works in a similar way. The inner clamp grasps state:<blockquote>These claims date originally from before the tip advent of evidence-based medicine, when doctors relied on the [[foreskin]]opinions of other clinicians to inform their practice, pulling it into the outer clamp which is closedrather than on scientifically collected evidence.<ref name="doc2016">{{REFweb |url=https://www. The outer clamp then grips the skindoctorsopposingcircumcision. After a few minutes of pressure, the org/for-professionals/alleged-medical-benefits/ |title=Alleged Medical Benefits |publisher=[[foreskinDoctors Opposing Circumcision (D.O.C.)]] is cut between the two clamps. |website= |date=2016-05 |accessdate=2019-11-20 |format= |quote=}}</ref></blockquote>

The use sheer mass of a shield, rather than forceps, is meant to provide a better protection of the [[Glans penis|glans]] from cutting injuries. However, if used improperly both the Mogen studies and the Sheldon clamp publications that were released during those almost 180 years on this topic are subject to the risk of the tip of the [[Glans penis|glans]] being accidentally clamped reason that even arguments that have been disproved multiple times, especially regarding infant and being cut into or severedchild circumcision, tenaciously persist up until today.

==== Complex clamps ====[[File:CircumpendiumAn ever-6-2-2-Gomco-clamp.jpg|center|thumb|Gomco clamp]]One recurring element of the most widely used clamps in the USA is the Gomco clamp. First, a cut is placed into the [[foreskin]], then the metal bell is placed over the [[Glans penis|glans]]. After that, the bell, together with the [[foreskin]], is pulled through the opening initiation rites found in the base plate and hung into the lever. By fastening the screw the lever pulls the bell upwards, jamming the [[foreskin]] between bell and base plate. After several minutes of clamping, the skin many different cultures is cut off with a scalpel along the upper side of the base plate and fixation upon the clamp removedgenitalia.

[[File:Circumpendium-6-2-2-plastibellIt reflects the fascination that emerges from the ability to create new life. In most cultures, fertility is seen as the most precious good, and the body parts involved frequently find themselves in the focus of ritual acts.jpg|center|thumb|plastibell method]]In many parts of the plastibell methodworld, those rites take place when the skin is first cut lengthwiseboy reaches puberty, then a plastic ring is placed over and are meant to symbolize his transition from boy to man. The removal of the male [[Glans penis|glansforeskin]] is just one of many phenomena that developed in this context. They range from the removal of the frenulum in boys and men through partial or complete removal of the [[foreskin]] pulled over itup to radical operations. A tightly tied string is used to fix the Australian [[Aborigines]], as mentioned above, have their [[foreskin]] to s removed. It is also usual that, a rim few weeks later, young men have their [[penis]]es sliced open in the ringa [[subincision]], thereby strangulating itresulting in a partly or completely divided [[urethra]].

The tissue beyond Another known, particularly massive, intervention is the string is cut off and stripping of the bell's handle cracked entire [[skin]] off. The strangulated tissue dies off in the following days, and the ring falls off on its own[[penis]]. Since this form of circumcision means part of the process goes on without medical supervisionIn Indonesia, it may not be possible to intervene promptly in boys have metal or bamboo balls inserted into their [[penis]] shaft or [[Glans penis|glans]] at the event of swelling; also there is a risk beginning of the ring being removed prematurely due to external influence. This may cause the healing wound to burst openpuberty, necessitating additional suturingwhich form little "humps".

[[File:Circumpendium-6-2-2-Smartclamp.jpg|center|thumb|Smartclamp]]The Smartclamp and a couple of For many cultures it is also common to perform similar designs are one way clamps, representing a mixture of the Gomco and Plastibell methodsrituals on girls. The [[Glans penis|glans]] is inserted into This can range from relatively small interventions such as piercing or cutting the plastic tubeclitoral hood, the [[foreskin]] pulled over it. The base plate to its complete removal and up to radical removal of the outer clamping mechanism is pushed over the clitoral hood, [[foreskinclitoris]] and cocked shut, jamming the [[foreskin]] between the bulging lower rim of the tube inner and the lower base plate. The [[foreskin]] is now cut off along the upper side of the base plate. The entire clamping mechanism remains on the [[penis]], until it - like the plastibell - falls off outer labia followed by itself after the clamped skin dies off in sewing up the following daysvagina.

All of these methods have in common that the [[foreskin]] has to be separated ''The following text is taken from the [[Glans penis|glans]] first. In case of the circumcision of a child, it is in most cases (see chart above) necessary to forcibly tear apart the balanopreputial membrane, which fuses the [[foreskin]] to the [[Glans penis|glans]], either by violently retracting the [[foreskin]] or separating it by pushing a blunt instrument underneath the [[foreskin]], both of which can result in injuries and inflammations of the [[Glans penis|glansCircumpendium]].''-->

== Risks and late effects = Prophylactic reasons ===

Just like tonsil or appendix surgerySome 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 a surgical intervention said to protect against. At first, these were diseases where [[masturbation]] was believed to be the cause. After bacteria and brings the usual risks related to surgical operationsviruses had been discovered, arguments changed, alongside several specific risks of complications and late effectsone after another miscellaneous diseases were cited.

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

Circumcision is surgeryThe fact that the [[USA]] has both the highest 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 |last=Grosskurth |init=H |last2=Mosha |init2=F |last3=Todd |init3=J |etal=yes |title=A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results |journal=AIDS |date=1995 |volume=9 |issue=8 |pages=927-34 |url=https://insights.ovid.com/aids/aids/1995/08/000/community-trial-impact-improved-sexually/15/00002030 |accessdate=2019-11-15}}</ref><ref>{{REFjournal |last=Barongo |init=LR |last2=Borgdorff |init2=MW |last3=Mosha |init3=FF |etal=yes |title=The epidemiology of HIV-1 infection in urban areas, roadside settlements and rural villages in Mwanza Region, Tanzania |journal=AIDS |date=1992 |volume=6 |issue=12 |pages=1521-8 |url= |accessdate=}}</ref><ref>{{REFconference |last=Changedia SM, Gilada IS |first= |title=Role of male circumcision in HIV transmission insignificant in conjugal relationship (abstract no. ThPeC7420) |url= |place=Barcelona, Spain |source=Presented at the Fourteenth International AIDS Conference |datefrom=2002-07-07 |dateto=2002-07-12 |accessdate=}}</ref><ref>{{REFconference |last=Connolly CA, Shishana O, Simbayi L, Colvin M |first= |title=HIV and circumcision in South Africa (Abstract No. MoPeC3491) |url= |place=Bangkok, Thailand |source=Presented at the 15th International AIDS Conference |datefrom=2004-07-11 |dateto=2004-07-16 |accessdate=}}</ref><ref>{{REFconference |last=Thomas AG, Bakhireva LN, Brodine SK, Shaffer RA |first= |title=Prevalence of male circumcision and its association with HIV and sexually transmitted infections in a U.S. navy population (Abstract no. TuPeC4861) |url=https://apps.dtic.mil/dtic/tr/fulltext/u2/a458066.pdf |place=Bangkok, Thailand |source=Presented at the 15th International AIDS Conference |datefrom=2004-07-11 |dateto=2004-07-16 |accessdate=2019-11-15}}</ref>* Urinary tract infections (UTI): a [[UTI]] can be effectively treated with antibiotics, this was also proven by studies.<ref>{{REFjournal |last=McCracken |init=G |title=Options in antimicrobial management of urinary tract infections in infants and children |journal=Pediatr Infect Dis J |date=1989 |volume=8 |issue=8 |pages=552-5 |url=https://www.cirp.org/library/disease/UTI/mccracken/ |accessdate=2019-11-19}}</ref><ref>{{REFjournal |last=Larcombe |init=J |title=Urinary tract infection in children |journal=BMJ |date=1999 |volume=319 |issue= |pages=1173-5 |url= |accessdate=}}</ref> A Swedish study<ref>{{REFjournal |last=Mårild |init=S |last2=Jodal |init2=U |title=Incidence rate of first–time symptomatic urinary tract infection in children under 6 years of age |journal=Acta Paediatr |date=1998 |volume=87 |issue=5 |pages=549-52 |url= |accessdate=}}</ref> found that, during the first 6 years of life, the incidence of [[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 |last=Mueller |init=ER |last2=Steinhardt |init2=G |last3=Naseer Surgical complications |init3=S |title=The incidence of genitourinary abnormalities in [[circumcised]] and [[uncircumcised]] boys presenting with an initial urinary tract infection by 6 months of age |journal=Pediatrics |date=1997 |volume=100 (Supplement) |issue= |page=580 |url= |accessdate=}}</ref> did not find a significant difference in UTI rates between [[circumcised]] and [[intact]] boys with normal urinary tract anatomy.* Other studies suggest that circumcision is more likely to raise than to lower the generally may 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 |last=Menahem |init=S |title=Complications arising from ritual circumcision: pathogenesis and possible prevention |journal=Isr J Med Sci |date=1981 |volume=17 |issue=1 |pages=45-8 |url= |accessdate=}}</ref><ref>{{REFjournal |last=Cohen |init=HA |last2=Drucker |init2=MM |last3=Vainer |init3=S |etal=yes |title=Postcircumcision urinary tract infection |journal=Clin Pediatr |date=1992 |volume=31 |issue=6 |pages=322-4 |url= |accessdate=}}</ref><ref>{{REFjournal |last=Goldman |init=M |last2=Barr |init2=J |last3=Bistritzer |init3=T |last4=Aladjem |init4=M |title=Urinary tract infection following ritual Jewish circumcision |journal=Isr J Med Sci |date=1996 |volume=32 |issue= |pages=1098-1102 |url= |accessdate=}}</ref>* It can be classified concluded that circumcision is ineffective as hemorrhagea preventive measure against [[UTI]].* Penile and cervical cancer / HPV: first studies on those diseases and their assumed prevention by circumcision date back to 1932, infectiona time when the cause for those illnesses was not yet fully understood.<ref>{{Wolbarst1932}}</ref> Today, or surgical misadventure up to it is known that sexually transmitted human papillomavirus (HPV) is a major risk factor<ref>{{REFjournal |last=McCance |init=DJ |last2=Kalache |init2=A |last3=Ashdown |init3=K |etal=yes |title=Human papillomavirus types 16 and including loss 18 in carcinomas of the penis from Brazil |journal=Int J Cancer |date=1986 |volume=37 |issue=1 |pages=55-9 |url= |accessdate=}}</ref>, as well as smoking<ref>{{REFjournal |last=Harish |init=K |last2=Ravi |init2=R |title=The role of tobacco in penile carcinoma |journal=Brit J Urol |date=1995 |volume=75 |issue=3 |pages=375-7 |url= |accessdate=}}</ref>. Studies have shown that there is no significant difference in the risk of getting penile cancer between [[circumcised]] and death[[intact]] men. To prevent a single case of penile cancer, it would statistically take 600 to 900 circumcisions<ref>{{REFdocument |title=Position Paper on Neonatal Circumcision |url= |contribution= |last= |first= |publisher=American Academy of Family Physicians (Leawood, Kansas) |format= |date=2002-02-14 |accessdate=}}</ref>. The influence of circumcision on the infection risk of the female partner with cervical cancer has been refuted several times as well. HPV vaccination is an effective measure against carcinoma of the cervix.

