Changes

There was little awareness of emotional and psychological issues when child circumcision was being promoted in the late 19th century and early 20th century. For example, [[Douglas Gairdner]] made no mention at all of pain, behavior changes, or psychological issues in his landmark 1949 paper.<ref name="fate1949">{{REFjournal

|last=Gairdner

|title=The fate of the foreskin: a study of circumcision

|journal=British Medical Journal

* Conditioned fear

* Hysteria.

|last=Levy

|first=David

|author-link=

|etal=no

|title=Psychic trauma of operations in children: and a note on combat neurosis

|journal=Am J Dis Child

|location=

|last=Freud

|first=Anna

|author-link=

|title=The role of bodily illness in the mental life of children

|last=Cansever

|first=Gocke

|author-link=

|etal=no

|title=Psychological effects of circumcision

|journal= Brit J Med Psychol

|location=

|last=Emde

|first=Robert M.

|author-link=

|last2=Harmon

|first2=Robert J.

|author2-link=

|last3=Metcalf

|first3=David

|author3-link=

|last4=Koenig

|first4=Kenneth L.

|author4-link=

|last5=Wagonfeld

|first5=Samuel

|author5-link=

|etal=no

|title=Stress and Neonatal Sleep

|journal=Psychosom Med

|location=

The extent to which circumcision does contribute to gender differences in behavior during the neonatal period, or subsequently, obviously demands detailed and focused study. Most certainly, the published description of any sample using male neonates should indicate circumcision status. At present, with rare exception, this information does not appear in any account of subject characteristics.<ref>{{REFjournal

|last=Richards

|author-link=

|last2=Bernal

|author2-link=

|last3=Brackbill

|first3=Yvonne

|author3-link=

|etal=no

|title=Early behavioral differences: gender or circumcision?

|journal=Dev Psychobiol

|location=

|last=Grimes

|first=David A.

|author-link=

|etal=no

|title=Routine circumcision of the newborn: a reappraisal

|journal=Am J Obstet Gynecol

|location=

Luther, Kraybill & Potter (1976) tested cortisol and cortisone in the blood of newborn infants before and after circumcision. Dramatic increases in cortisol and a lesser increase in cortisone was recorded.<ref name="luther1976">{{REFjournal

|last=Talbot

|author-link=

|last2=Kraybill

|author2-link=

|last3=Potter

|author3-link=

|etal=no

|title=Adrenal cortical response to circumcision in the neonate

|journal=Obstet Gynecol

|location=

Rawlins, Miller & Engel (1980) investigated the blood oxygen content after [https://www.thefreedictionary.com/unanesthetized unanesthetized] non-therapeutic circumcision. They reported that blood oxygen content decreased during non-therapeutic neonatal circumcision, although it returned to baseline or above later.<ref name="rawlins-miller-engel1980">{{REFjournal

|last=Rawlins

|author-link=

|last2=Miller

|author2-link=

|last3=Engel

|author3-link=

|etal=no

|title=The effect of circumcision on transcutaneous PO₂ in term infants

|journal=Am J Dis Child

|location=

Marshall ''et al''. (1980) tested newborn boys before and after plastibel circumcision. They reported that boys have a greater capacity for memory than previously believed, that infants behave differently after circumcision, that future researchers must consider and record the circumcision status of their subjects, and that boys might actually be feeling pain. They suggested that anesthesia by dorsal penile nerve block might be appropriate.<ref>{{REFjournal

|last=Marshall

|author-link=

|last2=Stratton

|author2-link=

|last3=Moore

|etal=yes

|title=Circumcision I: effects upon newborn behavior

|journal=Infant Behavior and Development

|location=

|last=Gunnar

|first=Megan R.

|author-link

|last2=Fisch

|first2=Robert O.

|author2-link=

|last3=Korsvik

|first3=Sherry

|author3-link=

|last4=Donhowe

|first4=John M.

|author4-link=

|etal=no

|title=The effects of circumcision on serum cortisol and behavior

|journal=Psychoneuroendocrinology

|location=

Marshall ''et al''. (1982) studied the effect of circumcision on mother-child interaction (primarily breastmilk substitute feeding behavior) in a hospital setting. They reported: "The experimental group exhibited fewer intervals of uninterrupted feeding than did the control group."<ref name="marshall1982">{{REFjournal

|last=Marshall

|author-link=

|last2=Porter

|author2-link=

|last3=Rogers

|author3-link=

|last4=Moore

|author4-link=

|last5=Anderson

|author5-link=

|last6=Boxerman

|author6-link=

|etal=yes

|journal=

|location=

The results showed that stimulating the newborn with the pacifier reduced crying by about 40%. Reducing crying, however, had no significant effect on adrenocortical response. Elevations of serum cortisol predicted average behavioral state following circumcision, whereas crying during circumcision did not. Furthermore, there was evidence that the neonatal adrenocortical system was sensitive in variations in surgical procedures. The results indicate the importance of obtaining data on both behavioral and hormonal systems in studies of stress and coping in human newborns.<ref name="gunnar1984">{{REFjournal

|last=Gunnar

|author-link=

|last2=Fisch

|author2-link=

|last3=Malone

|author3-link=

|etal=no

|title=The effects of a pacifying stimulus on behavioral and adrenocortical responses to circumcision in the newborn

|journal=J Am Acad Child Psychiatry

|location=

|last=Porter

|first=Fran Lang

|author-link=

|last2=Miller

|first2=Richard H.

|author2-link=

|last3=Marshall

|first3=Richard E.

|author3-link=

|etal=no

|title=Neonatal pain cries: effect of circumcision on acoustic features and perceived urgency

|journal=Child Dev

|location=

|last=Porter

|first=Fran Lang

|author-link=

|last2=Porges

|first2=Stephen W.

