Circumcision

{{cquote|Nip the tip! Who's first?|||Rabbi Tuckman, ''Robin Hood: Men in Tights''<ref>[https://www.youtube.com/watch?v=Iy-d7X09nj8 ROBIN HOOD: MEN IN TIGHTS Clip - "Rabbi" (1993) Mel Brooks]. YouTube.</ref>}}
{{sex}}
'''Circumcision''' refers to the surgical removal of the foreskin (partially or fully) from the [[penis]]. While it is rarely therapeutically required,<ref name="nhs-boys">[https://www.nhs.uk/conditions/circumcision-in-boys/ Circumcision in boys], National Health Service</ref> it is commonly performed across the world for non-therapeutic reasons such as [[religious]] or cultural reasons, or for perceived prophylactic benefits. Circumcision can be performed at any age, although it is often performed on babies and children. ''Female circumcision'' is sometimes used to euphemistically refer to [[female genital mutilation]].<ref name="met-police-fgm">[https://www.met.police.uk/advice/advice-and-information/fgm/female-genital-mutilation-fgm/ Female genital mutilation (FGM)], Metropolitan Police</ref>

Non-therapeutic circumcision on babies and children who are too young to consent to the procedure is a highly controversial practice that has become the subject of much debate in contemporary times.<ref name="pmid22125802">{{cite journal| author=Bristol N| title=Male circumcision debate flares in the USA. | journal=Lancet | year= 2011 | volume= 378 | issue= 9806 | pages= 1837 | pmid=22125802 | doi=10.1016/s0140-6736(11)61796-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22125802  }} </ref><ref>[https://www.bbc.co.uk/ethics/malecircumcision/cultural_1.shtml Ethics - Male circumcision: Cultural and health aspects to circumcision], [[BBC]]</ref> Critics of the practice argue against it on a variety of grounds, but primarily due to bodily autonomy concerns and alleged detriments of the practice such as pain, [[risk]], and supposed loss of sexual function or sensation.<ref>http://nocirc.org/</ref><ref name='circumstitions'>http://www.circumstitions.com/</ref><ref>[http://www.sfchronicle.com/health/article/Federal-circumcision-guidelines-meet-with-5944107.php#/0 Federal circumcision guidelines meet with opposition], ''San Fran Chronicle''.</ref><ref>http://Foreskin.Life/</ref> This movement is sometimes known as '''Intactivism''' ([[Fun:Portmanteau|portmanteau]] of ''intact'' + ''activism'').<ref>{{cite news |last=Nunn |first=Gary |date= 20 Jul 2019 |title=Foreskin reclaimers: the ‘intactivists’ fighting infant male circumcision |url=https://www.theguardian.com/society/2019/jul/21/foreskin-reclaimers-the-intactivists-fighting-infant-male-circumcision |work=The Guardian |access-date=5 Dec 2023}}</ref> Other individuals and organizations defend the practice. Some believe that Routine Infant Circumcision (RIC) should be strongly recommended, arguing that the procedure confers great prophylactic benefits that easily outweigh any risk, and that infancy is the optimal time for the procedure.<ref>http://www.circinfo.net</ref> Others believe that non-therapeutic child circumcision is permissible at parents' discretion, in part due to its significance to certain religious and/or cultural groups, but stop short of outright recommending the procedure as routine.{{cn}}

At RationalWiki, we support the right to bodily autonomy and integrity, and we therefore find that non-therapeutic circumcision of babies and children who cannot consent is unethical. While circumcision performed by qualified practitioners in clinical settings is a low-risk procedure, circumcision causes significant harm to children because it is a painful and invasive surgical operation which removes a significant part of the genitalia, and adversely affects sexual function at the very least insofar as precluding any sexual act inherently requiring the foreskin. We find that the prophylactic and hygienic benefits of circumcision, especially for those living in developed countries, are insufficiently compelling to justify invasive, non-consensual genital surgeries on children. In particular, many ostensible benefits are factually dubious, immaterial to babies and young children, have more effective and less invasive means of prophylaxis and/or treatment, confer a low absolute risk reduction, or benefit the child's possible future sexual partners rather than himself.<ref group=note>We wouldn't take organs from an adult without consent to save his partner's life today — so why should we take a foreskin from a baby to potentially save his hypothetical partner in 30 years?</ref> The claim that infancy is by far the optimal time for circumcision is questionable, and even if this claim were true, it would not justify non-therapeutic infant circumcision. Parental discretion, whether motivated by perceived religious obligation or otherwise, is ethically inappropriate to authorise medically unnecessary genital surgeries on children who cannot give their own consent.

Despite the controversy over non-therapeutic child circumcision, it isn't explicitly illegal anywhere in the world,{{cn}} although some authors have argued that it may already be implicitly unlawful under existing national and/or international law.<ref name="lempert-npc">Lempert, Antony & Chegwidden, James & Steinfeld, Rebecca & Earp, Brian. (2022). [https://www.researchgate.net/publication/360642209_Non-therapeutic_Penile_Circumcision_of_Minors_Current_Controversies_in_UK_Law_and_Medical_Ethics Non-therapeutic Penile Circumcision of Minors: Current Controversies in UK Law and Medical Ethics.] Clinical Ethics. 1-19. 10.1177/14777509221104703.</ref><ref name="pmid27338602">{{cite journal| author=Svoboda JS, Adler PW, Van Howe RS| title=Circumcision Is Unethical and Unlawful. | journal=J Law Med Ethics | year= 2016 | volume= 44 | issue= 2 | pages= 263-82 | pmid=27338602 | doi=10.1177/1073110516654120 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27338602  }} </ref><ref name="doc-policy-2008">[http://web.archive.org/web/20081202103401/http://www.doctorsopposingcircumcision.org/DOC/statement0.html Genital Integrity Policy Statement (archived)], Doctors Opposing Circumcision (June 2008)</ref> In recent years, there have been attempts or proposals to ban the practice in some European countries, and despite general public support among people in Germany, Denmark, and the UK for such bans,<ref>Susi Meret, Anita Nissen (17 December 2020) [https://www.fairobserver.com/region/europe/susi-meret-anita-nissen-danish-peoples-party-df-islam-male-circumcision-ban-anti-semitism-europe-news-15511/# Denmark’s Politics of the Foreskin], ''Fair Observer''</ref><ref>[https://yougov.co.uk/topics/society/survey-results/daily/2018/02/20/c51db/2 Iceland is contemplating a law that would make it a criminal offence to circumcise boys for non‑medical reasons. The law would still allow men to get circumcised once they have reached adulthood. To what extent would you support or oppose introducing such a law in the UK?], YouGov UK (20 Feb 2018)</ref><ref>[https://www.spiegel.de/politik/deutschland/studie-mehrheit-der-deutschen-gegen-beschneidungsgesetz-a-874473.html Mehrheit der Deutschen gegen Beschneidungsgesetz], Spiegel Politik (22 Dec 2012)</ref> they were ultimately vetoed, in large part due to allegations that the proposed bans would infringe [[freedom of religion]].<ref>[https://cne.news/article/29-danish-parliament-rejects-ban-on-boys-circumcision Danish parliament rejects ban on boys’ circumcision], Christian Network Europe (19 May 2021)</ref><ref>Madeline Chambers (12 Dec 2012), [https://www.reuters.com/article/us-germany-circumcision-idUSBRE8BB1AR20121212/ Germany passes law to protect circumcision after outcry], Reuters</ref>

