Bogus Evidence That Male Circumcision Prevents HIV Spread

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Transactional Analysis Journal, Volume 29, Number 3, Pages 215-221,
July 1999.

Neonatal Circumcision Reconsidered

John Rhinehart


Abtract

This article describes the present status of neonatal circumcision in the United States and presents clinical findings regarding the long-term somatic, emotional, and psychological consequences of this procedure in adult men. These consequences are seen as typical of complex post-traumatic stress disorder. They emerged during psychotherapy focused on the resolution of prenatal, perinatal, and developmental trauma and shock experiences. Their relationship to phenomena such as trauma, shock, somatic decisions, discounting, and scripting is described.


Psychological trauma is an affliction of the powerless. At the moment of trauma, the victim is rendered helpless by overwhelming force. When the force is that of nature, we speak of disasters. When the force is that of other human beings, we speak of atrocities. Traumatic events overwhelm the ordinary systems of care that give people a sense of control, connection, and meaning. (Herman, 1992, p. 33)

Male circumcision involves the surgical removal of the penile foreskin, a fold of skin and mucous membrane that normally covers the head or glans of the penis. Routine neonatal circumcision is usually done from one to three days after birth, while Jewish ritual circumcision is performed on the eighth day after birth.

Postnatal circumcision is still frequently performed in the United States, the only industrialized nation to continue this practice for non-religious reasons on a majority of newborn male babies--about 60 percent according to the National Center for Health Statistics. Estimating from this figure, doctors continue to circumcise over one million baby boys a year, an average of 3,500 a day or one every 25 seconds. Circumcisions performed on Jewish newborns by a trained religious person called a mohel (ritual circumciser) account for less than 4% of this number.

Controversy continues regarding the practice of newborn male circumcision. A variety of reasons are put forward both for and against the procedure, but recent information using reliable sources is often not well known to the general public or to health care professionals. My purpose in writing this article is to present what I found in my client population regarding the lifelong effects of this procedure. It is my hope that this will stimulate further thought and therapeutic exploration of this issue.

Clinical reports

The psychotherapeutic approach I use when working with early trauma resolution involves a guided associative process that follows my client's flow of thoughts, memories, images, and body sensations. This is intertwined with a sensitive repatterning of memories of traumatic events and is more fully described in my article "Touching and Holding During Regressive Therapy" (Rhinehart, 1998).

Many men who were circumcised as neonates consider it a nonissue because they cannot remember anything about it. In my psychotherapeutic work with men, however, it is clear that the memory is there. Since the event occurred at a very early preverbal level, it is most often experienced as a body or somatic memory rather than as a more familiar verbal memory. Various disturbing mental images and intense feelings often accompany the reemergence of this body memory, including the feel of sharp metallic instruments cutting into one's flesh (anesthesia is normally not used in circumcision), the sense of being overpowered by big people, being alone and helpless, feelings of terror, and a sense of paralysis and immobilization.

Case examples

The following four examples show the long-term effects of circumcision trauma, effects I have found typical among my clients.

ST is a 44-year-old man whose adult life is filled with a seemingly nameless terror. This feeling was most intense when he had to relate to people in other than a superficial manner. At those times has body might start shaking uncontrollably. He would look away, withdraw inwardly, and experience a high level of embarrassment. During our therapeutic work, as he reexperienced the terror, his trembling hands went automatically to his groin to cover his genitals in a protective way. He felt that he was reliving the time of his neonatal circumcision. He was in physical and emotional terror as he rocked back and forth, feeling completely powerless, betrayed and alone. He did not have words for this experience, which had been "forgotten" until we began our work--just moans and groans of agony and helplessness. In his view, his circumcision was one of the most important experiences underlying his early decision that people were unsafe and dangerous. This decision expressed itself in his lifelong sense of fear around other people, especially those in positions of authority. The circumcision experience, bad enough in itself was made more severe by his mother's inability to offer him comfort at the time. This greatly reinforced the degree of his trauma and the resulting negative decisions he made about the safety of his world and the people in it. At present, the trauma has been largely resolved and his neurologic circuitry repatterned, thus eliminating the terror and trembling.

BJ, 52 years old, came into therapy because he experienced "early issues coming up and polluting my life." During a particular session he kept using the term "cut off" in relation to family and other life issues. These issues had been triggered by his attending the bris (Jewish ritual circumcision) for a friend's newborn son. He heard the baby screaming and, much to his surprise, felt extremely uncomfortable, sweaty, dizzy, and aware that his genitals felt like they had suddenly been plunged into ice water and were "shrinking." Following this, he felt rage welling up at the idea that something was being taken from the baby--that he was being overpowered, reduced, and diminished against his will. BJ felt that this clearly related to his own neonatal circumcision. He was born three weeks before term weighing five pounds. He believes that he was not comforted or touched much after his premature birth or the circumcision which was performed on the third day in spite of his low birth weight. As we worked together, BJ made connections--cognitively, emotionally, and physically--between his early experience and his lifelong sense of anger, powerlessness, diminishment as a male, and underlying generalized ominous feeling that he was somehow going to be punished for being male. In photographs of himself as a young boy he noticed that he frequently had both hands covering his genitals. What also surfaced from a very young place was an incredulous "How can you do this to me--I can't trust you anymore," which reflected his feeling as an adult that people are untrustworthy. Connected with these was the belief that he was not supposed to cry or get mad as a result of what was done to him. Releasing and repatterning his feelings around his circumcision led to a significant increase in self-confidence, clarity in his relationships, and freedom to be the creative male person that he is without holding back because of fear of retaliation.

RJ is in his early sixties. He had a lifelong fear of any sharp metal instruments. When preparing food, he had to use knives as sparingly as possible, and he could not stand to have them lying out. When he did use a knife, he had to clean and put it away immediately. In therapy, the connection of this became clear to him. The body memory that he experienced was an excruciating feeling in his penis of a sharp "steely" knife (a scapel-like instrument) cutting his foreskin away. New he finds it increasingly easy to be around knives, and he has a new sense of freedom in the world.

WK is in his mid-forties and has experienced anxiety and panic all his life. As a child he described himself as being on edge constantly and unable to perform well in almost everything he tried. He felt particularly inadequate and worthless in academic and occupational settings--that is, around authority figures. During the initial part of our therapy, we made some progress through the effects of his father's frequent shaming behavior toward him as he grew up; this behavior created and reinforced feelings of powerlessness and hopelessness in WK. During therapy, we identified and worked with residues of birth trauma as well as residues of his mother's (and father's) unresolved depression and fear related to the SIDS death at six weeks of an older sister, which occurred about a year before his conception. However, the ease with which his anxiety and panic reactions could be triggered--particularly in relation to authority figures at work--persisted. It was not until he came on pictures of a neonatal circumcision that he became aware of the extreme trauma associated with his own experience. As the memory surfaced, his body suddenly became stiff, numb, and filled with terror, and his mind went blank ("cortical shock")--typical of what happens when experiencing this level of traumatic response). As an adult, any situation in which he felt vulnerable triggered this flooding reaction in his body/mind. It was as if his mind was operating on the basis of a very early decision that "big" people were dangerous and might attack him at any time. This early decision, then, had to do with maintaining a somatic state of hypervigilance and tension. While his rational mind could be clear that this was not necessary, his body maintained this stance anyway. This early decision had made intimate relationships difficult as an adult.

Later-Life Symptoms of Circumcision

Other men with whom I have worked have also made causal connections between present-day problems--such as a sense of defeat, shyness, anger, or fear--and their neonatal circumcision experiences. I have developed a list of symptoms and behaviors that appear to have been caused or significantly conditioned by these neonatal experiences. Since these symptoms and behaviors can result from other traumatic experiences as well, this list should not be used as a diagnostic checklist to identify circumcision trauma; however, they may suggest its presence. These symptoms include

* a sense of personal powerlessness
* fears of being overpowered and victimized by others
* lack of trust in others and life
* a sense of vulnerability to violent attack by others
* guardedness in relationships
* reluctance to be in relationships with women
* defensiveness
* diminished sense of maleness
* feeling damaged, especially in the presence of surgical complications< such as skin tags, penile curvature due to uneven foreskin removal, partial ablation of edges of the glans and so on
* sense of reduced penile size, a part cut off or amputated
* low self-esteem
* shame about not "measuring up"
* anger and violence toward women
* irrational rage reactions
* addictions and dependencies
* difficulties in establishing intimate relationships
* emotional numbing
* need for more intensity in sexual experience.
* sexual callousness
* decreased tenderness in intimacy
* decreased ability to communicate
* feelings of not being understood

Discussion

The idea that circumcision may cause problems in later life is not new. Freud (1916-1917/1933) suggested, in his discussion of anxiety and instinctual life (pp. 86-87), that there could be a connection between castration fears, neuroses, and circumcision:

It is our suspicion that during the human family's primaeval period castration used actually to be carried out by a jealous and cruel father upon growing boys, and that circumcision, which so frequently plays a part in puberty rites among primitive peoples, is a clearly recognizable relic of it, …We must hold fast to the view that fear of castration is one of the commonest and strongest motives for repression and thus for the formation of neuroses. The analysis of cases in which circumcision, though not, it is true, castration has been carried out on boys as a cure or punishment for masturbation (a far from rare occurrence in Anglo-American society) has given our conviction a last degree of certainty. (pp. 86-87)

Freud's thinking, advanced for its time, was in contrast to the more prevalent idea of his era that neonates are " very little more intelligent than a vegetable … not directly conscious of anything" (Goldman, 1997, p.7). This was the opinion of a renowned infant specialist at the University of Pennsylvania in 1895. Even "fifty years later, newborn infants were [still] believed to be incapable of anything except eating, moving, crying, and sleeping." (Spock, 1946, cited in Goldman, 1997, p.7).

While Freud's thinking was focused on the formation of neuroses, perhaps a more accurate way of thinking about circumcision today is in relation to trauma, which we now know much more about. We also know that the neonate is highly intelligent even though he or she is, most likely, not in a position to differentiate circumcision from castration.

In her model of human responses to trauma, Pomeroy (1995) brings together what we know about what trauma is, how it happens, and what our psychic responses to traumatic events. She describes three inborn levels or lines of defense for dealing with a threatening experience: (1) relational resources, consisting of boundaries and safe, trustworthy individual and communal connections; (2) fight, flight, and freeze defenses from the brains limbic system; and (3) shock defenses, also from the limbic system, but without emotional control (pp. 90-93). She points out that when an overwhelming threat alarm is signaled by the emotional brain, the emotional brain's defenses take over. The emotional brain responds at the level of fight-flight freeze (active defenses) or shock defenses (passive reflexes) (p. 92).

In the case of circumcision, relational resources are unavailable to the neonate. The next level of fight-flight-freeze also does not serve him since he is easily trapped and overpowered by those performing the procedure. All he has left, therefore is the level of shock defense, which consists of central nervous system flooding by terror, rage, and finally numbing, paralysis, and dissociation; this his his last chance to control the high level of central nervous system activation, which might otherwise result in death. Watchinig videotapes of neonates being circumcised portrays this clearly to the aware eye. The so-called "quiet" after circumcision is more likely a state of dissociation in response to the overwhelming pain and terror than it is a state of peaceful relaxation.

Van Howe (1996), reporting on his clinical study, writes, "Newborn males respond to circumcision with a marked reduction in oxygenation during the procedure, a cortisol surge [indicating strong adrenal arousal], decreased wakefulness, increased vagal tone, and less interactions with their environment following the procedure. All of these hinder the maternal-infant bonding experience that makes breastfeeding possible" (p. 431).

In translating this level of experience to adult life, Emerson (1991), a pioneer in healing pre- and perinatal trauma in infants and children, has said that perinatal trauma (such as circumcision) results in "anger and rage [that] are inexplicably intertwined with low self-esteem, shame, guilt, violence, and disempowerment."

Relevance to Transactional Analysis

In an earlier article (Rhinehart, 1998), p. 58) I noted that "in the October 1995 TAJ, which was a memorial to Robert Goulding, he is quoted as talking about 'somatic redecision' (Blackstone, 1995, p. 345). This concept arose during discussion of a group therapy session in which a client made a decision, during her work, to allow herself to reach out and be 'cuddled tightly' by another woman, whom she had chosen as her 'therapist.' This somatic redecision was felt to be a 'shift within the Child in the present' (p. 345)." From this we might infer that here was an earlier "somatic decision" in the Child of the past not to allow this type of cuddling.

Steiner (1979) talked about "the somatic component [of a script decision] which bodily reflects the decision" (p. 109). Later he wrote, "The somatic component refers to the fact that a person who has made a decision invariably brings certain aspects of her anatomy into play, especially the musculature' (p. 111).

Eskine (1980) described the three aspects of script that must be dealt with to achieve cure: behavioral, intrapsychic, and somatic (p. 103). He underlined that "the somatic aspects of script need to be an important focus of script cure" (p. 105) and that "with each scripting decision or script reaction I think that there is always a corresponding physiological inhibition or restriction within the body. The younger the child or more severe the trauma, the greater is the physiological reaction" (p. 105).