|author2-link=

|last3=Marshall

|first3=Richard E.

|author3-link=

|etal=no

|title=Newborn pain cries and vagal tone: Parallel changes in response to circumcision

|journal=Child Dev

|location=

Glover (1929) reported a case in which the memory of a traumatic circumcision was repressed.<ref name="glover1929">{{REFjournal

|last=Glover

|author-link=

|title=The ‘screening’ function of traumatic memories

|last=Taddio

|first=Anna

|author-link=

|last2=Goldbach

|first2=Morton

|author2-link=

|last3=Ipp

|first3=Moshe

|author3-link=

|last4=Stevens

|first4=Bonnie

|author4-link=

|last5=Koren

|first5=Gideon

|author5-link=

|etal=no

|title=Effect of neonatal circumcision on pain responses during vaccination in boys

|journal=Lancet

|location=

|last=Taddio

|first=Anna

|author-link=

|last2=Katz

|first2=Joel

|author2-link=

|last3=Ilersich

|author3-link=

|last4=Koren

|first4=Gideon

|author4-link=

|etal=no

|title=Effect of neonatal circumcision on pain response during subsequent routine vaccination

|journal=Lancet

|location=

|last=Chamberlain

|first=David

|author-link=

|etal=no

|title=Babies Remember Pain

|journal=Pre- and Peri-natal Psychology

|location=

A traumatic experience is defined in DSM-IV as the direct consequence of experiencing or witnessing of serious injury or threat to physical integrity that produces intense fear, helplessness or (in the case of children) agitation (American Psychiatric Association, 1994). The significant pain and distress described earlier is consistent with this definition. Moreover, the disturbance (e.g., physiological arousal, avoidant behaviour) qualifies for a diagnosis of acute stress disorder if it lasts at least two days or even a diagnosis of post-traumatic stress disorder (PTSD) if it lasts more than a month. Circumcision without anaesthesia constitutes a severely traumatic event in a child's life.<ref name="boyle2002">{{REFjournal

|last=Boyle

|last2=Goldman

|first2=Ronald

|author2-link=Ronald Goldman

|last3=Svoboda

|first3=J. Steven

|author3-link=J. Steven Svoboda

|last4=Fernandez

|first4=Ephrem

|author4-link=

|etal=no

|title=Male circumcision: pain, trauma and psychosexual sequelae

|journal= J Health Psychology

|location=

|last=van der Kolk

|first=Bessell

|author-link=

|etal=no

|title=The compulsion to repeat the trauma: re-enactment, revictimization, and masochism

|journal=Psychiatr Clin North Am

|location=

|last=deMause

|first=Lloyd

|author-link=

|etal=no

|title=Restaging Fetal Traumas in War and Social Violence

|location=

|date=1996

|last=Rhinehart

|first=John W.

|author-link=

|etal=no

|title=Neonatal Circumcision Reconsidered

|journal=Transactional Analysis Journal

|location=

|last=Goldman

|first=Ronald

|author-link=Ronald Goldman

|etal=no

|title=Psychological impact of circumcision

|journal=BJU Int

|location=

|last=Brown

|first=Mark S.

|author-link=

|last2=Brown

|first2=Cheryl A.

|author2-link=

|etal=no

|title=Circumcision decision: Prominence of social concerns

|journal=Pediatrics

|location=

|last=Rediger

|first=Chris

|author-link=

|last2=Muller

|first2=Andries J.

|author2-link=

|etal=no

|last=LeBourdais

|first=Eleanor

|author-link=

|etal=No

|journal=Can Med Assoc J

|location=

|last=Goldman

|first=Ronald

|author-link=Ronald Goldman

|etal=no

|title=Circumcision policy: a psychosocial perspective

|journal=Paedatrics & Child Health (Ottawa)

|location=

Research done since the 1960's forward to the present day has elucidated the nature, functions, and purpose of the [[foreskin]]. Circumcised men are learning what they have lost from the Internet, so they are less able to maintain the ego defense of denial of loss,<ref name="watson2017">{{REFjournal

|last=Watson

|author-link=

|last2=Golden

|first2=Tom

|author2-link=

|etal=no

|title=Male circumcision grief: effective and ineffective therapeutic approaches

|journal=New Male Studies: An International Journal

|location=

|last=Maguire

|first=Peter

|author-link=

|last2=Parkes

|first2=Colin Murray

|author2-link=

|etal=no

|title=Coping With Loss: Surgery and Loss of Body Parts

|journal=BMJ

|location=

|last=Howard

|first=Cynthia R.

|author-link=

|last2=Howard

|first2=Fred M.

|author2-link=

|last3=Weitzman

|first3=Michael L.

|author3-link=

|etal=no

|title=Acetaminophen analgesia in neonatal circumcision: the effect on pain

|journal=Pediatrics

|location=

|last=Bauer

|first=Ann

|author-link=

|last2=Kriebel

|first2=David

|author2-link=

|etal=no

|title=Prenatal and perinatal analgesic exposure and autism: an ecological link

|journal=Environ Health

|location=

|last=Frisch

|first=Morten

|author-link=

|last2=Simonsen

|first2=Jacob

|author2-link=

|etal=no

|title=Ritual circumcision and risk of autism spectrum disorder in 0- to 9-year-old boys: national cohort study in Denmark

|journal=J R Soc Med

|location=

|last=Bollinger

|first=Dan

|author-link=Dan Bollinger

|last2=Van Howe

|first2=Robert S.

|author2-link=Robert S. Van Howe

|etal=no

|title=Alexithymia and Circumcision Trauma: A Preliminary Investigation

|journal=International Journal of Men’s Health

|location=