==Groups that circumcise==
[[File:Global Map of Male Circumcision Prevalence at Country Level.png|thumb|right|450px|alt=A global map of male circumcision prevalence at the country level.|A global map of male circumcision prevalence at the country level.
{{legend|gray|no data}}
{{legend|blue|0-20%}}
{{legend|yellow|20-80%}}
{{legend|orange|80-100%}}
]]
It is one of the world's most common medical procedures, generally performed for [[Medicine|prophylactic]],{{efn|Purportedly, but whether routine male circumcision has a net positive effect is disputed.}} [[religion|religious]], and [[culture|cultural]] reasons. An estimated 37–39% of the global male population is circumcised, with the most circumcised areas being the [[Middle East]], [[Africa]], [[Southeast Asia]], and [[White Commonwealth|the Anglosphere]]. Global rates are presently significantly rising, probably in part due to African and Islamic population growth. [[South Korea]] has a high circumcision rate as well,<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772313 Estimation of country-specific and global prevalence of male circumcision]</ref> probably, one could say, because they're on the ''tip'' of the peninsula.{{efn|Actually, it's because of American influence. Circumcision there also tends to be performed beyond infancy, usually around age 12 as of a 2002 paper.<ref>{{Cite journal |last=Pang |first=M.G. |last2=Kim |first2=D.S. |date=2002 |title=Extraordinarily high rates of male circumcision in South Korea: history and underlying causes |url=https://bjui-journals.onlinelibrary.wiley.com/doi/10.1046/j.1464-410X.2002.02545.x |journal=BJU International |language=en |volume=89 |issue=1 |pages=48–54 |doi=10.1046/j.1464-410X.2002.02545.x |issn=1464-4096}}</ref> A report in 2012 also claimed circumcision was declining in South Korea as more information became available.<ref>{{Cite journal |last=Kim |first=DaiSik |last2=Koo |first2=Sung-Ae |last3=Pang |first3=Myung-Geol |date=2012 |title=Decline in male circumcision in South Korea |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3526493/ |journal=BMC Public Health |volume=12 |pages=1067 |doi=10.1186/1471-2458-12-1067 |issn=1471-2458 |pmc=3526493 |pmid=23227923}}</ref>}}

===Western world===
In the U.S., the majority of males are circumcised, usually as newborns.<ref>[http://www.boystoo.com/history/statistics.htm O’Donnell, Hugh. "The United States' Circumcision Century". Circumcision Statistics of the 20th Century. BoysToo.com. April 2001. Web. 09 October 2014.]</ref> The percentage circumcised has decreased in recent decades.<ref>[https://worldpopulationreview.com/state-rankings/circumcision-rates-by-state Circumcision Rates by State 2022.] World Population Review.</ref><ref>Zhang, Xinjian et al.[http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a4.htm?s_cid=mm6034a4_w Trends in In-Hospital Newborn Male Circumcision --- United States, 1999--2010.] ''MMWR''. CDC. 60(34);1167-1168. September 2, 2011.</ref> The still-considerable amount of circumcision in the United States has more to do with various claims of health or hygiene benefits, which historically included preventing masturbation,<ref>[https://link.springer.com/chapter/10.1007/978-0-585-39937-9_28 "The History of Circumcision in the United States"], Morris L. Sorrells</ref> than religious requirement. Canada and Australia do it for this reason as well, albeit not nearly to the same extent, and in fact it's been drastically declining in both countries over the last few decades. It is virtually ''non-existent'' in most other [[West]]ern nations, except among religious or cultural minorities who practise it.

===Abrahamic religions===
[[Judaism]] customarily requires circumcision of Jewish boys on their 8th day of life (<i>brit milah</i>, "Covenant of Circumcision"), as commanded in [[RationalWiki:Annotated Bible/Genesis#Genesis 17:10|Genesis 17:10-14]] as a contract between [[G-d]] and [[Abraham]], and unto his descendants. It is also an integral part of the conversion of a non-Jewish man<ref group=note>[https://www.rabbinicalassembly.org/sites/default/files/public/halakhah/teshuvot/2011-2020/transgender-halakhah.pdf Or more specifically, any person who was born with, and still has, a penis - trans men are not required to undergo ''milah'', while trans women usually are unless they have had gender-affirming surgery]</ref> to Judaism,<ref>[http://www.religionfacts.com/judaism/cycle/circumcision.htm "Circumcision in Judaism". ReligionFacts.com. 01 July 2013. Web. 09 October 2014.]</ref> although some Reform Rabbis do not require it.<ref>[https://www.nbcnews.com/id/wbna21113459 Jewish ‘intactivists’ stop circumcising], ''NBC News''</ref><ref>[https://www.jewishvirtuallibrary.org/the-tenets-of-reform-judaism Reform Judaism: The Tenets of Reform Judaism], Jewish Virtual Library.</ref> A Jewish traditional circumciser is known as a ''mohel''. If the person was previously circumcised, or born without a foreskin, ''hatafat dam brit'' ("Covenant of a drop of blood") is performed instead.

However, some Jews choose not to circumcise their sons and sometimes have an alternative ritual to welcome their son into the world, known as <i>brit shalom</i> ("Covenant of Peace").<ref> [https://www.nature.com/articles/s41443-022-00607-y "B’rit shalom: a Jewish ritual alternative to newborn male circumcision"], Max DuBoff & Dena S. Davis </ref><ref> Stephen Oryszczuk (28 Feb 2018) [https://www.jewishnews.co.uk/the-jewish-parents-cutting-out-the-bris/ The Jewish parents cutting out the bris], Jewish News</ref>

It is worth considering that originally, only the very tip of the foreskin was cut away. It wasn't until the Hellenization period that periah, the removal of the ''entire'' foreskin, caught on. This was because a fair number of [[Hebrew]] traditionalists were upset with how younger men were ''restoring'' their foreskin under advice and/or pressure from the [[Greek]]s, who viewed even the slight circumcision as a vile travesty against the sacrosanct physical body. This early form of [[Circumcision#Ways_of_restoring_the_foreskin|foreskin restoration]] was known as ''epispasm''. Despite the end of Hellenization, reversion to pre-periah has been… slow.<ref> James Peron, Circumcision: Then and Now, Many Blessings, Volume III, Pages 41-42, Spring 2000</ref>

[[Islam]], through ordering followers to uphold [[Judaism|the religion of Ibraheem]] and respect of the [[hadith]]s, similarly strongly supports circumcision (''khitān''), although it is not mentioned in the [[Qur'an]].<ref>{{see-wp|Khitan (circumcision)}}</ref><ref>[http://convertingtoislam.com/circum.html "Male circumcision - the Islamic View". ConvertingToIslam.com. Studio-S. ''n.d.'' Web. 09 October 2014.]</ref> The age of circumcision in Islam varies, though it is often around seven years old. Circumcision in Islam is seen as an matter of cleanliness, and/or being like the Prophet [[Muhammad]] (PBUH), who was ostensibly born without a foreskin.<ref>[https://www.bbc.co.uk/religion/religions/islam/islamethics/malecircumcision.shtml Religions - Circumcision of boys], [[BBC]]</ref> Male circumcision is considered ''wājib'' (obligatory) by some sects of Islam and ''sunnah'' (optional) by others.<ref name="pmid23610746">{{cite journal| author=Alahmad G, Dekkers W| title=Bodily integrity and male circumcision: an islamic perspective. | journal=J IMA | year= 2012 | volume= 44 | issue= 1 | pages=  | pmid=23610746 | doi=10.5915/44-1-7903 | pmc=3516177 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23610746  }} </ref><ref>Zuby Eusofe (23 February 2017), [https://beyondhijab.sg/2017/02/23/is-female-circumcision-islamic/ Is Female Circumcision Islamic?], Beyond The Hijab</ref>

[[Christianity]] does not require circumcision.<ref>[https://www.bbc.co.uk/religion/religions/christianity/christianethics/circumcision.shtml BBC - Religions - Christianity: Circumcision]</ref>

===Cultural rites===

Circumcision of boys is a rite of passage in some cultures, such as in the Philippines (where the rite is known as Tuli<ref name="FR-05 TULI">[https://www.auajournals.org/doi/10.1016/j.juro.2018.02.3025 FR-05 TULI: A RITE OF PASSAGE FOR FILIPINO BOYS], Patrick C. Samson, Justin Truglio and Joph Steckel</ref>, and typically occurs between the ages of 8 and 12.) and in some cultures in Africa.<ref name="pmid21124715">{{cite journal| author=Wilcken A, Keil T, Dick B| title=Traditional male circumcision in eastern and southern Africa: a systematic review of prevalence and complications. | journal=Bull World Health Organ | year= 2010 | volume= 88 | issue= 12 | pages= 907-14 | pmid=21124715 | doi=10.2471/BLT.09.072975 | pmc=2995181 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21124715  }} </ref>

== Arguments for circumcision of babies or children ==

=== Therapeutic reasons ===

Circumcision is rarely required for therapeutic reasons.<ref name="nhs-boys" /><ref name="nhs-men">[https://www.nhs.uk/conditions/circumcision-in-men/ Circumcision in men, National Health Service</ref> Inability to retract the foreskin of a baby or young boy is normal, as the foreskin is fused to the glans penis at birth and does not fully separate until around age 5-10.<ref name="nhs-boys" /> The foreskin should ''never'' be forcefully retracted on babies or young children, as this can cause injury. Phimosis can usually be resolved without resorting to circumcision, such as with topical steroids, or less invasive surgeries that preserve the foreskin. Circumcision may also be an emergency treatment for paraphimosis, although a doctor may be able to return the foreskin to its original position.<ref name="nhs-phimosis">[https://www.nhs.uk/conditions/phimosis/ Tight foreskin (phimosis)], National Health Service</ref> Circumcision may also be a treatment for recurrent infections such as Balanitis, although this is rarely needed, as balanitis can usually be treated by less invasive means such as antibiotic or antifungal creams.<ref name="nhs-balanitis">[https://www.nhs.uk/conditions/balanitis/ Balanitis], National Health Service</ref>

As the vast majority of infancy and childhood circumcisions are performed in the abscence of any therapeutic indication, these points are in most cases moot.

