Changes

Male circumcision is part of the culture of the Philippine Islands. Boys usually are not neonatally circumcised. Instead, [[Tuli| circumcision ]] is done when they are somewhat older. Some are medically circumcised while others are circumcised in a traditional manner. Ramos & Boyle (2001) studied the psychological effects of circumcision on Philippine boys. They reported that sixty-nine percent of traditionally circumcised boys and fifty-one percent of medically circumcised boys met the criteria for a diagnosis of post-traumatic stress disorder ([[PTSD]]).<ref name="ramos-boyle2001">{{REFbook

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