For a neonate undergoing circumcision, perhaps it would be accurate to say that his "decision" is primarily somatic and derives from the defensive patterning of his shock experience. Because of its content and context, circumcision sets in place an automatic central nervous system and generalized somatic reaction to interpersonal experience from that point on. Some males will experience continuing vigilance, some a readiness to fight, flee, or freeze; and other will jump to rage, terror, or disconnection. It is helpful to note that, in considering the levels of defense, whenever the two earlier levels (relational and fight or flight) are experienced by the mind as ineffective, the mind tends not to use them later. This means that a mind patterned in this way jumps right to terror, rage and/or dissociation when confronted with situations that are interpreted as threatening, even though to the rational mind or cortex these situations may not be significant. In other words, when an event occurs in a man's life that resembles any aspect of the original circumcision experience, the chances that the extreme forms of panic, rage, violence, or dissociation might result are much more likely--just as they are in any other posttraumatic stress situation.

The feelings and behaviors my clients experienced fit precisely unto what Herman (1992) called complex posttraumatic stress reaction (p. 121). They are no different from the experience of rape victims, combat veterans, female circumcision victims, and survivors of natural disasters. She also indicated that the common factor underlying the effects of trauma is the experience of violence and powerlessness (p. 33)--made worse if it is inflicted by other human beings in contrast to a natural disaster. Both are dramatically present in the procedure of neonatal circumcision.

Stern (1985) pointed out that the trauma disrupts the ability to cope with and assimilate information and also "that if the empathic failures of parents are too large, the sense of a cohesive self will be thrown too far off balance" (p. 245) Since intense affective states act as "cardinal organizing elements" (p. 245) in the personality, they leave lasting impressions.

Although good experiences immediately following routine circumcision--such as parental holding, nursing, soothing, and comforting--may mitigate the intensity of the traumatic experience, my experience with clients confirms that circumcision registers in the body-mind in myriad ways, direct and indirect, throughout the man's life.

Hammond (1999), in his survey of men circumcised in infancy or childhood, outlines the physical, sexual, and psychological consequences experienced by 546 men. The leading physical and sexual consequences were prominent scarring of the penis (33%), insufficient penile skin for a comfortable erection (27%) (neonatal circumcisions remove what would grow to be come 51% of the adult penile covering, and progressive sensory deficit in the glans (61%) leading to compensations such as compulsive sexual behaviors that offer more intense kinds of stimulation to a sensorily dulled glans, As to the psychological consequences, respondents described:

Emotional distress, manifesting as intrusive thought about one's circumcision, including feelings of mutilation (60%), low self esteem/inferioty to intact men (50%), genital dysmorphia (55%), rage (52%) resentment/depression (59%), violation (46%), or parental betrayal (30%). Many respondents (41%) reported that their physical/emotional suffering impeded emotional intimacy with partners(s), resulting in sexual dysfunction…. Almost a third of respondents (29%) reported dependence on substances or behaviors to relieve their suffering (tobacco, alcohol, drugs, food and/or sexual compulsivity). (p. 87)

It is important to note that the problematic symptoms and behaviors that my clients experienced and expressed as adults might not initially lead a therapist to suspect such an early causal origin. Instead, they may seem more closely related to a highly stressful lifestyle, and it is true that it is in stressful times that such symptoms tend to surface. In most of my clients, negative experiences that occurred at older ages, while often significant in themselves, were actually layered on earlier traumatic experiences such as circumcision, trauma that had set up a basic mode of reaction to perceived threat. Therefore, in cases in which working therapeutically at older levels does not resolve a problem over the long term, it is important to look at earlier layers.

Two other important considerations involving the transactions between parents, doctors, nurses, and the newborn are discounting and scripting.

Discounting: Given that the neonate is a fully aware, perceptive, and responsive sentient being, circumcision discounts his experience in at least five areas:

1. Pain: His physical pain is ignored.
2. Separation/abandonment: The terror of separation from mother and being immoblized in the circumstraint board is ignored.
3. Violence: The significance and memory for him is ignored or rationalized.
4. Protection: His cries of protest are not heard or respected.
5. Objectification: The decision to circumcise is made by others as if he were an object and his experience did not exist or matter. This is perhaps not much different than decisions made about the fate of concentration camp internees by camp commanders; they too had their rationalizations.

Scripting: The circumcision experience for the neonate centers around abandonment, helplessness, pain, and violence. The neonate is uniquely vulnerable and responsive to these experiences, which is why he needs protection rather than abandonment as he integrates his birth experience and attempts to establish his bonding connection with his parents in the outside world. In my client population, because they were not protected from injury by those who were responsible for this function, decisions were made and beliefs created or reinforced that supported fear of , indifference to, and violence toward other human beings. These decisions and beliefs evolved into life scripts expressed over time. Power became identified with violence so that perpetrators and victims become the fare of life.

Porter-Steele (1998) suggests that "even a little violence is too much, and our world has a tremendous amount of violence. … We [transactional analysts] recognize cultural and individual scripts that support violence instead of workable, compassionate problem solving" (p. 15). Perhaps routine neonatal circumcision is exactly this kind of culturally and individually determined scripting, and it can be stopped very simply, thus eliminating major discounting and victimization for millions of newborn males.

Finally, another provocative possibility is mentioned by Taoist Master Mantak Chia in his book Taoist Secrets of Love: Cultivating Male Sexual Energy (Chia with Winn, 1984, p. 243). He describes how the spot on a man's penis that is sexually assaulted during circumcision is reflexively connected to his heart and lung energies. This suggests that, in addition to the effects described in the article, circumcision may have a negative effect on the more subtle energy fields in a man's body around heart and lung function.

Both the history of circumcision and more current research regarding what the newborn male experiences are extensively presented in books such as Goldman's (1997) Circumcision: The Hidden Trauma and Questioning Circumcision--A Jewish Perspective (1998), Brigg's (1985) Circumcision: What Every Parent Should Know, Ritter and Denniston's (1992) Say No to Circumcision and Denniston and Milo's (1997) Sexual Mutilations: A Human Tragedy.

Summary

Circumcision of the newborn male child consists of removal of the penile foreskin, a normal, functional part of the child's body. The United States is now the only industrialized country in the world that continues to circumcise the majority of its newborn male children for non-religious reasons. In my client population of adult men, serious and sometimes disabling lifelong consequences appear to have resulted from this procedure, and long-term psychotherapy focusing on early trauma resolution appears to be effective in dealing with these consequences. Early prevention by eliminating the practice of routine circumcision is seen as desirable. The author welcomes sharing of readers' reactions and experiences via letter or email.

John W. Rhinehart, M.D. is a practicing psychiatrist and psychotherapist and director of Deep Brook Center, a holistic center for innovative psychotherapies and nutrition in Newtown, Connecticut. Send comments and reprint requests to 46 West Street, Newtown CT 06470 or call (203) 426-4553, or email to DEEPBROOKCTR1@webtv.com

REFERENCES

Blackstone, P. (1995). Between the lines: Evolution of redecision and impasse theory and practice. Transactional Analysis Journal, 25, 343-346.

Briggs, A. (1985). Circumcision: What every parent should know. Earlysville, VA: Birth and Parenting Publications.

Chia, M., with Winn, M. (1984) Taoist secrets of love: Cultivating male sexual energy. Santa Fe, NM: Aurora Press.

Denniston, G. C. & Milos, M. F. (Eds.). (1997) Sexual mutilations: A human tragedy. New York: Plenum

Emerson, W. (1991, October). Training. Ukiah, CA.

Erskine, R. G. (1980). Script cure: Behavioral, intrapsychic and physiological. Transactional Analysis Journal, 10, 102-106.

Freud, S. (1933). New introductory lectures on psychoanalysis (Lecture XXXII, Anxiety and Instinctual Life In J. Strachey (Ed. and Translator, The standard edition of the complete psychological works of Sigmund Freud (Vol. 22, pp. 81-95), London: Hogarth Press (Original work published 1916-1917)

Hammond, T. (1999) A preliminary poll of men circumcised in infancy or childhood. British Journal of Urology 83 (Supplement 1), 85-92.

Herman, J. (1992). Trauma and recovery. New York: Basic Books.

Pomeroy, W. (1995). A working model for trauma: The relationship between trauma and violence. Pre- and Perinatal Psychology Journal 10(2), 89-101.

Porter-Steele, N. (1998). Announcement for the special issue of the Transactional Analysis Journal on "Violence." Transactional Analysis Journal, 28, 15.

Rhinehart, J. (1998). Touching and holding during regressive therapy. Transactional Analysis Journal, 28, 57-64.

Ritter, T., & Denniston, G. C. (1992). Say no to circumcision (2nd ed.). Aptos, CA: Hourglass Publishing.

Steiner, C. (1979). Scripts people live: Transactional analysis of life scripts New York: Bantam.

Stern, D. (1985). The interpersonal world of the infant: A view from psychoanalysis and developmental psychology. New York: Basic Books.

Van Howe, R. (1996). Letter regarding peri-natal hospital stays and the performance of circumcision. The Journal of Family Practice. 43(5), 431.
 

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Circumcision:

Human Rights and Ethical Medical Practice

James W. Prescott, Marilyn Fayre Milos and George C. Denniston

When the American Academy of Pediatrics published its "Circumcision Policy Statement" in the March 1, 1999, issue of Pediatrics a notable amount of media and public commentary followed. The principle findings and recommendations of the statement are:

* The scientific data are not sufficient to recommend neonatal circumcision of males.
* The procedure is not essential to the child's well-being.
* Parents should determine what is in the best interests of the child.
* To make an informed choice, parents should be given accurate and unbiased information and be provided the opportunity to discuss this decision.
* Existing scientific evidence demonstrates potential medical benefits of newborn circumcision.
* Analgesia is safe and effective in reducing the procedural pain associated with circumcision and should be provided if a decision for circumcision is made.
* Circumcision should be done only on infants who are stable and healthy.

The full document is available on the Web at http://www.nocirc.org/position/aap1999.htm.

While this statement represents welcome progress in an area that has concerned many humanists and free-thinkers for the better part of this century, it falls short of taking an uncompromising stand on the issues of human rights and medical ethics that surround the medicalization of ritual circumcision. It also repeats the false claim that there are potential benefits to the practice.

From a purely medical standpoint, circumcision is justified only when performed to correct a pathological condition, never to remove normal healthy tissue, and the health benefits must outweigh the risks involved. From the standpoint of medical ethics, experimental and clinical procedures are not to be performed on a person who does not benefit from them.

The way defenders of circumcision try to argue around these objections is to expand the concepts of benefit and beneficiary to include a future class of unknown persons who may or may not develop a clinical condition. Within this class are not only the adult the infant may become but women or men with whom the adult may have intercourse. Yet it is impossible to predict whether any specific normal, healthy newborn or infant will develop any future clinical condition that may merit a medical circumcision or, by remaining whole and then failing to use proper hygiene, may contribute to a medical condition in another person.

From the standpoint of human rights, every newborn, infant, and child has a right to be free from the compelled donation of body parts or tissue--in this case, the foreskin--even if such might benefit a third party in the future. This issue was central to the case of McFall v. Shimp in the Court of Common Pleas of Allegheny County, Pennsylvania, in which the plaintiff sought to force provide bone marrow on the grounds of the plaintiff's dire need and the defendant's status as a rare, compatible donor. In his decision of July 26, 1978, Judge J. Flaherty declared:

For a law to compel the Defendant to submit to an intrusion of his body would change every concept and principle upon which our society is founded. To do so would defeat the sanctity of the individual and impose a rule which would know no limits and one could not imagine where the line would be drawn….Forcible extraction of living body tissue causes revulsion to the judicial mind.

In this context, the AAP "Circumcision Policy Statement" continues, in effect, to endorse, whenever parents so choose, a concept that our common law condemns. This becomes particularly onerous when the beneficiary of this "forcible extraction" is an unknown future person where the incidence of alleged future diseases has been acknowledged by the AAP in the same statement to be insufficient to justify the application of routine circumcision.

This practice further violates the "sanctity of the individual," denying the newborn, infant or child the right to bodily security and integrity. Neither the parent nor anyone else--even by proxy via the medical profession--should have the right to inflict such harm or injury. In other contexts his would be recognized as child abuse.

Nor should anyone have the right to deny the newborn, infant or child his rights as a born person, as set forth in the Fourteenth Amendment of the U.S. Constitution, which states:

All persons born or naturalized in the United States, and subject to the jurisdiction thereof are citizens of the United States and of the State wherein they reside. No State should make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without the process of law; nor deny to any person within its jurisdiction the equal protection of the laws.

Furthermore, the equal protection clause in the above takes on new relevance given the Federal Genital Mutilation Act of 1993 and Public Law No. 104-208 of September 30, 1996, both of which declare it a criminal offense to inflict genital mutilation on a female. Males should receive equal protection under these laws.

Arguably, circumcision violates international law as well, specifically the Universal Declaration of Human Rights, to which the United States is a signatory. Article 3 states; "Everyone has the right to life, liberty and security of person" and Article 5 which states, "No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment." Similar protections are provided in the United Nations Convention on the Rights of the Child, which the United States has signed but not ratified.

In light of all the above, the AAP "Circumcision Policy Statement" attempts on the basis of religious or cultural customs--to confer on parents rights that they should not have and endorses the denial of rights to the newborn, infant, or child. The AAP would be better advised to restrict its recommendations and actions about circumcision to medical procedures affecting pathological conditions. Attempting to validate ritual or religious circumcision falls beyond the purview and responsibilities of medicine and the AAP.