=== Purported prophylactic benefits ===

==== Phimosis and Paraphimosis ====
Removal of the foreskin ensures that problems such as {{wpl|phimosis}} and {{wpl|paraphimosis}} cannot occur. (NSFW)

Of course, no one recommends routinely removing other body parts that might possibly get cancer or experience other medical issues. As a justification for circumcision, this argument amounts to a rationalization. Notably, both conditions can usually be treated without surgery anyway<ref name="nhs-phimosis" />, meaning it's irrational to pre-emptively perform genital surgery on all boys to prevent them.

==== Balanitis and/or Posthitis ====
Circumcision quite obviously eliminates a male's risk of contracting posthitis (inflammation of the foreskin) for the same reason it prevents phimosis. Circumcision has also been touted as a way to prevent balanitis, although Van Howe (1997) found the opposite conclusion among boys under the age of 3.<ref name="van-howe-1997">{{cite journal| author=Van Howe RS| title=Variability in penile appearance and penile findings: a prospective study. | journal=Br J Urol | year= 1997 | volume= 80 | issue= 5 | pages= 776-82 | pmid=9393302 | doi=10.1046/j.1464-410x.1997.00467.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9393302}}</ref> Since these conditions are "not usually serious", can usually be treated conservatively, such as with the use of antifungal or antibiotic treatments, and often are caused by not washing the penis properly or using irritating substances such as soap,<ref name="nhs-balanitis" /> treatment of balanitis and posthitis is rarely a good reason to circumcise a child, and prevention is not a compelling reason at all to circumcise a healthy child.

==== HIV / AIDS ====

Circumcision is sometimes promoted as a way of reducing [[HIV]] transmission, especially in endemic regions. This claim comes chiefly from three randomized control trials (RCTs) in countries in Africa (specifically, Uganda, Kenya, and South Africa) where HIV is endemic, which found that "Voluntary Medical Male Circumcision" (VMMC) reduces relative risk of female-to-male HIV transmission by approximately 60%.<ref name="rct-south-africa">{{cite journal| author=Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren A| title=Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. | journal=PLoS Med | year= 2005 | volume= 2 | issue= 11 | pages= e298 | pmid=16231970 | doi=10.1371/journal.pmed.0020298 | pmc=1262556 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16231970  }}</ref><ref name="rct-kenya">{{cite journal| author=Bailey RC, Moses S, Parker CB, Agot K, Maclean I, Krieger JN | display-authors=etal| title=Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. | journal=Lancet | year= 2007 | volume= 369 | issue= 9562 | pages= 643-56 | pmid=17321310 | doi=10.1016/S0140-6736(07)60312-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17321310  }}  [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=17885152 Review in: Evid Based Med. 2007 Aug;12(4):104]</ref><ref name="rct-uganda">{{cite journal| author=Gray RH, Kigozi G, Serwadda D, Makumbi F, Watya S, Nalugoda F | display-authors=etal| title=Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. | journal=Lancet | year= 2007 | volume= 369 | issue= 9562 | pages= 657-66 | pmid=17321311 | doi=10.1016/S0140-6736(07)60313-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17321311}}</ref> All three RCTs were terminated early, which may cause "implausibly large treatment effects",<ref name="pmid16264162">{{cite journal| author=Montori VM, Devereaux PJ, Adhikari NK, Burns KE, Eggert CH, Briel M | display-authors=etal| title=Randomized trials stopped early for benefit: a systematic review. | journal=JAMA | year= 2005 | volume= 294 | issue= 17 | pages= 2203-9 | pmid=16264162 | doi=10.1001/jama.294.17.2203 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/utils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16264162}}</ref> and makes it hard to say if the protective effect would have been seen in longer-term follow-ups (the control group were offered VMMC at the end of the trial, making later follow-ups impossible). More participants were lost to follow-up than were found to have contracted HIV.<ref name="green-2008"> Green LW, McAllister RG, Peterson KW, Travis JW. [https://www.futuremedicine.com/doi/10.2217/17469600.2.3.193 Male circumcision is not the HIV ‘vaccine’ we have been waiting for! (2008)] Future HIV Therapy Vol. 2, No. 3.</ref> The group that were given VMMC couldn't have sex while recovering from the operation, obfuscating the results (lead time bias).<ref name="pmid22320006" /> Furthermore, the RCT in Uganda (while it was terminated early, making it difficult to conclude about long-term effects) possibly seems to suggest VMMC may have ''increased'' male-to-female HIV transmission.<ref name="pmid19616720">{{cite journal| author=Wawer MJ, Makumbi F, Kigozi G, Serwadda D, Watya S, Nalugoda F | display-authors=etal| title=Circumcision in HIV-infected men and its effect on HIV transmission to female partners in Rakai, Uganda: a randomised controlled trial. | journal=Lancet | year= 2009 | volume= 374 | issue= 9685 | pages= 229-37 | pmid=19616720 | doi=10.1016/S0140-6736(09)60998-3 | pmc=2905212 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19616720}}</ref> Boyle & Hill (2011) also accused the 3 RCTs of researcher expectation bias, participant expectation bias, and selection bias.<ref name="pmid22320006">{{cite journal| author=Boyle GJ, Hill G| title=Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: methodological, ethical and legal concerns. | journal=J Law Med | year= 2011 | volume= 19 | issue= 2 | pages= 316-34 | pmid=22320006 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22320006}}</ref> Of course, a man's circumcision status can't be hidden from him, meaning a double-blind RCT would be impossible. According to Van Howe & Storms (2011), a significant proportion of men who contracted HIV in the trials didn't do so from sexual contact.<ref name="pmid28299046">{{cite journal| author=Van Howe RS, Storms MR| title=How the circumcision solution in Africa will increase HIV infections. | journal=J Public Health Afr | year= 2011 | volume= 2 | issue= 1 | pages= e4 | pmid=28299046 | doi=10.4081/jphia.2011.e4 | pmc=5345479 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28299046}}</ref> Furthermore, assuming the findings of the 3 RCTs are correct, the absolute risk reduction in female-to-male HIV transmission is approximately 1.3%.<ref name="pmid22320006" /> It can then be calculated that the Number Needed to Treat (NNT) is 1 / (0.013) = 77 circumcisions to prevent one HIV infection.<ref>[https://www.cebm.ox.ac.uk/resources/ebm-tools/number-needed-to-treat-nnt Number Needed to Treat (NNT)], Centre for Evidence-Based Medicine</ref> And that is for men in endemic regions — outside of endemic regions, it is likely the NNT would be considerably higher. In fact, Sansom et al (2010) found that, based on the protective effect observed in the three RCTs in Africa, "The number of circumcisions needed to prevent one HIV infection [in the United States] was 298 for all males, and ranged from 65 for black males to 1,231 for white males."<ref name="pmid20090910">{{cite journal| author=Sansom SL, Prabhu VS, Hutchinson AB, An Q, Hall HI, Shrestha RK | display-authors=etal| title=Cost-effectiveness of newborn circumcision in reducing lifetime HIV risk among U.S. males. | journal=PLoS One | year= 2010 | volume= 5 | issue= 1 | pages= e8723 | pmid=20090910 | doi=10.1371/journal.pone.0008723 | pmc=2807456 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20090910  }} </ref>

Nonetheless, the World Health Organization responded with a statement advocating VMMC in HIV-endemic places,<ref>(March 9, 2007). [https://www.who.int/publications/i/item/9789241595988 "New data on male circumcision and HIV prevention: policy and programme implications"]. ''World Health Organization''.</ref> apparently targeting procedures at both adult men and adolescent boys. As of 2020 they reported: "Over 25 million men and adolescent boys in East and Southern Africa have been reached with VMMC services."<ref>(August 17, 2020). [https://www.who.int/publications/i/item/978-92-4-000854-0 "Preventing HIV through safe voluntary medical male circumcision for adolescent boys and men in generalized HIV epidemics: recommendations and key considerations"]. ''World Health Organization''.</ref>