* Intolerance or allergic reactions to the narcotics used.* Especially in newborns, where the bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is often insufficient for the operation. Even in conjunction with regional anaesthesia of the dorsal nerve of the [[penis]], the rate of failure to provide sufficient anaesthetic even for experienced anaesthetists is still 5-10%. The general anaesthesia that would be needed for newborns, however, poses significant risks for the child, and, therefore, is only likely to be used in emergencies. A surgical operation without proper pain control can lead to the development of a specific pain memory<ref>Prof. Dr. med. Boris Zernikow http://www.spiegel.de/spiegel/vorab/experte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-849534.html</ref>. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation. Overall, their pain threshold was lower and the risk of chronic pain increased. Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>Garry T. Circumcision: a survey of fees and practices. ''OBG Management'' 1994. (October): 34-6.</ref><ref>Howard CR, Howard FM, Garfunkel LC, de Blieck EA, Weitzman M. Neonatal circumcision and pain relief: current training practices. ''Pediatrics'' 1998; 101:423-428.</ref><ref>Stang HJ, Snellman LW. Circumcision practice patterns in the United States. ''Pediatrics'' 1998; 101: e5. 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>Gunnar MR, Fisch RO, Korsvik Sconclusion, Donhowe JM. The effects of circumcision on serum cortisol and behavior. ''Psychoneuroendocrinology'' 1981; 6(3):269-75.</ref>* Postoperative wound pain, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions.* Postoperative bleeding of the wound. This can have severe consequences especially for very young infants, if they are does not treated promptly. Their blood volume is only about 85 ml per kilogram of body weight, and even moderate blood loss can lead to hypovolaemia, hypovolaemic shock and even death.<ref>Smart J, Nolan T. (Editors). ''Paediatric Handbook'', Sixth Edition. Victoria, Australia: Blackwell Science Asia, 2000: p. 82</ref><ref>Wetli CV. Case 93-1711. ''Autopsy of Demetrius Manker''. Miami: Dade County Medical Examiner Department, June 23, 1993.</ref><ref>Hiss J, Horowitz A, Kahana T. Fatal haemorrhage following male ritual circumcision. ''J Clin Forensic Med'' 2000;7:32-4.</ref><ref>Newell TEC. ''Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan''. Burnaby, B.C.: B.C. Coroner's Service, Monday, 19 January 2004</ref>* Postoperative infections. This includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.<ref>Dr.med Wolfram Hartmann, Stellungnahme zur Anhörung am 26. November 2012 im ''Rechtsausschuss des Bundestages''.</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>Blalock HJ, Vemulakonda V, Ritchey ML, Ribbeck M. Outpatient management of [[phimosis]] Following newborn circumcision. ''J Urol'' 2003;169(6):2332-4.</ref>, the prevalence is 2.9%, according to Leitch<ref>Leitch IOW. Circumcision - a continuing enigma. ''Aust Paediatr J'' 1970;6:59-65.</ref> 5.5%.* Meatal stenosis, a pathological narrowing of the opening of the urethra, which mostly occurs in infancy and early childhood. It is one of the most common complications of infant circumcision. A study from 2006 found meatal stenosis exclusively in previously circumcised boys. The incidence rate after a circumcision is at approximately 10%.<ref>Van Howe RS. Incidence of meatal stenosis following neonatal circumcision in a primary care setting. ''Clin Pediatr'' (Phila). Jan-Feb 2006;45(1):49-54.</ref><ref>Stenram, A., Malmfors, G., & Okmian, L. (1986): Circumcision for [[phimosis]]: a follow-up study. ''Scandinavian journal of urology and nephrology'', 20(2), 89 PMID 3749823.</ref><ref>http://emedicine.medscape.com/article/1016016-overview</ref>* Knot formation of the veins. If the dorsal vein, which originates provide any proven benefits 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>http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritualpreventive medicine.html?_r=0</ref>

=== Physical late effects =Non-medical indications for circumcision ==

* An unavoidable late effect of any circumcision is the permanent loss of sexual sensitivity. This is partly due to the removal of sensory tissue. The [[foreskin]] contains very many nerve endings and touch receptors, which account for the major part of male sexual sensation. If the [[foreskin]] is removed, they can no longer provide sexual stimulation. It is also partly due to the fact that the surface of the [[Glans penis|glans]] reacts to the missing protection Apart from friction and drying out by developing a callus layer. This reduces the sensitivity of the remaining nerves in the [[Glans penis|glansmedical indication]] gradually over the years. The study conducted by Sorrells et.al.<ref>Sorrells ML, Snyder JL, Reiss MD, et al. Fine-touch pressure thresholds in the adult [[penis]]. BJU Int 2007;99:864-9.</ref> found a significant reduction of sensitivity to touch for circumcised compared to intact [[penis]]es in adult males. Other studies revealed that circumcised men use condoms significantly less often than intact menpathological phimosis, since they further limit the sexual sensitivity (see above).* Painful tension can occur when there is too little reserve skin left to support a full erection<ref>Taylor, J.R., Lockwood, A.P., & Taylor, A.J. (1996). The prepuce: „Specialized mucosa of the [[penis]] and its loss to circumcision.“ British Journal of Urology, 77, 291-295.</ref>. This risk is partly dependent on the anatomy of the [[penis]]. While some [[penis]]es already have the majority of their full size when flaccid ([[Flesh Penis]], or "[[shower]]"), others also are rather short when flaccid and double or more their size during an erection ([[Blood Penis]], or "[[grower]]"). Especially in children's circumcision, where the [[penis]] is not yet fully developed, the amount of reserve skin needed in adulthood cannot be estimated.* Erectile dysfunction: Both the damage inflicted to the blood vessels in the [[foreskin]] and the reduced sexual sensitivity can be causes for reduced erectile function with advancing age.<ref>Money, J., & Davison, J. (1983): Adult penile circumcision: Erotosexual and cosmetic sequelae. Journal of Sex Research, 19, 289-292</ref>* Orgasm problems: In the wake of reduced sexual sensitivity, due to the loss of sensory tissue and gradual keratinization of the surface of the [[Glans penis|glans]], orgasm problems may develop with increasing age. In this case, the sexual arousal created by intercourse or masturbation is not enough to achieve orgasm. A preliminary stage of this late effect is the prolonged time circumcised men need to reach an orgasm. This is often fielded as the "cut men have more endurance" argument for circumcision.* Vaginal dryness: Due to the loss of the natural gliding action, which comes from the mobility of the fore- and shaft skin, a much increased friction between [[penis]] and vagina occurs during intercourse. This can make intercourse painful other reasons for both partners and lead to abrasions<ref>[[Morten Frisch]], Morten Lindholm, Morten Grønbæk: Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark. In: International Journal of Epidemiology Oktober 2011, 40(5), S. 1367-1381, doi:10.1093/ije/dyr104, PMID 21672947.</ref><ref>Cortés-González, J., Arratia-Maqueo, J., & Gómez-Guerra, L. (2008): Does circumcision has an effect on female's perception of sexual satisfaction? Rev Invest Clin, 60(3), 227 PMID 18807735.</ref> The prolonged time it takes circumcised men to reach orgasm, as well as the often longer and more vigorous thrusting movements - compared to intact men - play a part in this.<ref>Cold CJ, Taylor JR. The prepuce BJU Int 1999;83 Suppl. 1:34-44.</ref><ref>Fink KS, Carson CC, DeVellis RF. Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction. J Urol 2002;167(5):2113-2116.</ref>

=== Psychological late effects Aesthetic reasons ===

Psychological late effects are also possible The visual appearance of the [[penis]] is changed radically after a circumcision, especially if the operation was carried out in childhood. On In this occasion case, personal taste is decisive whether an [[intact]] or a variety of trauma may occur, which depend, among others, on age and circumstances of the circumcision[[circumcised]] [[penis]] is more appealing. For example, whether the Since a circumcision took place with or without sufficient anaesthesiacannot be undone, if the individual has been it is essential to be fully informed about the operation beforehand, if he was circumcised against his will or without his consent, risks and also, in the case of infant possible later complications before embarking on an aesthetically motivated circumcision, if he was told about it during childhood or had to find it out coincidentally on his owndecide whether the appearance will justify such bodily modification.

The psychological late effects of It should be noted that every circumcision are not yet fully researched, and many studies took place on rather operation leaves a small scalelife-long [[circumcision scar]] that encircles the shaft of the [[penis]]. This situation needs to be rectifiedIn addition, because there frequently a a color change at the available studies, as well as the histories of negatively affected men, suggest that these late effects may have more impact than previously assumedcircumcision scar which results in a two-tone appearance.

* It was observed that infants, following circumcision without pain control, had a disturbed bond with their mother<ref>Marshall RE, Porter FL, Rogers AG, et al. Circumcision: II Since this modification and its possible late effects upon mother-infant interaction. Early Hum Dev 1982; 7(4):367-74.</ref>, as well as problems with nurturing, up to the point of refusal to be fed. The sleeping habits of these babies were also disturbed, with prolonged non-REM sleep and increased waking.* In boys circumcised in childhood, post traumatic stress disorder (PTSD) could will be diagnosed. In a study on Philippine boys, in whom no PTSD was found prior to the operation, 69% lifelong burden of the boys circumcised in the traditional ritual and 51% of those circumcised by standard medical procedures (including anaesthesia) fulfilled the DSM-IV criteria for PTSD following the operation.<ref>Ramos S, Boyle GJ. Ritual and medical person who undertakes an aesthetically motivated circumcision among Filipino boys: evidence of post-traumatic stress disorder. In: Denniston GCto suit his personal preferences, Hodges FM, Milos MF (eds) Understanding circumcision: A Multi-Disciplinary Approach a valid decision to a Multi-Dimensional Problem. New York: Kluwer Academic/Plenum Publishers, 2001: pp. 253-70.</ref>* Circumcisions, especially those that happen without consent, can spark feelings of helplessness and alienation, which proceed can persist as trauma. These feeling can also only 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% made by the doctor, and 73% felt that their human rights had been violated.<ref>http://www.circumcisionharm.org/</ref>* It can frequently be found that the loss is denied, much as happens with the loss of other body parts. This denial can lead to fathers having their sons circumcised in order not person to be reminded of their own loss. In this process, their own body is defined as "normal" and the [[foreskincircumcised]] redefined as a foreign object. Their own parents are seen as "good", so that this image is projected onto the circumcision their parents carried out as well, in order to keep the positive emotion intact. The father wants to be a "good" father later in life as well, and sohimself, following an idealised image of his own parents, circumcision, which once he has been redefined as a "good thing", is passed on to his son by having him circumcised as well.<ref>van der Kolk BA. The compulsion to repeat reached the trauma: re-enactment, revictimization, necessary age and masochism. Psychiatr Clin North Am 1989;12(2):389-411.</ref><ref>Goldman R. The psychological impact level of circumcision. BJU Int 1999;83 Suppl. 1:93-103.</ref>* If the circumcised male feels incomplete, or due maturity to the missing [[foreskin]] disadvantaged compared to intact males, an inferiority complex and depression may occurmake that decision. This can should normally be accompanied by conscious recognition of his own incompleteness, or the deficiency may remain completely subconscious<ref>Rhinehart J. Neonatal circumcision reconsidered. Transactional Analysis J 1999;29(3):215-21.</ref>. In an online study, 75% of those interviewed stated that they felt incomplete, and 66% said they felt inferior compared with intact males.<ref>http://www.circumcisionharm.org/</ref>* Cases in 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>Cansever, G. (1965). Psychological effects of circumcision. Brit. J. Med. Psychol. 38: 321-331.</ref>* Fear of being alone or darkness.<ref>David M. Levy, Psychic trauma of operations in children; and a note on combat neurosis, American Journal of Diseases of Children, Vol. 69, 1945, 7-25</ref>* Fear of doctors, clinics and also closed rooms.<ref>David M. Levy, Psychic trauma of operations in children; and a note on combat neurosis, American Journal of Diseases of Children, Vol. 69, 1945, 7-25</ref>* Relapse into the state of bed-wetting, even if the child was already dry before.<ref>David M. Levy, Psychic trauma of operations in children; and a note on combat neurosis, American Journal of Diseases of Children, Volcase when adulthood is reached. 69, 1945, 7-25</ref>

== Historical background =Financial reasons===

The amputation of In the United States, payment for non-therapeutic circumcision is made by most [[foreskinthird-party payment| third-party payers]] is a very old ritualwithout question of necessity. Doctors frequently perform medically-unnecessary, whose exact origin cannot be verified beyond doubt. Medical historians assume that non-therapeutic circumcision already served in ancient history as a way to control the sexuality of slaves infants and members of the lower classes without compromising their ability children simply to reproduce. In religious history circumcision may be seen as collect a substitute fee for human sacrifice. In prehistoric times it was not uncommon to placate the gods with human sacrificesurgical operation. Castration of slaves or conquered enemies was common as well. Following religious changes this sacrifice was altered, and The only a part beneficiary of such surgery is the very organ responsible for [[Financial Incentive| bank account of the creation of new life was sacrificedmedical doctor]].

