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''The following text Circumcision is taken from the classified as a form of [[Circumpendiumgenital mutilation]].''
Apart from 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=DeMeo |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=0-306-45589-7 |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 medical indication gods with human sacrifice. Castration of pathological phimosisslaves or conquered enemies was common as well. Following religious changes this sacrifice was altered, there also are other reasons and only a part of the very organ responsible for circumcisionthe creation of new life was sacrificed.
The visual appearance In many cultures circumcision during puberty serves as a rite of passage, bringing adolescents into the community. As with other painful or humiliating initiation rites, proof of courage and mastering of critical situations are the key motivations. From some African tribes it is also known that the [[penisamputation]] is changed radically after circumcision. In this case, personal taste is decisive whether an intact or a cut of the [[penisforeskin]] is more appealing. Since a circumcision cannot be undone, it is essential to be fully informed about seen as the risks and possible later complications before embarking on removal of an aesthetically motivated circumcisioninborn piece of femininity from the boys, to decide whether the appearance will justify such bodily modificationthus making them men.
Since this modification and its possible late effects will be the lifelong burden of the person who undertakes an aesthetically motivated circumcision to suit his personal preferences, a valid decision to proceed can only be made by the person to be circumcised himself, once he has reached the necessary age and level of maturity to make that decision. This should normally be the case when adulthood is reached.===Judaism===
=== Moral reasons ===In [[Judaism]], the tradition of [[Brit Milah| circumcision]] goes back to the [[Abrahamic covenant]] in a passage in the Book of Genesis (17:10-14). It was seen as a covenant between God and man, dating back to the patriarch Abraham. The validity of this passage is increasingly being questioned.
With {{Citation |Text=10 This is my covenant with you and your descendants after you, the [[foreskin]]covenant you are to keep: Every male among you shall be circumcised. 11 You are to undergo circumcision, circumcision removes approximately 70% and it will be the sign of the sensitive tissue of covenant between me and you. 12 For the [[penis]]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, lowering the potential for sexual stimulation accordinglythey must be circumcised. Due My covenant in your flesh is to the loss of around 50% of the entire penile skin, the be an everlasting covenant. 14 Any [[penisuncircumcised]] loses the reserve skin that provides cutaneous mobility male, who has not been circumcised in the erect [[penis]] and the gliding actionflesh, will be cut off from his people; he has broken my covenant.” |Author=Bible |Source=Gen 17, 10-14, NIV}}
In According to the anthropologist and sociologist Rabbi Nissan Rubin, the past[[Jewish circumcision| Jewish form of circumcision]], this circumstance called ''[[Brit Milah| brit mila]]'', during the first two millennia did not include the later customary ''[[periah]]'', namely the complete scraping of the inner [[foreskin]] from the [[Glans penis|glans]]. This was used only added around 135 AD, to make it harder for boys almost impossible to masturbaterestore the [[foreskin]] by [[stretching]], as masturbation was viewed as immoral and was assumed to cause a variety of diseases. More on that can be found which became popular in the chapter "historical background"wake of Hellenic influence. Today, it is known that masturbation has no negative health effects, but can contribute positively to While originally only the child's sexual development. Sexuality is no longer a taboo nowadays, while masturbation is considered to be a natural part tip of human sexuality and is no longer seen as immoral. Thereforethe [[foreskin]] was cut off, circumcision for moral reasons - which would only affect boys too young to give informed consent - is no longer justifiable nowadays''[[periah]]'' removes the entire [[foreskin]].
=== Hygiene reasons ===In the Greek society of the day, a denuded [[Glans penis|glans]] was considered obscene and risible. In ultra-orthodox communities, circumcision is followed by the ''[[mohel]]'', the ritual circumciser, sucking blood from the wound with his mouth. This practice is highly controversial, as it can result in an [[infection]] with [[herpes]] simplex type 1. In New York City, between 2000 and 2011 eleven children were infected with [[herpes]], 10 of whom had to be treated in hospital. Two of them suffered permanent brain damage, two others died. In the 12th century, the Jewish philosopher and doctor [[Moses Maimonides| Maimonides]] claimed that circumcision was necessary, as it diminished sexual desires and reduced the pleasure to a degree just sufficient for mere reproduction.
A common reason stated for circumcision is the assumption of hygienic benefits. This argument has to be viewed ===Christianity===Jesus was born into a Jewish family in [[Israel]], where [[Judaism]] was the context of prevailing religion, so He was [[circumcised]] on the environment the person in question grows up ineighth day.<ref>{{REFweb |url=https://www.biblegateway. It is commonly known that bad hygienic circumstancescom/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, especially insufficient access to clean drinking waterbefore His circumcision, pose a serious problem. The situation in disaster areas or refugee camps His name was then called Jesus, the name given by the angel before He was conceived in the so-called third world keep reminding us of thatwomb.}}</ref>
In western industrial nationsThe first Christians had been born Jewish, 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 so a daily basis - and that may question arose whether one must be assumed - no pathogens can accumulate under the [[foreskincircumcised]]to be a Christian. Cleaning of When Christian leaders met at the [[Glans penis|glansCouncil at Jerusalem]] and in the area underneath First Century to decide what was required to be a Christian, a letter was written to explain the [[foreskin]] is easy - they are simply washed along with the rest of the bodyrequirements, just like but circumcision was omitted from the areas between the toesrequirements.<ref>{{REFweb |url=https://www.biblegateway.com/passage/?search=Acts+15%3A1-30&version=NASB |title=Acts 15:1-30 |last=Luke |first= |accessdate=2019-11-10}}</ref>
The opening 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 to prevent [[foreskinmasturbation]] in small boys is often quite narrow and serves as a one. In those days, this so-called ‘self-way valve, allowing the urine to flow outabuse‘ was not only considered immoral, but preventing entry was supposedly responsible for a variety of microbesdiseases. Masturbation, however, is not mentioned anywhere in the Holy Bible, so there is no support for example from a dirty diaper. As long as the child belief that it is able to pass water, everything works as nature intendedsomehow immoral or sinful.
But even in areas where there are poorer hygienic conditions and an insufficient access to medical care, Even the benefits of easier cleaning mere existence of a circumcised [[penisforeskin]] are was falsoly linked to be viewed with a critical eyemany illnesses. Although even longer periods without personal hygiene will not result in an accumulation Among them one could find syphilis, epilepsy, paralysis of germs under the [[foreskin]]spine, bed wetting, scoliosis (spinal deformity), circumcision itself is not without risk paralysis of complications. If the operation is carried out without proper sterilitybladder, there is a high risk of an infection of club foot, nerve pain in the woundlower abdomen, tuberculosis and lazy eye. This also applies to One of the treatment best known advocates of common complications like postchild circumcision was [[John Harvey Kellogg]], co-operative bleedinginventor of the corn flakes bearing his name.In 1888, he wrote:
Some people claim that circumcision has prophylactic benefits. Especially in the USA those arguments have persisted Reasons for more then a 100 years, with ever changing diseases performing circumcision is said to protect against. At firstrange widely by culture, these were diseases where masturbation was believed to be the cause. After bacteria and viruses had been discoveredreligion, arguments changedlocation, and one after another miscellaneous diseases were citedage.
* 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>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 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>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.<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 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 and colleagues. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007:369;657-666.</ref><ref>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 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 cervix.===Cultural===
In conclusion, Many cultures perform circumcision does not provide any proven benefits as a rite of passage into manhood. This is common in preventive medicinethe Middle East and amongst some indigenous African and Southeast Asian peoples.
== Circumcision The [[United States]] and [[Israel]] are the only industrialized countries in detail: Stylesthe 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, techniques and instruments ==non-medical reasons. See [[History of circumcision]].
During ===Religious===The circumcision, of newborn boys is seen as a [[Abrahamic covenant| divine commandment]] in the [[foreskinJudaism| Jewish faith]] of . Though absent in the Koran, male circumcision is considered a religious requirement in [[penisIslam]] , and it is partly or completely removedperformed on male children of varying ages. The exact amount Converts to these faiths may also choose to undergo [[Adolescent and type of skin removed depends on the style and technique usedadult circumcision| circumcision]], and therefore also on the tools being usedbut it is not always required.
==== High & Tight<ref>de.Wikipedia user Tinoel</ref> ====The form of circumcision adopted by the medical community essentially was equivalent to the Jewish form with ''[[Image:Penis_unlabeled.jpg|300pxperiah]]'', so it inflicted the maximum injury.
This style In a few cases with older patients, circumcision is the most common in the USAlegitimately indicated; a patient may be suffering recurring infections, and other methods of treatment have failed. In this styleother cases, the outer a patient may be suffering from a severe case of [[foreskinphimosis]]. Overall, parts of the inner actual medical necessity for circumcision is extremely rare since many conditions respond to conservative treatment. All circumcisions injure the patient by amputating the [[foreskin]] its with many protective, immunological, sensory, and parts of the shaft skin are removedsexual [[Foreskin#Physiological_functions| functions]].
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:BeschneidungsstileIn such cases,_Styles_of_Circumcisionthe benefit of removing the problem foreskin may exceed the maleficial harms of tissue and function destruction.jpg</ref> ====
[[Image====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. {''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 Ninth Edition of the ''Encyclopǽdia Britannica'' (1876) made no mention of any prophylactic, medical, or therapeutic value or function.<ref>{{REFweb |url=https:Low_and_tight//www.cirp.org/library/history/encyclopaediabritannica1876/ |title=Circumcision |last=Cheyne |first=T. K.jpg |author-link= |publisher=Encyclopǽdia Brittanica |website=Circumcision Reference Library |date=1876 |accessdate=2019-11-10 |format= |300px]]quote=}}</ref>
In this styleInitially, both circumcision was adopted in the inner 19th century as a way to stop boys and outer men from masturbating, when [[foreskinmasturbation]] are completely removedwas claimed to be the cause for many diseases. The shaft skin is sewed just below As the rim myth that circumcision prevented masturbation became debunked, advocates of circumcision began the [[Glans penis|glans]]. The scar is located close great search to find the [[Glans penis|glans]], hence the term "lowmedical benefits"of circumcision.