Meanwhile, Nayan et al (2022) found that "circumcision was not independently associated with the risk of acquiring HIV among males from Ontario, Canada."<ref name="pmid34551593">{{cite journal| author=Nayan M, Hamilton RJ, Juurlink DN, Austin PC, Jarvi KA| title=Circumcision and Risk of HIV among Males from Ontario, Canada. | journal=J Urol | year= 2022 | volume= 207 | issue= 2 | pages= 424-430 | pmid=34551593 | doi=10.1097/JU.0000000000002234 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34551593}}</ref> Frish & Simonsen (2022) found that "non-therapeutic circumcision in infancy or childhood did not appear to provide protection against HIV or other STIs in males [in Denmark] up to the age of 36 years."<ref name="pmid34564796">{{cite journal| author=Frisch M, Simonsen J| title=Non-therapeutic male circumcision in infancy or childhood and risk of human immunodeficiency virus and other sexually transmitted infections: national cohort study in Denmark. | journal=Eur J Epidemiol | year= 2022 | volume= 37 | issue= 3 | pages= 251-259 | pmid=34564796 | doi=10.1007/s10654-021-00809-6 | pmc=9110485 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34564796  }} </ref>

By contrast, circumcision does not seem to reduce risk of transmission for men who have sex with men.<ref>http://jama.ama-assn.org/cgi/content/short/300/14/1674</ref>, who are much more at risk of HIV/AIDS than straight men in the UK<ref>[https://www.nat.org.uk/about-hiv/hiv-statistics UK HIV Statistics], National AIDS Trust</ref>

Condoms, when used correctly, are very effective in preventing sexual transmission of HIV,<ref>[https://www.nhs.uk/common-health-questions/sexual-health/do-condoms-always-prevent-hiv-transmission/ Do condoms always prevent HIV transmission?], National Health Service</ref><ref name="pmid11869658">{{cite journal| author=Weller S, Davis K| title=Condom effectiveness in reducing heterosexual HIV transmission. | journal=Cochrane Database Syst Rev | year= 2002 | volume=  | issue= 1 | pages= CD003255 | pmid=11869658 | doi=10.1002/14651858.CD003255 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11869658}}</ref> including for gay men.<ref name="pmid9805301">{{cite journal| author=Pinkerton SD, Abramson PR, Turk ME| title=Updated estimates of condom effectiveness. | journal=J Assoc Nurses AIDS Care | year= 1998 | volume= 9 | issue= 6 | pages= 88-9 | pmid=9805301 | doi=10.1016/S1055-3290(98)80012-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9805301}}</ref>

Pre-Exposure Prophylaxis (PrEP) is also extremely effective at HIV prevention when used correctly, offering 99% protection from sex.<ref>[https://www.nhs.uk/medicines/pre-exposure-prophylaxis-prep/common-questions-about-pre-exposure-prophylaxis-prep/ Common questions about Pre-Exposure Prophylaxis (PrEP)], National Health Service</ref>

In the U.S., where 77% of men are circumcised as of 2010,<ref name="77circ">[https://www.cbsnews.com/news/circumcision-rates-declining-health-risks-rising-study-says/ Circumcision rates declining in U.S., study says]</ref> the prevalence of HIV is 0.3%,<ref name="cdc-hiv">[https://www.cdc.gov/hiv/statistics/overview/index.html CDC HIV Stats]</ref> whereas in Denmark, where only 1.6% of men are circumcised,<ref name="dencirc">[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2543732/pdf/bmj00621-0029.pdf Falling incidence of penis cancer in an uncircumcised population (Denmark 1943-90)]</ref> the prevalence of HIV is only 0.1%.<ref name="denmark-hiv">[https://knoema.com/atlas/Denmark/HIV-prevalence Denmark HIV Prevalence]</ref>

We conclude that the claim that circumcision reduces female-to-male HIV transmission risk by about 60% is very possibly untrue or exaggerated, and even if this claim were true, circumcising a boy for this reason amounts to performing a genital surgery on a child who can't consent, in the hope that it may offer him protection from HIV in the distant future (by which time he may be able to consent to circumcision). Should he transpire to be [[LGBT]], [[Abstinence|abstinent]], in a monogamous relationship with an HIV-negative partner, or an intravenous drug user, it will confer him no benefit. Even if he transpires to be none of those things, circumcision alone would still be insufficient to reliably protect against HIV (and may be ineffective or even disadvantageous for male-to-female transmission), so other more effective means of protection against HIV are important regardless. It is clear that HIV prophylaxis is not a good justification for circumcising boys.

==== Other Sexually Transmitted Infections ====

Based on the 2000 British National Survey of Sexual Attitudes and Lifestyles (Natsal 2000), Dave et al (2003) found "We did not find any significant differences in the proportion of circumcised and uncircumcised British men reporting ever being diagnosed with any STI ... We also found no significant associations between circumcision and being diagnosed with any one of the seven specific STIs. [Gonorrhoea, Genital chlamydia, Syphilis, Non-specific urethritis, Genital herpes, Genital warts, and Trichomonas]"<ref name="pmid14663134">{{cite journal| author=Dave SS, Fenton KA, Mercer CH, Erens B, Wellings K, Johnson AM| title=Male circumcision in Britain: findings from a national probability sample survey. | journal=Sex Transm Infect | year= 2003 | volume= 79 | issue= 6 | pages= 499-500 | pmid=14663134 | doi=10.1136/sti.79.6.499 | pmc=1744763 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14663134}}</ref>

Frish & Simonsen (2022) did not find that non-therapeutic childhood circumcision "did not appear to provide protection" against STIs, and even increased incidence of certain STIs.<ref name="pmid34564796" />

Safe sexual practises, and not circumcision, are the best way to prevent STIs and remain necessary regardless of a man's circumcision status. Even if circumcision did appreciably reduce STI incidence, this benefit would only apply after an age that he may be able to consent to circumcision himself (16 is the age of sexual consent in the UK<ref>[https://rapecrisis.org.uk/get-informed/about-sexual-violence/sexual-consent/ What is sexual consent?] Rape Crisis England & Wales</ref> and also the age at which a person is presumed competent enough to consent to their own medical treatment<ref>[https://www.nhs.uk/conditions/consent-to-treatment/children/ Children and young people: consent to treatment], National Health Service</ref>), so it would not be a good reason to circumcise a boy in infancy or early childhood. In particular, if it were found that circumcision reduces STI transmission incidence to women, it'd be unethical to surgically alter a child's genitals to potentially benefit someone else.

==== Penile cancer ====

Obviously, by removing the foreskin (or any other part of the human body), circumcision removes any risk of cancer in the removed body part, though penile cancer, in general, is very rare and often stems from infection with HPV (against which boys can be immunized by the HPV vaccine<ref name="nhs-hpv-vaccine">[https://www.nhs.uk/conditions/vaccinations/hpv-human-papillomavirus-vaccine/ HPV vaccine] National Health Service</ref>).

Proponents of circumcision often bring up research from the Journal of the American Academy of Dermatology, which finds that "Regarding penile cancer, epidemiologic data have shown that penile SCC is extremely rare in men circumcised at birth."<ref>[https://www.jaad.org/article/S0190-9622(05)01488-X/fulltext Penile Cancer]. JAAD.</ref> However, due to later studies contradicting it, medial authorities have largely dismissed it. For example, the American Cancer Society writes "the protective effect of circumcision wasn't seen after factors like smegma and phimosis were taken into account."<ref>[https://www.cancer.org/cancer/penile-cancer/causes-risks-prevention/prevention.html Can Penile Cancer Be Prevented?]</ref> In fact, to quote a study from the National Center for Biotechnology Information: "Recent medical literature has failed to confirm the protective effect of circumcision on penile neoplasms. Physicians need to be aware that men circumcised after 1 month of age may be at higher risk for penile cancer than those never circumcised."<ref name="ncbi">[https://www.ncbi.nlm.nih.gov/pubmed/9108839 Carcinoma in situ of the penis in a 76-year-old circumcised man.]</ref>

While penile cancer can occur in anyone with a penis, penile cancer mostly affects men over 50.<ref>[https://www.nhs.uk/conditions/penile-cancer/ Penile cancer] National Health Service</ref> According to data from Cancer Research UK, penile cancer is practically non-existent in children and men under 25.<ref name="cancer-research-uk-penile-cancer">[https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/penile-cancer/incidence Penile cancer incidence statistics], Cancer Research UK</ref>