In many cultures With the [[foreskin]], circumcision during puberty serves as a rite removes approximately 70% of passagethe sensitive tissue of the [[penis]], bringing adolescents into lowering the communitypotential for sexual stimulation accordingly. As with other painful or humiliating initiation rites, proof Due to the loss of courage and mastering around 50% of critical situations are the key motivations. From some African tribes it is also known entire [[penile skin]], the [[penis]] loses the reserve skin that provides cutaneous mobility in the amputation of erect [[penis]] and the [[foreskingliding action]] is seen as the removal of an inborn piece of femininity from the boys, thus making them men.

In the Jewish religionpast, the tradition of circumcision goes back this circumstance was used to 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.{{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 make 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 harder for boys to the anthropologist masturbate and sociologist Nissan Rubin, the Jewish form of circumcision, called brit mila, during the first two millennia did not include the later customary periah, namely the complete scraping of the inner [[foreskinmasturbation]] from the less fun, as [[Glans penis|glansmasturbation]]. This was only added around 135 ADviewed as immoral and was assumed to cause a variety of mental diseases, to make it impossible to restore the [[foreskin]] caused by stretching, which became popular in the wake of Hellenic influence. While originally only the tip thinking of immoral thoughts! More on that can be found in the chapter "[[foreskinCircumcision#Historical_background|Historical background]] was cut off". Today, periah removes the entire it is known that [[foreskinmasturbation]]has no negative health effects, but can contribute positively to the child's sexual development. In the Greek society of the daySexuality is no longer a taboo nowadays, a denuded while [[Glans penis|glansmasturbation]] was is considered obscene to be a natural part of human sexuality and risibleis no longer seen as immoral. In ultra-orthodox communitiesTherefore, circumcision is followed by the for moral reasons - which would only affect boys too young to give [[mohelinformed consent]], the ritual circumciser, sucking blood from the wound with his mouth. This practice - is highly controversial, as it can result in an infection with herpes simplex type 1. In New York City, between 2000 and 2011 eleven children were infected with herpes, 10 of whom had to be treated in hospital. Two of them suffered permanent brain damage, two others died. In the 12th century, the Jewish philosopher and doctor Maimonides pointed out that circumcision was necessary, as it diminished sexual desires and reduced the pleasure to a degree just sufficient for mere reproductionno longer justifiable nowadays.

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

In One should note that the 1920s it was penile cancerhuman [[foreskin]] is endowed by nature with [[Foreskin#Immunological_functions| immunological functions]] that serve to protect the human body from disease.<refname="fleiss-hodges-vanhowe1998"/>Abraham L. Wolbarst behauptet, die Beschneidung könne dem Peniskrebs vorbeugen. The [[Is circumcision a prophylactic against glans penis cancer? Cancer 1926 Jul;3(4):301-10]] receives blood through the frenular artery.</ref>, in the 1940 prostate{{REFjournal |last=Persad |init=R |author-link= |last2=Sharma |init2=S |author2-link= |last3=McTavish |init3=J |author3- and tongue cancer as well as STDs<ref>Eugene H. Hand erklärt, dass die Beschneidung irgendwie gegen Geschlechtskrankheiten und Zungenkrebslink= |etal=yesschütze. [Circumcision |title=Clinical presentation and venereal disease. Archives pathophysiology of Dermatology and Syphilology 1949 Sep;60(meatal stenosis following circumcision |journal=Brit J Urol |date=1995 |volume=75 |issue=1 |pages=91-3) |url=https:341-6]</ref>, in the 1950s it was cervical cancer<ref>Abraham Ravich erfindet den Mythos, die Beschneidung verringere das Risiko von Frauen an Gebärmutterhalskrebs zu erkranken/www.onlinelibrary.wiley.com/doi/abs/10. [Prophylaxis of cancer of the prostate, penis, and cervix by circumcision1111/j. New York State Journal of Medicine 1951 Jun;51(12):15191464-20</ref>, in the late 1960s it was neuroses<ref>Morris Fishbein fordert die Beschneidung zur Prävention von Nervosität und natürlich auch Masturbation410X.1995. [Sex hygienetb07242. Modern Home Medical Adviserx |quote= |pubmedID=7850308 |pubmedCID= |DOI=10. Garden City, New York: Doubleday & Co: 1969 pp 90, 119]<1111/ref>, in the 1970s bladder- and rectal cancer<ref>Abraham Ravich behauptet, dass die Beschneidung Blasenkrebs und Rektumskrebs vorbeugen würdej. [Viral carcinogenesis in venereally susceptible organs. Cancer 1971 Jun;27(6)14931464-6]</ref>, nd in the 1980s UTIs<ref>Thomas E410x. Wiswell behauptet, eine Beschneidung verringere das Risiko für Harntraktinfektionen1995. [Decreased incidence of urinary tract infections in circumcised male infantstb07242. Pediatrics 1985 May;75(5):901x |accessdate=2019-11-3]26}}</ref> and AIDS<ref>Aaron J. Fink behauptet, dass die Beschneidung gegen AIDS schütze. [A possible explanation These facts are generally overlooked in arguments for heterosexual male infection with AIDS. New England Journal alleged hygienic benefits of Medicine 1986 Oct 30;31(18):1167]</ref> followed. Retrospectively, circumcision was always advertised as a cure for whatever disease was in the public spotlight at the time.

The sheer mass A common reason stated for circumcision is the assumption of hygienic benefits. This argument has to be viewed in the context of studies and publications that were released during those almost 180 years on this topic are the reason that even arguments environment the person in question grows up in. It is commonly known that have been disproved multiple timesbad hygienic circumstances, especially regarding infant and child circumcisioninsufficient access to clean drinking water, tenaciously persist up until todaypose a serious problem. The situation in disaster areas or refugee camps in the so-called third world keep reminding us of that.

An ever-recurring element 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 initiation rites found in many different cultures the [[Glans penis|glans]] and the [[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 fixation upon areas between the genitaliatoes.

It reflects the fascination that emerges from the ability to create new life. In most culturessmall boys, fertility is seen as where the most precious good[[foreskin]] cannot be retracted yet, and the body parts involved frequently find themselves in the focus of ritual acts. In many parts of the world, those rites take place when the boy reaches pubertycleaning is not necessary, and are meant to symbolize his transition from boy to man. The removal of since the male [[foreskinSynechia| membrane]] is just one of many phenomena that developed in this context. They range from the removal of the frenulum in boys and men through partial or complete removal of fuses the [[foreskin]] up to radical operationsthe [[Glans penis|glans]] prevents the accumulation of micro-organisms. Australian Aborigines, as mentioned above, have their The so-called "[[Ballooning of the foreskin| ballooning]]s removed. It is also usual that", a few weeks later, young men have their where the [[penisforeskin]]es sliced openinflates during urination, resulting in is not a partly or completely divided urethraconcern.

Another known, particularly massive, intervention is the stripping The opening of the entire skin off the [[penisforeskin]]. In Indonesiain small boys is often quite narrow and serves as a one-way valve, boys have metal or bamboo balls inserted into their allowing the [[penisurine]] shaft or [[Glans penis|glans]] at to flow out, but preventing entry of microbes, for example from a dirty diaper. As long as the beginning of pubertychild is able to pass water, which form little "humps"everything works as nature intended.

For many cultures it is also common 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 perform similar rituals on girlsbe viewed with a critical eye. This can range from relatively small interventions such as piercing or cutting Although even longer periods without personal hygiene will not result in an accumulation of germs under the clitoral hood[[foreskin]], to its complete removal and up to radical removal circumcision itself is not without risk of clitoral hoodcomplications. If the operation is carried out without proper sterility, clitoris, inner and outer labia followed by sewing up there is a high risk of an [[infection]] of the wound. This also applies to the vaginatreatment of common complications like post-operative [[bleeding]].

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

Considering The [https://www.cirp.org/library/statements/aap1999/|AAP Circumcision Policy Statement] (1999) states quite clearly that ''"There is considerable evidence that newborns who are [[circumcised]] without analgesia experience pain and physiologic stress"''. Furthermore, the severity pain is quite severe, and requires injections for proper pain management. Sucrose and Acetaminophen ''"cannot be recommended as the sole method of analgesia"''. Topical cream is no longer thought sufficient as ''"the intrusion into analgesic effect is limited during the body phases associated with extensive tissue trauma such as...tightening of the affected person, the question arises, whether it is both legally and morally acceptable to leave the decision about a nonclamp"''.<ref>{{REFjournal |last= |first= |title=American Academy of Pediatrics: Circumcision Policy Statement; Task Force on Circumcision |journal=Pediatrics |date=1999-03 |volume=103 |issue=3 |pages=686-93 |url=https://pediatrics.aappublications.org/content/103/3/686#sec-9 |accessdate=2019-11-therapeutic operation on a child too young to understand or give valid consent, to the parents alone26 |note=Statement Reaffirmed Sept. In Germany1, several basic rights are concerned:2005}}</ref>

* the right to bodily integrity* the right to sexual self-determination* the right to equal treatment of genders The [[AAFP]] (circumcision2002) states quite simply in their [https://www.cirp.org/library/statements/aafp2002/FGM of females is illegal)* the right to religious freedom (where the | position paper], ''"Newborns experience pain during circumcision has a religious motive)".''<ref>{{REFweb |title=Circumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 ReaffirmedThese four basic rights are relevant from the legal as well as the ethical point |website=Official American Academy of viewFamily Physicians Website |url=http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html Let us begin with the most obvious intrusion |accessdate=2011- the one into the bodily integrity. Under German law, children enjoy far05-reaching protection, that limits the parental rights and the powers delegated to third persons overseeing the upbringing (such as kindergarten staff or teachers). Methods of upbringing that may cause physical or mental harm are prohibited. 02}}</ref> This is not only corporal punishment, which was common in familiesa debatable fact, schools and vocational training for agesyet, which may cause direct (and sometimes severe) bodily harm - it also covers spankingis not widely accepted, which is included under degrading treatmenteven by some doctors. It is assumed might be hard for some doctors to accept, as they may have been taught that the infant does not only does the immediate injury harm the childfeel [[pain]], but also the feeling of helplessness and of being at someone's mercy at the time of punishment by an authority figuremay have performed countless circumcisions with this idea. This also applies to other treatment that harms the dignity Usage of a child - anesthesia for example being forced to publicly change clothes in front of infant circumcision is still by no means the kindergarten group after wetting his pantsrule.

If you take Penile injections of local anesthetic are now recommended by all of the major medical institutions if a look at circumcision is to be performed. In their [http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml Report 10 of the list of possible bodily and mental harms and late-effects listed in Council on Scientific Affairs], the AMA states ''"When the decision is made to proceed with circumcision, local anesthesia should be provided for the procedure. [[Ring block]] or [[dorsal penile nerve block]] [injections] are most effective. [[Circumcision#Risks_and_late_effects|"Risks and late effects"EMLA]]cream has limited utility"''. Alarmingly, ''"Despite the imbalance becomes apparent. Spanking is already unlawfulclear evidence that newborn males generate brisk pain responses during circumcision, but the irreversible amputation a recent survey of an important, healthy part residency training programs found that 26% of programs that taught circumcision provided no instruction on the genital organ is notuse of local anesthesia". The inevitable and possible consequences of this operation are ignored to a degree AMA reports that is in harsh contrast to the established protection "Of physicians performing circumcision, 45% use anesthesia, 71% of children. Legalizationpediatricians, therefore56% of family practitioners, represents a considerable limitation and 25% of the male childobstetricians"''s right to bodily integrity and protection from potentially harmful methods .<ref>{{REFweb |title=Report 10 of upbringingthe Council on Scientific Affairs (I-99): Neonatal Circumcision |website=American Medical Association Official Website |url=http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml |accessdate=2011-05-04}}</ref>

There are also ethical problemsThe AAP's [http://www.healthychildren. Can a child be denied the right org/English/ages-stages/prenatal/decisions-to determine -make/pages/Where-We-Stand-Circumcision.aspx Heatlhy Children website] suggests ''"Your pediatrician (or your obstetrician) should discuss the visible appearance and degree forms of functionality of his body? Should a circumcised boy later in life decide analgesia that he would prefer to have an intact are available"''.<ref>{{REFweb |title=Where We Stand: Circumcision |publisher=[[penisAAP]] |date=2011-03-23 |url=http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx |accessdate=2019-10-12}}</ref> Be that as it may, he has no means few forms of reversing the decision his parents madeanalgesia are recommended. Other people's ideas about his body‘s appearance and functionality There are imposed upon him irreversibly. He is denied the possibility basically two types of deciding upon that according injections to his own preferenceschoose from, which can lead to inferiority complexes and depression - regardless of the parents‘ reasons or their idea of what would be best for their child. So great website does not go into the difference between a level of paternalism regarding such 'dorsal nerve block' and a severe intrusion, especially in the most intimate area of the child, cannot be justified by the parents‘ will'ring block' injection.