But if the AAP insist on commenting about such matters, then it should amend its statement to oppose the medical circumcision of normal, healthy newborns, infants and children irrespective of gender, taking a position consonant with its own 1998 policy statement opposing female genital mutilation and 1999 position paper, The Role of the Pediatrician in Youth Violence Prevention in Clinical Practice and at the Community Level.

Circumcision is a needless act of violence performed upon a resisting and nonconsenting newborn infant, or child. The pain and trauma of the procedure cannot be adequately ameliorated by anesthesia or analgesia, and the suffering can continue long after the painkiller has worn off.

James W. Prescott, Ph.D is a developmental neuropsychologist, a cross-cultural psychologist, and director of the Institute of Humanistic Science. He can be reached via e-mail at jprescot@twcny.rr.com. Marilyn Fayre Milos, R.N. is founder and director of the National Organization of Circumcision Information Resource Centers, the coordinator of the International Symposia on Sexual Mutilations, and coeditor of Sexual Mutilations: A Human Tragedy. She can be reached via e-mail at nocirc@concentric.net. George C. Denniston, M.D., M.P.H., is president of Doctors Opposing Circumcision, with members on six continents. He can be reached via e-mail at gcd@u.washington.edu or on the Web at weber.u.washington.edu/~gcd/DOC/.

This article first appeared in The Humanist, Volume 59, Number 3, Pages 45-46, May-June 1999.
 

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Similarities in Attitudes and Misconceptions toward Infant Male Circumcision in North America and Ritual Female Genital Mutilation in Africa

by Hanny Lightfoot-Klein, author of Prisoners of Ritual: An Odyssey into Female Genital Circumcision in Africa

Clitoridectomy and Infibulation in Africa

"She loses only a little piece of the clitoris, just the part that protrudes. The girl does not miss it. She can still feel, after all. There is hardly any pain. Women's pain thresholds are so much higher than men's."


Infant Male Circumcision in North America

"It's only a little piece of skin. The baby does not feel any pain because his nervous system is not developed yet."


Clitoridectomy and Infibulation in Africa

"The parts that are cut away are disgusting and hideous to look at. It is done for the beauty of the suture."


Infant Male Circumcision in North America

"An uncircumcised penis is a real turn-off. Its disgusting. It looks like the penis of an animal."


Clitoridectomy and Infibulation in Africa

"Female circumcision protects the health of a woman. Infibulation prevents the uterus from falling out [uterine prolapse]. It keeps her smelling so sweet that her husband will be pleased. If it is not done, she will stink and get worms in her vagina. "


Infant Male Circumcision in North America

"An uncircumcised penis causes urinary infections and penile cancer. It generates smegma and smegma stinks. A circumcised penis is more hygienic and oral sex with an uncircumcised penis is disgusting to women."


Clitoridectomy and Infibulation in Africa

"An uncircumcised vulva is unclean and only the lowest prostitute would leave her daughter uncircumcised. No man would dream of marrying an unclean woman. He would be laughed at by everyone."


Infant Male Circumcision in North America

"An uncircumcised penis is dirty and only the lowest class of people with no concept of hygiene leave their boys uncircumcised."


Clitoridectomy and Infibulation in Africa

"Leaving a girl uncircumcised endangers both her husband and her baby. If the baby's head touches the uncut clitoris during birth, the baby will be born hydrocephalic [excess cranial fluid]. The milk of the mother will become poisonous. If a man's penis touches a woman's clitoris he will become impotent."


Infant Male Circumcision in North America

"Men have an obligation to their wives to give up their foreskin. An uncircumcised penis will cause cervical cancer in women. It also spreads disease."


Clitoridectomy and Infibulation in Africa

"A circumcised woman is sexually more pleasing to her husband. The tighter she is sewn, the more pleasure he has."


Infant Male Circumcision in North America

"Circumcised men make better lovers because they have more staying power than uncircumcised men."


Clitoridectomy and Infibulation in Africa

"All the women in the world are circumcised. It is something that must be done. If there is pain, then that is part of a woman's lot in life."


Infant Male Circumcision in North America

"Men in all of the `civilized' world are circumcised."


Clitoridectomy and Infibulation in Africa

"Doctors do it, so it must be a good thing."


Infant Male Circumcision in North America

"Doctors do it, so it must be a good thing."


Sudanese grandmother: "In some countries they only cut out the clitoris, but here we do it properly. We scrape our girls clean. If it is properly done, nothing is left, other than a scar. Everything has to be cut away."

My own father, a physician, speaking of ritual circumcision inflicted upon my son: "It is a good thing that I was here to preside. He had quite a long foreskin. I made sure that we gave him a good, tight circumcision."

35-year-old Sudanese woman: "Yes, I have suffered from chronic pelvic infections and terrible pain for years now. You say that all of this is the result of my circumcision? But I was circumcised over 30 years ago! How can something that was done for me when I was four years old have anything to do with my health now?"

35-years-old American male: "I have lost nearly all interest in sex. You might say that I'm becoming impotent. I don't seem to have much sensation in my penis anymore, and it is becoming more and more difficult for me to reach orgasm. You say that this is the result of my circumcision? That doesn't make any sense. I was circumcised 35 years ago, when I was a little baby. How can that affect me in any way now?"

Clidoridectomy: surgical removal of clitoris. Infibulation: surgical removal of labia, then suturing. Circumcision: surgical removal of foreskin.
 

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http://www.nocirc.org/articles/effects.php

Human Sexuality: an Encyclopedia
edited by Vern L. Bullough and Bonnie Bullough
New York: Garland Pub., 1994.
p. 119-122


CIRCUMCISION: MALE - EFFECTS UPON HUMAN SEXUALITY

Circumcision, once accepted as the norm in the United States, has become controversial. Technically, circumcision is the surgical removal of the skin that normally covers and protects the head, or glans, of the penis. At birth, the penis is covered with a continuous layer of skin extending from the pubis to the tip of the penis where the foreskin (prepuce) folds inward upon itself, creating a double protective layer of skin over the glans penis. The inner lining of the prepuce is mucous membrane and serves to keep the surface of the glans penis (also mucous membrane) soft, moist, and sensitive. The prepuce is often erroneously referred to as "redundant" tissue, which allows the medical community and society-at-large to consider the foreskin an optional part of the male sex organ and, therefore, to condone its routine removal in a variety of procedures collectively known as "circumcision."

Circumcision, however, was also a part of religious ritual, including Judaism and Islam as well as others. However, 85 percent of the world's male population is not circumcised. Circumcision in 1992 was still the most commonly performed surgical procedure in America, where 59 percent of newborn males underwent this operation. Circumcision reached its peak of 85 to 90 percent during the 1960s and 1970s. The surgery, usually performed on baby boys within the first few days of life, is often considered "routine." The most popular methods, the Gomco clamp and the Plastibell procedures, differ somewhat in technique and instrumentation but the effects on the penis and the baby are basically the same. Most of the American circumcisions are not done for religious reasons, but rather, for hygienic ones.

Medical Procedure

Usually, the procedure for circumcision in America involves the baby being strapped spread-eagle to a plastic board, with his arms and legs immobilized by Velcro straps. A nurse scrubs his genitals with an antiseptic solution and places a surgical drape - with a hole in it to expose his penis - across his body. The doctor grasps the tip of the foreskin with one hemostat and inserts another hemostat between the foreskin and the glans. (In 96 percent of newborns, these two structures are attached to one another by a continuous layer of epithelium, which protects the sensitive glans from urine and feces in infancy and childhood.) The foreskin is then torn from the glans. The hemostat is used to crush an area of the foreskin lengthwise, which prevents bleeding when the doctor cuts through the tissue to enlarge the foreskin opening. This allows insertion of the circumcision instrument. The foreskin is crushed against this device circumferentially and amputated.

Anesthesia was not used to alleviate infant suffering until recently because it was believed that babies do not feel pain. Additionally, it was recognized that anesthesia was risky for the newborn, thus contributing to the medical reluctance to use it for painful procedures on infants, such as circumcision. Currently, some doctors use a dorsal penile nerve block to numb the penis during infant circumcision. While not always effective, this anesthesia may afford some pain relief during the surgery, although it offers no pain relief during the recovery period (which can last up to 14 days) when the baby urinates and defecates into the raw wound.

Function of the Foreskin

To understand the function of the prepuce, it is necessary to understand the function of the penis. While it is commonly recognized that the penis has two functions - urination and procreation - in reality, it is essential only for procreation, since it is not required for urination.

For procreation to occur, the normally flaccid penis must become erect. As it changes from flaccidity to rigidity, the penis increases in length about 50 percent. As it elongates, the double fold of skin (foreskin) provides the skin necessary for full expansion of the penile shaft. But microscopic examination reveals that the foreskin is more than just penile skin necessary for a natural erection; it is specialized tissue, richly supplied with blood vessels, highly innervated, and uniquely endowed with stretch receptors. These attributes of the foreskin contribute significantly to the sexual response of the intact male. The complex tissue of the foreskin responds to stimulation during sexual activity. Stretching of the foreskin over the glans penis activates preputial nerve endings, enhances sexual excitability, and contributes to the male ejaculatory reflex. Besides the neurological role of the preputial tissue, the mucosal surface of the inner lining of the foreskin has a specific function during masturbation or sexual relations.

During masturbation, the mucosal surface of the foreskin rolls back and forth across the mucosal surface of the glans penis, providing nontraumatic sexual stimulation. During heterosexual activity, the mucosal surfaces of the glans penis and foreskin move back and forth across the mucosal surfaces of the labia and vagina, providing nontraumatic sexual stimulation of both male and female. This mucous- membrane- to- mucous- membrane contact provides the natural lubrication necessary for sexual relations and prevents both the dryness responsible for painful intercourse and the chafing and abrasions which allow entry of sexually transmitted diseases, both viral and bacterial.

When normal, sexually functioning tissue is removed, sexual functioning is also altered. Changes of the penis that occur with circumcision have been documented. These may vary according to the procedure used and the age at which the circumcision was performed, nevertheless penile changes will inevitably occur following circumcision.

Circumcision performed in the newborn period traumatically interrupts the natural separation of the foreskin from the glans that normally occurs somewhere between birth and age 18. The raw, exposed glans penis heals in a process that measurably thickens the surface of the glans and results in desensitization of the head of the penis.

When circumcision is performed after the normal separation of the foreskin from the glans, the damage done by forcible separation of these two parts of the penis is avoided, but the glans must still thicken in order to protect itself from constant chafing and abrasion by clothing.

The thickened, drier tissue covering the glans of the circumcised penis may necessitate the use of synthetic lubricants to facilitate nontraumatic sexual intercourse. Often, it is erroneously considered the woman's lack of lubrication that makes intercourse painful rather than the lack of natural male lubrication, which is more likely the cause. During masturbation, the circumcised male must use his hands for direct stimulation of the glans, and this may require synthetic lubrication as well.

In addition to the predictable physical changes that occur with circumcision, there are inherent risks and potential complications from the surgery. These include, but are not limited to, hemorrhage, infection, surgical damage and, while rare, death. Surgical damage and healing complications can result in extensive scarring, skin bridging, curvature of the penis, and deformities of the glans penis and urethral meatus (urinary opening). Extreme mutilations have resulted from inappropriate electrocautery use in circumcision, causing loss of the entire penis. Sex-change operations have been used as a "remedy" for this iatrogenic condition.

While circumcision has potential risks and alters normal, sexual functioning of the penis, proponents of the practice consider it to confer many "prophylactic" benefits on the recipient. This rationale was initiated in the English-speaking countries during the 19th century when the etiology of diseases was unknown. At that time, circumcision evolved from a religious ritual or puberty rite into routine surgery for "health" reasons.

Within the miasma of myth and ignorance, a theory emerged that masturbation caused many and varied ills, so some physicians thought it logical to perform genital surgery on both sexes to stop masturbation. In 1891, P.C. Remondino advocated circumcision to prevent or to cure alcoholism, epilepsy, asthma, hernia, gout, rheumatism, curvature of the spine, and headaches. As scientific research uncovered legitimate pathological etiology for diseases previously thought to be prevented or cured by circumcision, new rationales were postulated to validate the practice.

Prophylactic circumcision of females fell out of vogue in English-speaking countries, but the incidence of male circumcision steadily rose. In the early 20th century, circumcision was advocated as a hygienic measure. Though criticism of the practice mounted, it was not until 1975 that the American Academy of Pediatrics came out in opposition, arguing that good personal hygiene would offer all the advantages of routine circumcision without the attendant surgical risk. The advent of antibiotics negated the rationale that circumcision was needed to prevent venereal disease.

As a religious ritual, circumcision is practiced by Jews and Moslems in accordance with the biblical account of Abraham's covenant with God. Even so, the "purpose" of the Jewish ritual of circumcision has been argued by Jews throughout history. Noted Rabbi Moses Maimonides, in the Guide of the Perplexed, explains a rationale for circumcision that merits attention when circumcision is considered relative to human sexuality.

