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The performance of a circumcision takes very little force but it makes up for that by the extreme level of damage that it does to penile anatomy and function, as well as the extreme [[Pain| pain and trauma]] that it inflicts.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 |last=Ramos |first=Samuel |init=S |author-link= |last2=Boyle |first2=Gregory J. |init2=GJ |author2-link=Gregory J. Boyle |year=2001 |title=Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder |url=https://www.researchgate.net/publication/300649237_Ritual_and_Medical_Circumcision_among_Filipino_Boys |work=Understanding circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem |editor=Denniston GC, Hodges FM, Milos M |edition= |volume= |chapter= |pages=253-70 |location=New York |publisher=Kluwer Academic/Plenum Publishers |isbn= |quote= |accessdate=2019-12-08 |note=}}</ref>