It Given what is not much different with the right to sexual self-determination. Hereknown from aforementioned official documents, the consequences that circumcision has AAP website may be more informative and can have for effective if it would say ''"Make sure your doctor knows of the bodyineffectiveness of anything short of local anesthesia, play a significant roleand make sure your baby is given an injection. NormallyThis is your responsibility, a man has free choice as because your doctor may or may not be up to how he wants date on the latest understandings of infant sensitivity to experience his sexuality[[pain]] during circumcision. It is solely up to him to decide in which way he wants to "'' The AAP may be stimulatedholding back, however, perhaps because this would upset the doctor/parent power relationship, and he can - if he so desires - limit his sexual experience without a problemmay cause too much questioning of doctors in general. A circumcised man does One may not have these options. The full range expect to find this kind of his sexual experience advice on such a website, and sensation yet, anything less than this is not available to him due the to bodily modificationa dangerously weak statement.

An intact To control [[penispain]] enables many men to reach orgasm just by manipulation of , some physicians that circumcise use Tylenol, sugar,<ref>{{REFweb |quote=To calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, and soothing music is played in the [[foreskin]]room. |url=http://www.pollockclinics.com/circumcision/circumcision-guide. html |title=Parents' Guide to Circumcision |last= |first= |publisher= |date= |accessdate=2011-04-08}}</ref><ref>{{REFweb |quote=During masturbationthe circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions. |url=http://www.pollockclinics.com/circumcision/circumcision-before.html |title=Before the man can choose whether Circumcision |last= |first= |publisher= |date=2011-04-08 |accessdate=2011-04-08}}</ref> a topical cream,<ref>{{REFweb |quote=Then in our office, he wants will have topical anesthetic applied to his penis. |url=http://www.pollockclinics.com/circumcision/circumcision-before.html |title=Before the Circumcision |last= |first= |publisher= |date=2011-04-08 |accessdate=2011-04-08}}</ref> and/or a local anaesthetic injection called a dorsal penile ring block.<ref>{{REFweb |quote=We use extensive pain control methods including Tylenol, a sugar solution (to reduce pain perceptions), a topical freezing cream, and a local anesthetic injection. |url=http://www.pollockclinics.com/circumcision/circumcision-guide.html |title=Parents' Guide to Circumcision |last= |first= |publisher= |date= |accessdate=2011-04-08}}</ref> Topical anaesthetic only serves to numb the area to stimulate lessen the pain of the injection, but studies have shown that a [[Glans penis|glansdorsal penile nerve block]] directly or indirectly through the movement of is only partially effective in stopping the [[foreskinPain| pain of circumcision]]. Since he has <ref name="Journal of Perinatology April/May 2002">{{REFjournal |last=Taeusch |first=H. William |init=HW |last2=Martinez |first2=Alma M. |init2=AM |last3=Partridge |first3=J. Colin |init3=JC |last4=Sniderman |first4=Susan |init4=S |last5=Armstrong-Wells |first5=Jennifer |init5=J |last6=Fuentes-Afflick |first6=Elena |init6=E |title=Pain During Mogen or Plastibell Circumcision |journal=Journal of Perinatology |volume=22 |issue=3 |pages=214-8 |url=http://www.nature.com/jp/journal/v22/n3/full/7210653a.html |quote=...more than half of the study group had what we considered excessive pain/discomfort over the full, naturally given potential course of sensitivity at his disposal, he can use it the entire procedure. |pubmedID= |pubmedCID= |DOI= |note=April/May 2002 |date=2002-04 |accessdate=2011-04-08}}</ref><ref name="Clinical Pediatrics August 1986">{{REFjournal |last=Williamson |first=Paul S. |init=PS |last2=Evans |first2=Nolan Donovan |init2=ND |title=Neonatal Cortisol Response to according to his own preferencesCircumcision with Anesthesia |journal=Clinical Pediatrics |volume=25 |issue=8 |pages=412-6 |url=http://cpj.sagepub.com/content/25/8/412. abstract |quote=The circumcised man, however, does adrenal cortisol response to surgery was not have that freedom significantly reduced by the administration of choicelidocaine. He has neither the opportunity |pubmedID= |pubmedCID= |DOI= |date=1986-08 |accessdate=2011-04-08}}</ref> During circumcision, somp physicians give children sugar pacifiers to include "reduce the [[foreskin]] into perception of pain",<ref>{{REFweb |quote=During the stimulationcircumcision, nor can he utilize its nerves and touch receptorsyour son will receive sugar pacifiers to suck on which reduce his pain perceptions. |url=http://www.pollockclinics. He also only has access to 15com/circumcision/circumcision-50% of before.html |title=Before the potential sensitivity of an intact manCircumcision |last= |first= |publisher= |date=2011-04-08 |accessdate=2011-04-08}}</ref> but in at least one study, depending on the amount and kind of tissue data shows that was removed, and giving sugar to a child doesn't help to reduce the degree of keratinization perception of pain in the [[Glans penischild.<ref name="Lancet, The 2010-10-09">{{REFjournal |last=Slater |first=Rebeccah |init=R |first2=Laura |init2=L |last2=Cornelissen |first3=Lorenzo |init3=L |last3=Fabrizi |first4=Debbie |init4=D |last4=Patten |first5=Jan |init5=J |last5=Yoxen |first6=Alan |init6=A |last6=Worley |first7=Stewart |init7=S |last7=Boyd |first8=Judith |init8=J |last8=Meek |first9=Maria |init9=M |last9=Prof. Fitzgerald |title=Oral sucrose as an analgesic drug for procedural pain in newborn infants: a randomised controlled trial |journal=The Lancet |volume=376 |issue=9748 |pages=1225-32 |glans]]url=http://www.thelancet. In some casescom/journals/lancet/article/PIIS0140-6736%2810%2961303-7/fulltext |quote=Our data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuits, the limitation can and therefore might not be even more severean effective analgesic drug. On a heavily desensitized [[penis]], condoms can limit the sexual stimulation The ability of sucrose to the point where reduce clinical observational scores after noxious events in newborn infants should not enough arousal can be built up to reach an orgasm interpreted as pain relief. |pubmedID= |pubmedCID= |DOI= |date=2010-10-09 |accessdate=2011-04-08}}</ref> Post- which means that fulfilling safer sex operative pain and the pain the child must endure during recovery is not possiblehardly, if ever, addressed by professionals.

In particular, the tight styles of circumcision bear the risk, It has been shown that the loss of the friction-reducing gliding effect leads an infant's response to unpleasant feelings or even [[pain for both partners during intercourse. The ability to masturbate without aid - for example, from lubricants - ]] can be significantly reduced or even be lost in such altered for years as a caseconsequence of circumcision. In a study<ref>DaiSik Kim, Myung-Geol Pang: The effect of male circumcision on sexuality. In: BJU international, Volume 99, Issue 3, März 2007, S. 619-622. doi:10.1111{{TaddioA etal 1995}}</j.1464-410X.2006.06646.x, PMID 17155977ref><ref>{{TaddioA KatzJ IlersichAL KorenG 1997}}</ref>, 63% of the men interviewed reported problems with masturbation after being circumcised. If a boy or man is circumcised, without him making that decision for himself after thorough consideration and in full knowledge and understanding of all possible consequences, he is denied his constitutionally guaranteed freedom to experience his sexuality according to his own preferences. This is much like parental interference to promote a prohibition of masturbation, or to inhibit a homosexual relationship - with the key difference that the parental intervention in form of a circumcision, unlike prohibitions during childhood, will have an irreversible, lifelong effect. Both do not comply with modern views of children's well-being and accepting the child as an autonomous individual, and are, therefore, not ethically justifiable.

The basic right to equal treatment {{Box|Boxtext=<big><b>However, none of the sexes is also breached, since girls are legally protected from violations above three procedures totally eliminate pain. A baby boy will still experience some pain despite any of their genital integrity, while boys are notthose analgesic procedures. This not only contradicts the constitution, but also is contrary to all efforts Prevention of equal treatment[[pain]] requires protecting a boy from elective neonatal non-therapeutic circumcision. Because in this case, decisions Only boys who are made during childhood that will affect protected from the entire later life, it equals the attempt to have certain educational grades open to one gender unconditionally, while giving parents the right to deny them to the other gender for life. That such an unequal treatment of genders is not justifiable, neither legally nor morally, is obviousmedically unnecessary circumcision surgery experience no [[pain]] or [[trauma]].</b></big>}}

Last not least== Risks and effects ==Just like tonsil or appendix surgery, religious freedom circumcision is impaireda surgical intervention and brings the usual risks related to surgical operations, alongside several specific risks of complications and late effects. Uberoi et al. If (2022) report "some men are experiencing a boy is circumcised for religious reasons as complex negative constellation of psychological, physical, and sexual associations that lead to significant emotional distress directed both internally and externally. The posts also reveal a child before he reaches discovery phenomenon wherein men discover the age physical and psychological manifestations of competence, he will carry the sign decisions made by others to modify their genitals."<ref name ="uberoi2022">{{REFjournal |last=Uberoi |first= |init=M |author-link= |last2=Abdulcadir |first2= |init2=J |author2-link= |last3=Ohi |first3= |init3=DA |author3-link= |last4=Santiago |first4= |init4=JE |author4-link= |last5= |first5= |init5= |author5-link= |last6= |first6= |init6= |author6-link= |last7= |first7= |init7= |author7-link= |last8= |first8= |init8= |author8-link= |last9= |first9= |init9= |author9-link= |etal=yes |title=Potentially under-recognized late-stage physical and psychosexual complications of that religion on his body for his entire life non- even if he decides to abjure that religion in the course therapeutic neonatal penile circumcision: a qualitative and quantitative analysis of his lifeself-reports from an online community forum |trans-title= |language= |journal=Int J Impot Res |location= |date=2022-10-23 |volume= |issue= |article= |page= |pages= |url=https://www.nature.com/articles/s41443-022-00619-8 |archived= |quote= |pubmedID=36274189 |pubmedCID= |DOI=10.1038/s41443-022-00619-8 |accessdate=2023-01-08}}</ref>

While his condition will not keep him from changing his religion=== Physical effects ===* [[Bodily harm]]* [[Circumcision scar]] is an invariable effect.* An unavoidable effect of any circumcision is the permanent loss of sexual sensitivity. This is partly due to the removal of sensory tissue. The [[foreskin]] contains very many nerve endings and touch receptors, or to renounce it entirelywhich account for the major part of male sexual sensation. If the [[foreskin]] is removed, he has they can no way longer provide sexual stimulation. It is also partly due to discard the symbol fact that the surface of his old religionthe [[Glans penis|glans]] reacts to the missing protection from friction and drying out by developing a callus layer. This could be compared to a tattoo reduces the sensitivity of the remaining nerves in the form of a religious symbol, with [[Glans penis|glans]] gradually over the difference that such a tattoo could still be removed years. The study conducted by laser or covered with Sorrells et al.<ref>{{Sorrells etal 2007}}</ref> found a new tattoosignificant reduction of sensitivity to touch for [[circumcised]] compared to [[intact]] [[penis]]es in adult males. Other studies revealed that [[circumcised]] men use condoms significantly less often than [[intact]] men, if need besince they further limit the sexual sensitivity (see above).