As regards circumcision... ome people believe that circumcision is to remove a defect in man's formation; but every one can easily reply: How can products of nature be deficient so as to require external completion, especially as the use of the foreskin to that organ is evident. This commandment has not been enjoined as a complement to a deficient physical creation, but as a means for perfecting man's moral shortcomings. The bodily injury caused to that organ is exactly that which is desired; it does not interrupt any vital function, nor does it destroy the power of generation. Circumcision simply counteracts excessive lust; for there is no doubt that circumcision weakens the power of sexual excitement, and sometimes lessens the natural enjoyment; the organ necessarily becomes weak when it loses blood and is deprived of its covering from the beginning.

The Moslems, who also circumcise in accordance with the biblical covenant between Abraham and God, traditionally circumcised their males at age 13. More recently, however, Moslem boys are circumcised at varying ages from birth to puberty.

In the United States, the religious rights of parents are being questioned in regard to the constitutional rights of infants and children. Freedom of religion became a legal issue when it was introduced in a circumcision lawsuit claiming a male had been denied his right to freedom of religion when his body was marked by circumcision in accordance with his parents' religion.

The inalienable body ownership rights of infants and children continue to be addressed within the U.S. legal system in lawsuits asserting that the only person who can legally consent to a circumcision is a person making this personal decision for himself. The reports of dissatisfaction with parental circumcision decisions by circumcised men help to illustrate this point. Performed on their penises without their consent, thousands are now undergoing foreskin restoration, either medical or surgical, to reconstruct what they consider was violently taken from their bodies early in their lives. The Declaration of the First International Symposium on Circumcision acknowledges the unrecognized victims of circumcision and, in support of genital ownership rights of infants and children, states:

"We recognize the inherent right of every human being to an intact body. Without religious or racial prejudice, we affirm this basic human right."
Due to the lifelong consequences of the permanent surgical alteration of children's genitals, it becomes imperative that children have the right to own their own reproductive organs and to preserve their natural sexual function.

These, then, are the human genitals. Considering their great delicacy, complexity and sensitivity, one might imagine that an intelligent species like man would leave them alone. Sadly, this has never been the case. For thousands of years, in many different cultures, the genitals have fallen victim to an amazing variety of mutilations and restrictions. For organs that are capable of giving us an immense amount of pleasure, they have been given an inordinate amount of pain. (Morris, 1985)
References

American Academy of Pediatrics. Care of the Uncircumcised Penis. Evanston, Ill.: American Academy of Pediatrics, 1984.

American Academy of Pediatrics' Task Force on Circumcision. Report of the Task Force on Circumcision. Elk Grove Village, Ill.: 1989.

Morris, D. Body Watching. New York: Crown, 1985.

Remondino, P.C. History of Circumcision From the Earliest Times to the Present. Philadelphia: F.A. Davis Co., 1892. Republished New York: AMS Press, 1974.

Wallerstein, E. Circumcision: An American Health Fallacy. New York: Springer Publishing Co., 1980.

Marilyn Fayre Milos
Donna R. Macris
 

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Thursday, 22 November, 2001
Circumcision dangers spelt out

By BBC London's John McManus

Muslim boys in London are risking infection and mutilation by inexperienced and bogus circumcision practitioners.

Circumcision is widely practiced among Muslim communities, though the age at which boys are circumcised varies.

The practice is only available through the NHS if there are compelling medical reasons, though local GP's may carry out the operation themselves.

Problems arise when the procedure is carried out in an unsterile environment, such as the boy's home. This can leave the boys open to infection.

A bigger problem are the "community practitioners", people who have no medical training, who carry out the circumcisions themselves.

Crisis meeting

At a meeting held last week at the East London Mosque, concerned parents, community leaders and doctors gathered to try and find a solution to the problem.

The Royal London Hospital, which serves much of London's East End, treated 32 boys who were suffering from circumcision complications this summer.

Matthew Ryan from Tower Hamlets Community Health Council, said the Hospital experienced a flood of sick boys every summer, as parents had their children circumcised over the long summer holidays, to allow them time to heal.

And one Muslim parent told BBC London that his sons, aged 5 and 10, were left in agony after being circumcised by a "community practitioner".

Six people had to hold the boys down while they were circumcised without an anasthestic, and his GP was horrified when he later examined the children.

The five-year-old eventually had to be kept isolated in hospital for 10 days while he recovered.

Within the law

Male circumcision, unlike the female variety, isn't illegal in Britain.

It's classed as "consensual assault", similar to tattooing, and anyone can legally carry it out.

If a GP is involved they must have had training.

Unlike other forms of medicine, no list of registered practitioners exists, which is why parents often turn to unqualified people recommended to them through the Muslim community.

Circumcision is practiced by nearly all of Britain's Muslims, says The Royal London's Muslim chaplain, Shafiqur Rahman.

"Circumcision has been the practice of the Holy Prophets, from Abraham to Mohammed.

"So it's an act of virtue to follow the Prophets, as well as a health choice."

NHS call

Mr Rahman believes the only way to protect Muslim boys from serious injury is to provide Circumcision through the NHS, monitoring procedures and making Doctors more accountable.

The scale of the problem in London may lead to the NHS agreeing to provide the service. Tower Hamlets Primary Care Trust is considering plans to offer the service for free, and are due to comment tomorrow.

But they may decide to fund circumcisions on younger children only.

Other areas of Britain, such as Leeds, already carry out the procedure for religious, rather than medical reasons.

In the meantime, the Trust is issuing an information pack to parents, to alert them to the dangers posed by unqualified practitioners.
 

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Tuesday, 25 May, 2004

SA considers circumcision dangers

By Victoria Phenethi
BBC, Johannesburg

Traditional leaders and officials in South Africa are meeting to discuss the alarming number of injuries and deaths due to botched circumcisions.

In the last year, 12 boys have died and close to 92 have been hospitalised due to illegal circumcisions.

In the latest incident, a man aged 20 was beaten to death in a circumcision ceremony in the Eastern Cape.

"We cannot just sit back and fold our arms," said the chairperson of the National House of Traditional Leaders.

The house has convened leaders and healers, researchers and government officials to discuss the problem.

"If we don't stop the killing and the deaths... the culture is going to be looked at as if it is a criminal exercise," said Nkosi Mpiyezintombi Boy Mzimela.

Traditional schools

The government feels compelled to do something about the horrific incidents that often occur at traditional schools, said the minister for provincial and local government.

There has been a 70% decline in incidences of unlawful initiations from 2001 to date - but a lot of work still needs to be done to stop further deaths, Minister for Provincial and Local Government Sydney Mufamadi said.

A national law to regulate traditional initiation schools will be considered by parliament later this year, he said.

"We want to make sure that people are made to scrupulously observe all those things that will... guarantee the wellbeing of the initiates," he added.

On the agenda

"Traditional leaders have recognised that something has gone wrong and that they are also responsible for correcting the mistakes," said Dr Mathole Motshekga, director of the Kara Heritage Institute.

There is also a need for all stakeholders, such as government and traditional leaders, to come together to deal with the problem, Mr Motshekga added.

The conference is expected to develop a national legal framework to serve as a guideline for initiation schools throughout the country.
 

Fifth Way

Jedi Council Member
BRAVO Laura!!!

The barbaric dangers of "religious", "traditional" and butchered "medical" circumcision cannot be stressed enough.

It is MUTILATION at best and murder at worst!

4D feeding 101: First you infect everybody by waxinating them with the gruesome bio-weapon AIDS (http://www.tetrahedron.org/), to then "prevent" the spreading by mass mutilation.

Like the Raptoids say: "Bon Appétit"
 

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http://www.mothersagainstcirc.org/

The Circumcision Decision: An Overview
by Mary G. Ray,©1998

Quite a number of famous child care experts and doctors recommend against circumcision in their books. Dr. Dean Edell has expressed oposition against infant cirumcision for at least 15 years now. Sheila Kitzinger very emphatically recommends that parents leave their sons intact. Dr. Lendon Smith goes into detail explaining the foreskin’s purposes and giving all the reasons why circumcision should not be performed. Dr. Spock, in his most recent book, stated “I feel that there’s no solid medical evidence at this time to support routine circumcision.
 

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http://www.foxnews.com/story/0,2933,59639,00.html

Routine Procedure or Child Abuse?

By Wendy McElroy

A disconcerting issue has hit the political radar: male circumcision. Is it a medical procedure or child abuse?

As furor over female genital mutilation grows, so does the criticism of male circumcision.

This June, Arizona eliminated Medicaid funding for infant circumcision, following the lead of six other states: California, Oregon, Washington, Nevada, North Dakota, and Mississippi. In July, a North Dakota court ruled that an adult male could sue the doctor who circumcised him even though the parents had consented and there was no "botch." Flatt v. Kantak became the latest in a series of circumcision cases that test the legal status of the procedure.

Circumcision has been under attack for the last few years. In 1999, the American Academy of Pediatrics revised its guidelines to state, "the benefits are not significant enough for the AAP to recommend circumcision as a routine procedure." In 2000, the American Medical Association modified its policy to read, "Existing scientific evidence demonstrates potential medical benefits ... however, these data are not sufficient to recommend routine neonatal circumcision."

Yet most male babies in North America continue to be circumcised. Advocates loudly proclaim its advantages for men, including an HIV-protective effect for men, and its benefits for women — those with circumcised partners are said to have a reduced risk of cervical cancer.

Yet the central question keeps returning: Is the removal of any part of a healthy sexual organ justified?

The passionate debate has implications far wider than medicine. One is equality under the law. Female genitalia mutilation is already a criminal act under Title 18 United States Code Section 116, which reads, in part, "whoever knowingly circumcises, excises, or infibulates the whole or any part of the labia majora or labia minora or clitoris of another person who has not attained the age of 18 years shall be fined under this title or imprisoned not more than five years, or both." [Emphasis added.]

Procedures necessary to health are excluded.

To remove any part of healthy male genitalia would seem to be an act parallel in law to female genital mutilation. Indeed, the plaintiff in Flatt v. Kantak will probably argue along these lines.

What does this mean for Jewish ritual circumcision, called Brit Milah — a sign of the Jewish covenant with God? The U.S. Code against mutilating female genitalia makes no exception for religion or culture. It states, "no account shall be taken of the effect on the person on whom the operation is to be performed of any belief on the part of that person, or any other person, that the operation is required as a matter of custom or ritual."

If variations of Islamic religion and culture do not justify mutilating women, then can religion justify non-therapeutic male circumcision? Nothing in international or domestic law would seem to allow the discriminatory banning of only female genital mutilation. Indeed, for decades, international law has come down against routine circumcision. For example, the U.N.'s Universal Declaration of Human Rights (1948) speaks of the "human rights" involved in "the ethics of circumcision," which are "the rights to security of person, to freedom from torture and other cruel and unusual treatment, and to privacy."

Those who claim that the mutilation of female genitalia cannot be likened to circumcision should read the many anti-circumcision sites that offer horror stories. Mothers Against Circumcision claim that these "side effects" are not uncommon and that circumcision has inherent and universal disadvantages, such as a diminishment of sexual pleasure.

Circumcision is also a moral issue. The organization Doctors Opposing Circumcision decries the procedure as "painful," "tragic," "contra-indicated," and states "that no one has the right to forcibly remove sexual body parts from another individual." DOC claims that circumcision violates the physician's Golden Rule — First, Do No Harm — as well as all seven principles of the A.M.A. Code of Ethics.

These are merely some of the political and moral questions surrounding circumcision. For better or worse, the parameters of this issue may well be determined in the courts through lawyers' arguments and judges' decisions. Which brings us back to Flatt v. Kantak.

Unfortunately, this case muddies the discussion by introducing other significant issues. For example, since the parents consented, the case implicitly asks whether parents have a right to make decisions about their children's bodies. Or is the real issue "informed consent"? Do doctors need to fully reveal all the possible side effects of, current thinking on and alternatives to circumcision, so that it is no longer "routine"?

On the other hand, if circumcision is legally shown to be a form of criminal harm, then the "informed consent" of parents may be irrelevant: doctors, nurses, hospitals, and mohels might be held criminally liable, alongside parents, for child abuse.

As medical associations one-by-one refuse to support routine circumcision, the procedure is losing ground — medically, morally, politically, and legally. This process is being sped along by aggressive groups like The National Organization of Circumcision Information Resource Centers, a "non-profit educational organization committed to securing the birthright of male and female children and babies to keep their sexual organs intact."

The ensuing debate will help define medical ethics for a new generation.

Wendy McElroy is the editor of ifeminists.com and a research fellow for The Independent Institute in Oakland, Calif. She is the author and editor of many books and articles, including the new book, Liberty for Women: Freedom and Feminism in the 21st Century (Ivan R. Dee/Independent Institute, 2002). She lives with her husband in Canada.
 

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http://www.cnn.com/HEALTH/9712/23/circumcision.anesthetic/

Circumcision study halted due to trauma

ATLANTA (CNN) -- A new study found circumcision so traumatic that doctors ended the study early rather than subject any more babies to the operation without anesthesia.

The researchers discovered that for those circumcised without anesthesia there was not only severe pain, but also an increased risk of choking and difficulty breathing.

The necessity of circumcision is the subject of increasing debate , but the traditional reasons for the operations have always been prevention.

Dr. Arthur Gumer of Northside Hospital in Atlanta says circumcision has been thought to provide "protection against infectious diseases later in life which would include either sexually transmitted diseases or urinary tract infections."