This style is 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 most radicalpast, as it removes the entire sensitive tissue some advocates of mass circumcision have considered the [[foreskinprepuce]]. As in the high & tight style, large amounts to be a "mistake of skin are removed. In a flaccid statenature, "<!--{{Cold and Wiswell (1995)}} | [[Template:Cold and Wiswell (1995)|see more]]--> but this notion has no validity because the skin prepuce is barely movableubiquitous in primates and because it provides functional advantages.<ref name="cold-mcgrath1995">{{REFbook |last=Cold |first=Christopher |init=C |last2=McGrath |first2=Kenneth |init2=K |author2-link=Ken McGrath |year=1999 |title=Male and female circumcision: medical, legal, and ethical considerations in an erect state it is totally immobilepediatric practice |url=https://www.cirp.org/library/anatomy/cold-mcgrath/ |work= |editor= |edition= |volume= |chapter=Anatomy and histology of the penile and clitoral prepuce in primates |pages= |location=New York |publisher= |isbn=0306461315 |quote= |accessdate=2019-10-12 |note=}}</ref>
An insufficient amount of reserve skin can hamper an erection All claims that circumcision prevents future disease are false.<ref>{{REFweb |url=https://www.doctorsopposingcircumcision.org/for-professionals/alleged-medical-benefits/conclusions-and lead -references/ |title=Conclusions |last=Anonymous |first= |init= |publisher=Doctors Opposing Circumcision |date=2016 |accessdate=2023-10-22}}</ref> They are made to enable a physician to painful tension perform circumcision and collect a skewed [[penis]] in this style as wellfee.<!--===Search for prophylactic reasons===
[[image:High_and_looseFollowing the discovery of bacteria as a cause of many diseases – such as tuberculosis – the search began for other illnesses that could be prevented by circumcision.jpg|300px]]
hence In 1870 the term "high"prominent Dr. Unlike the high & tight style, the inner [[foreskinLewis Albert Sayre|Lewis A. Sayre]] is less reduced, and lies in folds behind 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 [[Glans penis|glans]https://intaction.org/circumcision-facts-and-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>
There is enough remaining reserve skin to ensure a complete and unhindered erectionIn the 1920s it was penile cancer. [[Abraham L. Wolbarst]] (1926) claims that circumcision can prevent penile cancer.<ref name="wolbarst1926">{{REFjournal |last=Wolbarst |first=Abraham L. Of all variants, this one removes the smallest amount of sensitive tissue |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>
The inner [[foreskin]] is removed, In the outer late 1960s it was neuroses. [[foreskinMorris Fishbein]] is sewed on below the [[Glans penis|glans]]. The scar is therefore located close (1969) calls for circumcision to the [[Glans penis|glans]]prevent nervousness and, of course, hence the term "low". The outer [[foreskin]] lies in folds behind the [[Glans penis|glansmasturbation]]. Enough skin is left in place to ensure a complete and unhindered erection.<ref>{{Fishbein1969}}</ref>
Since, in contrast to In the high & loose style, the inner instead of the outer 1970s bladder- and rectal cancer. [[foreskinAbraham Ravich]] is removed, this style results in the loss of almost all of the sensitive tissue(1971) claims that circumcision would prevent bladder cancer and rectal cancer.<ref>{{Ravich1971}}</ref>
Over time, a vast variety of methods has been developed to remove the [[foreskinAaron J. Fink]]. A multitude of clamps and tools is available to ease the work of the circumciser(1986), with no evidence whatsoever, to improve the chance for visually symmetrical results and to prevent injuries to the claims that circumcision protects against [[Glans penis|glansAIDS]] from inexpert cutsfollowed.<ref name="fink1986">{{REFjournal |last=Fink |first=Aaron J. |init=AJ |author-link=Aaron J. I will introduce some Fink |title=A possible explanation for heterosexual male infection with AIDS |journal=New England Journal of the most widely spread variantsMedicine |date=1986-10-30 |volume=31 |issue=18 |page=1167 |url=https://www.nejm.org/doi/full/10.1056/NEJM198610303151818 |DOI=10.1056/NEJM198610303151818 |accessdate=2019-11-20}}</ref>
In modern operating theatres the [[foreskin]] is first grasped with forceps, pulled out and clamped above the [[Glans penis|glans]] for a while to reduce bleeding. Next, the skin An ever-recurring element of initiation rites found in many different cultures is cut along the forceps with a scalpel. Following that, the remaining skin is manually trimmed according to fixation upon the desired style and finally suturedgenitalia.
Completely freehand techniques are also commonIt reflects the fascination that emerges from the ability to create new life. The penile skin In most cultures, fertility is first cut in two places along seen as the circumferencemost precious good, and the body parts involved frequently find themselves in the area focus of ritual acts. In many parts of the shaft skin world, those rites take place when the boy reaches puberty, and are meant to symbolize his transition from boy to man. The removal of the male [[foreskin]]is just one of many phenomena that developed in this context. After that They range from the skin area between removal of the cuts is removed frenulum in boys and men through partial or complete removal of the remaining skin sutured[[foreskin]] up to radical operations. Australian [[Aborigines]], as mentioned above, have their [[foreskin]]s removed. It is also usual that, a few weeks later, young men have their [[penis]]es sliced open in a [[subincision]], resulting in a partly or completely divided [[urethra]].
Also among Another known, particularly massive, intervention is the freehand techniques are stripping of the shield variantsentire [[skin]] off the [[penis]]. In Indonesia, boys have metal or bamboo balls inserted into their [[penis]] shaft or [[Glans penis|glans]] at the beginning of puberty, which form little "humps".
In ritual Jewish circumcision For many cultures it is also common to perform similar rituals on girls. This can range from relatively small interventions such as piercing or cutting the clitoral hood, to its complete removal and up to radical removal of clitoral hood, [[foreskinclitoris]] in inserted into the slit of the shield (left) , inner and then cut on the upper side of outer labia followed by sewing up the shieldvagina.
The Sheldon-Clamp (right) works in a similar way. The inner clamp grasps the tip of the [[foreskin]], pulling it into the outer clamp which is closed. The outer clamp then grips the skin. After a few minutes of pressure, the [[foreskin]] is cut between the two clamps.=== Prophylactic reasons ===
The use of a shield, rather than forceps, is meant to provide a better protection of Some people claim that circumcision has prophylactic benefits. Especially in the [[Glans penis|glansUSA]] from cutting injuriesthose arguments have persisted for more then a 100 years, with ever changing diseases circumcision is said to protect against. HoweverAt first, if used improperly both the Mogen and the Sheldon clamp are subject to the risk of the tip of the these were diseases where [[Glans penis|glansmasturbation]] being accidentally clamped was believed to be the cause. After bacteria and viruses had been discovered, arguments changed, and being cut into or severedone after another miscellaneous diseases were cited.
One The fact that the [[USA]] has both the highest percentage of [[circumcised]] males in the most widely used clamps in western world, as well as the USA is highest [[HIV]] infection rate, makes the Gomco clampstudies look dubious. FirstBesides that, several other studies concluded that circumcision does not have a cut is placed into significant impact on the risk of infection with [[foreskinHIV]].<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, then Thailand |source=Presented at the metal bell is placed over 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 [[Glans penis|glansUTI]]can be effectively treated with antibiotics, this was also proven by studies. After <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 bellfirst 6 years of life, together with the incidence of [[foreskinUTI]]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 |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 pulled through more likely to raise than to lower the opening in generally low risk of acquiring UTI: multiple studies from [[Israel]] showed a strong correlation between ritual circumcision on the base plate 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 concluded that circumcision is ineffective as a preventive measure against [[UTI]].* Penile and cervical cancer / HPV: first studies on those diseases and hung into their assumed prevention by circumcision date back to 1932, a time when the levercause for those illnesses was not yet fully understood. By fastening <ref>{{Wolbarst1932}}</ref> Today, 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 18 in carcinomas of the screw the lever pulls the bell upwardspenis from Brazil |journal=Int J Cancer |date=1986 |volume=37 |issue=1 |pages=55-9 |url= |accessdate=}}</ref>, jamming 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 [[foreskincircumcised]] between bell and base plate[[intact]] men. After several minutes 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 clampingFamily Physicians (Leawood, Kansas) |format= |date=2002-02-14 |accessdate=}}</ref>. The influence of circumcision on the infection risk of the skin female partner with cervical cancer has been refuted several times as well. HPV vaccination is cut off with a scalpel along the upper side an effective measure against carcinoma of the base plate and the clamp removedcervix.
The tissue beyond the string is cut off and the bell's handle cracked off. The strangulated tissue dies off in the following days, and the ring falls off on its own. Since this form of == Non-medical indications for circumcision means part of the process goes on without medical supervision, it may not be possible to intervene promptly in the event of swelling; also there is a risk of the ring being removed prematurely due to external influence. This may cause the healing wound to burst open, necessitating additional suturing.==
The Smartclamp and a couple of similar designs are one way clamps, representing a mixture of the Gomco and Plastibell methods. The [[Glans penis|glans]] is inserted into the plastic tube, Apart from the [[foreskinmedical indication]] pulled over it. The base plate of the outer clamping mechanism is pushed over the [[foreskin]] and cocked shutpathological phimosis, jamming the [[foreskin]] between the bulging lower rim of the tube 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 by itself after the clamped skin dies off in the following daysthere also are other reasons for circumcision.
All of these methods have in common that the [[foreskin]] has to be separated 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|glans]].=== Aesthetic reasons ===
== Risks The visual appearance of the [[penis]] is changed radically after circumcision. In this case, personal taste is decisive whether an [[intact]] or a [[circumcised]] [[penis]] is more appealing. Since a circumcision cannot be undone, it is essential to be fully informed about the risks and late effects ==possible later complications before embarking on an aesthetically motivated circumcision, to decide whether the appearance will justify such bodily modification.
Just like tonsil or appendix surgery, It should be noted that every circumcision is operation leaves a surgical intervention and brings life-long [[circumcision scar]] that encircles the usual risks related to surgical operationsshaft of the [[penis]]. In addition, alongside several specific risks of complications and late effectsthere frequently a a color change at the circumcision scar which results in a two-tone appearance.
=== Possible operative Since this modification and postoperative complications ===its possible late effects will be the lifelong burden of the person who undertakes an aesthetically motivated circumcision to suit his personal preferences, a valid decision to proceed can only be made by the person to be [[circumcised]] himself, once he has reached the necessary age and level of maturity to make that decision. This should normally be the case when adulthood is reached.
* 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 S, 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 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 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-ritual.html?_r=0</ref>==Financial reasons===
=== Physical late effects ===In the United States, payment for non-therapeutic circumcision is made by most [[third-party payment| third-party payers]] without question of necessity. Doctors frequently perform medically-unnecessary, non-therapeutic circumcision of infants and children simply to collect a fee for the surgical operation. The only beneficiary of such surgery is the [[Financial Incentive| bank account of the medical doctor]].
* 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 approximately 20,000 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 from friction and drying out by developing a callus layer. This reduces the sensitivity of the remaining nerves in the [[Glans penis|glans]] 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 men, 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 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 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>=== Moral reasons ===
=== Psychological late effects ===With the [[foreskin]], circumcision removes approximately 70% of the sensitive tissue of the [[penis]], lowering the potential for sexual stimulation accordingly. Due to the loss of around 50% of the entire [[penile skin]], the [[penis]] loses the reserve skin that provides cutaneous mobility in the erect [[penis]] and the [[gliding action]].
Psychological late effects are also possible after a circumcisionIn the past, this circumstance was used to make it harder for boys to masturbate and [[masturbation]] less fun, especially if the operation as [[masturbation]] was viewed as immoral and was carried out in childhood. On this occasion assumed to cause a variety of trauma may occur, which depend, among othersmental diseases, caused by the thinking of immoral thoughts! More on age and circumstances of that can be found in the circumcisionchapter "[[Circumcision#Historical_background|Historical background]]". For exampleToday, whether the circumcision took place with or without sufficient anaesthesiait is known that [[masturbation]] has no negative health effects, if but can contribute positively to the individual has been informed about the operation beforehand, if he was circumcised against his will or without his consentchild's sexual development. Sexuality is no longer a taboo nowadays, while [[masturbation]] is considered to be a natural part of human sexuality and alsois no longer seen as immoral. Therefore, in the case of infant circumcision, if he was told about it during childhood or had for moral reasons - which would only affect boys too young to find it out coincidentally on his owngive [[informed consent]] - is no longer justifiable nowadays.
The psychological late effects of circumcision are not yet fully researched, and many studies took place on rather a small scale. This situation needs to be rectified, because the available studies, as well as the histories of negatively affected men, suggest that these late effects may have more impact than previously assumed.=== Hygiene reasons ===
* 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 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 ''Hygiene'' refers to be fed. The sleeping habits of these babies were also disturbed, with prolonged non-REM sleep health and increased waking.* In boys circumcised in childhood, post traumatic stress disorder (PTSD) could be diagnosed. In a study on Philippine boys, in whom no PTSD was found prior only secondarily to the operation, 69% of the boys circumcised in the traditional ritual and 51% of those circumcised by standard medical procedures (including anaesthesia) fulfilled the DSM-IV criteria for PTSD following the operation.<ref>Ramos S, Boyle GJ. Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder. In: Denniston GC, Hodges FM, Milos MF (eds) Understanding circumcision: A Multi-Disciplinary Approach 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 can persist as trauma. These feeling can also be triggered later, when someone circumcised as an infant becomes aware of his circumcision. In an online study, interviewed men stated they felt betrayed - 55% by the mother, 50% by the father, and 58% by the doctor, and 73% felt that their human rights had been violated.<ref>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 to be reminded of their own loss. In this process, their own body is defined as "normal" and the [[foreskin]] 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 so, following an idealised image of his own parents, circumcision, which has been redefined as a "good thing", is passed on to his son by having him circumcised as well.<ref>van der Kolk BA. The compulsion to repeat the trauma: re-enactment, revictimization, and masochism. Psychiatr Clin North Am 1989;12(2):389-411.</ref><ref>Goldman R. The psychological impact of circumcision. BJU Int 1999;83 Suppl. 1:93-103.</ref>* If the circumcised male feels incomplete, or due to the missing [[foreskin]] disadvantaged compared to intact males, an inferiority complex and depression may occur. This can 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, Volcleanliness. 69, 1945, 7-25</ref>
The amputation A common reason stated for circumcision is the assumption of the [[foreskin]] is a very old ritual, whose exact origin cannot hygienic benefits. This argument has to be verified beyond doubt. Medical historians assume that circumcision already served viewed in ancient history as a way to control the sexuality of slaves and members context of the lower classes without compromising their ability environment the person in question grows up in. It is commonly known that bad hygienic circumstances, especially insufficient access to reproduce. In religious history circumcision may be seen as clean drinking water, pose a substitute for human sacrificeserious problem. In prehistoric times it was not uncommon to placate the gods with human sacrifice. Castration of slaves The situation in disaster areas or conquered enemies was common as well. Following religious changes this sacrifice was altered, and only a part of refugee camps in the very organ responsible for the creation so-called third world keep reminding us of new life was sacrificedthat.