Therefore * Painful tension can occur when there is too little reserve [[skin]] left to support a circumcision does not impair full [[erection]]<ref name="taylor1996"/>. This risk is partly dependent on the anatomy of the [[penis]]. While some [[penis]]es already have the ability to change religionmajority 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]], but it makes it impossible to discard oneor "[[grower]]"). Especially in children's old religion entirely. This circumcision, where the [[penis]] is not only a violation yet fully developed, the amount of the basic law, it is also ethically unjustifiable to force someone to carry a religious symbol for his entire life - especially reserve [[skin]] needed in his most private body areaadulthood cannot be estimated.

So why is circumcision tolerated as a means of upbringing, and even explicitly legalized? In Germany, this stems from - although it is not stated in * Erectile dysfunction: Both the law for legal reasons - damage inflicted to the belief that a ban would impair blood vessels in the religious freedom of [[foreskin]] and the parentsreduced sexual sensitivity can be causes for reduced erectile function with advancing age. Even though it is stated in Art.140 GG (German basic law)<ref>{{REFjournal |last=Money |init=J |last2=Davison |init2=J |title=Adult penile circumcision:Erotosexual and cosmetic sequelae |journal=Journal of Sex Research |date=1983 |volume=19 |issue= |pages=289-92 |url= |accessdate=}}</ref>

* Orgasm problems: In the wake of reduced sexual sensitivity, due to the loss of sensory tissue and gradual [[keratinization]] of the surface of the [[Glans penis|glans]], orgasm problems may develop with increasing age. In this case, the sexual arousal created by intercourse or [[masturbation]] is not enough to achieve orgasm. A preliminary stage of this late effect is the prolonged time [[circumcised]]] men need to reach an orgasm. This is often fielded as the "cut men have more endurance" argument for circumcision.* Vaginal dryness: Due to the loss of the natural [[gliding action]], which comes from the mobility of the [[foreskin]] and [[shaft skin]], a much increased friction between [[penis]] and [[vagina]] occurs during intercourse. This can make intercourse painful for both partners and lead to abrasions<blockquoteref>{{FrischM LindholmM GroenbaekM 2011}}</ref><ref>{{REFjournal |last=Cortés-González |init=J |last2=Arratia-Maqueo |init2=J |last3=Gómez-Guerra |init3=L |title=Does circumcision has an effect on female''(1) Civic rights s perception of sexual satisfaction? |journal=Rev Invest Clin |date=2008 |volume=60 |issue=3 |page=227 |url= |pubmedID=18807735 |accessdate=}}</ref> The prolonged time it takes [[circumcised]] men to reach orgasm, as well as the often longer and duties are neither dependant more vigorous thrusting movements - compared to [[intact]] men - play a part in this.<ref name="ColdCJ TaylorJR 1999">{{ColdCJ TaylorJR 1999}}</ref><ref>{{REFjournal |last=Fink |init=KS |last2=Carson |init2=CC |last3=DeVellis |init3=RF |title=Adult Circumcision Outcomes Study: Effect onErectile Function, nor impaired byPenile Sensitivity, the exercise of religious freedom.''Sexual Activity and Satisfaction |journal=J Urol |date=2002 |volume=167 |issue=5 |pages=2113-6 |url= |accessdate=}}</ref>

''* [[Lymphoedema]] of the penis is a normal and expected complication of male circumcision...]''

''(4) No * [[Meatal stenosis]], a pathological narrowing of the opening of the [[urethra]], which mostly occurs in infancy and early childhood. It is one may be forced to take part 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 religious act or ceremony, or circumcision is approximately 10 to participation 20 percent.<ref name="vanhowe2006">{{REFjournal |last=Van Howe |init=RS |author-link=Robert S. Van Howe |title=Incidence of meatal stenosis following neonatal circumcision in religious rites or to the use a primary care setting |journal=Clin Pediatr (Phila) |note=Jan-Feb 2006 |date=2006-01 |volume=45 |issue=1 |pages=49-54 |url=https://www.academia.edu/6992015/Incidence_of_Meatal_Stenosis_following_Neonatal_Circumcision_in_a_Primary_Care_Setting |accessdate=2019-12-15}}</ref><ref>{{REFjournal |last=Stenram |init=A |last2=Malmfors |init2=G |last3=Okmian |init3=L |title=Circumcision for [[phimosis]]: a follow-up study |journal=Scandinavian journal of a religious oathurology and nephrology |date=1986 |volume=20 |issue=2 |page=89 |url= |pubmedID=3749823 |accessdate=}}</ref><ref>{{REFweb |url=http://emedicine.medscape.''com/article/1016016-overview |title=Meatal Stenosis |publisher=Medscape |accessdate=2019-10-11}}</blockquoteref>

Still, it * Shorter adult penile length was considered intolerable for the parents to be unable to perform reported by Park et al. (2016) as a religious rite that involved interference with the body result of another person - in the case of that person being their sonNMC (newborn male circumcision). While normally the religious freedom ends "at someone else‘s nose"{{Citation |Title= |Text=In conclusion, an exemption was legalized second to enable parents to comply with their ownfourth digit ratio, personalflaccid penile length, religious duties, even if that means that several and age of their son's basic rights are impairedcircumcision were significant predictive factors for erectile penile length. This does, however, not apply for other religious traditionsFurthermore, so that a ritual beating - no matter how religiously important it may be to the parents - is still considered child abuse and would likely result in penile lengths of the loss NMC group were shorter than those of child custody herethe non-NMC group. |Author=Park et al. |Source= |ref=<ref>{{REFjournal |last= Business Interests Park |first= |init=JK |author-link= |last2=Doo |first2=Only very few will supposedly know that circumcision has become a lucrative business. Not only the operation itself, but also the potentially needed aftercare, bring profits. But while this is still obvious, there are also other trades that make money from it. |init2=AR |author2-link= |last3=Kim |first3=Baby [[foreskin]]s are a coveted resource. Under the name "Apligraf" an artificial skin product is marketed worldwide, which is used |init3=JH |author3- among other uses link= |last4=Park |first4= |init4=HS |author4- as an alternative to skin grafts using the patient’s own skin. It is grown from the [[foreskin]]s of children as young as possible. Since they are also mostly free link= |etal=yes |title=Prospective investigation of pathogenic organisms, they are also used as the basis for collagen, which is, among other purposes, used for anti wrinkle therapy and for lip augmentation. The manufacturer of the british product "Vavelta" advertised penile length with the use of "freshly harvested (!) [[foreskin]]s". It is ''inter alia'' used as a replacement for animal experiments testing the compatibility of cosmetic products. In the face of the falling numbers of routine infant circumcisions in the USA, manufacturers have already expressed concerns that they might not "bring in enough harvest" more than 10 years ago. The parents of the circumcised boys, however, very rarely know of the "secondary use" of their son's "donated" body parts. While preimplantation genetic diagnosis, stem cell research newborn male circumcision and genetic engineering are time and again critically questioned and discussed, the lifelong, significant modification of infant bodies for the good of the cosmetic industry is still common practice - supposedly partly because many women do not know what their augmented lips and wrinkle-free cheeks are made of - baby [[foreskin]]. An ethical justification cannot be valid heresecond to fourth digit ratio. |trans-title= |language= |journal=Can Urol Assoc J |location= |date=2016-09 |season= |volume=10 |issue=9----10 |article= |page={{FromIntactWiki |pages= | URLurl=httphttps://intactwikiwww.orgncbi.nlm.nih.gov/wikipmc/articles/PMC5028213/ |archived= |quote= |pubmedID=27695583 |pubmedCID=5028213 |DOI=10.5489/Circumcisioncuaj.3590 | Titleaccessdate=Circumcision2022-09-04}}</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 [[Image:Intact vs circumcised]] men, due to their infant circumcision, with complaints of [[glans]] insensitivity, delayed [[ejaculation]], and unpleasant sensation.JPG <ref name="cepeda2023">{{REFjournal |last=Cepe da-Emiliani |first= |init=A |author-link=Alfonso Cepeda-Emiliani |last2=Gándara-Cortés |first2= |init2=M |author2-link= |last3=Otero-Alén |first3= |init3=M |author3-link= |last4=García |first4= |init4=H |author4-link= |last5=Suárez-Quintanilla |first5= |init5=J |author5-link= |last6=García-Caballero |first6= |init6=T |author6-link= |last7=Gallego |first7= |init7=R |thumbnailauthor7-link= |rightlast8=García-Caballero |300pxfirst8= | The intact init8=R |author8-link= |etal=no |title=Immunohistological study of the density and circumcised distribution of human penis, side by sidepenile neural tissue: gradient hypothesis |trans-title= |language= |journal= Int J Impot Res |location= |date=2023-05-02 |volume=35 |issue=3 |article= |page= |pages=286-305 |url=https://www.nature.com/articles/s41443-022-00561-9 |archived= |quote= |pubmedID=35501394 |pubmedCID= |DOI=10.]]1038/s41443-022-00561-9 |accessdate=2023-11-26}}</ref>

The term Circumcision and frenectomy remove tissues with heightened erogenous sensitivity.<ref name="circumcisioncepeda2023" /> <ref name=" without a gender qualifier refers specifically to male circumcision. It means winkleman1959"to cut around>{{WinkelmannRK 1959}}</ref> They concluded," and it refers Evidence has also started to the excision of the [[foreskin]] from the penis. Circumcision is most often performed accumulate that male circumcision may result in healthy males for [[Religion and Culture|religious or cultural]] reasons. The procedure may be performed on consenting adults, but it is most often performed on non-consenting minors, particularly newborn childrenlifelong physical, 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 violationsexual, unless there is concrete medical indication. Proponents of circumcision consider the circumcision of non-consenting minors to be a "religious freedom" and a "parental rightsometimes psychological harm as well."

The [[amputation]] of the prepuce results in the loss of the majority of fine-touch neuroreceptors found in the [[penis]], leaving only the uninhibited protopathic sensibility of the artificially externalized [[glans penis]]. The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of the changes in sexual behavior noted in [[circumcised]] human males.<ref>{{REFjournal |last=Van Howe |init= Rationale RS |author-link=Robert S. Van Howe |last2=Cold |init2=CJ |title=Advantages and Disadvantages of Neonatal Circumcision |journal=The Journal of the American Medical Association |volume=277 |issue=13 |pages=1052-7 |url=http://www.ncbi.nlm.nih.gov/pubmed/9218663 |quote= |pubmedID=9218663 |pubmedCID= |DOI= |date=1997-04-02 |accessdate=}}</ref>

Reasons 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 performing 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 range widely , 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 culturebeing strapped to a special plastic board called the [[circumstraint]]. The procedure is most often an elective, religionnon-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]], locationbut in older patients may be rarely indicated for therapeutic reasons. It is a radical treatment option for pathological [[phimosis]], refractory [[balanoposthitis]] and agechronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health.

Many cultures perform === Psychological effects ===[[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effects]] are also possible after a circumcision as , especially if the operation was carried out in childhood. On this occasion a rite variety of passage into manhood[[trauma]] may occur, which depend, among others, on age and circumstances of the circumcision. This is common 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 Middle East and amongst some indigenous African and Southeast Asian peoplescase of infant circumcision, if he was told about it during childhood or had to find it out coincidentally on his own.

The United States psychological late effects of circumcision are not yet fully researched, and Israel are the only industrialized countries in the world to have many studies took place on rather a high incidence of routine infant male circumcisionsmall scale. The vast majority of infant circumcisions performed in This situation needs to be rectified, because the United States are for non-religiousavailable studies, non-medical reasons. See [[History as well as the histories of Circumcision]]negatively affected men, suggest that these late effects may have more impact than previously assumed.