Up to 96 percent of the babies in the United States and Canada receive no anesthesia when they are circumcised, according to a report from the University of Alberta in Edmonton.

One of the reasons anesthesia is not used, the study found, is the belief that infants feel little or no pain from the procedure. It has also been argued that injecting anesthesia can be as painful as circumcision itself, and that infants don't remember the procedure, anyway.
Study measured heart rate, crying pattern But there are those who find that reasoning difficult to believe, and Gumer is one of them.

"To say that the baby doesn't remember it is not an adequate excuse to me," he said. "Babies experience other painful procedures and we worry about that, and we do give them anesthetics for those procedures."

But the Edmonton researchers, whose study was published in this week's Journal of the American Medical Association, studied the heart rates and crying patterns of babies during different stages of circumcision. Some babies were given an anesthetic and others were not.

Topicals woefully inadequate

Rabbi Ariel Asa has performed hundreds of circumcisions. When families request it, he says he puts an anesthetic on the skin, in an effort to reduce some of the pain. But he admits it's not very effective.

"Due to the fact that moyels (the people who do the procedure) do it very quickly and the pain that the baby experiences is minimal, I don't think that the overall benefits are gained," he says.

But the researchers found that while topical anesthetics may help initially, they are woefully inadequate during foreskin separation and incision.

They concluded that if circumcision must be performed, it should be preceded by an injected anesthetic.

In fact, they found the results so compelling that they took the unusual step of stopping the study before it was scheduled to end rather than subjecting any more babies to circumcision without anesthesia.

Medical Correspondent Dr. Steve Salvatore and Reuters contributed to this report.
 

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http://www.cirp.org/library/complications/



four complications of circumcision [A] Urethral fistula at frenulum (note probe), probably the result of incisional trauma. Three-year-old boy with an almost transected glans from circumcision at birth, but parents did not note the abnormality until age 3. Urethra had been completely transected (arrow). [C] Neonate referred immediately after Gomco clamp circumcision in which all the skin of the shaft had been amputated. This is a fairly common complication caused by pulling too much skin up into the clamp and amputating it. Fortunately sometimes there is enough of the mucosal side of the prepuce to fold back to resurface the shaft, but some require a free skin graft. [D] Six-month-old baby was referred after loss of the entire penis from cautery used during circumcision. Evidently both corpora had thrombosed and sloughed, so no phallus remained.
(From the textbook Pediatric Trauma, edited by Robert J. Touloukian, M.D., Yale University School of Medicine (John Wiley & Sons).

Complications of circumcision

This directory contains articles about the complications, risks, adverse effects, and disadvantages of circumcision and their treatments (not including repair of the circumcision itself; see Foreskin reconstruction). See also Psychological Impacts of Circumcision.



Medical journal articles about complications are divided into case reports, propective studies, retrospective studies, and literature survey articles. Case reports report individual cases. Prospective studies are forward looking studies that record the complications experienced by a particular group of infants. Retrospective studies look backward by examination of medical and/or hospital records. Survey articles provide a summary of the existing medical literature.

Case report articles provide information about the variety and incidence of complications of circumcision but do not provide information on the total number of complications that result from circumcision. Cases are reported only when the complication has not been previously seen or when new information can be added to the store of medical knowledge of treatment or management.

The incidence of complications, risks, and adverse effects of male circumcision is controversial. There is wide disagreement on what constitutes a complication. Some studies only record immediate in hospital complications, while other studies record complications that occur later in life. Needless to say, these variations cause a wide range in the reported incidence of complications. None of the available prospective studies consider the sexual effects of male circumcision in adult life. The National Organization to Halt the Abuse and Routine Mutilation of Males (NOHARMM) has compiled statistical data on the estimated total number of complications and has made it available on the World Wide Web.

Williams and Kapila estimate that a realistic rate of complications from neonatal circumcision ranges from 2% to 10%. To many men who become aware of the function and value of the prepuce, the fact that this genital sensory organ was amputated from them at birth is itself a complication of circumcision; in which case, the actual complication rate is 100%... For males fortunate enough to survive the surgery without immediate complications, there is a growing awareness among men of other delayed, long-term consequences of neonatal circumcision, which are only now beginning to be documented.
--Awakenings (NOHARMM)

----
Prospective Studies of Circumcision Complications

Prospective studies of circumcision complications are controlled studies of the type and number of complications of circumcision that occur in a clinical setting. CIRP provides studies from Canada, England, New Zealand, Turkey, and the United States. Prospective studies usually provide information on the incidence (percentage of boys suffering adverse effects) of complications. Reported rates of complications range up to 55%.

1. Patel H. The problem of routine infant circumcision. Can. Med. Assoc. J. (Sept 10, 1966); 95: 576-581.
2. Metcalf TJ, Osborn LM, Mariani EM. Circumcision: a study of current practices. Clin Pediatr (Phila) 1983; 22: 575-579.
3. Leitch IOW. Circumcision - a continuing enigma. Aust Paediatr J 1970;6:59-65.
4. Griffiths DM. Atwell JD. Freeman NV. A prospective survey of the indications and morbidity of circumcision in children. European Urology 1985;11(3):184-7.
5. Fergusson DM, Lawton JM, Shannon FT. Neonatal circumcision and penile problems: an 8-year longitudinal study. Pediatrics 1988; 81: 537-41.
6. Ozdemir E. Significantly increased complication risk with mass circumcisions. Brit J Urol, Vol 80, Pages 136-139, August 1997.
7. Van Howe RS. Variability in penile appearance and penile findings: a prospective study. Brit J Urol 1997;80:776-782.
8. Mayer E, Caruso DJ, Ankem M, et al. Anatomic variants associated with newborn circumcision complications. Can J Urol 2003;10(5):2013-6.
9. Corbett HJ, Humphrey GME. Early complications of circumcisions performed in the community. Br J Gen Pract 2003;53(496):887-8.

Retrospective Studies

Retrospective studies examine medical records. In a small retrospective study limited to the incidence of adhesions in circumcised boys, Gracely-Kilgore reported that 15 percent of circumcised boys experience adhesions. Three percent required surgical correction. El-Bahnasawy reported that circumcision is the most frequent cause of penile injury.

10. Gracely-Kilgore KA. Penile adhesion: the hidden complication of circumcision. Nurse Pract 1984; 9: 22-4.
11. Ahmed A, Mbibi NH, Dawam D, Kalayi GD. Complications of traditional male circumcision. Ann Trop Paediatr 1999;91(1):113-7.
12. El-Bahnasawy MS, El-Sherbiny MT. Penile pediatric trauma. BJU Int 2002;90:92-96.

Survey Articles

Survey articles survey the medical literature. They provide a summary of the literature. CIRP provides two of the best.

13. Kaplan GW. Complications of circumcision. Urol Clin N Amer 1983;10:543-549.
14. Williams N, Kapila L. Complications of circumcision. Br J Surg 1993; 80:1231-36.

Case reports

Case reports are reports of individual cases that have appeared in the medical literature regarding complications of circumcision. The list provided here is extensive but it is not comprehensive. There are other reports that are not listed here.
Ablation of the Penis

15. Brown JB, Fryer MP. Surgical reconstruction of the penis. GP 1958; 17: 104-7.
16. Money, John. Ablatio Penis: Normal Male Infant Sex-Reassigned As A Girl Archives of Sexual Behavior (New York) vol. 4 no. 1 January 1975 pp. 65-71
17. Pearlman CK. Reconstruction following iatrogenic burn of the penis. J Pediatr Surg 1976;11:121-2.
18. Pearlman CK. Caution advised on electrocautery circumcisions. Urology 1982; 19: 453.
19. Gearhart JP, Rock JA. Total Ablation of The Penis After Circumcision With Electrocautery: A Method Of Management and Long-term Followup. Journal of Urology (Baltimore) vol. 142 no. 3 September 1989 pp. 799-801.
20. Stefan, H. Reconstruction of the Penis Following Necrosis from Circumcision Used High Frequency Cutting Current. Sbornik Vedeckych Praci Lekarske Fakulty Karlovy Univerzity (Hradci Kralove) vol. 35, no. 5 (Suppl) 1992, pp. 449-454.
21. Gilbert DA, Jordan GH, Devine CJ Jr, Winslow BH, Schlossberg SM. Phallic construction in prepubertal and adolescent boys. J Urol 1993; 149: 1521-6.
22. Bradley SJ, Oliver GD, Chernick AB. Experiment of Nurture: Ablatio Penis at 2 Months, Sex Reassignment at 7 Months, and a Psychosexual Follow-up in Young Adulthood. Pediatrics 1998;102(1):e9.

Adhesions (see also Treatment of Phimosis)

23. Marks MB. Preputial adhesions in the circumcised penis. Arch Pediatr 1939; 56: 458-9.
24. Gracely-Kilgore KA. Penile adhesion: the hidden complication of circumcision. Nurse Pract 1984; 9: 22-4.
25. Attalla MF, Taweela MN. Pathogenesis of post-circumcision adhesions. Pediatr Surg Int 1994; 9: 103-5.
26. Ponsky LE, Ross JH, Knipper N, Kay R. Penile adhesions after neonatal circumcision. J Urol 2000;164(2):495-6.

Amputation of the penis

27. Brimhall JB. Amputation of the penis following a unique method of preventing hemorrhage after circumcision. St Paul Med J 1902; 4: 490.
28. Lerner BL. Amputation of the penis as a complication of circumcision. Med Rec Ann 1952;46:229-31.
29. Levitt SB, Smith RB, Ship AG. Iatrogenic microphallus secondary to circumcision. Urology 1976; 8: 472-4.
30. Izzidien AY. Successful replantation of a traumatically amputated penis in a neonate. Journal of Pediatric Surgery April 1981,16(2):202-203.
31. Hanash KA. Plastic reconstruction of partially amputated penis at circumcision. Urology 1981; 18(3): 291-3.
32. Azmy A, Boddy SA, Ransley PG. Successful reconstruction following circumcision with diathermy. Br J Urol 1985; 57: 587-8.
33. Yilmaz AF, Sarikaya S, Yildiz S, et al. Rare complication of circumcision: penile amputation and reattachment. European Urology (Basel) 1993; 23(3): 423-424.
34. Audry G, Buis J, Vazquez MP, Gruner M. Amputation of penis after circumcision--penoplasty using expandable prosthesis. Eur J Pediatr Surg 1994; 4: 44-5.
35. Hanukoglu A, Danielli L, Katzir Z, Gorenstein A, Fried D. Serious complications of routine ritual circumcision in a neonate: hydro ureteronephrosis, amputation of glans penis, and hyponatraemia. Eur J Pediatr 1995; 154: 314-5.
36. Gluckman GR et al. Newborn Penile Glans Amputation During Circumcision and Successful Reattachment. Journal of Urology (Baltimore), vol. 153 no. 3 Part 1 March 1995 pp. 778-779.
37. Strimling BS. Partial amputation of glans penis during Mogen clamp circumcision. Pediatrics 1996; 97: 906-7.
38. Neulander E, Walfisch S. Kaneti J. Amputation of distal penile glans during neonatal ritual circumcision -- a rare complication. Br J Urol 1996; 77: 924-5.
39. Sherman J, Borer JG, Horowitz M, Glassberg KI. Circumcision: successful glanular reconstruction and survival following amputation. J Urol 1996; 156: 842.
40. Van Howe RS. Re: circumcision: successful glanular reconstruction and survival following traumatic amputation (Letter). J Urol. 1997;158:550.
41. Coskunfirat OK, Sayiklkan S, Velidedeoglu H.. Glans and penile skin amputation as a complication of circumcision (letter). Ann Plast Surg 1999;43(4):457.
42. Siegel-Itzkovich J. Baby's penis reattached after botched circumcision. BMJ 2000;321:529.
43. Park JK, Min JK, Kim HJ. Reimplantation of an amputated penis in prepubertal boys. J Urol 2001;165:586-7.

Anesthesia

44. Sara CA, Lowry CJ. A complication of circumcision and dorsal nerve block of the penis. Anaesth Intensive Care 1985; 13: 79-82.
45. Berens R, Pontus SP Jr A complication associated with dorsal penile nerve block. Reg Anesth 1990; 15: 309-10.
46. Snellman LW, Stang HJ. Prospective evaluation of complications of dorsal penile nerve block for neonatal circumcision. Pediatrics 1995; 95: 705-708.
47. Tse S, Barrington K. Methemoglobinemia associated with prilocaine use in neonatal circumcision. Am J Perinatol 1995; 12: 331.
48. Arda IS, Özbek N, Akpek NE and Ersoy E. Toxic neonatal methaemoglobinaemia after prilocaine administration for circumcision. BJU Int 2000;85(9):1-1.
49. Couper RTL. Methaemoglobinaemia secondary to topical lignocaine/prilocaine in a circumcised neonate. J Paediatr Child Health 2000;36(4):406-407.
50. Odemis E, Sonmez FM, Aslan Y. Toxic methemoglobinemia due to prilocaine injection after circumcision. Int Pediatr 2004;19(2):96-7.

Apnea

51. Fleiss PM, Douglass J. The case against neonatal circumcision. Brit Med J 1979;2(6189):554.
52. Lander J, Brady-Freyer B, Metcalfe JB, et al. Comparison of ring block, dorsal penile nerve block, and topical anesthesia for neonatal circumcision. JAMA 1997; 278:2158-2162.