Furthermore, the lifetime risk of developing penile cancer in the United States, where around 77% of all men are circumcised as of 2010,<ref name="77circ" /> is 1/1437.<ref name="ncbi"/> However, in Denmark, where only 1.6% of all men are circumcised,<ref name="dencirc" /> the lifetime risk is only 1/1694.<ref name="ncbi"/>

==== HPV / Cervical cancer in female sexual partners ====
Circumcision has been claimed to reduce cervical cancer in the female sexual partners of circumcised men, as the vast majority of cases of cervical cancer are caused by infection with Human PapillomaVirus (HPV),<ref>[https://www.nhs.uk/conditions/cervical-cancer/ Cervical cancer] National Health Service</ref> and transmission of HPV is allegedly reduced by male circumcision. Even ignoring the large ethical problem of performing a non-voluntary invasive surgery on a child's genitals for the possible distant future benefit of someone else's health, and even if circumcision were significantly effective in reducing oncogenic HPV incidence, it would not be a compelling reason to circumcise healthy boys since boys and girls can now be immunized against HPV.<ref name="nhs-hpv-vaccine" />

Male circumcision is not associated with overall incidence and clearance of HPV in men, and increases time to clearance of HPV type 16,<ref name="pmid24517172">{{cite journal| author=Albero G, Castellsagué X, Lin HY, Fulp W, Villa LL, Lazcano-Ponce E | display-authors=etal| title=Male circumcision and the incidence and clearance of genital human papillomavirus (HPV) infection in men: the HPV Infection in men (HIM) cohort study. | journal=BMC Infect Dis | year= 2014 | volume= 14 | issue=  | pages= 75 | pmid=24517172 | doi=10.1186/1471-2334-14-75 | pmc=3925013 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24517172}}</ref> one of the two types of HPV that most commonly cause cervical cancer.<ref>[https://www.cancerresearchuk.org/about-cancer/cervical-cancer/risks-causes Risks and causes of cervical cancer], Cancer Research UK</ref> Additionally, Winer RL et al (2003) found that among female university students in the Washington state, with a mean follow-up time of 41.2 months, circumcision of their male partners was "not associated with incident infection" of HPV.<ref name="pmid12543621">{{cite journal| author=Winer RL, Lee SK, Hughes JP, Adam DE, Kiviat NB, Koutsky LA| title=Genital human papillomavirus infection: incidence and risk factors in a cohort of female university students. | journal=Am J Epidemiol | year= 2003 | volume= 157 | issue= 3 | pages= 218-26 | pmid=12543621 | doi=10.1093/aje/kwf180 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12543621}}</ref>

==== Urinary tract infections ====

Non-therapeutic neonatal male circumcision is sometimes purported as reducing Urinary Tract Infections (UTIs) during their first year of life. To et al (1998) found that it would take ''195'' circumcisions to prevent a single hospital admission for a UTI during the first year of life.<ref name="pmid9851381">{{cite journal| author=To T, Agha M, Dick PT, Feldman W| title=Cohort study on circumcision of newborn boys and subsequent risk of urinary-tract infection. | journal=Lancet | year= 1998 | volume= 352 | issue= 9143 | pages= 1813-6 | pmid=9851381 | doi=10.1016/S0140-6736(98)02392-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9851381}}</ref> UTIs are also significantly more common in girls anyway.<ref name="pmid9641738">{{cite journal| author=Mårild S, Jodal U| title=Incidence rate of first-time symptomatic urinary tract infection in children under 6 years of age. | journal=Acta Paediatr | year= 1998 | volume= 87 | issue= 5 | pages= 549-52 | pmid=9641738 | doi=10.1080/08035259850158272 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9641738}}</ref><ref group=note>This study concerns Swedish children in their first 6 years of life. Swedish boys are seldom circumcised.</ref> UTIs in boys and girls can easily be treated with a course of antibiotics,<ref>[https://www.nhs.uk/conditions/urinary-tract-infections-utis/ Urinary tract infections (UTIs)], National Health Service</ref> without anything as invasive as genital surgery. UTIs are hence not at all a compelling reason to circumcise infant boys for prophylaxis.

===Freedom of religion===

Attempts to prohibit circumcision in European countries have been accused of infringing the [[freedom of religion]] of [[Jews]] and [[Muslims]].<ref>[https://blogs.lse.ac.uk/europpblog/2018/04/27/the-problem-with-icelands-proposed-ban-on-circumcision/ The problem with Iceland’s proposed ban on circumcision], Iddo Porat</ref><ref>[https://www.theguardian.com/society/2018/feb/18/iceland-ban-male-circumcision-first-european-country Iceland law to outlaw male circumcision sparks row over religious freedom], Harriet Sherwood</ref><ref>[https://www.theguardian.com/commentisfree/2013/oct/11/ban-male-circumcision-antisemitic A ban on male circumcision would be antisemitic. How could it not be?], Tanya Gold</ref>

However, per Article 18 of the International Covenant on Civil and Political Rights,<ref>[https://www.ohchr.org/en/instruments-mechanisms/instruments/international-covenant-civil-and-political-rights International Covenant on Civil and Political Rights], Office of the High Commissioner for Human Rights</ref> "Freedom to manifest one's religion or beliefs may be subject only to such limitations as are prescribed by law and are necessary to protect public safety, order, health, or morals or the fundamental rights and freedoms of others." (A very similar limitation on freedom of religion and belief is declared in Article 9 of the European Convention on Human Rights.<ref>[https://www.echr.coe.int/documents/d/echr/convention_ENG European Convention on Human Rights]</ref>)

Since circumcision causes significant harm to children and violates their absolute right to bodily autonomy and physical integrity, it follows that the qualified right to freedom of religion can justifiably be restricted to exclude ritual circumcision.

===Parental authority===

It is argued by some<ref>[https://www.ucsfhealth.org/education/the-circumcision-decision The Circumcision Decision], University of California San Francisco Health</ref>{{Better source}} that at the end of the day, since a baby boy cannot make any decision for himself, it is ultimately the decision of his parents whether or not he shall be circumcised. After all, parents make decisions for their sons all the time, such as bedtimes, what name he'll be given at birth, and which school he'll go to — [[Satire|so why shouldn't they get to choose how much of his genitals he gets to keep?]]

Clearly, there are limits to the choices that are acceptable for parents to make for their children. Parents have a responsibility for and a duty to protect their children, and not dominion over them. We don't allow parents to make other permanent alterations to their children's bodies without medical need. Parental authority to consent to treatment on behalf of their children is considered limited to those that are deemed in their child's "necessary" medical interest,<ref>[https://cps.ca/en/documents/position/circumcision Newborn male circumcision], Canadian Paediatric Society</ref> or at least their "best" interest.<ref>[https://www.bma.org.uk/media/1840/bma-parental-responsibility-oct-2008.pdf Parental responsibility], British Medical Association</ref> It follows that if circumcision cannot be proven to be in the best interests of a boy, his parents have no right to have him circumcised.

=== Hygiene ===

Perceived hygiene benefits are one of the most common reasons why American parents choose to circumcise their sons.<ref name="rediger-rationales">{{cite journal| author=Rediger C, Muller AJ| title=Parents' rationale for male circumcision. | journal=Can Fam Physician | year= 2013 | volume= 59 | issue= 2 | pages= e110-5 | pmid=23418252 | doi= | pmc=3576965 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23418252}}</ref> This isn't a very good reason to ablate body parts from your son instead of teaching him to spend a few seconds in the shower to wash himself properly (which is important regardless of circumcision status). The foreskin should never be forcefully retracted during infancy or early childhood. Once a boy becomes able to do so, he should gently retract his foreskin and rinse the glans penis and inside of the foreskin with warm water (not with soap). Smegma is a natural lubricant of the penis, but can become a breeding ground for bacteria if it builds up too much, so all boys should regularly clean their genitalia.<ref>[https://www.nhs.uk/common-health-questions/mens-health/why-is-my-penis-smelly-and-sore/ Why is my penis smelly and sore?], National Health Service</ref><ref name="nhs-balanitis" />