* It was observed that infants, following circumcision without [[pain]] control, had a disturbed bond with their mother<ref>{{REFjournal |last=Marshall |init=RE |last2=ReligiousPorter |init2=FL |last3=Rogers |init3=AG |etal=yesThe circumcision of newborn boys is seen as a divine commandment in the Jewish faith |title=Circumcision: II effects upon mother-infant interaction |journal=Early Hum Dev |date=1982 |volume=7 |issue=4 |pages=367-74 |url=https://www.cirp. Though absent in the Koranorg/library/birth/marshall2/ |accessdate=2020-02-01}}</ref>, male circumcision is considered a religious requirement in Islamas well as problems with nurturing, and it is performed on male children up to the point of varying agesrefusal to be fed. Converts to The sleeping habits of these faiths may babies were also choose to undergo circumcisiondisturbed, but it is not always requiredwith prolonged non-REM sleep and increased waking.

===Medical Indication===* In some casesboys [[circumcised]] in childhood, circumcision is legitimately indicated; a patient may [[post-traumatic stress disorder]] ([[PTSD]]) could be suffering recurring infections, and other methods of treatment have faileddiagnosed. In other casesa study on Philippine boys, a patient may be suffering from a severe case of in whom no [[phimosisPTSD]]. Overall, the actual medical necessity for circumcision is extremely rare. ====Arguments of Prophylaxia====Though the practice of ritual circumcision of males, both consenting and non-consenting, has existed for millenia, the search for "potential medical benefits" began relatively recently. Initially, circumcision was adopted as a way found prior to stop boys and men from masturbating, where mastubration was seen as the cause for many diseases. As the myth that circumcision prevented masturbation became debunkedoperation, advocates 69% of circumcision began the great search to find boys [[circumcised]] in the "medical benefits" of circumcision.  Male and female circumcision involves the removal and disruption of normal anatomical structures that are primary areas of sexual sensation.<ref>{{REFjournal | last=Taylor | first=J.R. | coauthors=A.P. Lockwood traditional ritual and A.J. Taylor | title=The prepuce: Specialized mucosa 51% of the penis and its loss to circumcision | journal=British Journal of Urology International | volume=77 | issue= | pages=291-95 | url=http://www.cirp.org/library/anatomy/taylor/ | quote= | pubmedID=8800902 | pubmedCID= | DOI= | date=1996-2 | accessdate=}}</ref> In the past, some advocates of mass circumcision have considered the prepuce to be a "mistake of nature,"<ref><nowiki>{{Cold and Wiswell (1995)}} | those [[Template:Cold and Wiswell circumcised]] by standard medical procedures (1995including anaesthesia)|see more]]</nowiki></p></ref> but this notion has no validity because fulfilled the DSM-IV criteria for PTSD following the prepuce is ubiquitous in primates and because it provides functional advantagesoperation.<ref>{{REFbook |last=ColdRamos |firstinit=ChristopherS |last2=McGrath |first2=KennethBoyle |author2-linkinit2=Ken McGrathGJ |year=19992001 |title=Male and female Understanding circumcision: medical, legal, and ethical considerations in pediatric practiceA Multi-Disciplinary Approach to a Multi-Dimensional Problem |url=httphttps://wwwlink.cirpspringer.orgcom/librarychapter/anatomy10.1007/cold978-1-4757-3351-mcgrath/8_14

|editoreditors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]]

|chapter=Anatomy Ritual and histology medical circumcision among Filipino boys: evidence of the penile and clitoral prepuce in primatespost-traumatic stress disorder |pages=253-70

|publisher=Kluwer Academic/Plenum Publishers |isbn=0306461315

[[Intact America]] (2019) called circumcision an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]],<ref name-"bollinger2019">{{REFdocument |title=Child genital cutting as an adverse childhood experience |url=http://adversechildhoodexperiences.net/CGC_as_an_ACE.pdf |last=Bollinger |first=Dan |author-link=Dan Bollinger |last2=Chapin |first2=Georganne |author2-link=Circumcision methodsGeorganne Chapin |publisher=Intact America |location=Tarrytown |format=PDFCircumcision is performed in many ways which vary by culture, the person performing it, and the age of the subject. It may be performed by a specialized ritual circumciser in a non |date=2019-medical setting, or a medical practitioner at a hospital or clinic. In some cultures, only the protruding end of the foreskin is cut off, and in others, the entire foreskin which covers the glans is removed. Some circumcisers take more skin than others, resulting in a "loose" or "tight" circumcision.08 |accessdate=2021-11-02Generally, the foreskin is pulled forward and enough of it is removed to permanently expose the glans of the penis. Sometimes a protective device is used to avoid hurting the glans, and sometimes the circumciser simply performs the procedure freehand. In adults, stitches are used to stop the bleeding and help close the wound. In infants, circumcisers often use a clamp that crushes the foreskin and seals the wound, eliminating the need for stitches.}}</ref>

=== Pain Possible operative and postoperative complications ===In the past, advocates Circumcision is surgery. Surgical complications of circumcision claimed that a newborn child's nerve system was not yet fully developedgenerally may be classified as [[Bleeding| hemorrhage]], [[infection]], or surgical misadventure up to and that as a result, including loss of the child felt penis and [[death]].<ref name="deacon2022" /><ref name="williams-kapilla1993">{{REFjournal |last=Williams |init=N |author-link= |last2=Kapilla |init2=L |author2-link= |etal=no pain during the |title=Complications of circumcision procedure |trans-title= |language= |journal=Brit J Surg |location= |date=1993-10 |volume=80 |issue=10 |pages=1231-6 |url=https://www.cirp. Research has shown that newborn children do in fact feel pain, and more acutely than adultsorg/library/complications/williams-kapila/ |quote= |pubmedID=8242285 |pubmedCID= |DOI=10. This has led American health associations to recommend doctors take measures to reduce the pain of circumcision in infants1002/bjs.1800801005 |accessdate=2019-11-27}}</ref>

The [[Position Statements on Infant Circumcision|AAP Circumcision Policy Statement]] states quite clearly that ''"There is considerable evidence that * Intolerance or allergic reactions to the narcotics used.* Especially in newborns who are circumcised without analgesia experience pain and physiologic stress"''. Furthermore, where the bodily pain reduction mechanisms are not yet fully developed, local anaesthesia is quite severe, and requires injections often insufficient for proper pain management. Sucrose and Acetaminophen ''"cannot be recommend as the sole method of analgesia"''operation. Topical cream is no longer thought sufficient as ''"the analgesic effect is limited during the phases associated Even in conjunction with extensive tissue trauma such as...tightening regional anaesthesia of the clamp"''.<ref>American Academy dorsal nerve of Pediatrics: Circumcision Policy Statement; Task Force on Circumcision" Pediatrics Vol 103 No.3 March 1999, pp.686-693. (Statement Reaffirmed Sept. 1, 2005)."</ref> The AAFP states quite simply in their the [[Position Statements on Infant Circumcision|position paperpenis]], ''"Newborns experience pain during circumcision".''<ref>"Circumcision: Position Paper on Neonatal Circumcision. Board Approved: August 2007 Reaffirmed". Official American Academy the rate of Family Physicians Website. http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html. Accessed 5/2/2011.</ref> This is not a debatable fact, and yet, it is not widely accepted, failure to provide sufficient anaesthetic even by some doctors. It might be hard for some doctors to accept, as they may have been taught that the infant does not feel pain, and may have performed countless circumcisions with this idea. Usage of anesthesia for infant circumcision experienced anaesthetists is still by no means the rule. Penile injections of anesthetic are now recommended by all of the major medical institutions. In their [http://www.ama-assn.org/ama/no-index/about5-ama/13585.shtml Report 10 of the Council on Scientific Affairs], the AMA states ''"When the decision is made to proceed with circumcision, local anesthesia should be provided for the procedure. Ring block or dorsal penile blocks [injections] are most effective. EMLA cream has limited utility"''. Alarmingly, ''"Despite the clear evidence that newborn males generate brisk pain responses during circumcision, a recent survey of residency training programs found that 26% of programs that taught circumcision provided no instruction on the use of local anesthesia". The AMA reports general anaesthesia that "Of physicians performing circumcisionwould be needed for newborns, 45% use anesthesiahowever, 71% of pediatricians, 56% of family practitioners, and 25% of obstetricians"''.<ref>"Report 10 of poses significant risks for the Council on Scientific Affairs (I-99): Neonatal Circumcision". American Medical Association Official Website. http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml. Accessed May 4, 2011.</ref> The AAP's [http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx Heatlhy Children website] suggests ''"Your pediatrician (or your obstetrician) should discuss the forms of analgesia that are available"''.<ref>Where We Stand: Circumcision". AAP Official Website. 03/23/2011. http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx</ref> Be that as it may, few forms of analgesia are recommended. There are basically two types of injections to choose fromchild, and the website does not go into the difference between a 'dorsal nerve block' and a 'ring block' injection. Given what is known from aforementioned official documents, the AAP website may be more informative and effective if it would say ''"Make sure your doctor knows of the ineffectiveness of anything short of local anesthesiatherefore, and make sure your baby is given an injection. This is your responsibility, because your doctor may or may not be up only likely 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 used in generalemergencies. One may not expect A surgical operation without proper [[pain]] control can lead to find this kind the development of advice on such a website, and yet, anything less than this is a dangerously weak statement. To control specific pain, some physicians that circumcise use Tylenol, sugar,memory<ref>{{REFweb | quote=To calm the baby during the procedure, a sugar filled gauze pacifier soaked with sweet juice is used, and soothing music is played in the room. | url=http://www.pollockclinicsspiegel.comde/spiegel/circumcisionvorab/circumcisionexperte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-guide849534.html | title=Parents' Guide to Circumcision | last= | first= | publisher= | work= | date=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder | accessdate=2011trans-04-08}}</ref><ref>{{REFweb | quotetitle=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his Children's pain perceptions. | url=httpexpert warns://www.pollockclinics.com/Ritual circumcision/circumcision-before.htmlchanges the brain of children | titlelanguage=Before the CircumcisionGerman | last=Prof. Dr. med. Boris Zernikow | first= | publisher=Spiegel Online | workwebsite= | date=20112012-0408-0812 | accessdate=20112019-0410-08}}</ref> a topical cream,<ref>{{REFweb11 | quoteformat=Then in our office, he will have topical anesthetic applied to his penis. | url=http://www.pollockclinics.com/circumcision/circumcision-before.html | title=Before the Circumcision | last= | first= | publisherquote= | work= | date=2011-04-08 | accessdate=2011-04-08}}</ref> . In unsedated and/or a local anaesthetic injection called a dorsal penile ring blockpartially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation.<ref>{{REFweb | quote=We use extensive pain control methods including TylenolOverall, a sugar solution (to reduce their pain perceptions), a topical freezing cream, threshold was lower and a local anesthetic injection. | url=http://www.pollockclinics.com/circumcision/circumcision-guide.html | title=Parents' Guide to Circumcision | last= | first= | publisher= | work= | date= | accessdate=2011-04-08}}</ref> Topical anaesthetic only serves to numb the area to lessen the risk of chronic pain increased. Regardless of the injectionthese findings, but studies have shown that a dorsal penile ring block is not always effective in stopping the pain of circumcision.infant circumcisions with insufficient or no anaesthetic are still common practice<ref name='Journal of Perinatology April/May 2002'>{{REFjournal | last=Taeusch | first=H WilliamGarry | coauthorsinit=Alma M Martinez, J Colin Partridge, Susan Sniderman, Jennifer Armstrong-Wells, Elena Fuentes-AfflickT | title=Pain During Mogen or PlastiBell Circumcision | journal=Journal : a survey of Perinatologyfees and practices | volume=22 | issue=3 | pages=214-218 | url=http://www.nature.com/jp/journal/v22/n3/full/7210653a.html | quote=...more than half of the study group had what we considered excessive pain/discomfort over the course of the entire procedure. | pubmedID= | pubmedCID= | DOI=OBG Management | date=April/May 2002 | accessdate=2011-04-08}}</ref><ref name='Clinical Pediatrics August 1986'>{{REFjournal | last=Williamson | first=Paul S. | coauthors=Nolan Donovan Evans | title=Neonatal Cortisol Response to Circumcision with Anesthesia | journal=Clinical Pediatrics1994 | volume=25October | issue=8 | pages=41234-4166 | url=http://cpj.sagepub.com/content/25/8/412.abstract | quote=The adrenal cortisol response to surgery was not significantly reduced by the administration of lidocaine. | pubmedID= | pubmedCID= | DOI= | date=August 1986 | accessdate=2011-04-08}}</ref> During circumcision, somp physicians give children sugar pacifiers to "reduce the perception of pain",<ref>{{REFwebREFjournal | quotelast=During the circumcision, your son will receive sugar pacifiers to suck on which reduce his pain perceptions.Howard | urlinit=http://www.pollockclinics.com/circumcision/circumcision-before.htmlCR | titlelast2=Before the CircumcisionHoward | lastinit2=FM | firstlast3=Garfunkel | publisherinit3=LC | worklast4=de Blieck | dateinit4=2011-04-08EA | accessdatelast5=2011-04-08}}</ref> but in at least one study, data shows that giving sugar to a child doesn't help to reduce the perception of pain in the child.<ref name='Lancet, The 2010-10-09'>{{REFjournalWeitzman | lastinit5=Slater | first=Rebeccah | coauthors=Laura Cornelissen, Lorenzo Fabrizi, Debbie Patten, Jan Yoxen, Alan Worley, Stewart Boyd, Judith Meek, Prof Maria FitzgeraldM | title=Oral sucrose as an analgesic drug for procedural Neonatal circumcision and pain in newborn infantsrelief: a randomised controlled trialcurrent training practices | journal=The Lancet | volume=376 | issue=9748 | pages=1225-1232 | url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2961303-7/fulltext | quote=Our data suggest that oral sucrose does not significantly affect activity in neonatal brain or spinal cord nociceptive circuits, and therefore might not be an effective analgesic drug. The ability of sucrose to reduce clinical observational scores after noxious events in newborn infants should not be interpreted as pain relief. | pubmedID= | pubmedCID= | DOI=Pediatrics | date=2010-10-09 | accessdate=2011-04-08}}</ref> Post-operative pain and the pain the child must endure during recovery is hardly, if ever, addressed by professionals. It has been shown that an infant's response to pain can be altered for years as a consequence of circumcision.<ref>{{REFjournal | last=Taddio | first=Anna | coauthors=Morton Goldbach, Moshe Ipp, Bonnie Stevens, Gideon Koren | title=Effect of neonatal circumcision on pain responses during vaccination in boys | journal=The Lancet1998 | volume=345101 | issue=8945 | pages=291423-28 | url=http://www.cirp.org/library/pain/taddio/ | quote= | pubmedID=7837863 | pubmedCID= | DOI= | date=1995 | accessdate=