In The opening of the Jewish religion, the tradition of circumcision goes back to a passage [[foreskin]] in the Book of Genesis (17, 10-14). It small boys is seen often quite narrow and serves 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 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, 10one-14, NIV}}According to the anthropologist and sociologist Nissan Rubin, the Jewish form of circumcision, called brit milaway valve, during the first two millennia did not include the later customary periah, namely the complete scraping of the inner [[foreskin]] from allowing the [[Glans penis|glansurine]]. This was only added around 135 AD, to make it impossible to restore the [[foreskin]] by stretching, which became popular in the wake of Hellenic influence. While originally only the tip of the [[foreskin]] was cut offflow out, periah removes the entire [[foreskin]]. In the Greek society but preventing entry of the daymicrobes, for example from a denuded [[Glans penis|glans]] was considered obscene and risibledirty diaper. In ultra-orthodox communities, circumcision is followed by As long as the mohel, the ritual circumciser, sucking blood from the wound with his mouth. This practice child 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 able 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 necessarypass water, everything works as it diminished sexual desires and reduced the pleasure to a degree just sufficient for mere reproductionnature intended.
In Islam, circumcision is also religiously founded, But even though in areas where there is no mention of it in the Koran itself. According are poorer hygienic conditions and an insufficient access to traditionmedical care, the Prophet Mohammed was born without benefits of easier cleaning of a [[foreskincircumcised]] [[penis]]are to be viewed with a critical eye. It is seen as a sign Although even longer periods without personal hygiene will not result in an accumulation of prophets that they are born without a germs under the [[foreskin]] already. It , circumcision itself is considered an honour to "resemble the example not without risk of complications. If the Prophet", meaning to be circumcised. In Islam, unlike Judaismoperation is carried out without proper sterility, there is no specific age at which a high risk of an [[infection]] of the circumcision should be performedwound. Most circumcisions take place at ages between 6 and 10 years, but This also applies to the range goes from birth to adulthoodtreatment of common complications like post-operative [[bleeding]].
In Christianity, circumcision is only common in a few orthodox churches. Nevertheless, Christian moral notions had decisive influence on the spread The benefit of this practice. In easier cleaning must be balanced against the puritan influenced USA, circumcision risk of children was popular in the 19th century as a means to prevent masturbation. In those days, this so-called ‘self-abuse‘ was not only considered immoral, but was supposedly responsible for a variety of diseases. Even the mere existence of a promoting serious infections — among others [[foreskinHIV]] 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 — during 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 parts of allaying the abnormal excitementAfrica, and preventing the recurrence several dozen of the practice 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>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 one tribe's boys die each year as a cause result of many diseases – such as tuberculosis – the search began for other illnesses that could be prevented by their circumcision.
In the 1920s it was penile cancer<ref>Abraham L. Wolbarst behauptet, die Beschneidung könne dem Peniskrebs vorbeugen. [Is circumcision a prophylactic against penis cancer? Cancer 1926 Jul;3(4):301-10]</ref>, in the 1940 prostate- and tongue cancer as well as STDs<ref>Eugene H. Hand erklärt, dass die Beschneidung irgendwie gegen Geschlechtskrankheiten und Zungenkrebsschütze. [== Circumcision and venereal disease. Archives of Dermatology and Syphilology 1949 Sep;60(3):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. [Prophylaxis of cancer of the prostate, penis, and cervix by circumcision. New York State Journal of Medicine 1951 Jun;51(12):1519-20</ref>, in the late 1960s it was neuroses<ref>Morris Fishbein fordert die Beschneidung zur Prävention von Nervosität und natürlich auch Masturbation. [Sex hygiene. Modern Home Medical Adviser. Garden City, New York: Doubleday & Co: 1969 pp 90, 119]</ref>, in the 1970s bladder- and rectal cancer<ref>Abraham Ravich behauptet, dass die Beschneidung Blasenkrebs und Rektumskrebs vorbeugen würde. [Viral carcinogenesis in venereally susceptible organs. Cancer 1971 Jun;27(6)1493-6]</ref>, nd in the 1980s UTIs<ref>Thomas E. Wiswell behauptet, eine Beschneidung verringere das Risiko für Harntraktinfektionen. [Decreased incidence of urinary tract infections in circumcised male infants. Pediatrics 1985 May;75(5):901-3]</ref> and AIDS<ref>Aaron J. Fink behauptet, dass die Beschneidung gegen AIDS schütze. [A possible explanation for heterosexual male infection with AIDS. New England Journal 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.methods ==
An ever-recurring element 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 pain is quite severe, and requires injections for proper pain management. Sucrose and Acetaminophen ''"cannot be recommended as the sole method of initiation rites found in many different cultures analgesia"''. Topical cream is no longer thought sufficient as ''"the fixation upon analgesic effect is limited during the genitaliaphases associated with extensive tissue trauma such as...tightening of the clamp"''.<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=2019-11-26 |note=Statement Reaffirmed Sept.1, 2005}}</ref>
It 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. In many parts of the world, those rites take place when the boy reaches puberty, and are meant to symbolize his transition from boy to man. The removal of the male [[foreskinAAFP]] is just one of many phenomena that developed (2002) states quite simply in this contexttheir [https://www.cirp.org/library/statements/aafp2002/| position paper], ''"Newborns experience pain during circumcision".''<ref>{{REFweb |title=Circumcision: Position Paper on Neonatal Circumcision. They range from the removal Board Approved: August 2007 Reaffirmed |website=Official American Academy of the frenulum in boys Family Physicians Website |url=http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html |accessdate=2011-05-02}}</ref> This is not a debatable fact, and men through partial or complete removal of the [[foreskin]] up to radical operations. Australian Aboriginesyet, as mentioned aboveit is not widely accepted, have their [[foreskin]]s removedeven by some doctors. It is also usual thatmight be hard for some doctors to accept, a few weeks later, young men as they may have their been taught that the infant does not feel [[penispain]]es sliced open, resulting in a partly or completely divided urethraand may have performed countless circumcisions with this idea. Usage of anesthesia for infant circumcision is still by no means the rule.
Another knownPenile injections of local anesthetic are now recommended by all of the major medical institutions if a circumcision is to be performed. In their [http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml Report 10 of the Council on Scientific Affairs], particularly massive, intervention is the stripping of AMA states ''"When the entire skin off decision is made to proceed with circumcision, local anesthesia should be provided for the procedure. [[penisRing block]]. In Indonesia, boys have metal or bamboo balls inserted into their [[penisdorsal penile nerve block]] shaft or [injections] are most effective. [[Glans penis|glansEMLA]] at 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 beginning use of local anesthesia". The AMA reports that "Of physicians performing circumcision, 45% use anesthesia, 71% of pediatricians, 56% of pubertyfamily practitioners, which form little "humpsand 25% of obstetricians"''.<ref>{{REFweb |title=Report 10 of the 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>
For many cultures it is also common The AAP's [http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to perform similar rituals on girls-make/pages/Where-We-Stand-Circumcision. This can range from relatively small interventions such as piercing aspx Heatlhy Children website] suggests ''"Your pediatrician (or cutting your obstetrician) should discuss the clitoral hoodforms of analgesia that are available"''.<ref>{{REFweb |title=Where We Stand: Circumcision |publisher=[[AAP]] |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, few forms of analgesia are recommended. There are basically two types of injections to its complete removal and up to radical removal of clitoral hoodchoose from, clitoris, inner and outer labia followed by sewing up the vaginawebsite does not go into the difference between a 'dorsal nerve block' and a 'ring block' injection.
== Rights Given what is known from aforementioned official documents, the AAP website may be more informative and Ethics ==effective if it would say ''"Make sure your doctor knows of the ineffectiveness of anything short of local anesthesia, and make sure your baby is given an injection. This is your responsibility, because your doctor may or may not be up to date on the latest understandings of infant sensitivity to [[pain]] during circumcision."'' The AAP may be holding back, however, perhaps because this would upset the doctor/parent power relationship, and may cause too much questioning of doctors in general. One may not expect to find this kind of advice on such a website, and yet, anything less than this is a dangerously weak statement.
NonTo control [[pain]], 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 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 the 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 Circumcision |last= |first= |publisher= |date=2011-04-08 |accessdate=2011-04-08}}</ref> a topical cream,<ref>{{REFweb |quote=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= |publisher= |date=2011-therapeutic 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 lessen the pain of children the injection, but studies have shown that a [[dorsal penile nerve block]] is not only one partially effective in stopping the [[Pain| pain of circumcision]].<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 most widespread surgical operations in study group had what we considered excessive pain/discomfort over the world, but also one course of the oldestentire 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. It is probably due |init=PS |last2=Evans |first2=Nolan Donovan |init2=ND |title=Neonatal Cortisol Response to Circumcision with Anesthesia |journal=Clinical Pediatrics |volume=25 |issue=8 |pages=412-6 |url=http://cpj.sagepub.com/content/25/8/412.abstract |quote=The adrenal cortisol response to this long traditionsurgery was not significantly reduced by the administration of lidocaine. |pubmedID= |pubmedCID= |DOI= |date=1986-08 |accessdate=2011-04-08}}</ref> During circumcision, that despite its violating the common basic rights somp physicians give children sugar pacifiers to bodily integrity and medical ethics in "reduce the western worldperception of pain", it is still widely tolerated there<ref>{{REFweb |quote=During the circumcision, even though there are barely any legal exemptions 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 Circumcision |last= |first= |publisher= |date=2011-04-08 |accessdate=2011-04-08}}</ref> but in place. The few regulationsat least one study, which mostly emerged data shows that giving sugar to a child doesn't help to reduce the perception of pain in the recent pastchild.<ref name="Lancet, usually only deal with the basic conditionsThe 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 |url=http://www.thelancet. They regulate how 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 under what conditions the operation 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 carried out, while interpreted as pain relief. |pubmedID= |pubmedCID= |DOI= |date=2010-10-09 |accessdate=2011-04-08}}</ref> Post-operative pain and the pain the general compatibility with basic human rights child must endure during recovery is rarely questionedhardly, if ever, let alone taken into considerationaddressed by professionals.
=== Examples It has been shown that an infant's response to [[pain]] can be altered for years as a consequence of legal regulationscircumcision.<ref>http:{{TaddioA etal 1995}}<//de.wikipedia.org/wiki/Zirkumzision#Regelung_der_Beschneidung_Minderj.C3.A4hriger_in_einzelnen_Staatenref><ref>{{TaddioA KatzJ IlersichAL KorenG 1997}}</ref> ===
Generally== Risks and effects ==Just like tonsil or appendix surgery, circumcision of children met is a surgical intervention and brings the criteria usual risks related to surgical operations, alongside several specific risks of bodily assault until December 2012complications and late effects. Uberoi et al. Practically(2022) report "some men are experiencing a complex negative constellation of psychological, howeverphysical, it was not legally pursued, since it was considered unclear whether parents had the right to consent and sexual associations that lead to significant emotional distress directed both internally and externally. The posts also reveal a discovery phenomenon wherein men discover the operation on behalf physical and psychological manifestations of the decisions made by others to modify their children (see §228 StGB)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 non-therapeutic neonatal penile circumcision: a qualitative and quantitative analysis of self-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>
In 2004=== 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, which account for the major part of male sexual sensation. If the ''Landgericht'' (regional court) [[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 from friction and drying out by developing a callus layer. This reduces the sensitivity of Frankenthal ruled the remaining nerves in the [[Glans penis|glans]] gradually over the years. The study conducted by Sorrells et al.<ref>{{Sorrells etal 2007}}</ref> found a case significant reduction of a circumcision done by non-medical peoplesensitivity 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, that parental consent was not legally validsince they further limit the sexual sensitivity (see above).