=== "Better early than late" ===
Some authors contend that it is in some ways significantly "better" to be circumcised in infancy than in adolescence or adulthood, and therefore it is in a boy's best interest to be circumcised while he is still an infant so that he won't have to deal with the supposedly "worse" experience of being circumcised as an adult.<ref name="pmid22373281">{{cite journal| author=Morris BJ, Waskett JH, Banerjee J, Wamai RG, Tobian AA, Gray RH | display-authors=etal| title=A 'snip' in time: what is the best age to circumcise? | journal=BMC Pediatr | year= 2012 | volume= 12 | issue=  | pages= 20 | pmid=22373281 | doi=10.1186/1471-2431-12-20 | pmc=3359221 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22373281}}</ref> This point is sometimes brought up as a counterargument to the view that boys not circumcised in infancy or childhood can choose to get circumcised as an adult (while a circumcised man can never fully reverse his circumcision). The "better early than late" argument is used to argue that even benefits of circumcision that don't matter prior to late adolescence or adulthood (such as all STIs including HIV/AIDS and HPV, and penile cancer) should be important considerations in the discussion of whether it is a baby boy's interest to be circumcised.<ref name="pmid22373281" />

Ways in which is it is suggested that infancy is the "best" time to be circumcised include:
* '''Risk of complications''': It has been claimed that infant circumcisions have much lower risk of adverse surgical complications than adult circumcisions.<ref name="myers-best-age">{{cite journal| author=Myers A, Earp BD| title=What is the best age to circumcise? A medical and ethical analysis. | journal=Bioethics | year= 2020 | volume= 34 | issue= 7 | pages= 645-663 | pmid=32068898 | doi=10.1111/bioe.12714 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32068898}}</ref> However, complications of adult circumcision in the African RCTs occured around 1.7% to 3.8% of the time, and were generally mild to moderate complications that were effectively resolved.<ref name="rct-south-africa" /><ref name="rct-kenya" /><ref name="rct-uganda" /> This is compared to a 1.5% complication rate in babies.<ref name="pmid20158883">{{cite journal| author=Weiss HA, Larke N, Halperin D, Schenker I| title=Complications of circumcision in male neonates, infants and children: a systematic review. | journal=BMC Urol | year= 2010 | volume= 10 | issue=  | pages= 2 | pmid=20158883 | doi=10.1186/1471-2490-10-2 | pmc=2835667 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20158883}}</ref> It therefore seems that increased risk of complications, while possibly a genuine disadvantage of deferring your son's circumcision decision until he is capable of making it himself, is not a compelling enough reason to circumcise him as a baby.
* '''Pain''': It has been claimed that adult circumcision is more painful than infant circumcision, and/or that it's better to have such a painful experience as an infant because he won't remember it later.<ref name="pmid22373281" /> During the 20th century, it was commonly believed, even by medical professionals, that babies couldn't feel pain.<ref name="pmid22528505">{{cite journal| author=Bellieni CV| title=Pain assessment in human fetus and infants. | journal=AAPS J | year= 2012 | volume= 14 | issue= 3 | pages= 456-61 | pmid=22528505 | doi=10.1208/s12248-012-9354-5 | pmc=3385812 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22528505}}</ref> For this reason, many surgeries including circumcisions were often performed on babies with zero pain relief. It is now known that babies if anything feel more pain than adults,<ref>[https://www.ox.ac.uk/news/2015-04-21-babies-feel-pain-adults Babies feel pain 'like adults'], University of Oxford</ref> and while it is certainly true that little to no men circumcised as infants will ''consciously'' recall that experience, it nonetheless may cause lasting trauma.<ref>{{cite journal | author = Goldman R |date= 1 Jan 1999 |title=The Psychological Impact of Circumcision |url=https://www.cirp.org/library/psych/goldman1/ |journal=BJU International |volume=83 |pages=93-102 |access-date=2nd Dec 2023}}</ref> The fact that the boy won't consciously remember the pain is not an excuse at all for inflicting it in the first place, especially when it is likely to be a frightening experience for him as he cannot understand what is happening, unlike an adult or adolescent who has requested circumcision of his own volition. Furthermore, newborn boys cannot safely receive general anesthesia for the procedure, unlike a male undergoing the procedure later in life.{{cn}}
* '''Cost''': Some argue that it's more cost effective to circumcise infants than adults.<ref name="myers-best-age" />
* '''Simplicity''': Infant circumcision is believed by some to be a "simpler" operation than adult circumcision.<ref name="myers-best-age" /> Note that for neonatal circumcision, the foreskin must first be forcefully separated from the glans due to the natural adhesion to the glans in the first few years of a boy's life, which is untrue of adolescent or adult circumcision.{{cn}}
* '''Recovery''': Some argue that for infant circumcision, the recovery from the surgery is shorter and/or less inconvenient than for adults.<ref name="myers-best-age" /> This is likely true to some extent,<ref>[https://www.nhs.uk/conditions/circumcision-in-men/ Circumcision in men], National Health Service]</ref>{{Better source}} as men must take a week off work, while newborn boys wouldn't be walking around anyway.

Notably, one could object to the "better early than late" argument by pointing out that few men not circumcised at birth will ever want or need to be circumcised later in life.{{cn}} Therefore, rather than thinking about it as "circumcision early or circumcision later", it would be more accurate to think of it as "have circumcision forced on him at birth, or he gets to choose as an adult."

In conclusion, the claim that it is overwhelmingly better to be circumcised as a baby than as an adult is questionable, and even if it were true, it would not be an ethical reason to deny children autonomy over their own genitalia.

=== Other rationales to circumcise ===
Parents also circumcise their sons for other rationales, including some that are unrelated to health or religion. Many rationales are related to the cultural normalization of circumcision, such as in the United States:

*Belief that a boy's circumcision status needs to match his father's.<ref name="rediger-rationales" />
*Aesthetic reasons.<ref name="rediger-rationales" />
*Belief that being circumcised will be more sexually pleasing to his future partners.{{cn}}
*Thinking that non-therapeutic neonatal circumcision "just seems right" or "it's just what you do."<ref name="rediger-rationales" />
*Concern that he may be teased for being uncircumcised.{{cn}}

== Arguments against circumcision of babies or children ==

=== Bodily autonomy and integrity ===

Bodily autonomy is the right of a person to ownership and choice over their own body.<ref>[https://www.unfpa.org/press/bodily-autonomy-fundamental-right Bodily autonomy: A fundamental right], United Nations Population Fund</ref><ref>[https://www.unfpa.org/news/bodily-autonomy-busting-7-myths-undermine-individual-rights-and-freedoms Bodily autonomy: Busting 7 myths that undermine individual rights and freedoms], United Nations Population Fund</ref>, while bodily integrity refers to the right "freedom from physical non-consented acts."<ref>[https://www.ohchr.org/sites/default/files/2021-11/Summary-Bodily-Autonomy-Integrity.pdf Bodily Autonomy & Integrity], UN Human Rights Office</ref>

Non-therapeutic circumcision of infants and children who are too young to consent to the procedure is a violation of the child's right to bodily autonomy and integrity. It subjects children to an unnecessary irreversible alteration of their bodies (indeed the most private and intimate part of their bodies, no less), with significant lifelong consequences for the appearance, anatomical structure, and possibly function of their genitalia, that they certainly cannot consent to, and usually have not requested, and in the case of infants, are entirely unable to even object to. It denies a boy, and the man he will become, the right to own his complete genitalia that he was born with. It is a violation of bodily integrity because it subjects him to a physical invasion of his genitalia without his own consent.

=== Pain and trauma ===
Having part of your genitalia cut off as a child with no pain relief is a supremely painful experience.{{fact|joke}} In the 20th century, it was widely believed that newborn babies couldn't feel pain, and therefore many neonatal circumcisions were done without any pain relief.<ref name="pmid22528505" /> Some circumcisions performed today still do not use pain relief, especially those performed in non-medical settings as a custom or ritual.<ref name="pmid31080593" />

No method of pain relief can fully prevent clinically significant pain from the procedure.<ref name="pmid35352017">{{cite journal| author=Bellieni CV| title=Neonatal Infant Pain Scale in assessing pain and pain relief for newborn male circumcision. | journal=Int J Impot Res | year= 2023 | volume= 35 | issue= 3 | pages= 282-285 | pmid=35352017 | doi=10.1038/s41443-022-00551-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35352017}}</ref> Thus, the only way to spare a boy from suffering significant pain is to not circumcise him.

All circumcisions cause physical trauma, as the surgery causes injury to the tissue in order to excise the foreskin.