| last=TaddioStang | firstinit=AnnaHJ | coauthorslast2=Katz J, Ilersich AL, Koren G.Snellman |init2=LW | title=Effects of neonatal circumcision on pain response during subsequent routine vaccinationCircumcision practice patterns in the United States | journal=The LancetPediatrics |date=1998 | volume=349101 | issue=9052e5 | pages=599-603 | url=http:/ |accessdate= |note=Link to [[AAP]] website}}</wwwref>.thelancetDuring 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.com/journals/lancet/article/PIIS0140Measurements taken in those cases revealed a typically 3-6736(96)10316to 4-0/fulltextfold increase in cortisol levels, which equals a state of severe [[shock]].<ref>{{REFjournal |last=Gunnar |init=MR |last2=Fisch |init2=RO |last3=Korsvik |init3=S |last4=Donhowe |init4=JM |title=The effects of circumcision on serum cortisol and behavior |journal=Psychoneuroendocrinology | quotedate=1981 | pubmedIDvolume=90577316 | pubmedCIDissue=3 | DOIpages=10.1016/S0140269-6736(96)10316-075 | dateurl=March 1997https://www.cirp.org/library/pain/gunnar/ | accessdate=2019-11-26

* Postoperative wound pain, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions.=== Sexual effects ===* 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. Circumcision and frenectomy remove tissues with heightened erogenous sensitivity* Postoperative [[bleeding]] of the wound. Boyle ''et alThis can have severe consequences especially for very young infants, if they are not treated promptly.'' (2002) wroteTheir blood volume is only about 85 ml per kilogram of body weight, "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings&mdash;many of which are lost even moderate blood loss can lead to circumcisionhypovolaemia, hypovolaemic [[shock]] and even death."<ref>{{REFjournalREFbook | last=Boyle | first=Gregory |year=2000 |title=Paediatric Handbook |url= |work= |editors=Smart J, Nolan T. | coauthorsedition=Gillian A. Bensley6 | titlevolume=Adverse Sexual and Psychological Effects of Male Infant Circumcision | journalchapter=Psychological reports | volumepage=8882 | issuelocation=3{{AUSC|VIC}}, Part 2Australia | pagespublisher=1105–1106Blackwell Science Asia | urlisbn=http://www.cirp.org/library/psych/boyle5/ | quote= | pubmedIDaccessdate= |note=}}</ref><ref>{{REFdocument |title=11597060Autopsy of Demetrius Manker | pubmedCIDurl= | DOIcontribution=10.1046/j.1464Case 93-410x.1999.0830s1085.x1711 |last=Wetli |first=CV |publisher=Miami: Dade County Medical Examiner Department |format= | date=July 20011993-06-23 | accessdate=}}</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 penis, leaving only the uninhibited protopathic sensibility of the artificially externalized glans penis. The imbalance caused by not having the input from the now ablated fine-touch receptors may be a leading cause of the changes in sexual behavior noted in circumcised human males.<ref>{{REFjournal | last=Van HoweHiss |init=J |last2=Horowitz |init2=A | firstlast3=RSKahana | coauthorsinit3=Cold CJT | title=Advantages and Disadvantages of Neonatal CircumcisionFatal haemorrhage following male ritual circumcision | journal=The Journal of the American Medical AssociationJ Clin Forensic Med |date=2000 | volume=2777 | issue=13 | pages=105232-4 |url=https://www.cirp.org/library/death/hiss1/ |accessdate=2019-11-706}}</ref><ref>{{REFdocument |title=Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan | url=http://www.ncbicircumstitions.com/death-exsang.html |contribution= |last=Newell |first=TEC |publisher=Burnaby, B.C.nlm: B.nihC.govCoroner's Service |format= |date=2004-01-19 |accessdate=2019-11-26}}</pubmed/9218663ref>* Post operative [[lymphoedema]].* Postoperative [[Infection| infections]]. This includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.<ref>{{REFconference |last=Dr. med. Hartmann | quotefirst=Wolfgang | pubmedIDurl=9218663 | pubmedCIDplace=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German) | DOItitle=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German) | date=19972012-0411-0226 | accessdate=

* [[Wound dehiscence]], meaning the separation of the edges of the wound or the tissue after suturing.Histology * Adhesion between the surface or rim of the male [[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 scar shows amputation neuromasnecessary.* Postoperative [[phimosis]]: a phimotic ring can develop during scarring, Schwann cell proliferation and the bulbous collection of variably sized neuriteswhich makes a re-circumcision necessary. Amputation neuromas do not mediate normal sensation and are notorious for generating painAccording to a study by Blalock et al.<ref>{{REFjournal | last=ColdBlalock |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 | firstissue=6 |pages=2332-4 |url=Chttps://www.Jcirp.org/library/complications/blalock1/ | coauthorsaccessdate=J2019-11-26}}</ref>, the prevalence is 2.R. Taylor9%, according to Leitch<ref>{{REFjournal |last=Leitch |init=IOW | title=The prepuceCircumcision - a continuing enigma | journal=British Journal of Urology InternationalAust Paediatr J |date=1970 | volume=836 | issue= | pages=3459-4465 | url=httphttps://www.cirp.org/library/anatomygeneral/leitch1/cold |accessdate=2019-taylor12-15}}</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 | quoteurl=http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritual.html?_r=0 | pubmedIDtitle=10349413Baby’s Death Renews Debate Over a Circumcision Ritual | pubmedCIDlast=Robbins | DOIfirst=Liz | date=19992012-103-07 | accessdate=2019-10-11

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]].<refname="Bollinger 2010">{{REFjournal | last=Bollinger | first=Dan | coauthorsinit=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

| quote= | 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]].

 <!--=== United States Military military === American soldiers serving in World War II were subjected to regular inspections of their genitals. If uncircumcisedintact, the soldiers risked being ordered to undergo immediate circumcision.<ref>{{REFbook