Bleeding and Hemorrhage

[CIRP Comment: No one knows if a newborn baby has a bleeding disorder. Although circumcision cuts through arteries and veins that provide blood to the foreskin, it is not customary to do a clotting factor test prior to circumcision. If a bleeding disorder exists it will be discovered only during the course of the operation.

Post-circumcision bleeding is an extremely serious matter. Substantial bleeding cannot be tolerated, because the quantity of blood is an infant's body is quite small. Bleeding can lead to exsanguination, followed by hypovolemic shock, followed by death. Post-circumcision bleeding requires immediate medical attention.]

53. Shulman J, Ben-hur N, Neuman Z. Surgical complications of circumcision. Am J Dis Child 1964; 107:149-54.
54. Patel H. The problem of routine infant circumcision. Can. Med. Assoc. J 95 (Sept 10, 1966): 576-581.
55. Gee WF, Ansell, NF. Neonatal circumcision: a ten year overview; with comparison of the Gomco clamp and the Plastibell device. Pediatrics 1976; 58: 824-7.
56. Kaplan GW. Complications of circumcision. Urol Clin N Amer 1983;10:543-549.
57. Griffiths DM. Atwell JD. Freeman NV. A prospective survey of the indications and morbidity of circumcision in children. European Urology 1985 11(3):184-7.
58. Williams N, Kapila L. Complications of circumcision. Br J Surg 1993; 80:1231-36.
59. Killick CJ, Barton CJ, Aslam S, Standen GR. Prenatal diagnosis in factor XIII-A deficiency. Arch Dis Child Fetal Neonatal Ed 1999;80:F238-F239.
60. Hiss J, Horowitz A, Kahana T. Fatal haemorrhage following male ritual circumcision. J Clin Forensic Med 2000;7:32-4.
61. Corbett HJ, Humphrey GME. Early complications of circumcisions performed in the community. Br J Gen Pract 2003;53(496):887-8.
62. Newell TEC. Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan. Burnaby, B.C.: British Columbia Coroner's Service, Monday, 19 January 2004. [HTML file]

Balanitis Xerotica Obliterans (BXO) secondary to circumcision

63. Stuehmer A. Balanitis xerotica obliterans (post operationem) und ihre beziehungen zur "kraurosis glandis et praeputii penis". Arch Derm Syph. 1928;156:613-23.
64. Franks AG. Balanitis xerotica obliterans. J Urol. 1946;56:243.
65. Potter B. Balanitis xerotica obliterans manisfesting on the stump of amputated penis. Arch Dermatol. 1959;79:473.
66. Weigand DA. Lichen sclerosus et atrophicus, multiple displastic keratosis and squamous cell carcinoma of the glans penis. J Dermatol Surg Oncol. 1980;6 45-50.
67. Campus GV, Ena P, Scuderi N. Surgical treatment of balanitis xerotica obliterans. Plast Reconstr Surg. 1984;73(4):652-7.
68. Zungri E, Chechile G, Algaba F, Mallo N. Balanitis xerotica obliterans: surgical treatment. Eur Urol 1988;14:160-2.
69. Garat JM, Checile G, Algaba F, Santaularia JM. Balanitis xerotica obliterans in children. J Urol 1988;136:136-7
70. Datta C, Dutta SR, Chaudhuri A. Histopathological and immunological studies in a cohort of balanitis xerotica. obliterans. J Ind Med Assoc1993;91 146-8.

Benign Prostatic Hyperplasia

71. McCredie M, Staples M, Johnson W, et al. Prevalence of urinary symptoms in urban Australian men aged 40-69. J Epidemiol Biostat 2001;6(2):211-8.

Botched Circumcisions

72. McGowan AJ. A complication of circumcision. JAMA 207(11) p. 2104, March 1969.
73. Stefan H. Reconstruction of the penis following necrosis from circumcision used high frequency cutting current. Sb Ved Pr Lek Fak Karlovy Univerzity Hradci Kralove Suppl 1992; 35: 449-54.
74. Stefan H. Reconstruction of the penis after necrosis due to circumcision burn. Eur J Pediatr Surg 1994; 4: 40-3.
75. Patel HI, Moriarty KP, Brisson PA, Feirs NR. Genitourinary injuries in the newborn. J Ped Surg 2001;36:235-239.

Buried, Concealed, and Hidden Penis

76. Stewart DH. The toad in the hole circumcision -- a surgical bugbear. Boston Med Surg J 1924; 191: 1216-8.
77. Talarico RD, Jasaitis JE. Concealed penis: a complication of neonatal circumcision. J Urol 1973; 110: 732-3.
78. Trier WC, Drach GW. Concealed penis. Another complication of circumcision. Am J Dis Child 1973; 125: 276-7.
79. Radhakrishnan J, Reyes HM. Penoplasty for buried penis secondary to "radical" circumcision. J Pediatr Surg 1984;19: 629-31.
80. Kon M. A rare complication following circumcision: the concealed penis. J Urol 1983; 130: 573-4.
81. Donahoe PK, Keating MA. Preputial unfurling to correct the buried penis. J Pediatr Surg 1986; 21: 1055-7.
82. Maizels M, Zaontz M, Donovan J, Bushnick PN, Firlit CF. Surgical correction of the buried penis: description of a classification system and a technique to correct the disorder. J Urol 1986; 136: 268-73.
83. Shapiro SR. Surgical treatment of the "buried" penis. Urology 1987; 30: 554-9.
84. Horton CE, Vorstman B, Teasley D, Winslow B. Hidden penis release: adjunctive suprapubic lipectomy. Ann Plast Surg 1987; 19: 131-4.
85. van-der Zee JA, Hage JJ, Groen JM, Bouman FG. Een ernstige complicatie ten gevolge van rituele circumcisie van een 'begraven' penis. [A serious complication of ritual circumcision of a 'buried' penis] Ned Tijdschr Geneeskd 1991; 135: 1604-6.
86. Bergeson PS. et al. The Inconspicuous Penis. Department of General Pediatrics and Urology, Phoenix Children's Hospital. Pediatrics 1993;92:794-9.
87. Alter GJ, Horton CE Jr; Horton CE Jr. Buried penis as a contraindication for circumcision. J Am Coll Surg 1994; 178: 487-90.
88. Alter G. Buried Penis. (link to http://www.altermd.com/pconstruct/urethral.htm)
89. Blalock HJ, Vemulakonda V, Ritchey ML, Ribbeck M. Outpatient Management of Phimosis Following Newborn Circumcision. J Urol 2003;169(6):2332-4.
90. Raboei L. Surgical management of a concealed penis. Saudi Med J 2003 May;24(5):S50
91. Sivakumar B, Brown AA, Kangesu L. Circumcision in 'buried penis'--a cautionary tale. Ann R Coll Surg Engl 2004;86(1):35-7.

Cancer, Post-Circumcision

92. Bissada NK, Morcos RR, el-Senoussi M. Post-circumcision carcinoma of the penis. I. Clinical aspects. J Urol 1986 Feb;135(2):283-5.
93. Bissada NK. Post-circumcision carcinoma of the penis: II. Surgical management. J Surg Oncol 1988;37(2):80-3.

Chilling

94. Spence GR. Chilling of newborn infants: its relation to circumcision immediately following birth. South Med J 1970; 63: 309-11.

Chordee

95. Kaplan GW. Circumcision: an overview. Curr Probl Pediatr 1977 7:1-33.

Circulatory Complications

96. Hamm WG, Kanthak FF. Gangrene of the penis following circumcision with high frequency current. South Med J 1949; 42: 657-9.
97. Thorek P, Egel P. Reconstruction of the penis with split-thickness skin graft: a case of gangrene following circumcision for acute balanitis. Plast Reconst Surg 1949; 4: 469-72.
98. Pinkham EW Jr, Stevenson AW Jr. Unusual reaction to local anesthesia: gangrene of the prepuce. US Armed Forces Med J 1958; 9: 120-2.
99. Rosefsky JB Jr. Glans necrosis as a complication of circumcision. Pediatrics 1967; 39: 774-6.
100. du Toit DF, Villet WT. Gangrene of the penis after circumcision: a report of 3 cases. S Afr Med J 1979; 55: 521-2.
101. Sterenberg N, Golan J, Ben-Hur N. Necrosis of the glans penis following neonatal circumcision. Plast Reconstr Surg 1981; 68: 237-9.
102. Evbuomwan I, Aliu AS. Acute gangrene of the scrotum in a one month old child. Trop Geogr Med 1984; 36: 299-300.
103. Ahmed S, Shetty SD, Anandan N, Patil KP, Ibrahim AIA. Penile reconstruction following post-circumcision penile gangrene. Pediatr Surg Int 1994; 9: 295-6.
104. Kurel S. Iatrogenic penile gangrene: 10-year follow-up. Plast Reconst Surg 1995; 95: 210-1.
105. Aslan A, Karaguzel G, Melikoglu M. Severe ischemia of the glans penis following circumcision: A successful treatment via pentoxifylline. Int J Urol 2005;12(7):705-7.

Clamp Complications

106. David W. Feigal, Jr. Potential for Injury from Circumcision Clamps. Rockville: U.S. Food and Drug Administration, 2000.

Death

For more information on death as a consequence of circumcision, see Circumcision Deaths.

107. Holt LE. Tuberculosis acquired through ritual circumcision. JAMA 1913;LXI(2):99-102.
108. Reuben MS. Tuberculosis from ritual circumcision. Proceedings of the New York Academy of Medicine 1916; (December 15): 333-334.
109. Rosenstein JL. Wound diphtheria in the newborn infant following circumcision. J Pediatr 1941;18:657-8.
110. Gairdner D. The fate of the foreskin. A study of circumcision. BMJ 1949; 2: 1433-37.
111. Scurlock JM, Pemberton PJ. Neonatal meningitis and circumcision. Med J Aust 1977;1:332-334.
112. Cleary TG, Kohl S. Overwhelming infection with group B beta-hemolytic streptococcus associated with circumcision. Pediatrics, Vol 64, no 3, (September 1979), pp. 301-303.
* (and responses to the Editor)
113. Dustin Evans, Jr., October 20, 1998(Link to www.noharmm.org)
114. Hiss J., Horowitz A., Kahana T. Fatal haemorrhage following male ritual circumcision. J Clin Forensic Med 2000;7:32-4.
115. Newell TEC. Judgement of inquiry into the death of McWillis, Ryleigh Roman Bryan. Burnaby, B.C.: British Columbia Coroner's Service, Monday, 19 January 2004. [HTML file]

Denudation of the penile shaft

116. Brown JB. Restoration of the entire skin of the penis. Surg Gynecol Obstetr 1937; 65: 362-5.
117. Wilson CL, Wilson MC. Plastic repair of the denuded penis. South Med J 1959; 52: 288-90.
118. Van Duyn J, Warr WS. Excessive penile skin loss from circumcision. J Med Assoc Georgia 1962;51:394-6.
119. Sotolongo JR Jr; Hoffman S, Gribetz ME. Penile denudation injuries after circumcision. J Urol 1985; 133: 102-3.
120. Smey P. Re: Penile denudation injuries after circumcision. J Urol 1985; 134: 1220.
121. Orozco-Sanchez J, Neri-Vela R. Denudacion total del pene por circuncision. Descripcion de una tecnica de plastia del pene para su correccion. [Total denudation of the penis in circumcision: Description of a penoplasty technique for its correction.] Bl Med Hosp Infant Mex 1991; 48: 565-9.

Emesis

122. Fleiss PM, Douglass J. The case against neonatal circumcision. Brit Med J 1979;2(6189):554.

Use of EMLA Anesthetic Cream

122. Methemoglobinemia following neonatal circumcision. JAMA 1989; 261: 702.
123. Özbek N, Sarikayalar F. Toxic methaemoglobinaemia after circumcision. Eur J Pediatr 1993; 152: 80.
124. The Canadian Nurse, August 1994, pp. 5-6.
125. Tse S, Barrington K, Byrne P. Methemoglobinemia associated with prilocaine use in neonatal circumcision. Am J Perinatology 1995; 12: 331-2. Mandel S.
126. Gazarian M, Taddio A, Klein J, Kent G, Koren G. Penile absorption of EMLA cream in piglets: implications for use of EMLA in neonatal circumcision. Biol Neonate 1995; 68: 334-41.
127. Physicians' Desk Reference, 1996, pp. 545-547.
128. Özbek N, Akpek NE and Ersoy E. Toxic neonatal methaemoglobinaemia after prilocaine administration for circumcision. BJU International 2000, 85 (9), 1-1.
129. Couper RTL. Methaemoglobinaemia secondary to topical lignocaine/prilocaine in a circumcised neonate. J Paediatr Child Health 2000;36(4):406-407.

Erotosexual complications

Please see Foreskin Sexual Function/Circumcision Sexual Dysfunction for more information on sexual complications of circumcision.

131. Money J, Davison, J. Adult penile circumcision: erotosexual and cosmetic sequelae. The Journal of Sex Research, Vol 19 No. 3, pp. 289-292, August 1983.