In August 2007 the ''Oberlandesgericht'' (upper regional court) Frankfurt* Painful tension can occur when there is too little reserve [[skin]] left to support a full [[erection]]<ref name="taylor1996"/Main found that >. This risk is partly dependent on the decision about a circumcision, because anatomy of the "bodily modifications that cannot be reversed [[penis]]...While some [[penis]] belongs to es already have the core majority of a persontheir 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]], or "[[grower]]"). Especially in children's rights to decide upon for themselves"circumcision, where the [[penis]] is not yet fully developed, the amount of reserve [[skin]] needed in adulthood cannot be estimated.
The ''Landgericht'' (regional court) of Cologne, * Erectile dysfunction: Both the damage inflicted to the blood vessels in a second trial, ruled on May 7th, 2012the [[foreskin]] and the reduced sexual sensitivity can be causes for reduced erectile function with advancing age.<ref>http{{REFjournal |last=Money |init=J |last2=Davison |init2=J |title=Adult penile circumcision://dejure.org/dienste/vernetzung/rechtsprechung?GerichtErotosexual and cosmetic sequelae |journal=Journal of Sex Research |date=1983 |volume=19 |issue= |pages=LG%20K%F6ln&Datum289-92 |url=07.05.2012&Aktenzeichen |accessdate=151%20Ns%20169/11}}</ref>, that circumcision is a bodily assault, which is not justified by the religious motivation and wishes of the parents and is not in the interest of a child's well-being.
The ruling from May 2012 sparked fierce protests * 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 representatives 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 religious groupsthe natural [[gliding action]], which were instantly answered by politicians with comes from the mobility of the assurance that religiously motivated [[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<ref>{{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's perception of underage Muslim 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 Jewish boys more vigorous thrusting movements - compared to [[intact]] men - play a part in Germany would remain legalthis.<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 on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction |journal=J Urol |date=2002 |volume=167 |issue=5 |pages=2113-6 |url= |accessdate=}}</ref>
On August 23rd, 2012, * [[Lymphoedema]] of the ''Deutscher Ethikrat'' (German Council of Ethics), during penis is a publicly held plenary session, came to terms "despite profound differences" (!) upon four minimum requirements for legal regulation normal and expected complication of male circumcision:.
The explicitly mentioned profound differences point out the difficulty * Shorter adult penile length was reported by Park et al. (2016) as a result of legally regulating the NMC (newborn male circumcision of underaged boys). The legislative procedure led {{Citation |Title= |Text=In conclusion, second to a broad public debate over the legitimacy fourth digit ratio, flaccid penile length, and legality age of circumcision of minors in German societywere significant predictive factors for erectile penile length. Despite Furthermore, the fierce resistance penile lengths of medical associations, jurists, constitution experts, child and human rights activists as well as 100 Members the NMC group were shorter than those of Parliament, the following Act was adopted in December 2012non-NMC group. |Author=Park et al. |Source= |ref=<ref>{{REFjournal |last=Park |first= |init=JK |author-link= |last2=Doo |first2= |init2=AR |author2-link= |last3=Kim |first3= |init3=JH |author3-link= |last4=Park |first4= |init4=HS |author4-link= |etal=yes |title=Prospective investigation of penile length with newborn male circumcision and second to fourth digit ratio. |trans-title= |language= |journal=Can Urol Assoc J |location= |date=2016-09 |season= |volume=10 |issue=9-10 |article= |page= |pages= |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028213/ |archived= |quote= |pubmedID=27695583 |pubmedCID=5028213 |DOI=10.5489/cuaj.3590 |accessdate=2022-09-04}}</ref>}}
''Circumcision of the and frenectomy remove tissues with heightened erogenous sensitivity.<ref name="cepeda2023" /> <ref name="winkleman1959">{{WinkelmannRK 1959}}</ref> They concluded, "Evidence has also started to accumulate that male child''circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well."
''(1) Personal Care also includes The [[amputation]] of the prepuce results in the right to consent to loss of the circumcision majority of fine-touch neuroreceptors found in the male child who lacks competence and understanding[[penis]], if it is to be performed according to proper medical standardsleaving only the uninhibited protopathic sensibility of the artificially externalized [[glans penis]]. This does The imbalance caused by not apply when having the input from the circumcision, also considering now ablated fine-touch receptors may be a leading cause of the motivation, endangers changes in sexual behavior noted in [[circumcised]] human males.<ref>{{REFjournal |last=Van Howe |init=RS |author-link=Robert S. Van Howe |last2=Cold |init2=CJ |title=Advantages and Disadvantages of Neonatal Circumcision |journal=The Journal of the child's wellAmerican Medical Association |volume=277 |issue=13 |pages=1052-being7 |url=http://www.ncbi.nlm.nih.''gov/pubmed/9218663 |quote= |pubmedID=9218663 |pubmedCID= |DOI= |date=1997-04-02 |accessdate=}}</ref>
''Histology of the male circumcision scar shows [[amputation]] neuromas, Schwann cell proliferation and the bulbous collection of variably sized neurites. [[Amputation]] neuromas do not mediate normal sensation and are notorious for generating pain.<ref name="ColdCJ TaylorJR 1999"/> Cepeda-Emiliani et al. (22023) During commented:<blockquote> Taking the sleve technique as an example of surgical flexibility during circumcision, to the first 6 months extent that this technique is of lifesuch versatility that it allows highly variable quantities of cutaneous and subcutaneous tissue to be excised directly from the penile body, persons appointed and to the extent that the prepuce is still conceived by segments of the medical community as "just a religious group may perform small piece of skin", we are concerned that aggressive circumcisions according to paragraph 1, if they are specially trained intentionally or unintentionally being performed in pediatric andadult patients in the belief that "redundant" or " extra" tissue is being excised, without or in the belief that "excesive sensitivity" is being a medical doctor, are similarly competent reduced to perform circumcisionaugment ejaculatory latency time.''<ref name="cepeda2023" />
Therefore, a non-therapeutic See [[Sexual effects of circumcision of a male child lacking competence and understanding ]] for whatever reason is generally legal. A right of veto for the affected boys was turned down in parliament, as well as a proposed change destined to introduce an evaluation of the regulations after five years. Giving the Ministry of Heath the right to determine more specific guidance - for example regarding pain management and the qualification and training of non-medical circumcisers - by issuing additional regulations was also rejected. A call for mandatory documentation of non-therapeutic circumcisions was ignored. Merely stating the intent to have the operation performed according to proper medical standards was considered sufficientinformation.
In December 2012=== Psychological effects ===[[Psychological_issues_of_male_circumcision#Circumcision_trauma_in_adults| Psychological late effects]] are also possible after a circumcision, especially if the operation was carried out in childhood. On this occasion a representative poll done by Infratest dimap revealed that only 24 percent variety of [[trauma]] may occur, which depend, among others, on age and circumstances of the interviewed citizens were circumcision. For example, whether the circumcision took place with or without sufficient anaesthesia, if the individual has been informed about the operation beforehand, if he was [[circumcised]] against his will or without his consent, and also, in favour the case of the lawinfant circumcision, while 70 percent explicitly disapproved of if he was told about it during childhood or had to find itout coincidentally on his own.<ref>http://die-betroffenen.de/blog/mehrheit-der-bevoelkerung-lehnt-beschneidungsgesetz-ab/ und http://www.infratest-dimap.de/umfragen-analysen/bundesweit/umfragen/aktuell/bewertung-der-gesetzlichen-regelung-zu-beschneidungen/</ref>
==== Austria ====The psychological late effects of circumcision are not yet fully researched, and many studies took place on rather a small scale. This situation needs to be rectified, because the available studies, as well as the histories of negatively affected men, suggest that these late effects may have more impact than previously assumed.
In Austria, bodily assault is, as in Germany, punishable* It was observed that infants, following circumcision without any specific regulations regarding circumcision. There is[[pain]] control, however – unlike in Germany had a disturbed bond with their mother<ref>{{REFjournal |last=Marshall |init=RE |last2=Porter |init2=FL |last3=Rogers |init3=AG |etal=yes |title=Circumcision: II effects upon mother- no specific basic right to an unharmed body in the constitutioninfant interaction |journal=Early Hum Dev |date=1982 |volume=7 |issue=4 |pages=367-74 |url=https://www. It is regulated in §146a ABGB that "the application of bodily violence and the infliction of bodily or mental suffering" by the parents is unlawfulcirp. According to §90 (3) StGB it is impossible to consent to "a mutilation or other injuring of the genitalsorg/library/birth/marshall2/ |accessdate=2020-02-01}}</ref>, as well as problems with nurturing, that is able up to inflict a lasting impairment of the sexual sensitivity" even for adults. On the other hand, the ''"Israelitengesetz"'' (Law for the Israelites) entitles the Jewish religious group and their members to "bring their children and juveniles, also outside point of school, through all traditional rites and refusal to educate them according to their religious commandments"be fed. Circumcision The sleeping habits of boys for religious reasons is not considered punishable by the Austrian Ministry of Justicethese babies were also disturbed, with prolonged non-REM sleep and is justified by the parental rightsincreased waking.
In France[[Intact America]] (2019) called circumcision an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]], there is no specific regulation for circumcision. The question of parental consent is neither debated under religious aspects nor by the parenting laws. Article 16.3 of the civil code states that <ref name-"the integrity of the human body may not be harmed, other then in cases of medical necessity for those affectedbollinger2019">{{REFdocument |title=Child genital cutting as an adverse childhood experience |url=http://adversechildhoodexperiences. However, there is a "silent toleration" of the circumcision of minorsnet/CGC_as_an_ACE.pdf |last=Bollinger |first=Dan |author-link=Dan Bollinger |last2=Chapin |first2=Georganne |author2-link=Georganne Chapin |publisher=Intact America |location=Tarrytown |format=PDF |date=2019-08 |accessdate=2021-11-02}}</ref>
In Italy, there is a basic agreement between the State and the Jewish communities that was formulated == Forced circumcision ==<!--=== United States military ===American soldiers serving in 1987 and secured in the law in 1989World War II were subjected to regular inspections of their genitals. It implies that If intact, the Jewish way of soldiers risked being ordered to undergo immediate circumcision is in accord with the Italian system of laws. According to Article 19 <ref>{{REFbook |last=Schoen |first=Ed |init=E |author-link=Edgar J. Schoen |year=2005 |title=On Circumcision |url=https://books.google.de/books?id=-zUhdvSt7cgC |work= |editor=Dianne Yeakey |edition= |volume= |chapter= |pages=72-3 |location=Georgetown, Canada |publisher=RDR Books |isbn=1-157143-123-3 |quote=For a critical view, see Sorrells, "The History of the Italian constitutionCircumcision, religious freedom is to be respected, as long as no acts are performed that contradict good manners" p. 333 |accessdate= |note=}}</ref> This practice was discontinued at least six decades ago.-->=== Non-therapeutic circumcision of male children ===
At In recent years, legal writers in several English-speaking countries have been questioning the end practice of 1999acceding to parental wishes.<ref>See, the Finnish parliament issued a declaration regarding ritual circumcisione.g., [[Margaret A. Ombudsman RiitaSomerville|Somerville]], "Therapeutic and Non-Leena Paunio statedTherapeutic Medical Procedures"; Poulter, that ''English Criminal Law''; [[Abbie Chessler|Chessler]], "Justifying the operation could not be recommended without a medical indicationUnjustifiable"; Smith, "Male Circumcision."</ref> For example, and critics have pointed out that , in the affected children should be consulted and give consent[[United States]], more than 1. She said, the Finnish parliament had 3% of male neonatal deaths are attributable to weigh the religious rights complications of the parents against the responsibility of the society to protect their children from ritual operations that have no immediate benefit for themnon-therapeutic circumcision surgery. Since then, the written consent of both parents <ref name="Bollinger 2010"/>==Video=====Is circumcision healthy?===The video ''Is Circumcision Healthy'' is mandatoryrecommended for parental viewing.<br><br> <youtube>D_3LQjZgdbQ</youtube>
In Sweden, non-therapeutic ===Plastibel circumcision of boys under 18 years of age is regulated since 2001 by the ''"Lag (2001:499) om omskärelse av pojkar"'' (Law regarding circumcision of boys). According to it, such circumcisions are a surgical procedure and have to be carried out by a qualified doctor and under anaesthesia. For boys under 2 month of age, circumcision may also be carried out by another competent person with a government license. This applies to persons that have been nominated by religious groups in which circumcision is part of the religious tradition. Persons who perform a circumcision without the necessary qualification or license face a fine or prison sentence of up to six months. The circumcision requires the consent of the legal guardians. It may not be carried out against the child's will, if he has the age and level of maturity for such a statement.===
==== USA ===={{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]
The USA have by far the highest rate of ===Gomco clamp circumcision among the western nations. In many maternity wards the routine circumcision of newborn boys is common. The US paediatric society, AAP, is the only major medical society in the world still advocating the non-therapeutic circumcision of newborns and children.===
In the autumn of 2010, Californian intactivists called '''Not for a ban of routine infant circumcision and thereby sparked a nation-wide discussion of the topic.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.