|pages=72-733

}}</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>{{REFbook |last=Fletcher |first=Christopher R. |init=CR |year=1999 |title=Circumcision in America in 1998: Attitudes, Beliefs, and Charges of American Physicians |url=http://www.springerlink.com/content/h2150v731233m177/ |work=Male and 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.<ref>See, e.g., Shephard and Shephard, ''The Complete Guide'', p. 125.</ref> A statement published by the [[American Academy of Pediatrics]] in 1999 claimed that "parents should determine what is in the best interest of the child... It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in additions to the medical factors, when making a decision."<ref>Lannon and Bailey, "Circumcision Policy Statement," p. 691.</ref> however surrogate consent for non-therapeutic circumcision is now viewed as unethical. In the [[United Kingdom]], where non-therapeutic circumcision has now become far less prevalent than in the [[United States]], the written consent of both parents is required, if a physician is to perform a non-therapeutic circumcision of a child.<ref>{{REFjournal |last= |first= |title=Re J (child's religious upbringing and circumcision) |journal=Family Court Reports |date=2000 |volume=1 |issue= |pages=307-14 |url=https://www.cirp.org/library/legal/Re_J/2000.html |accessdate=2019-10-12}}</ref> (The National Health Service does not provide non-therapeutic circumcision.) In recent years, legal writers in several English-speaking countries have been questioning the practice of acceding to parental wishes.<ref>See, e.g., [[Margaret A. Somerville|Somerville]], "Therapeutic and Non-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; [[Abbie Chessler|Chessler]], "Justifying the Unjustifiable"; Smith, "Male Circumcision."</ref> For example, critics have pointed out that, in the [[United States]], more than 1.3% of male neonatal deaths are attributable to the complications of non-therapeutic circumcision surgery.<ref name="Bollinger 2010"/>==Video=====Is circumcision healthy?===The video ''Is Circumcision Healthy'' is recommended for parental viewing.<br><br> <youtube>D_3LQjZgdbQ</youtube> ===Dr. Christopher Guest discusses circumcision===<br><youtube>v=TQIp9f4krVQ</youtube> ===Plastibel circumcision=== {{UNI|Stanford University|SU}} has published a video of an actual non-therapeutic plastibell circumcision. The infant has received two injections of local anesthesia to deaden the dorsal nerves. The ventral nerves were not deadened so the infant still feels pain. One can his cries on the soundtrack.* [https://med.stanford.edu/newborns/professional-education/circumcision/plastibell-technique.html Plastibell Technique] ===Gomco clamp circumcision=== '''Not 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 Hill| Hill]] (2007) said:<blockquote>Male circumcision is harmful because it excises healthy tissue and permanently impairs beneficial physiological functions. Male circumcision also causes psychological problems that tend to perpetuate the cycle of abuse. Male circumcision is a costly diversion of medical resources away from beneficial services. Male circumcision violates legal rights, [[human rights]], and ethical standards. Finally, we must remember that males are the 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 [[genital integrity]] of all children should be respected and protected.<ref name="hill2007">{{REFjournal |last=Hill |first=George |init=G |author-link=George Hill |title=The case against circumcision |journal=Journal of Men's Health and Gender |date=2007 |volume=4 |issue=3 |pages=318-23 |url=https://www.academia.edu/8367383/The_Case_Against_Circumcision |quote= |pubmedID= |pubmedCID= |DOI= |accessdate=2021-05-30}}</ref></blockquote>* Andrew E. MacNeiiy, Head, Division of Pediatric Urology, Department of Urological Sciences, {{UNI|University of British Columbia|UBC}}, Vancouver, BC, (2008) said:<blockquote>Newborn circumcision remains an area of 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= |etal=no |title=Routine circumcision: the opposing view |trans-title= |language= |journal=Can Urol Assoc J |location= |date=2007-11 |volume=1 |issue=4 |article= |page= |pages=395-7 |url=http://europepmc.org/article/PMC/2422979 |pubmedID=18542825 |pubmedCID= |DOI=10.5489/cuaj.455 |accessdate=2021-11-08}}</ref></blockquote> * 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 Association |format=PDF |date=2010 |accessdate=2021-11-08}}</ref></blockquote> * The [[Royal Australasian College of Physicians]] (2010) said: <blockquote>Ethical and [[human rights]] concerns have been raised regarding elective infant male circumcision because it is recognised that the foreskin has a functional role, the operation is non-therapeutic and 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 complication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand. However it is reasonable for parents to weigh the benefits and risks of circumcision and to make the decision whether or not to circumcise their sons.<ref name="racp2010">{{REFdocument |title=Circumcision of Infant Males |url=https://www.racp.edu.au//docs/default-source/advocacy-library/circumcision-of-infant-males.pdf |contribution= |last= |first= |publisher=The Royal Australasian College of Physicians |format=PDF |date=2010-09-01 |accessdate=2021-11-08}}</ref></blockquote> * The [[American Academy of Pediatrics]] (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 |last=Darby |first= |init=R |author-link=Robert Darby |etal=no |title=To avoid circumcision complications, avoid circumcision |trans-title= |language= |journal=Can Urol Assoc J |location= |date=2014-08-14 |volume=8 |issue=7-8 |article= |page=231 |pages= |url=https://cuaj.ca/index.php/journal/article/view/1709/1823 |archived= |quote= |pubmedID= |pubmedCID= |DOI=10.5489/cuaj.1709 |accessdate=2022-12-16}}</ref></blockquote>* The [[Canadian Paediatric Society]] (CPS) (2015) said: <blockquote>In most jurisdictions, authority is limited only to interventions deemed to be medically necessary. In cases in which medical necessity is not established or a proposed treatment is based on personal preference, interventions should be deferred until the individual concerned is able to make their own choices.<ref name="CPS2015">{{REFjournal |last=Sorokin |first=S. Todd |init=ST |author-link= |last2=Finlay |first2=JC |author2-link= |last3=Jeffries |first3=AL |author3-link= |etal=yes |title=Newborn male circumcision |journal=Paediatr Child Health |location= |date=2015-08 |volume=20 |issue=6 |pages=311-20 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4578472/ |quote= |pubmedID=26435672 |pubmedCID=4578472 |DOI=10.1093/pch/20.6.311 |accessdate=2019-10-27}}</ref></blockquote> * 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=Sumit |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.php/journal/article/view/5034/3470 |quote= |pubmedID= |pubmedCID= |DOI= |accessdate=2021-11-09}}</ref></blockquote>==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 == The [[Rights situation on circumcision|rights situation]] is discussed in a separate article. [[Image:Intact vs circumcised.JPG |thumbnail|right|300px| The intact and circumcised human penis, side by side.]]

Human babies, because they are not yet in possession of language, are incapable of giving or refusing consent for being circumcised. The element of force has led some scholars to view the term "circumcision of baby boys as " without a category of forced gender qualifier refers specifically to male circumcision.<ref>For example, Frederick M. Hodges, a medical historianIt means "to cut around, writes: "In and it refers to the late 1970s, as the Americans were growing increasingly aware [[excision]] 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|Glickforeskin]], ''Marked in Your Flesh'', pp. 273-281.</ref> There are, however, physicians in from the United States who argue strongly for routine circumcision of newborn babies; and circumcision is widely accepted as a postnatal procedure in American hospitals.<ref>{{REFbook | last=Fletcher | first=Christopher R. | year=1999 | title=Circumcision in America in 1998: Attitudes, Beliefs, and Charges of American Physicians | url=http://www.springerlink.com/content/h2150v731233m177/ | work= | editor= | edition= | volume= | chapter=Section 5 | pages=259-271 | location=New York | publisher=Kluwer Academic/Plenum Publishers | isbn= | quote= | accessdate= | note=ID 10penis.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> A statement published by the American Academy of Pediatrics in 1999 declares that "parents should determine what term is in the best interest of the child... It is legitimate for parents to take into account cultural, religious, inaccurate and ethnic traditions, in additions to the medical factors, when making a decision."<ref>Lannon and Bailey, "Circumcision Policy Statement," p. 691.</ref> In euphemism because the United Kingdom, where routine circumcision has now become far less prevalent than in operation actually cuts off or [[amputation| amputates]] the United States, a written consent of both parents is required, if a physician is to perform a non-therapeutic circumcision of a child.<ref>[http://www.cirp.org/library/legal/Re_J/2000.html Re J (child's religious upbringing and circumcision)[foreskin]], ''Family Court Reports'', vol. 1 (2000), pp. 307-314which in adults comprises about fifteen square inches of highly functional erogenous tissue.</ref>

In recent yearsCircumcision is most often performed in healthy males for [[Religion and Culture|religious or cultural]] reasons. The procedure may be performed on consenting adults, legal writers in several Englishbut it is most often performed on non-speaking countries have been questioning consenting minors, particularly newborn children, which is why the practice ritual is so controversial. Opponents of circumcision consider the circumcision of acceding non-consenting minors to parental wishesbe unethical and a [[human rights]] violation, unless there is concrete [[medical indication]].=== Consent by surrogates ===Medical ethics has long recognized limitations on the power of consent by surrogates.<ref>See{{REFjournal |last=Committee on Bioethics, e.g.American Academy of Pediatrics |etal=no |title= Informed consent, Somervilleparental permission, "Therapeutic and Nonassent in pediatric practice |trans-Therapeutic Medical Procedures"; Poulter, ''English Criminal Law''; Chessler, "Justifying the Unjustifiable"; Smith, "Male Circumcisiontitle= |language= |journal=Pediatrics |location= |date=1995 |volume=95 |issue=2 |article= |page= |pages=314-17 |url=https://www.cirp."org/library/ethics/AAP/ |archived= |quote= |pubmedID=7478854 |pubmedCID= |DOI= |accessdate=2023-05-21}}</ref> For example, critics have pointed out that, in the United States, more than 1.3% of male neonatal deaths are attributable to the complications of non-therapeutic circumcision surgery.<ref>{{REFjournal | last=BollingerCommittee on Bioethics | firstetal=Danno | coauthorstitle=Boy's Health AdvisoryInformed Consent in Decision-Making in Pediatric Practice | trans-title=Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths |language= | journal=Thymos: Journal of Boyhood StudiesPediatrics |location= |date=2016-08 | volume=4138 | issue=12 |article= |page=e20161485 | pages=78-90 | url=httphttps://wwwwatermark.mensstudiessilverchair.com/content/b64n267w47m333x0/peds_20161485.pdf?ptoken=7ebbd6b446d940cbbd4274c095754b12πAQECAHi208BE49Ooan9kkhW_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=5 | quote= | pubmedID=27456510 | pubmedCID= | DOI=10.31491542/thypeds.0401.782016-1485 | dateformat=2010-04-26PDF | accessdate=2023-05-21}}</ref><ref>{{REFwebREFjournal |last=Committee on Bioethics ||etal=no |title=Informed Consent in Decision-Making in Pediatric Practice |trans-title= |language= |journal=Pediatrics |location= | quotedate=2016-08 |volume=138 |issue=2 |article= |page=e20161484 |pages= | url=httphttps://wwwwatermark.icgisilverchair.orgcom/2010/04/infantpeds_20161484.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMYv3coRY-UCYMgTaqAgEQgIICT4di03qn2Hbho3i8Li_78lod0lNMunch25nx1rKvaM_aeFerz5eN6_k8VVeNv-circumcisionDLocZp28whQr1x4WYDVwSs4uF73vZpYZYuDphYQkwxV1HHgMbZAbHBFuE8QyCHyDvSY-causesfhQcUl-100JrYxa3TbhYgd4bKiU9zfIyXUsCnItroCc9iNrMicPg0v_A0AJJlhxioOlAU-deathsim6OPI06OcCBj78yqkPO0J4nMTN1FLochsOyvZZdtFQQzLhrnM_Gey8K75lFYIBJHA7uzMmP2o5KZ-eachFTGUkEA_eSpEIpwv2WI4SbtrA8WYk3cQqXOmLIWjkSs9CTELD7CQP29xarr1ANrF_id4CiCX7zIomC2Ciz9lHBEgz8EH2i9Woke_YuZeLax52_6JpdhH1qdMQyF1bByjP8mU98V5_B4BPPiBpKt4pVA_UgtaABRHL8oPv6SwOUQZ2Bc-year0_E2tod0VIF1FJBwZRZJm2ZkJPgBSKUo8VBe5Pz_6Vpt2DqLzwqVUYscPsIJMvxl09mMtvJrsBa8yVoTRWj4Rd0OBTMV7zhZskDnYYyrAZ6sHMk0MzvbHilPNbNgU5o7mXmcbFGDgGgWbqrIdT6sVSSfPJm4TnR0HSWbc_EnHhhyye7tVlFGjAsR0R46_DSwEMz8M5DkSln8xfKtX_so9rjCvYeq45wqn09g8DqtV-inWHEA9PIrcw5kTcz5I0JkNuW4-usvKVU1Xz9XHiYi4Zqbq0vx9NWLdNSYHQSOGMZ1MCAxT152evQdipQB5wokR8Q4rICoJYII5bsmRMYd7JQ | titlearchived=Infant circumcision causes 100 deaths each year in US | lastquote=ICGI | firstpubmedID=27456514 | publisherpubmedCID= | Special:CreateMassMessageListDOI=International Coalition for Genital Integrity10.1542/peds.2016-1484 | dateformat=2010-04-26PDF | accessdate=2023-05-21

* [[CircumpendiumPain]]* [[Psychological issues of male circumcision]]* [[Rights situation on circumcision]]* [[Risks and complications]]* [[Sexual effects of circumcision]]* [[Sudden Infant Death Syndrome]] (SIDS)* [[Trauma]]{{LINKS}} * {{REFweb |url=https://www.cirp.org/library/anatomy/garcia/ |title=What exactly is circumcision and what is it not? |last=Garcia |first=Francisco |date=1995-12-11 |accessdate=2020-09-08}}* {{REFjournal |last=Fleiss |first=Paul |init=P |author-link=Paul M. Fleiss |title=The foreskin is necessary |journal=Mothering |date=1997-01 |volume= |issue= |pages=36-45 |url=http://www.noharmm.org/mothering.htm |accessdate=2020-06-29}}*{{REFweb |url=https://15square.org.uk/losses-from-circumcision/ |title=Losses from Circumcision |last=Ball |first=Peter |publisher=15 Square |date=2003-08-09 |accessdate=2023-02-23}}* {{REFweb |url=http://members.tranquility.net/~rwinkel/MGM/primer.html |title=Male Circumcision in the USA: A Human Rights Primer |last=Winkel |first=Rich |author-link=Rich Winkel |date=2005-05-12 |accessdate=2021-01-27}} * {{REFjournal |last=Testa |first=Patrick |init= |author-link= |last2=Block |first2=Walter E. |init2= |author2-link= |etal=no |title=Libertarianism and circumcision |trans-title= |language= |journal=Int J Health Poiicy Manag |location= |date=2014-05-26 |volume=3 |issue= |article= |page= |pages=33-40 |url=https://www.academia.edu/7587653/Libertarianism_and_Circumcision?email_work_card=view-paper |pubmedID=24987720 |pubmedCID=4075101 |DOI=10.15171/ijhpm.2014.51 |accessdate=}}