69% of boys in the Philippines circumcised in the traditional Tuli ritual, and 51% of those circumcised by medical operators or medical assistants, exhibit symptoms of Post-Traumatic Stress Disorder (PTSD).<ref name="pmid31080593">{{cite journal| author=Boyle GJ, Ramos S| title=Post-traumatic stress disorder (PTSD) among Filipino boys subjected to non-therapeutic ritual or medical surgical procedures: A retrospective cohort study. | journal=Ann Med Surg (Lond) | year= 2019 | volume= 42 | issue=  | pages= 19-22 | pmid=31080593 | doi=10.1016/j.amsu.2019.04.004 | pmc=6506608 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31080593}}</ref> Note that Filipino boys are typically circumcised between the ages of 8 and 12.<ref name="FR-05 TULI" />

The pain that circumcision causes to infants is often downplayed by the belief that "he won't remember it". Even if this were entirely true, it's certainly not an excuse to inflict unnecessary pain on a defenseless baby. Furthermore, while men cannot consciously recall their infant experiences, pain in infants can cause long-term consequences,<ref name="pmid17273395">{{cite journal| author=Page GG| title=Are there long-term consequences of pain in newborn or very young infants? | journal=J Perinat Educ | year= 2004 | volume= 13 | issue= 3 | pages= 10-7 | pmid=17273395 | doi=10.1624/105812404X1725 | pmc=1595204 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17273395}}</ref> including heightened responses to vaccination which were only mitigated by pain relief (specifically EMLA cream).<ref>{{cite journal |authors=Anna Taddio, Joel Katz, A Lane Ilersich, Gideon Koren |date=1 March 1997 |title=Effect of Neonanatal Circumcision on Pain Response During Subsequent Routine Vaccination |url=https://www.cirp.org/library/pain/taddio2/ |journal=The Lancet |volume=349 |issue=9052 |pages=599-603 |access-date=5 Dec 2023}}</ref>

=== Adverse sexual effects ===

Though the foreskin is noted for its significant innervation,<ref>https://onlinelibrary.wiley.com/doi/full/10.1111/joa.13481</ref> there does not appear to be a clear consensus in the medical community on whether or not circumcision markedly reduces overall sexual pleasure. It is a difficult topic to assess, due to the extremely subjective nature of sexual pleasure, and the fact that both uncircumcised and circumcised men usually have nothing to compare to. Obviously however, circumcision renders impossible any sexual act that inherently requires a foreskin, such as docking.

According to the NHS, circumcision in men may cause "permanent reduction in sensation in the head of the penis, particularly during sex".<ref name="nhs-men" /> However, a 2009 manual by the World Health Organization, UNAIDS, and Johns Hopkins Program for International Education in Gynecology and Obstetrics instructed that circumcision didn't cause impotence or a reduction of sexual pleasure.<ref>{{cite web|date=December 2009 |title=Manual for Male Circumcision Under Local Anaesthesia |url=https://web.archive.org/web/20120115175057/http://www.who.int/hiv/pub/malecircumcision/who_mc_local_anaesthesia.pdf |archive-url=https://web.archive.org/web/20120115175057/http://www.who.int/hiv/pub/malecircumcision/who_mc_local_anaesthesia.pdf |archive-date=January 15, 2012 |publisher=World Health Organization, UNAIDS, and Jhpiego (Johns Hopkins Program for International Education in Gynecology and Obstetrics) |quote=...there are many myths about male circumcision that circulate. For example, some people think that circumcision can cause impotence (failure of erection) or reduce sexual pleasure. Others think that circumcision will cure impotence. Let me assure you that none of these is true.}}</ref>{{rp|Chapter 3-4}}

Data from Bossio et. al (2016) indicates that the foreskin has lower thresholds to tactile sensitivity than any other part of the penis, and lower and warmth detection than the glans penis.<ref name="pmid26724395">{{cite journal| author=Bossio JA, Pukall CF, Steele SS| title=Examining Penile Sensitivity in Neonatally Circumcised and Intact Men Using Quantitative Sensory Testing. | journal=J Urol | year= 2016 | volume= 195 | issue= 6 | pages= 1848-53 | pmid=26724395 | doi=10.1016/j.juro.2015.12.080 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26724395  }} </ref> Bizarrely, however, media reporting of this study and even the study's own Abstract contradicts this data.<ref>Earp, B.D. (2016), Infant circumcision and adult penile sensitivity: implications for sexual experience. Trends Urology & Men Health, 7: 17-21. https://doi.org/10.1002/tre.531 </ref> On the other hand, the study <i>did</i> find that the parts of the penis not ablated by circumcision are no less sensitive in circumcised men. Limitations of this study include a low sample size (62 participants) and a lack of older participants (all were <= 37 years).

A study performed by the British Journal of Urology found that, of their sample of roughly 1,300 men (of which 310 were circumcised), those that were circumcised "reported decreased sexual pleasure and lower orgasm intensity. They also stated more effort was required to achieve orgasm, and a higher percentage of them experienced unusual sensations (burning, prickling, itching, or tingling and numbness of the glans penis [as well as other complications])."<ref>http://www.ncbi.nlm.nih.gov/pubmed/23374102</ref>

Sorrells et al (2007) found that "The glans of the circumcised penis is less sensitive to fine touch than the glans of the uncircumcised penis" and also found that the most sensitive part of the uncircumcised penis was the "transitional region from the external to the internal prepuce", therefore concluding that "circumcision ablates the most sensitive parts of the penis."<ref name="pmid17378847">{{cite journal| author=Sorrells ML, Snyder JL, Reiss MD, Eden C, Milos MF, Wilcox N | display-authors=etal| title=Fine-touch pressure thresholds in the adult penis. | journal=BJU Int | year= 2007 | volume= 99 | issue= 4 | pages= 864-9 | pmid=17378847 | doi=10.1111/j.1464-410X.2006.06685.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17378847  }} </ref>

Kim & Pang (2007) reported that men circumcised as adults reported that circumcision had generally negatively impacts on masturbatory pleasure (48% decrease vs 8% increase) and more difficulty in masturbation (63% more difficult, 37% less difficult), and more men reported worse (20%) than better (6%) sex lives after circumcision.<ref name="pmid17155977">{{cite journal| author=Kim D, Pang MG| title=The effect of male circumcision on sexuality. | journal=BJU Int | year= 2007 | volume= 99 | issue= 3 | pages= 619-22 | pmid=17155977 | doi=10.1111/j.1464-410X.2006.06646.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17155977  }} </ref>

Frisch et al (2011) reported that circumcision is associated with orgasm difficulties in Danish men and various sexual difficulties in their female sexual partners.<ref name="pmid21672947">{{cite journal| author=Frisch M, Lindholm M, Grønbæk M| title=Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark. | journal=Int J Epidemiol | year= 2011 | volume= 40 | issue= 5 | pages= 1367-81 | pmid=21672947 | doi=10.1093/ije/dyr104 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21672947  }} </ref>

A meta-analysis by Morris & Krieger (2013) concluded that circumcision had "no adverse effect on sexual function, sensitivity, sexual sensation, or satisfaction."<ref name="pmid23937309">{{cite journal| author=Morris BJ, Krieger JN| title=Does male circumcision affect sexual function, sensitivity, or satisfaction?--a systematic review. | journal=J Sex Med | year= 2013 | volume= 10 | issue= 11 | pages= 2644-57 | pmid=23937309 | doi=10.1111/jsm.12293 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23937309  }} </ref> However, this has been criticized by other authors, including allegations that Morris cited his own letters and opinion pieces which criticized studies indicating adverse sexual effects of circumcision without accounting for authors' replies to these letters, and failing to account for serious limitations of studies that show no adverse effects.<ref> Boyle, G. (2015) Does Male Circumcision Adversely Affect Sexual Sensation, Function, or Satisfaction? Critical Comment on Morris and Krieger (2013). Advances in Sexual Medicine, 5, 7-12. doi: [http://dx.doi.org/10.4236/asm.2015.52002 10.4236/asm.2015.52002].</ref><ref name="pmid25284631">{{cite journal| author=Bossio JA, Pukall CF, Steele S| title=A review of the current state of the male circumcision literature. | journal=J Sex Med | year= 2014 | volume= 11 | issue= 12 | pages= 2847-64 | pmid=25284631 | doi=10.1111/jsm.12703 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25284631  }} </ref> Other works about circumcision by Morris have faced similar criticism. <ref name="pmid36261537">{{cite journal| author=Deacon M, Muir G| title=Reply to Morris et al. re: 'The medical evidence on non-therapeutic circumcision of infants and boys-setting the record straight'. | journal=Int J Impot Res | year= 2023 | volume= 35 | issue= 3 | pages= 267-268 | pmid=36261537 | doi=10.1038/s41443-022-00631-y | pmc=10159837 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=36261537  }} </ref><ref>Earp, Brian & Darby, Robert. (2015). [https://www.researchgate.net/publication/269899744_Does_Science_Support_Infant_Circumcision Does Science Support Infant Circumcision?]. Skeptic. 25. 23-30.</ref>