Infection

[CIRP Comment: Methicillin resistant staphylococcus aureus (MRSA) infection is becoming increasingly found in epidemic proportions world wide. It may be only a matter of time before newly circumcised boys in a hospital nursery are infected with this antibiotic resistant pathogen with life-threatening results. Staph infection can cause arthritis, bacteremia, cellulitis, impetigo, necrotizing fasciitis, pneumonia, osteomyletis, staphylococcal pyoderma, staphylococcus scalded skin syndrome (SSSS), and other diseases. Reassessment of the risk-benefit ratio associated with non-therapeutic neonatal circumcision urgently is necessary.]

132. Holt LE. Tuberculosis acquired through ritual circumcision. JAMA 1913;LXI(2):99-102.
133. Reuben MS. Tuberculosis from ritual circumcision. Proceedings of the New York Academy of Medicine 1916; (December 15): 333-334.
134. Reuben MS. Tuberculosis following ritual circumcision. Arch Pediatr 1917; XXXIV:186-90.
135. Gosden M. Tetanus following circumcision. Trans R Soc Trop Med Hyg 1935; 28; 645-8.
136. Rosenstein JL. Wound diphtheria in the newborn infant following circumcision. J Pediatr 1941;18:657-8.
137. Sauer LW. Fatal staphylococcus bronchopneumonia following ritual circumcision. Am J Obstetr Gynecol 1943; 46: 583.
138. Southby R, Myers N. A case against circumcision. Med J Austr 1965; 2: 393.
139. Thompson DJ, Gezon HM, Rogers KD, et al. Excess risk of staphylococcus infection and disease in newborn males. Am J Epidemiol 1965;84(2):314-28.
140. Dinari G, Haimov H, Geiffman M. Umbilical arteritis andh phlebitis with scrotal abscess and peritonitis. J Pediatr Surg 1971; 6: 176.
141. Kirkpatrick BV, Eitzman DV. Neonatal septicemia after circumcision. Clin Pediatr 1974;13:767-768.
142. Nelson JD, Dillon HC Jr, Howard JB. A prolonged nursery epidemic associated with a newly recognized type of group A streptococcus. J Pediatr 1976; 89: 792-6.
143. Mahlberg FA, Rodermund OE, Muller RW. Ein Fall von Zirkumzisions-tuberkulose. [A case of circumcision tuberculosis] Hautarzt 1977; 28: 424-5.
144. Scurlock JM, Pemberton PJ. Neonatal meningitis and circumcision. Med J Aust 1977;1:332-334.
145. Annunziato D, Goldman LM. Staphlococcal scalded skin syndrome. A complication of circumcision. Am J Dis Child 1978; 132:1178-1188.
146. Sussman SJ, Schiller RP, Shashikumar VL. Fournier's syndrome. Report of three cases and review of the literature. Am J Dis Child 1978; 132: 1189-91.
147. Cleary TG, Kohl S. Overwhelming infection with group B beta-hemolytic streptococcus associated with circumcision. Pediatrics, Vol 64, no 3, (September 1979), pp. 301-303.
* (and responses to the Editor)
148. Woodside, Jeffrey R. Necrotizing Fasciitis After Neonatal Circumcision. Am J Dis Child (Chicago) 1980:134(3):301-302.
149. Woodside JR. Circumcision Disasters. Pediatrics 1980;65:1053-1054.
150. Woodside JR. How to lessen risk of wound infection after circumcision. Mod Med 1980; 48(16): 93.
151. Curran JP, Al-Salihi FL. Neonatal staphylococcal scalded skin syndrome: massive outbreak due to an unusual phage type. Pediatrics 1980;66(2):285-90.
152. Menahem S. Complications arising from ritual circumcision: pathogenesis and possible prevention. Isr J Med Sci 1981;17(1):45-8.
153. Anday EK, Kobori J. Staphylococcal scalded skin syndrome: a complication of circumcision. Clin Pediatr Phila 1982;21:420.
154. Adeyokunnu AA. Fournier's syndrome in infants. A review of cases from Ibadan, Nigeria. Clin Pediatr Phila 1983;22:101-3.
155. Enzenauer RW et al. Increased Incidence of Neonatal Staphylococcal Pyoderma in Males. Military Medicine 1984;47:408.
156. Enzenauer RW et al. Male Predominance in Persistent Staphylococcal Colonization and Infection of the Newborn. Hawaii Med J. 44(10):389-90, 392, 394-6, Oct 1985.
157. Stranko J, Ryan ME, Bowman AM. Impetigo in newborn infants associated with a plastic bell clamp circumcision. Pediatr Infect Dis 1986; 5: 597-9
158. Uwyyed K, Korman SH, Bar Oz B, Vromen A. Scrotal abscess with bacteremia caused by Salmonella group D after ritual circumcision. Pediatr Infect Dis J 1990; 9: 65-6.
159. Braun D. Neonatal bacteremia and circumcision. Pediatrics 1990;85:135-6.
160. Wiswell TE, Curtis J, Dobek AS, Zierdt CH. Staphylococcus aureus colonization after neonatal circumcision in relation to device used. J Pediatr 1991;119:302-4.
161. Zafar AB, Butler RC, Reese DJ, Gaydos LA, Mennonna PA. Use of 0.3% triclosan (Bacti Stat) to eradicate an outbreak of methicillin resistant Staphylococcus aureus in a neonatal nursery. Am J Infect Control 1995; 23:200-8.
162. Ngan JH, Mitchell M. Necrotizing fasciitis following neonatal circumcision. Children's Hospital and Medical Center, Seattle, WA, USA. (link to www.infocirc.org)
163. Bliss DP, Healey PJ, Waldhausen JHT. Necrotizing fasciitis after Plastibell circumcision. Journal of Pediatrics, Volume 31, pages 459-462, September 1997.
164. Hoffman KK, Weber DJ, Bost R, Rutala WA. Neonatal staphyloccus aureus pustulous rash outbreak linked by molecular typing to colonized healthcare workers. Infection Control and Hospital Epidemiology 2000;21(2):136.
165. Chanpong GF, Laras K, Sulaiman HA, et al. Hepatitis C among child transfusion and adult renal dialysis patients in Indonesia. Am J Trop Med Hyg 2002;66(3):317-20.
166. Gesundheit B, Grisaru-Soen G, Greenberg D, et al. Neonatal Genital Herpes Simplex Virus Type 1 Infection After Jewish Ritual Circumcision: Modern Medicine and Religious Tradition. Pediatrics 2004;114(2):E259-63.
167. Fortunov M, Hulten KG, Hammerman WA, et al. Community-acquired Staphylococcus aureus infections in term and near-term previously healthy neonates. Pediatrics 2006;118(3):874-81.
168. Epidemic Methicillin-Resistant Staphylococcus Aureus: Dramatically Increased Risk for Circumcised Newborn Boys. Seattle: Doctors Opposing Circumcision, 2006.

Impotence

169. Glover E. The `screening' function of traumatic memories. Int J Psychoanal 1929; 10:90-93.
170. Hanash KA. Plastic reconstruction of partially amputated penis at circumcision. Urology 1976; 18: 121.
171. Stinson JM. Impotence and adult circumcision. J Nat Med Assoc 1973; 65:161.
172. Palmer JM, Link D. Impotence following anesthesia for elective circumcision. JAMA 1979; 241:2635-6.
173. Stief CG, Thon WF, Djamilian M, et al. Transcutaneous registration of cavernous smooth muscle electrical activity: noninvasive diagnosis of neurogenic autonomic impotence. J Urol 1992;147(1):47-50.

Keloid Formation

174. Warwick D.J., Dickson W.A.: Keloid of the penis after circumcision. Postgrad. Med. J., 69 (809): 236-7, 1993.
175. Gürünlüoglu R, Bayramiçli M, Numanoglu A. Two patients with penile keloids: A review of the literature. Ann Plast Surg 1997; 39: 662-5.
176. Eldin US. Post-circumcision keloid - a case report. Annals of Burns and Fire Disasters 1998;XII(3):174.
177. Köksal T., Kadioglu A. & Tefekli A. Keloid as a complication after circumcision. British Journal of Urology 85 (6), 1-2, April 2000.

Lack of Anesthesia

178. Auerbach MR, Scanlon JW Recurrence of pneumothorax as a possible complication of elective circumcision. Am J Obstet Gynecol 1978; 132: 583.
179. Ruff ML, Clarke TA, Harris JP et al. Myocardial injury following immediate postnatal circumcision. Am J Obstet Gynecol 1982; 144:850-1.
180. Connelly DO, Shropshire LC, Salzberg A. Gastric rupture associated with prolonged crying in a newborn undergoing circumcision. Clinical Pediatrics, September 1992, pp. 560-561.

Lymphedema

181. Yildirim S, Taylan G, Akoz T. Circumcision as an unusual cause of penile lymphedema (letter). Ann Plast Surg 2003;50(6):665-6.

Meatitis, Meatal Ulceration, and Meatal Stenosis

182. Mastin WM. Infantile circumcision: a cause of contraction of the external urethral meatus. Ann Anatomy Surg 1881;4:123-8.
183. Brennemann J. The ulcerated meatus in the circumcised child. Am J Dis Child 1921; 21: 38-47.
184. Thompson AR. Stricture of the external urinary meatus. Lancet 1935;1:1373-7.
185. Freud P. The ulcerated urethral meatus in male children. J Pediatr 1947;31:131-42.
186. Berry CD Jr, Cross RR Jr. Urethral meatal caliber in circumcised and uncircumcised males. Am J Dis Child 1956; 92: 621.
187. Mackenzie AR. Meatal ulceration following neonatal circumcision. Obstet Gynecol 1966;28:221-3.
188. Graves J. Pinpoint meatus: iatrogenic? Pediatrics 1968;41:1013.
189. Daley MC. Circumcision. JAMA 1970; 214: 2195.
190. Meyer HF. Meatal ulcer in the circumcised infant. Med Times 1971;99:77-8.
191. Steg A, Allouch G. Stenose du meat et circoncision. [Meatal stenosis and circumcision] J Urol Nephrol Paris 1979; 85: 727-9.
192. Viville C, Weltzer J. Les retrecissements iatrogenes de l'urethre (R.I.U.) masculin. A propos de 50 observations. J Urol Paris 1981; 87: 413-8.
193. Kunz HV. Circumcision and Meatotomy. Prim Care 1986; 13: 523-25.
194. Frank JD, Pocock RD, Stower MJ. Urethral strictures in childhood. Br J Urol 1988; 62: 590-2.
195. Persad R; Sharma S; McTavish J; Imber C; Mouriquand PD. Clinical presentation and pathophysiology of meatal stenosis following circumcision. British Journal of Urology 1995; 75(1):91-93.
196. Upadhyay V, Hammodat HM, Pease PW. Post circumcision meatal stenosis: 12 years' experience. N Z Med J 1998;111(1060):57-8.

Miscellaneous Complications

197. Curtis JE. Circumcision complicated by pulmonary embolism. Nurs Mirror Midwives J 1971; 132: 28-30.
198. Michelowski R. Silica granuloma at the site of circumcision for phimosis; a case report. Dermatologica 1983; 166:261-3.
199. Mor A, Eshel G, Aladjem M, et al. Tachycardia and heart failure after circumcision. Arch Dis Child 1987; 62: 80-81.
200. Arnon R, Zecharia A, Mimouni M, Merlob P. Unilateral leg cyanosis: an unusual complication of circumcision. Eur J Pediatr 1992; 151: 716.

Penile Ischemia

201. Smith DJ, Handy FC, Chapple CR. An uncommon complication of circumcision. Br J Urol 1994; 73: 459-60.

Phimosis (see also Treatment of Phimosis)

202. Redman JF, Schriber LJ, Bissada NK. Postcircumcision phimosis and its management. Clin Pediatr 1975; 14: 407-409.
203. Blalock HJ, Vemulakonda V, Ritchey ML, Ribbeck M. Outpatient Management of Phimosis Following Newborn Circumcision. J Urol 2003;169(6):2332-4.

Complications from use of Plastibell Circumcision Device

204. Rubenstein MM, Bason WM. Complication of circumcision done with a plastic bell clamp. Am J Dis Child 1968;176:381.
205. Malo T, Bonforte RJ. Hazards of plastic bell circumcision. Obstet Gynecol 1969; 33: 869; 1969.
206. Kirkpatrick BV, Eitzman DV. Neonatal septicemia after circumcision. Clin Pediatr 1974;13:767-768.
207. Datta NS, Zinner NR. Complication from Plastibell circumcision ring. Urology 1977; 9: 57-8.
208. Johnsonbaugh RE. Complication of a circumcision performed with a plastic disposable circumision device: long-term follow-up. Am J Dis Child. 1979; 133: 438.
209. Jonas G. Retention of a plastibell circumcision ring: report of a case. Obstetr Gynecol 1984; 24: 835.
210. Stranko J, Ryan ME, Bowman AM. Impetigo in newborn infants associated with a plastic bell clamp circumcision. Pediatr Infect Dis 1986; 5: 597-9.
211. Sorensen SM, Sorensen MR. Circumcision with the Plastibell device. A long-term followup. Int Urol Nephrol 1988; 20: 159-66.
212. Owen ER, Kitson JL. Plastibell circumcision. Br J Clin Pract 1990; 44: 661.
213. Wiswell TE, Curtis J, Dobek AS, Zierdt CH. Staphylococcus aureus colonization after neonatal circumcision in relation to device used. J Pediatr 1991; 119: 302-4.
214. Lee LD, Millar AJW. Ruptured bladder following circumcision using Plasticbell device. Br J Urol 1990; 65: 216-17.
215. Ly L, Sankaran K. Acute venous stasis and swelling of the abdomen after circumcision. Can Med Assoc J 2003;169(3):216-7.