It is noteworthy that, despite the wide spread of non-therapeutic circumcision of children and the fact that it contradicts many national laws, there is barely a country that has issued explicit exemptions* [https://www. The principle of "silent toleration" is, regardless of a possible illegality, common practicereddit.com/r/Intactivism/comments/qbpzqr/trained_medical_professionals_restrain_infant_to/ Circumcision video]
Considering the severity of the intrusion into the body of the affected person, the question arises, whether it is both legally and morally acceptable to leave the decision about a non-therapeutic operation on a child too young to understand or give valid consent, to the parents alone. In Germany, several basic rights are concerned* The [[Royal Dutch Medical Association]] (KNMG) (2010) said:
* the right to bodily integrity<blockquote>* the right to sexual selfThe official viewpoint of KNMG and other related medical/scientific organisations is that non-determination* the right to equal treatment of genders (therapeutic circumcision/FGM of females male minors is illegal)* the right to religious freedom (where the circumcision has a religious motive) These four basic rights are relevant from the legal as well as the ethical point violation of view. Let us begin with the most obvious intrusion - the one into the bodily integrity. Under German law, children enjoy far-reaching protection, that limits the parental children’s rights to autonomy 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 prohibitedintegrity. This is not only corporal punishmentContrary to popular belief, which was common in familiescircumcision can cause complications – [[bleeding]], schools and vocational training for agesinfection, which may cause direct ([[urethra]]l stricture and sometimes severe) bodily harm - it also covers spanking, which panic attacks are particularly common. KNMG is included under degrading treatmenttherefore urging a strong policy of deterrence. It KNMG is assumed that not only does calling upon doctors to actively and insistently inform parents who are considering the immediate injury harm the child, but also procedure of the feeling absence of helplessness medical benefits and of being at someone's mercy at the time danger of punishment by an authority figurecomplications. This also applies to other treatment that harms the dignity <ref>{{REFdocument |title=Non-therapeutic circumcision of a child male minors |url=https://www.doctorsopposingcircumcision.org/wp-content/uploads/2016/09/knmg-non-therapeutic-circumcision- for example being forced to publicly change clothes in front of the kindergarten group after wetting his pants-male-minors-27-05-2010.pdf |contribution= |last= |first= |publisher=Royal Dutch Medical Association |format=PDF |date=2010 |accessdate=2021-11-08}}</ref></blockquote>
If you take a look at the list of possible bodily and mental harms and late-effects listed in * The [[Circumcision#Risks_and_late_effects|"Risks and late effects"Royal Australasian College of Physicians]], the imbalance becomes apparent. Spanking is already unlawful, but the irreversible amputation of an important, healthy part of the genital organ is not. The inevitable and possible consequences of this operation are ignored to a degree that is in harsh contrast to the established protection of children. Legalization, therefore, represents a considerable limitation of the male child's right to bodily integrity and protection from potentially harmful methods of upbringing.(2010) said:
There are also ethical problems. Can a child be denied the right to determine the visible appearance <blockquote>Ethical and degree of functionality of his body? Should a circumcised boy later in life decide that he would prefer to have an intact [[penishuman rights]], he has no means of reversing the decision his parents made. Other people's ideas about his body‘s appearance and functionality are imposed upon him irreversibly. He concerns have been raised regarding elective infant male circumcision because it is denied the possibility of deciding upon recognised that according to his own preferences, 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 a level of paternalism regarding such foreskin has a severe intrusionfunctional role, especially in the most intimate area of operation is non-therapeutic and the child, cannot be justified by the parents‘ willinfant is unable to consent.
It is not much different with After reviewing the right to sexual self-determination. Herecurrently available evidence, the consequences RACP believes that the frequency of diseases modifiable by circumcision, the level of protection offered by circumcision has and can have for the body, play a significant rolecomplication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand. Normally, a man has free choice as to how he wants to experience his sexuality. It However it is solely up reasonable for parents to him weigh the benefits and risks of circumcision and to decide in which way he wants make the decision whether or not to be stimulated, and he can 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- if he so desires infant- limit his sexual experience without a problem. A circumcised man does not have these optionsmales. pdf |contribution= |last= |first= |publisher=The full range Royal Australasian College of his sexual experience and sensation is not available to him due the to bodily modification.Physicians |format=PDF |date=2010-09-01 |accessdate=2021-11-08}}</ref></blockquote>
An intact * The [[penis]] enables many men to reach orgasm just by manipulation American Academy of the [[foreskin]]. During masturbation, the man can choose whether he wants to stimulate the [[Glans penis|glansPediatrics]] directly or indirectly through the movement of the [[foreskin]]. Since he (AAP) has the fullnot re-affirmed its disastrous, naturally given potential of sensitivity at his disposalfailed 2012 Circumcision Policy Statement, he can use it to according to his own preferences. The circumcised manwhich expired in 2017, however, does not have that freedom of choice. He so currently has neither the opportunity to include the [[foreskin]] into the stimulation, nor can he utilize its nerves and touch receptors. He also only has access to 15-50% of the potential sensitivity of an intact man, depending no position on the amount and kind of tissue that was removed, and the degree of keratinization of the [[Glans penis|glans]]. In some cases, the limitation can be even more severe. On a heavily desensitized [[penis]], condoms can limit the sexual stimulation to the point where not enough arousal can be built up to reach an orgasm - which means that fulfilling safer sex is not possiblechild circumcision.
In particular* Medical historian [[Robert Darby]] (2014) wrote simply:<blockquote>"To avoid circumcision complications, the tight styles of avoid circumcision bear the risk, that the loss of the friction-reducing gliding effect leads 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 a case. In a study"<ref>DaiSik Kim{{REFjournal |last=Darby |first= |init=R |author-link=Robert Darby |etal=no |title=To avoid circumcision complications, Myungavoid circumcision |trans-title= |language= |journal=Can Urol Assoc J |location= |date=2014-Geol Pang08-14 |volume=8 |issue=7-8 |article= |page=231 |pages= |url=https: The effect of male circumcision on sexuality//cuaj. In: BJU international, Volume 99, Issue 3, März 2007, Sca/index. 619-622. doi:php/journal/article/view/1709/1823 |archived= |quote= |pubmedID= |pubmedCID= |DOI=10.11115489/jcuaj.14641709 |accessdate=2022-12-410X.2006.06646.x, PMID 1715597716}}</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.</blockquote>* The [[Canadian Paediatric Society]] (CPS) (2015) said:
The basic right <blockquote>In most jurisdictions, authority is limited only to interventions deemed to equal be medically necessary. In cases in which medical necessity is not established or a proposed treatment of the sexes is also breachedbased on personal preference, since girls are legally protected from violations of their genital integrity, while boys are not. This not only contradicts interventions should be deferred until the constitution, but also individual concerned is contrary able to all efforts of equal treatmentmake 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. Because in this case, decisions are made during childhood that will affect 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 life1093/pch/20. That such an unequal treatment of genders is not justifiable, neither legally nor morally, is obvious6.311 |accessdate=2019-10-27}}</ref></blockquote>
Last not least, religious freedom is impaired. If a boy is circumcised for religious reasons as a child before he reaches * The [[Canadian Urological Association]] (CUA) considered the age matter of competence, he will carry the sign of that religion on his body for his entire life - even if he decides to abjure that religion circumcision and issued a statement in the course of his lifeFebruary 2018.The CUA concluded:
While his condition will not keep him from changing his religion<blockquote>"Given the socioeconomic, or to renounce it entirelyeducational status, he has no way to discard 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 symbol care of his old religionthe 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. This could be compared to a tattoo 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 form case of a religious symbol''[[Re B and G (children) (No 2) EWFC 3]] (2015)'' . In that case, with the difference Judge Sir James Munby ruled that such a tattoo could still be removed by laser or covered with a new tattoo, if need becircumcision of male children caused ''significant harm''.== Rights and ethics ==
Therefore a The [[Rights situation on circumcision does not impair the ability to change religion, but it makes it impossible to discard one's old religion entirely. This |rights situation]] is not only discussed in a violation of the basic law, it is also ethically unjustifiable to force someone to carry a religious symbol for his entire life - especially in his most private body areaseparate article.
So why is circumcision tolerated as a means of upbringing, [[Image:Intact vs circumcised.JPG |thumbnail|right|300px| The intact and even explicitly legalized? In Germanycircumcised human penis, this stems from - although it is not stated in the law for legal reasons - the belief that a ban would impair the religious freedom of the parentsside by side. Even though it is stated in Art.140 GG (German basic law):]]
<blockquote>''(1) Civic rights The term "circumcision" without a gender qualifier refers specifically to male circumcision. It means "to cut around," and it refers to the [[excision]] of the [[foreskin]] from the penis. The term is inaccurate and duties are neither dependant ona euphemism because the operation actually cuts off or [[amputation| amputates]] the [[foreskin]], nor impaired by, the exercise which in adults comprises about fifteen square inches of religious freedomhighly functional erogenous tissue.''