Post-Traumatic Stress Disorder

216. Rhinehart J. Neonatal circumcision reconsidered. Transactional Analysis Journal 1999;29(3):215-21.

Psychological Complications

217. Glover E. The ‘screening’ function of traumatic memories. Int J Psychoanal 1929; 10:90-93.
218. Cansever G. Psychological effects of circumcision. Br J Med Psychol 1965; 38: 321-31.
219. Flaherty, JA. Circumcision and Schizophrenia. J Clin Psychiatry 1980; 41: 96-98.
220. Kennedy H. Trauma in childhood: signs and sequelae as seen in the analysis of an adolescent. The Psychoanalytic Study of the Child 1986; 41:209-219.
221. Gunnar MR, Porter FL, Wolf CM, Rigatuso J, Larson MC. Neonatal stress reactivity: predictions to later emotional temperment. Child Dev 1995; 66: 1-13.
222. Davis M, Emory E. Sex differences in neonatal stress reactivity. Child Dev 1995; 66: 14-27.
223. Goldman R. The psychological impact of circumcision. BJU International 1999; 83, Suppl. 1:93-102.
224. Rhinehart J. Neonatal circumcision reconsidered. Transactional Analysis Journal 1999; 29(3):215-221.
225. Boyle GJ, Goldman R, Svoboda JS, Fernandez E. Male circumcision: pain, trauma and psychosexual sequelae. .J Health Psychol 2002;7(3):329-43.

Pyogenic granuloma

226. Naimer SA, Cohen A, Vardy D. Pyogenic granuloma of the penile shaft following circumcision. Pediatr Dermatol 2002;19(1):39-41.

Ritual Circumcision

227. Holt LE. Tuberculosis acquired through ritual circumcision. JAMA 1913;LXI(2):99-102.
228. Reuben MS. Tuberculosis from ritual circumcision. Proceedings of the New York Academy of Medicine 1916; (December 15): 333-334.
229. Reuben MS. Tuberculosis following ritual circumcision. Arch Pediatr 1917; XXXIV:186-90.
230. Sauer LW. Fatal staphylococcus bronchopneumonia following ritual circumcision. Am J Obstetr Gynecol 1943; 46: 583.
231. Frand M, Berant N, Brand N, Rotem Y. Complication of ritual circumcision in Israel. Pediatrics 1974; 54: 521.
232. Berman W. Urinary retention due to ritual circumcision (letter). Pediatrics (October 1975);56:621.
233. Horwitz J, Schussheim A, Scalettar HE. Letter: Abdominal distension following ritual circumcision. Pediatrics 1976; 57: 579.
234. Mahlberg FA, Rodermund OE, Muller RW. Ein Fall von Zirkumzision-stuberkulose. [A case of circumcision tuberculosis] Hautarzt 1977; 28: 424-5.
235. Menahem S. Complications arising from ritual circumcision: pathogenesis and possible prevention. Isr J Med Sci 1981; 17: 45-8.
236. Sterenberg N, Golan J, Ben-Hur N. Necrosis of the glans penis following neonatal circumcision. Plast Reconstr Surg 1981; 68: 237-9.
237. Horowitz, J., Schussheim, A., and Scalettar, H.E. Abdominal distension following ritual circumcision. Pediatrics 1982; 70:597.
238. Breuer GS, Walfisch S. Circumcision complications and indications for ritual recircumcision--clinical experience and review of the literature. Isr J Med Sci 1987;23:252-6.
239. Uwyyed K, Korman SH, Bar Oz B, Vromen A. Scrotal abscess with bacteremia caused by Salmonella group D after ritual circumcision. Pediatr Infect Dis J 1990;9:65-6.
240. van-der Zee JA, Hage JJ, Groen JM, Bouman FG. Een ernstige complicatie ten gevolge van rituele circumcisie van een 'begraven' penis. [A serious complication of ritual circumcision of a 'buried' penis] Ned Tijdschr Geneeskd 1991; 135: 1604-6.
241. Cohen HA, Drucker MM, Vainer S, et al. Postcircumcision urinary tract infection. Clinical Pediatrics 1992;31(6):322-4.
242. Hanukoglu A, Danielli L, Katzir Z, Gorenstein A, Fried D. Serious complications of routine ritual circumcision in a neonate: hydro ureteronephrosis, amputation of glans penis, and hyponatraemia. Eur J Pediatr 1995; 154: 314-5.
243. Neulander E, Walfisch S. Kaneti J. Amputation of distal penile glans during neonatal ritual circumcision -- a rare complication. Br J Urol 1996; 77: 924-5.
244. Goldman M, Barr J, Bistritzer T, Aladjem M. Urinary tract infection following ritual jewish circumcision. Israel Journal of Medical Sciences 1996;32(11),1098-1102.
245. Walfisch et al. [Complications of ritual circumcision]. British Journal of Urology 77, June 1996, p. 924.
246. Hiss J, Horowitz A, Kahana T. Fatal haemorrhage following male ritual circumcision. J Clin Forensic Med 2000;7:32-4.
247. Gesundheit B, Grisaru-Soen G, Greenberg D, et al. Neonatal Genital Herpes Simplex Virus Type 1 Infection After Jewish Ritual Circumcision: Modern Medicine and Religious Tradition. Pediatrics 2004;114(2):E259-63.

Ruptured Bladder

248. Jee LD, Millar AJ. Ruptured bladder following circumcision using the Plastibell device. Br J Urol 1990;65(2):216-7.

Skin Bridges

249. Klauber GT, Boyle J. Preputial skin-bridging. Complication of circumcision. Urology 1974; 3: 722-3.
250. Sathaye VU, Goswami AK, Sharma SK. Skin bridge - a complication of paediatric circumcision. Br J Urol 1990; 66: 214.
251. Ritchey ML, Bloom DA. Re: Skin bridge--a complication of paediatric circumcision. Br J Urol 1991; 68: 331.
252. Naimer SA, Peleg R, Meidvidovski Y, et al. Office management of penile skin bridges with electrocautery. J Am Board Fam Pract 2002;15(6):485-8.

Sub-cutaneous mass

253. Atikeler MK, Onur R., Gecit I., et al. Increased morbidity after circumcision from a hidden complication. BJU Int 2001; 88(9): 938-940.

Urethral Fistula

251. Johnson S. Persistent urethral fistula following circumcision: report of a case. US Naval Med Bull 1949; 49: 120-2.
252. Limaye RD, Hancock RA. Penile urethral fistula as a complication of circumcision. J Pediatr 1968;72:105-6.
253. Lackey JT, Mannion RA, Kerr JE. Urethral fistula following circumcision. JAMA 1968; 206: 2318.
254. Lackey JT, Mannion RA, Kerr JE. Subglanular urethral fistula from infant circumcision. J Indiana State Med Assoc 1969; 62: 1305-6.
255. Shiraki, IW. Congenital megalourethra with urethracutaneous fistula following circumcision: a case report. J Urol 1973: 109: 723.
256. Lau, JTK, Ong GB. Subglandular urethral fistula following circumcision: repair by the advancement method. J Urol 1981; 126: 702-703.
257. Benchekroun A, Lakrissa A, Tazi A, Hafa D, Ouazzani N. Fistules urethrales apres circoncision: a propos de 15 cas. [Urethral fistulas after circumcision: apropos of 15 cases] Maroc Med 1981; 3: 715-8.
258. Palmer SY, Colodny AH. Congenital urethrocutaneous fistulas. Urology. 1994; 44: 149-50.
259. Baskin LS. Canning DA. Snyder III HM. Duckett JW Jr. Surgical repair of urethral circumcision injuries. Journal of Urology 1997;158(6):2269-2271.

Urinary Retention

260. Berman W. Letter: Urinary retention due to ritual circumcision. Pediatrics 1975;56:621.
261. Horowitz J, Schussheim A, Scalettar HE. Letter: Abdominal distension following ritual circumcision. Pediatrics 1976;57:579.
262. Ochsner MG. Acute urinary retention: causes and treatment. Postgrad Med 1982;71:221-6.
263. Lee LD, Millar AJW. Ruptured bladder following circumcision using Plasticbell device. Br J Urol 1990;65:216-17.
264. Craig JC, Grigor WG, Knight JF. Acute obstructive uropathy--a rare complication of circumcision. Eur J Pediatr 1994;153:369-71.
265. Eason JD, McDonnell M, Clark G. Male ritual circumcision resulting in acute renal failure. Br Med J 1994;309:660-1.
266. Mihssin N, Moorthy K, Houghton PW. Retention of urine: an unusual complication of the Plastibell device. BJU Int 1999;84(6):745.
267. Pearce I. Retention of urine: an unusual complication of the Plastibell device. BJU Int 2000; 85(4):560-1.

Urinary Tract Infection

268. Menahem S. Complications arising from ritual circumcision: pathogenesis and possible prevention. Isr J Med Sci 1981;17(1):45-8.
269. Amir J. et al. Circumcision and Urinary Tract Infections in Infants. Am J Dis Child 1986;140(11):1092.
270. Cohen HA, Drucker MM, Vainer S, et al. Postcircumcision urinary tract infection. Clinical Pediatrics 1992;31(6):322-4.
271. Eason JD, McDonnell M, Clark G. Male ritual circumcision resulting in acute renal failure. Brit Med J 309 (No. 6955), Sept. 10, 1994, pp. 660-661.
272. Goldman M, Barr J, Bistritzer T, Aladjem M. Urinary tract infection following ritual jewish circumcision. Israel Journal of Medical Sciences 1996;32(11),1098-1102.

Venous Stasis

276. Ly L, Sankaran K. Acute venous stasis and swelling of the abdomen after circumcision. Can Med Assoc J 2003;169(3):216-7.

Vomiting

277. Fleiss PM, Douglass J. The case against neonatal circumcision. Brit Med J 1979;2(6189):554.

Other References

278. Romberg, Rosemary. Circumcision: The Painful Dilemma. Bergin and Garvey Publishers, Inc. 1985. (excerpt)
279. "Awakenings: A Preliminary Poll of Circumcised Men" NOHARMM, P.O. Box 460795, San Francisco, CA 94146. (excerpt)
 

Laura

Administrator
Administrator
Moderator
FOTCM Member
The last page posted above definitely deserves a visit because it is rich in hyperlinks to excellent articles.

All in all, after this survey, it strikes me that, since circumcision has really lost its position as having any benefits whatsoever, this nonsense about AIDS is just a Zionist plot to perpetuate a horrible form of infant mutilation and torture so as to ensure that as many people as possible will be psychologically damaged so that they are easier to control.

It's truly horrible.
 

Fifth Way

Jedi Council Member
Laura said:
this nonsense about AIDS is just a Zionist plot to perpetuate a horrible form of infant mutilation and torture so as to ensure that as many people as possible will be psychologically damaged so that they are easier to control.
I just suddenly connected some other dots:
In anther thread (http://www.cassiopaea.org/forum/index.php?topic=5213) I am discussing this friend of mind that professionally (as a humanitarian) has to got to all the heavy crises areas around the world (Darfur, Iraq, Afghanistan, Palestine, Congo, Columbia etc).
Earlier today I wanted to include some information (or better a personal assessment of his) that I then deemed "off topic" and didn't include in my post. However here it makes sense.

I asked him where he thought where people behaved the worst in terms of torture. He thought this to be the Israeli military - and as far as I know, he is jewish.

One has to ask oneself: How can the people that suffered genocide/holocaust themselves be able to be the biggest violators, perpetrators of murder an torture, engaging in medical experiments on people and shooting school children in Palestine for fun?

Could that have to do that all men of that society are being systematically and most gruesomely mutilated/tortured within the neonatal period????????????
 
G

Guest

Guest
Yeah, and I think they might be trying to squeeze every bit of mileage possible from the HIV scare. Day before yesterday, while writing my goad to the lawyers about them letting criminals murder our women and children, and lo and behold on the front page they were advertising new HIV vaccine 70% effective to prevent cervical cancer so naturally I knew to expect, yep, the Federal Vaccines For Children VPC, a "a public purchased vaccine program that provides immunization at no cost to eligible children.

thats more than social engineered murder, unless, of course, one calls using government agencies and public employees as hit man social
 

Adaryn

SuperModerator
Moderator
FOTCM Member
Thank you for all these massive evidence against circumcision.
My companion and his brother were circumcised when they were respectively 7 and 11 (if I remember well for his brother) for "medical reasons", the reason being that the "doctors" had said that his brother's prepuce wouldn't "unstick" easily and so the best way to solve the problem, prevent infection, etc was to circumcise him... and why not his brother also, as a prevention ? Their parents, who always followed blindly what the doctors say, obeyed and they were both circumcised. My companion was butchered, it was a quite nasty job, not the whole foreskin was removed, there was a bit of skin left, and the surgery left him bleeding and hurting for a long time afterwards, and very sensitive in that area (you can bet!).
All in all it's just as cruel and barbaric as femal genital cutting.
 
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