''Circumcision is most often performed 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 children, which is why the ritual is so controversial.Opponents of circumcision consider the circumcision of non-consenting minors to be unethical and a [[human rights]] violation, unless there is concrete [[medical indication]].]''=== Consent by surrogates ===Medical ethics has long recognized limitations on the power of consent by surrogates.<ref>{{REFjournal |last=Committee on Bioethics, American Academy of Pediatrics |etal=no |title= Informed consent, parental permission, and assent in pediatric practice |trans-title= |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> <ref>{{REFjournal |last=Committee on Bioethics |etal=no |title=Informed Consent in Decision-Making in Pediatric Practice |trans-title= |language= |journal=Pediatrics |location= |date=2016-08 |volume=138 |issue=2 |article= |page=e20161485 |pages= |url=https://watermark.silverchair.com/peds_20161485.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQM8zYHFd0Ylu9Annq_AgEQgIICT24ikc839aJMYOiypqC2G9f7_yKGAGkAekzzbCtck5TElALWVCGNoVSOaA6rDA_dOkQ_LyJnxYlZ88J9-uk15tvlIBbE82_aNyYfq5e9xmEfqD2vh374q3Naz57dxZaUbgxUkKX4PqsiLmYHLvVrr7bQK2MZuuUOKiQU8JZy7lLjkp-PjJO1U9cyIplTAgs_EdvgK8MWWoIsj-X-ZUDImAG63-rlj_qLsy5dYwytmxfCuVa47RdZseLSr2_bdDpwKAKGhq_Ly9rlHZeW_f7fYktVfF_sFTgcJziAlvEQmdyWIw0qf-hlO31Qb3sH6kDdcvHAbm7llY5xa34XLYIt8QR0YFIimgDGFliN4-ce2vjvvrwS85WeeNFhpn-Ywn4Qjpy06hPuLDL-MtI2Z3BZbBsKq4dp8qGu1q9GlXaKw193riTFG9G5bF5GCKmxmt0nCQTthrb_CcK2UhKjZwPekC9zkIUHPZ9BXJt0SM03F_g-GgqbE0hTYKMqNdJ3sHDQu2luFrJ9JEiMzxtP28gJoYh20d2APA0xrRbXBYsFdAlr50gb1BSAbNJhTyx-Kh3geoSHsAYMjPaG7cIbh0jd42pWCUx30vjlAGK8zXTuf7-31oi81CLbHTAJLuzK3NT4Whi17jVq1SbXsIXlWpKc_d-HujCvlb74rkZQ6RG9wkxW7gAKaDqtKv5zTOTMBD9vLVxgp8lDmVA8PFB59Bqd6w-fi86tW132oWQM-mTfwdIBXFbUFXkeTUC5RYyqJQIXAEwLJSRm1RX-LRbKRzgaRQ |archived= |quote= |pubmedID=27456510 |pubmedCID= |DOI=10.1542/peds.2016-1485 |format=PDF |accessdate=2023-05-21}}</ref> <ref>{{REFjournal |last=Committee on Bioethics ||etal=no |title=Informed Consent in Decision-Making in Pediatric Practice |trans-title= |language= |journal=Pediatrics |location= |date=2016-08 |volume=138 |issue=2 |article= |page=e20161484 |pages= |url=https://watermark.silverchair.com/peds_20161484.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAApwwggKYBgkqhkiG9w0BBwagggKJMIIChQIBADCCAn4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMYv3coRY-UCYMgTaqAgEQgIICT4di03qn2Hbho3i8Li_78lod0lNMunch25nx1rKvaM_aeFerz5eN6_k8VVeNv-DLocZp28whQr1x4WYDVwSs4uF73vZpYZYuDphYQkwxV1HHgMbZAbHBFuE8QyCHyDvSY-fhQcUl-JrYxa3TbhYgd4bKiU9zfIyXUsCnItroCc9iNrMicPg0v_A0AJJlhxioOlAU-im6OPI06OcCBj78yqkPO0J4nMTN1FLochsOyvZZdtFQQzLhrnM_Gey8K75lFYIBJHA7uzMmP2o5KZ-FTGUkEA_eSpEIpwv2WI4SbtrA8WYk3cQqXOmLIWjkSs9CTELD7CQP29xarr1ANrF_id4CiCX7zIomC2Ciz9lHBEgz8EH2i9Woke_YuZeLax52_6JpdhH1qdMQyF1bByjP8mU98V5_B4BPPiBpKt4pVA_UgtaABRHL8oPv6SwOUQZ2Bc-0_E2tod0VIF1FJBwZRZJm2ZkJPgBSKUo8VBe5Pz_6Vpt2DqLzwqVUYscPsIJMvxl09mMtvJrsBa8yVoTRWj4Rd0OBTMV7zhZskDnYYyrAZ6sHMk0MzvbHilPNbNgU5o7mXmcbFGDgGgWbqrIdT6sVSSfPJm4TnR0HSWbc_EnHhhyye7tVlFGjAsR0R46_DSwEMz8M5DkSln8xfKtX_so9rjCvYeq45wqn09g8DqtV-WHEA9PIrcw5kTcz5I0JkNuW4-vKVU1Xz9XHiYi4Zqbq0vx9NWLdNSYHQSOGMZ1MCAxT152evQdipQB5wokR8Q4rICoJYII5bsmRMYd7JQ |archived= |quote= |pubmedID=27456514 |pubmedCID= |DOI=10.1542/peds.2016-1484 |format=PDF |accessdate=2023-05-21}}</ref>
Still, * {{REFweb |url=https://www.cirp.org/library/anatomy/garcia/ |title=What exactly is circumcision and what is it was considered intolerable for the parents to be unable to perform a religious rite that involved interference with the body of another person 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- in the case of that person being their son29}}*{{REFweb |url=https://15square. While normally the religious freedom ends "at someone else‘s nose", an exemption was legalized to enable parents to comply with their own, personal, religious duties, even if that means that several of their son's basic rights are impairedorg. This does, however, not apply for other religious traditions, so that a ritual beating uk/losses-from-circumcision/ |title=Losses from Circumcision |last=Ball |first=Peter |publisher=15 Square |date=2003-08-09 |accessdate=2023- no matter how religiously important it may be to the parents 02- is still considered child abuse and would likely result 23}}* {{REFweb |url=http://members.tranquility.net/~rwinkel/MGM/primer.html |title=Male Circumcision in the loss of child custody here.USA: A Human Rights Primer |last=Winkel |first=Rich |author-link=Rich Winkel |date=2005-05-12 |accessdate=2021-01-27}}
Only very few will supposedly know that * {{REFweb |url=https://intaction.org/what-is-circumcision/ |title=What is circumcision has become a lucrative business? |last=Simone |first=Judy |author-link= |publisher=Intaction |website=https://intaction. Not only org/ |date=2020-07-26 |accessdate=2020-10-04 |format= |quote=}}* {{REFjournal |last=Deacon |first= |init=M |author-link= |last2=Muir |first2= |init2=G |author2-link= |etal=no |title=What is the operation itself, but also the potentially needed aftercare, bring profitsmedical evidence on non-therapeutic child circumcision? |trans-title= |language= |journal= Int J Impot Res |location= |date=2022-01-08 |volume= |issue= |article= |page= |pages= |url=https://www.nature.com/articles/s41443-021-00502-y |archived= |quote= |pubmedID=34997197 |pubmedCID= |DOI=10.1038/s41443-021-00502-y |accessdate=2023-04-30}}* {{REFweb |url=https://intactamerica.org/pros-and-cons-of-circumcision/ |title=Pros and Cons of Circumcision (Spoiler: You’ve Been Lied to) |last=Garrett |first= |init=CJ |publisher=Intact America |date=2023-11-10 |accessdate=2024-03-22}}* {{REFweb |url=https://intactamerica.org/groups-who-pressure-you-to-circumcise/ |title=The 4 Authority Figures and Groups Who Will Pressure You to Circumcise (and What You Can Do) |last=Anonymous |first= |init= |publisher=Intact America |date=2024-01-24 |accessdate=2024-01-27}}* {{REFweb |url=https://intactamerica. But while this is still obvious, there are also other trades that make money from itorg/keeping-your-sons-penis-intact/ |title=Keeping Your Son’s Penis Intact: A Guide for Parents |last=Anonymous |first= |init= |publisher=Intact America |date=2024-01-24 |accessdate=2024-01-29}}* {{REFweb |url=https://intactamerica.org/timeline-of-circumcision-suffering/ |title=A Timeline of Circumcision Suffering: A Detailed Look |last=Anonymous |first= |init= |publisher=Intact America |date=2024-02-02 |accessdate=2024-02-09}}{{REF}}
Baby [[foreskin]]s are a coveted resource. Under the name "Apligraf" an artificial skin product is marketed worldwide, which is used - among other uses - 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 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 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 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 here.
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== See also ==[[Category:Circumcision]][[Category:Genital mutilation]][[Category:Body modification]][[Category:Genital surgery]][[Category:Islam]][[Category:Judaism]][[Category:Male circumcision]][[Category:Parental information]]* [[FGMCategory:Penile surgery]]* [[MGMCategory:Medical term]]* [[CircumpendiumCategory:Male genital mutilation]]
== References ==[[Category:From Intactipedia]]<references />[[Category:From IntactWiki]]
Add text and Wikify.
{{GraphicWarning}}"Male '''circumcision''' (from Latin ''circumcidere'', meaning "to cut around") is the surgical removal or [[amputation]] of the [[foreskin]] (prepuce) from , a major part of the human [[penis]]. The foreskin comprises ''more than fifty percent'' of the epithelium of the [[penis]]...] The procedure <ref name="taylor1996">{{TaylorJR LockwoodAP TaylorAJ 1996}}</ref> When the "cutting around" 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 the foreskin falls off, so [[amputation]] and prophylactic reasons[[mutilation]] is the result. It is a treatment option for pathological phimosisThe amputation destroys the [[Foreskin#Physiological_functions| many protective, immunological, sexual, refractory balanoposthitis and chronic urinary tract infections (UTIs); sensory physiological functions]] of the foreskin, so it is contraindicated in cases of certain genital structure abnormalities or poor general health." (Source: a very harmful and [[http://en.wikipediaPain| painful]] surgery.org/wiki/Circumcision Wikipedia])
'''Posthectomy''' is the more accurate medical term that more accurately reflects the injury and loss of functional body tissue, but the Biblical [[euphemism]], ''circumcision'', is more commonly used.
With reference to involuntary, non-therapeutic circumcision of children, [[Child Genital Cutting (CGC)]] is a newer term that has been introduced to avoid issues associated with more traditional terms. Bollinger (2023) identifed CGC as an [[Adverse Childhood Experiences (ACEs)| adverse childhood experience]].<ref name="bollinger2023">{{REFjournal
|last=Bollinger
|init=D
|author-link=Dan Bollinger
|last2=
|init2=
|author2-link=
|url=https://kindredmedia.org/2023/02/adverse-childhood-experiences-dysfunctional-households-and-circumcision/
|title=Adverse Childhood Experiences, Dysfunctional Households, And Circumcision.
|journal=Kindred
|date=2023-02-28
|volume=
|issue=
|pages=
|accessdate=2023-03-01
}}</ref>
Deacon & Muir (2022) have reviewed the evidence and concluded that "there is no medical justification for performing a circumcision prior to an age that he can assess the known risks and potential benefits, and choose to give or withhold [[informed consent]] himself."<ref name="deacon2022">{{REFjournal |last=Deacon |first=Matthew |init=M |author-link= |last2=Muir |first2=Gordon |init2=G |author2-link= |etal=no |title=What is the medical evidence on non-therapeutic child circumcision? |journal= Int J Impot Res |date=2022-01-08 |url=https://www.nature.com/articles/s41443-021-00502-y |pubmedID=34997197 |DOI=10.1038/s41443-021-00502-y |accessdate=2022-01-30}}</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.
== Non-medical indications for circumcision Historical background ==
[[Image:Circumcision Sakkara 3.jpg|200px|right]] For the [[Aborigines]], the [[Australia| Australian]] natives, the tradition of circumcision is said to go back to 10,000 BC. On the African continent, the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of circumcision date 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= Aesthetic reasons ===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.
In small boysChristianity, where circumcision is practiced only in the [[foreskin]] cannot be retracted yet, cleaning Coptic denomination. There is not necessary, since the membrane no general belief that fuses the [[foreskin]] to the [[Glans penis|glans]] prevents the accumulation circumcision is a requirement of micro-organismsChristianity. The so-called <ref name="ballooninghill2004">{{REFweb |url=https://www.cirp.org/pages/cultural/christian.php |title=The Holy Bible, where the [[foreskin]] inflates during urinationCircumcision, False Prophets, and Christian Parents |last=Hill |first=George |author-link=George Hill |publisher=Circumcision Reference Library |website= |date=2004-08-29 |accessdate=2019-11-10 |format=HTML |quote=The falseness of those who advocate circumcision is not a serious problemrecurrent theme in the New Testament.}}</ref>
{{Citation |Text=A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of [[phimosis]]. The benefit of easier cleaning must operation should be balanced against performed by a surgeon without administering an anaesthetic, as the risk of promoting serious infections - among others HIV - during brief pain attending the operationwill 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 parts females, the author has found the application of pure carbolic acid to the [[clitoris]] an excellent means of Africaallaying the abnormal excitement, several dozen and preventing the recurrence of one tribe's boys die each the practice 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.org/details/plainfaorold00kell/page/290 |chapter=Treatment for Self-abuse and Its Effects |title=Plain Facts for Old and Young |location=Burlington, Iowa |publisher=F. Segner & Co. |year as a result of their circumcision.=1888 |page=107}}</ref>}}
===Islam===
In [[Islam]], circumcision is also religiously founded, even though there is no mention of 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 example of the Prophet", meaning to be [[circumcised]]. In Islam, unlike [[Judaism]], there is no specific age at which the circumcision should be performed. Most circumcisions take place at ages between 6 and 10 years, but the range goes from birth to adulthood.
=== Prophylactic reasons =Rationale ==
=== First, a look on the common styles: Medical indication ===There are no [[medical indication| medical indications]] for circumcision of the newborn. The [[circumcision industry]] offers circumcision of the newborn to the public because of the [[financial incentive]].
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= High & Loose<ref>DavidJM |author-matthias httplink= |year=2001 |title=Medicine and the German Jews |url=https://commonswww.wikimediacirp.org/wikilibrary/history/File:Beschneidungsstile,_Styles_of_Circumcision.jpg<ephron1/ref> |work= |editor= |edition= |volume= |chapter=6 |pages=222-33 |location=New Haven |publisher={{UNI|Yale University|Yale}} Press |isbn=0-300-08377-7 |quote= |accessdate=2019-11-20 |note=}}</ref> And so started the long tradition of Jewish doctors inventing reasons for circumcision (and deceving gentile doctors).
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= Low & Loose<ref>DavidEH |author-matthias httplink=Eugene H. Hand |url=https://commonspubmed.wikimediancbi.orgnlm.nih.gov/wiki18135844/File:Beschneidungsstile,_Styles_of_Circumcision |title=Circumcision and venereal disease |journal=Archives of Dermatology and Syphilology |date=1949-09 |volume=60 |issue=3 |pages341-6 |pubmedID=18135844 |DOI=10.1001/archderm.1949.jpg01530030037004 |accessdate=2021-10-08}}</ref> ====
In the 1950s it was cervical cancer. [[image:Low_and_loose.jpg|300pxAbraham Ravich]](1951) invents the myth that circumcision reduces the risk of women getting cervical cancer.<ref name="ravich1951">{{Ravich1951}}</ref>
In the 1980s, UTIs. [[Thomas E. Wiswell]] (1985) claims that circumcision, using a methodologically flawed report, reduces the risk of urinary tract infections.<ref name="wiswell1985">{{REFjournal |last=Wiswell |first= Techniques and instruments 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>
Retrospectively, circumcision was always advertised as a cure for whatever disease was in the public spotlight at the time. [[Doctors Opposing Circumcision (D.O.C.)]] (2016) state:<blockquote>These claims date originally from before the advent of evidence-based medicine, when doctors relied on the opinions of other clinicians to inform their practice, rather than on scientifically collected evidence.<ref name="doc2016">{{REFweb |url=https://www.doctorsopposingcircumcision.org/for-professionals/alleged-medical-benefits/ |title=Alleged Medical Benefits |publisher= Freehand[[Doctors Opposing Circumcision (D.O.C.)]] |website= |date=2016-techniques =05 |accessdate=2019-11-20 |format= |quote=}}</ref></blockquote>
The oldest method sheer mass of removing the [[foreskin]] uses just a few instruments. In the simplest case, the [[foreskin]] is pulled out with a cord, a knife is placed directly above the [[Glans penis|glans]], studies and the skin finally cut with a hit publications that were released during those almost 180 years on this topic are the blunt edge of the knife. No stitches are placed reason that even arguments that have been disproved multiple times, especially regarding infant and the skin is left to grow together naturallychild circumcision, tenaciously persist up until today.
''The Mogen-Clamp works in a similar way (middle), with the difference that it following text is locked shut after taken from the [[foreskinCircumpendium]] is inserted, thus clamping it. After a few minutes the [[foreskin]] is cut in the same fashion as with the simple shield. The clamping is meant to reduce or prevent bleeding from the wound.''-->
* [[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= Complex clamps 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 |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 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>
In the plastibell methodconclusion, the skin is first cut lengthwise, then a plastic ring is placed over the [[Glans penis|glans]] and the [[foreskin]] pulled over it. A tightly tied string is used to fix the [[foreskin]] to a rim circumcision does not provide any proven benefits in the ring, thereby strangulating itpreventive medicine.
One should note that the human [[foreskin]] is endowed by nature with [[Foreskin#Immunological_functions| immunological functions]] that serve to protect the human body from disease.<ref name="fleiss-hodges-vanhowe1998"/> The [[glans penis]] receives blood through the frenular artery.<ref>{{REFjournal |last= Historical background Persad |init=R |author-link= |last2=Sharma |init2=S |author2-link= |last3=McTavish |init3=J |author3-link= |etal=yes |title=Clinical presentation and pathophysiology of meatal stenosis following circumcision |journal=Brit J Urol |date=1995 |volume=75 |issue=1 |pages=91-3 |url=https://www.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.1995.tb07242.x |quote= |pubmedID=7850308 |pubmedCID= |DOI=10.1111/j.1464-410x.1995.tb07242.x |accessdate=2019-11-26}}</ref> These facts are generally overlooked in arguments for alleged hygienic benefits of circumcision.
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 [[Image:Circumcision Sakkara 3foreskin]].jpg|200pxCleaning of the [[Glans penis|rightglans]] For and the Aborigines, [[preputial sac]] underneath the Australian natives, [[foreskin]] is easy — they are simply [[Preputial_sac#Washing| washed with warm water along with the tradition rest of circumcision is said to go back to 10,000 BC. On the African continentbody]], just like the first circumcisions are assumed to have emerged around 6000 BC. From ancient Egypt hints of various forms of circumcision date back to the time around 3000-2000 BC. The oldest known depiction<ref>http://commons.wikimedia.org/wiki/File:Circumcision Sakkara 3.jpg</ref> is an Egyptian tomb relief from areas between the 6th dynasty, approximately 2300-2000 BC. It is not known precisely who was circumcised and why in those timestoes.
In many cultures circumcision during puberty serves as a rite of passagesmall boys, bringing adolescents into where the community. As with other painful or humiliating initiation rites[[foreskin]] cannot be retracted yet, cleaning is not necessary, proof of courage and mastering of critical situations are since the key motivations. From some African tribes it is also known [[Synechia| membrane]] that fuses the amputation of [[foreskin]] to the [[foreskinGlans penis|glans]] is seen as prevents the removal accumulation of an inborn piece micro-organisms. The so-called "[[Ballooning of femininity from the boysforeskin| ballooning]]", where the [[foreskin]] inflates during urination, thus making them menis not a concern.
The sheer mass [[Circumcision methods]] are discussed in a separate article.== Pain ==In the past, advocates of studies circumcision claimed that a newborn child's nerve system was not yet fully developed, and publications that were released as a result, the child felt no [[pain]] during those almost 180 years on this topic are the reason circumcision procedure. [[Kanwaljeet J. Singh Anand| Anand]] & Hickey (1987) have shown that even arguments 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 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 have been disproved multiple timeshumane considerations should apply as forcefully to the care of neonates and young, especially regarding infant nonverbal infants as they do to children and adults in similar painful and child 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, tenaciously persist up until todayin infants.
{{Box|Boxtext==== Germany ====<big><b>However, none of the above three procedures totally eliminate pain. A baby boy will still experience some pain despite any of those analgesic procedures. Prevention of [[pain]] requires protecting a boy from elective neonatal non-therapeutic circumcision. Only boys who are protected from the medically unnecessary circumcision surgery experience no [[pain]] or [[trauma]].</b></big>}}
* Fully informed consent by [[Meatal stenosis]], a pathological narrowing of the opening of the legal guardians[[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 approximately 10 to 20 percent.<ref name="vanhowe2006">{{REFjournal |last=Van Howe |init=RS* Qualified pain management |author-link=Robert S. Van Howe* The operation to be performed by |title=Incidence of meatal stenosis following neonatal circumcision in a professional andprimary 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* Approval of |title=Circumcision for [[phimosis]]: a right follow-up study |journal=Scandinavian journal of veto depending on the maturity of the affected boyurology 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}}</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 [[circumcised]] men, due to their infant circumcision, with complaints of [[glans]] insensitivity, delayed [[ejaculation]], and unpleasant sensation.<blockquoteref 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 |author7-link= |last8=García-Caballero |first8= |init8=R |author8-link= |etal=no |title=Immunohistological study of the density and distribution of human penile neural tissue: gradient hypothesis |trans-title= |language=''§ 1631d BGB'' |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>
</blockquote>
The un-anesthetized and un-sedated newborn infant is restrained by being strapped to a special plastic board called the [[circumstraint]]. The procedure is most often an elective, non-therapeutic surgery without [[medical indication]] performed on neonates and children for religious and cultural reasons in violation of the child's [[human rights]] to [[physical integrity]], but in older patients may be rarely indicated for therapeutic reasons. It is a radical treatment option for pathological [[phimosis]], refractory [[balanoposthitis]] and chronic [[urinary tract infection]]s (UTIs); it is contraindicated in cases of certain genital structure abnormalities or poor general health.
* In boys [[circumcised]] in childhood, [[post-traumatic stress disorder]] ([[PTSD]]) could be diagnosed. In a study on Philippine boys, in whom no [[PTSD]] was found prior to the operation, 69% of the boys [[circumcised]] in the traditional ritual and 51% of those [[circumcised]] by standard medical procedures (including anaesthesia) fulfilled the DSM-IV criteria for PTSD following the operation.<ref>{{REFbook |last=Ramos |init=S |last2=Boyle |init2= France GJ |year=2001 |title=Understanding circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem |url=https://link.springer.com/chapter/10.1007/978-1-4757-3351-8_14 |work= |editors=[[George C. Denniston]], [[Frederick M. Hodges]], [[Marilyn Fayre Milos]] |edition= |volume= |chapter=Ritual and medical circumcision among Filipino boys: evidence of post-traumatic stress disorder |pages=253-70 |location=New York |publisher=Kluwer Academic/Plenum Publishers |isbn= |quote= |accessdate= |note=}}</ref>* Circumcisions, especially those that happen without consent, can spark feelings of helplessness and alienation, which can persist as [[trauma]]. These feeling can also be triggered later, when someone [[circumcised]] as an infant becomes aware of his circumcision. In an online study, interviewed men stated they felt betrayed - 55% by the mother, 50% by the father, and 58% by the doctor, and 73% felt that their [[human rights]] had been violated.<ref name="GSoCH">{{REFweb |url=http://www.circumcisionharm.org/ |title=Global Survey of Circumcision Harm |accessdate=2019-10-12}}</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 to be reminded of their own loss. In this process, their own body is defined as "normal" and the [[foreskin]] 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 so, following an idealised image of his own parents, circumcision, which has been redefined as a "good thing", is passed on to his son by having him [[circumcised]] as well.<ref>{{VanderKolkBA 1989}}</ref><ref>{{REFjournal |last=Goldman |init=R |author-link=Ronald Goldman |url=https://www.cirp.org/library/psych/goldman1/ |title=The psychological impact of circumcision |journal=BJU Int |date=1999 |volume=83 |issue=Suppl. 1 |pages=93-103 |accessdate=2019-10-12}}</ref>* If the [[circumcised]] male feels incomplete, or due to the missing [[foreskin]] disadvantaged compared to [[intact]] males, an inferiority complex and [[depression]] may occur. This can be accompanied by conscious recognition of his own incompleteness, or the deficiency may remain completely subconscious<ref>{{REFjournal |last=Rhinehart |init=J |url=https://www.cirp.org/library/psych/rhinehart1/ |title=Neonatal circumcision reconsidered |journal=Transactional Analysis J |date=1999 |volume=29 |issue=3 |pages=215-21 |accessdate=2019-10-12}}</ref>. In an online study, 75% of those interviewed stated that they felt incomplete, and 66% said they felt inferior compared with [[intact]] males.<ref name="GSoCH"/>* Cases in which children felt ill treated or punished have been documented as well. G. Cansever found in her study on 12 boys aged between 4 and 7 years, who had previously been prepared for their impending circumcision, that the children experienced the operation as an aggressive assault on their bodies.<ref>{{REFjournal |last=Cansever |init=G |date=1965 |url=https://www.cirp.org/library/psych/cansever/ |title=Psychological effects of circumcision |journal=Brit. J. Med. Psychol |volume=38 |pages=321-31 |accessdate=2019-10-12}}</ref>* Fear of being alone or darkness.<ref name="Levy1945">{{REFjournal |last=Levy |first=David M. |init=DM |url=https://www.cirp.org/library/psych/levy1/ |title=Psychic trauma of operations in children; and a note on combat neurosis |journal=American Journal of Diseases of Children |volume=69 |date=1945 |pages=7-25 |accessdate=2019-10-12}}</ref>* Fear of doctors, clinics and also closed rooms.<ref name="Levy1945"/>* Relapse into the state of bed-wetting, even if the child was already dry before.<ref name="Levy1945"/>* [[Circumcised]] males who become fathers frequently manifest [[adamant father syndrome]].
==Complications == Italy ===Possible operative and postoperative complications ===Circumcision is surgery. Surgical complications of circumcision generally may be classified as [[Bleeding| hemorrhage]], [[infection]], or surgical misadventure up to and including loss of the penis and [[death]].<ref name="deacon2022" /><ref name="williams-kapilla1993">{{REFjournal |last=Williams |init=N |author-link= |last2=Kapilla |init2=L |author2-link= |etal=no |title=Complications of circumcision |trans-title= |language= |journal=Brit J Surg |location= |date=1993-10 |volume=80 |issue=10 |pages=1231-6 |url=https://www.cirp.org/library/complications/williams-kapila/ |quote= |pubmedID=8242285 |pubmedCID= |DOI=10.1002/bjs.1800801005 |accessdate=2019-11-27}}</ref> * 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>{{REFweb |url=http://www.spiegel.de/spiegel/vorab/experte-warnt-rituelle-beschneidung-veraendert-das-gehirn-der-kinder-a-849534.html |title=Kinderschmerz-Experte warnt: Rituelle Beschneidung verändert das Gehirn der Kinder |trans-title=Children's pain expert warns: Ritual circumcision changes the brain of children |language=German |last=Prof. Dr. med. Boris Zernikow |first= |publisher=Spiegel Online |website= |date=2012-08-12 |accessdate=2019-10-11 |format= |quote=}}</ref>. In unsedated and partially sedated infants increased secretion of the stress hormone cortisol could be observed for months after the operation. Overall, their pain threshold was lower and the risk of chronic pain increased. Regardless of these findings, infant circumcisions with insufficient or no anaesthetic are still common practice<ref>{{REFjournal |last=Garry |init=T |title=Circumcision: a survey of fees and practices |journal=OBG Management |date=1994 |volume=October |issue= |pages=34-6 |url= |accessdate=}}</ref><ref>{{REFjournal |last=Howard |init=CR |last2=Howard |init2=FM |last3=Garfunkel |init3=LC |last4=de Blieck |init4=EA |last5=Weitzman |init5=M |title=Neonatal circumcision and pain relief: current training practices |journal=Pediatrics |date=1998 |volume=101 |issue= |pages=423-8 |url= |accessdate=}}</ref><ref>{{REFjournal |last=Stang |init=HJ |last2=Snellman |init2=LW |title=Circumcision practice patterns in the United States |journal=Pediatrics |date=1998 |volume=101 |issue=e5 |pages= |url= |accessdate= |note=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>{{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 |date=1981 |volume=6 |issue=3 |pages=269-75 |url=https://www.cirp.org/library/pain/gunnar/ |accessdate=2019-11-26}}</ref>* Postoperative wound pain, in the case of children's circumcisions conceivably worsened by the forceful breaking of the preputial adhesions.* 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.* Postoperative [[bleeding]] of the wound. This can have severe consequences especially for very young infants, if they are not treated promptly. Their blood volume is only about 85 ml per kilogram of body weight, and even moderate blood loss can lead to hypovolaemia, hypovolaemic [[shock]] and even death.<ref>{{REFbook |last= |first= |year=2000 |title=Paediatric Handbook |url= |work= |editors=Smart J, Nolan T. |edition=6 |volume= |chapter= |page=82 |location={{AUSC|VIC}}, Australia |publisher=Blackwell Science Asia |isbn= |quote= |accessdate= |note=}}</ref><ref>{{REFdocument |title=Autopsy of Demetrius Manker |url= |contribution=Case 93-1711 |last=Wetli |first=CV |publisher=Miami: Dade County Medical Examiner Department |format= |date=1993-06-23 |accessdate=}}</ref> <ref>{{REFjournal |last=Hiss |init=J |last2=Horowitz |init2=A |last3=Kahana |init3=T |title=Fatal haemorrhage following male ritual circumcision |journal=J Clin Forensic Med |date=2000 |volume=7 |issue= |pages=32-4 |url=https://www.cirp.org/library/death/hiss1/ |accessdate=2019-11-06}}</ref><ref>{{REFdocument |title=Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan |url=http://www.circumstitions.com/death-exsang.html |contribution= |last=Newell |first=TEC |publisher=Burnaby, B.C.: B.C. Coroner's Service |format= |date=2004-01-19 |accessdate=2019-11-26}}</ref>* Post operative [[lymphoedema]].* Postoperative [[Infection| infections]]. This includes both local infections, which can be treated with local therapy, and systemic infections, requiring systemic antibiotic treatment.<ref>{{REFconference |last=Dr. med. Hartmann |first=Wolfgang |url= |place=Rechtsausschuss des Bundestages [Legal Committee of the Bundestag] (German) |title=Stellungnahme zur Anhörung am 26. November 2012 [Opinion on the hearing on 26 November 2012] (German) |date=2012-11-26 |accessdate=}}</ref>* [[Wound dehiscence]], meaning the separation of the edges of the wound or the tissue after suturing.* Adhesion between the surface or rim of the [[Glans penis|glans]] with the neighbouring [[penile skin]], causing [[skin]] pockets and bridges, as well as visually unpleasant results like uneven scars, which make a re-circumcision necessary.* Postoperative [[phimosis]]: a phimotic ring can develop during scarring, which makes a re-circumcision necessary. According to a study by Blalock et al.<ref>{{REFjournal |last=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=2003 |volume=169 |issue=6 |pages=2332-4 |url=https://www.cirp.org/library/complications/blalock1/ |accessdate=2019-11-26}}</ref>, the prevalence is 2.9%, according to Leitch<ref>{{REFjournal |last=Leitch |init=IOW |title=Circumcision - a continuing enigma |journal=Aust Paediatr J |date=1970 |volume=6 |issue= |pages=59-65 |url=https://www.cirp.org/library/general/leitch1/ |accessdate=2019-12-15}}</ref> 5.5%.* [[Sudden Infant Death Syndrome]] (SIDS).* Knot formation of the veins. If the dorsal vein, which originates in the tip of the [[foreskin]], is cut during circumcision without being clamped and sutured at its origin separately, it starts to develop new branches over time, which can lead to the development of knots.* Possible deformities due to circumcision include hypoplasia of the [[penis]] (micro-penis) and induratio [[penis]] plastica (skewed penis).* Medical malpractice can also not be ruled out. Injuries, partly or entirely severing the [[Glans penis|glans]] or the [[penis]] can occur.* In rare cases, [[necrosis]], gangrene, ischaemia, keloid formation, and circulatory problems may also occur.* When the circumcision is followed by the ultra-orthodox Jewish ritual of Metzitzah B'Peh (which consists of sucking blood from the wound with the mouth), there is a risk of infection with [[herpes]] simplex type 1, which can lead to brain damage or [[death]].<ref>{{REFweb |url=http://www.nytimes.com/2012/03/08/nyregion/infants-death-renews-debate-over-a-circumcision-ritual.html?_r=0 |title=Baby’s Death Renews Debate Over a Circumcision Ritual |last=Robbins |first=Liz |date=2012-03-07 |accessdate=2019-10-11}}</ref>=== Death ===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]].<ref name="Bollinger 2010">{{REFjournal |last=Bollinger |first=Dan |init=D |author-link=Dan Bollinger |last2=Boy's Health Advisory |title=Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths |journal=Thymos: Journal of Boyhood Studies |volume=4 |issue=1 |pages=78-90 |url=http://www.mensstudies.com/content/b64n267w47m333x0/?p=7ebbd6b446d940cbbd4274c095754b12π=5 |quote= |pubmedID= |pubmedCID= |DOI=10.3149/thy.0401.78 |date=2010-04-26 |accessdate=2019-10-12}}</ref><ref>{{REFweb |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]].
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 ruling 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 "High Court parents should determine what is in the best interest of Cassation" from Novthe child... 24thIt is legitimate for parents to take into account cultural, 2011religious, a mother was found not guiltyand ethnic traditions, whose son almost bled in additions to death after being circumcised by the medical factors, when making a medically unqualified laymandecision."<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= Finland 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.)
==== Sweden Dr. Christopher Guest discusses circumcision===<br><youtube>v=TQIp9f4krVQ</youtube>
==Recommendations of medical authorities= Legal =* [[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 issues 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>
Two ethicists, Myers & Earp (2020), have conducted a detailed review and analysis of the claimed medical benefits of ''(4) No one may be forced to take part in non-therapeutic'' [[circumcision]]. They have determined than the alleged benefits are not material, so they do not support granting of consent by a religious act or ceremonysurrogate. In other words, ''Non-therapeutic'' circumcision is not truly healthcare. Moreover, or to participation in religious rites or they comment that even the most perfectly executed surgery produces [[trauma]] and harm to the use patient. Circumcision also produces tissue loss and loss of function, therefore, circumcision should be performed only after the individual reaches the age of consent. <u>Consent by a religious oath.surrogate for a ''non-therapeutic''circumcision of a minor child is an unethical practice.</u><ref name="myers2020">{{REFjournal |last=Myers |first= |init=A |author-link= |last2=Earp |first2= |init2=BD |author2-link=Brian D. Earp |etal=no |title=What is the best age to circumcise? A medical and ethical analysis |trans-title= |language= |journal=J Biosoc Sci |location= |date=2020-09 |volume=34 |issue=7 |pages=560-72 |url=https://onlinelibrary.wiley.com/doi/abs/10.1111/bioe.12714 |archived= |quote= |pubmedID=32068898 |pubmedCID= |DOI=10.1111/bioe.12714 |accessdate=2023-05-18}}</ref> == Tipping point ==[[Intact America]] (2024) argues that public opinion regarding non-therapeutic [[circumcision]] of children is approaching or at a "tipping point" at which [[intact]] genitals would be preferred over the [[circumcised]] variety.<ref>{{REFweb |url=https://intactamerica.org/public-opinion-on-circumcision/ |title=Public Opinion on Circumcision: Can Intactivists Hit A Tipping Point? |last=Anonymous |first= |init= |publisher=Intact America |date=2024-03-23 |accessdate=2024-04-09}}</blockquoteref>{{SEEALSO}}* [[Adolescent and adult circumcision]]* [[Bodily harm]]* [[Breastfeeding]]* [[Case Histories]]* [[Circumcision maps]]* [[Circumcision methods]]* [[Circumcision scar]]* [[Circumpendium]]* [[Circumstraint]]* [[Documented severe complications of circumcision]]* [[Ethics of non-therapeutic child circumcision]]* [[FGM]]* [[Human rights]]* [[Lymphoedema]]* [[MGM]]* [[Pain]]* [[Psychological issues of male circumcision]]* [[Rights situation on circumcision]]* [[Risks and complications]]* [[Sexual effects of circumcision]]* [[Sudden Infant Death Syndrome]] (SIDS)* [[Trauma]]{{LINKS}}
* {{REFjournal |last=Testa |first=Patrick |init= Business Interests |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=}}
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