=== Lack of safety ===

According to the NHS, "The risks associated with circumcisions when carried out by qualified and experienced doctors are small." <ref name="nhs-boys" />

Unfortunately, circumcision performed outside of hygienic clinical settings by non-medical practitioners is unambiguously risky. In New York City, at least 11 baby boys were infected with herpes over an 11-year period in the early 21st century due to an [[Ultra-Orthodox Judaism|Ultra-Orthodox Jewish]] circumcision ritual known as <i>metzitzah b’peh</i> in which a mohel 
orally sucks off the tip of the bloody baby penis
 sucks blood out of the incision.<ref>http://healthland.time.com/2012/06/07/how-11-new-york-city-babies-contracted-herpes-through-circumcision/</ref><ref>http://www.nytimes.com/2015/01/15/nyregion/mayor-de-blasio-and-rabbis-near-accord-on-new-circumcision-rule.html?_r=0</ref> Other sects of Judaism do not have the mohel suck blood out of the incision, so their practices are less risky. Circumcision initiation rites in some cultural groups in Africa are also very dangerous as they are carried out in unsafe settings by traditional practitioners.<ref name="pmid21124715" /> According to Dan Bollinger, "a prominent opponent of circumcision",<ref name="NYT">https://www.nytimes.com/2012/08/27/science/benefits-of-circumcision-outweigh-risks-pediatric-group-says.html</ref> around 117 neonatal deaths occur in the United States every year due to circumcision, or 1 out of every 77 neonatal deaths. This is compared with 44 neonatal deaths from suffocation, 8 in automobile accidents, and 115 from Sudden Infant Death Syndrome.<ref>[http://circinfo.org/USA_deaths.html Just a harmless snip?]</ref> However, this statistic is "widely disputed by medical professionals. A spokeswoman for the Centers for Disease Control and Prevention said the agency did not keep track of deaths from infant circumcision [in the United States] because they are exceedingly rare. In the agency’s last mortality report, which looked at all deaths in the country in 2010, no circumcision-related deaths were found."<ref name="NYT" />

Neonatal circumcision increases risk of Meatal Stenosis by 10-26 fold and risk of other urethral stricture diseases (USDs) by 5-14 fold. The former affects 5%-20% of circumcised boys. <ref name="pmid28017691">{{cite journal| author=Frisch M, Simonsen J| title=Cultural background, non-therapeutic circumcision and the risk of meatal stenosis and other urethral stricture disease: Two nationwide register-based cohort studies in Denmark 1977-2013. | journal=Surgeon | year= 2018 | volume= 16 | issue= 2 | pages= 107-118 | pmid=28017691 | doi=10.1016/j.surge.2016.11.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28017691  }} </ref>

Unfortunately, as with any medical procedure, on rare occasions things can go wrong, even with a medical circumcision performed by professional surgeons in a hospital; the tragic story of {{wpl|David Reimer}} began with a botched circumcision due to phimosis,<ref group=note>This was an inappropriate intervention, as David was an infant when he was referred for circumcision, so his phimosis shouldn't have been considered pathological as the foreskin is normally fused to the glans penis during infancy.</ref> using a somewhat unconventional method: electro-cauterization. There is conflicting testimony, but the doctors may have also used a non-standard clamp.<ref>John Colapinto (2000). [https://archive.org/details/isbn_9780732274337 "As Nature Made Him: The Boy Who Was Raised as a Girl"]. ''HarperCollins''.</ref>{{rp|12–15}} This left his penis so badly burned that it necessitated removal.<ref>http://documentarystorm.com/dr-money-and-the-boy-with-no-penis/</ref> '''Ouch.'''

=== Sex reassignment surgery ===

While circumcision does not render [[sex reassignment surgery]] impossible for [[trans women]], circumcision complicates the surgery and possibly adversely affects its results, since circumcision ablates tissue that would ideally be used to create parts of the vulva.<ref name="pmid30511988">{{cite journal| author=Opsomer D, Gast KM, Ramaut L, De Wolf E, Claes K, Sommeling C | display-authors=etal| title=Creation of Clitoral Hood and Labia Minora in Penile Inversion Vaginoplasty in Circumcised and Uncircumcised Transwomen. | journal=Plast Reconstr Surg | year= 2018 | volume= 142 | issue= 5 | pages= 729e-733e | pmid=30511988 | doi=10.1097/PRS.0000000000004926 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30511988  }} </ref><ref name="pmid27141451">{{cite journal| author=Garcia MM| title=Men's health and transgender surgery: a urologist's perspective. | journal=Transl Androl Urol | year= 2016 | volume= 5 | issue= 2 | pages= 225-7 | pmid=27141451 | doi=10.21037/tau.2016.01.09 | pmc=4837315 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27141451  }} </ref>

=== Far-right opposition ===
Unfortunately, criticism of the procedure has often been co-opted as an antisemitic [[Code word|dog-whistle]] by some far-right parties and activists in [[Western world|the Western World]],<ref>[https://www.dazeddigital.com/beauty/article/48684/1/how-intactivists-anti-circumcision-movement-was-co-opted-by-the-alt-right How intactivist’s anti-circumcision movement was co-opted by the alt-right]</ref> as well as a wrongful justification to bash [[feminists|feminism]] from individuals within the so-called [[Men's rights movement|men's rights movement]].<ref>[https://everydayfeminism.com/2016/05/mens-rights-circumcision/  How Men’s Rights Activists Hijacked the Circumcision Debate]</ref>

==Circum-parisons==
=== Female Genital Mutilation ===
{{main|Female genital mutilation}}

Female Genital Mutilation (FGM), also known as Female Genital Cutting (FGC) or female circumcision, is a term that collectively refers to procedures that remove, alter, or injure the female genitalia in the abscence of a valid medical reason for this to be done.<ref name="nhs-fgm">[https://www.nhs.uk/conditions/female-genital-mutilation-fgm/ Female genital mutilation], National Health Service</ref><ref name="met-police-fgm" />. The vast majority of such procedures are carried out on children who can't consent to it, as with male circumcision. Some people compare medically unnecessary male circumcision to FGM, as the former removes, alters, and injures part of the male genitalia, arguing that the strong categorical condemnation (and explicit illegality) of FGM in the West, coupled with acceptance of male circumcision, is a [[double standard]].<ref>Earp, Brian. (2014). [https://www.researchgate.net/publication/266971287_Female_Genital_Mutilation_FGM_and_Male_Circumcision_Should_There_Be_a_Separate_Ethical_Discourse Female Genital Mutilation (FGM) and Male Circumcision: Should There Be a Separate Ethical Discourse?]</ref><ref>Georganne Chapin (3 May 2017), [https://www.huffpost.com/entry/americas-infuriating-double-standard-on-cutting-childrens_b_5908fef7e4b03b105b44bd0e America's Infuriating Double Standard on Cutting Children's Genitals], Huffpost</ref>. However, others object to this comparison, arguing that FGM is very different from, and much worse than, male circumcision.{{cn}}

While more severe forms of FGM such as excision of the glans clitoris (Type Ib) or infibulation (Type III) are above and beyond male circumcision - more congruous procedures would be [[castration]] or [[subincision]] which are thankfully much less common across the world today - other forms of FGM are no more destructive than male circumcision. For example, in 2017 in Michigan, USA, several people were prosecuted for performing a minor form of FGM that involved “removing a sesame seed-sized amount of mucous membrane from the clitoral hood" without removing the clitoris. This corresponds to Type Ia FGM.<ref>https://www.nytimes.com/2017/06/10/health/genital-mutilation-muslim-dawoodi-bohra-michigan-case.html</ref>

FGM is performed at a variety of ages, usually between infancy and age 15<ref name="nhs-fgm" />. Some contend that FGM shouldn't be compared to male circumcision because the former often happens at an age where the victim will remember the horrid experience for life{{cn}}, although the same can be said about male circumcision in some cultural groups<ref name="pmid31080593" />, and the fact infants "won't remember it" isn't an excuse to inflict unnecessary pain to infants - especially as it may still cause long-term effects.<ref name="pmid10475600">{{cite journal| author=Porter FL, Grunau RE, Anand KJ| title=Long-term effects of pain in infants. | journal=J Dev Behav Pediatr | year= 1999 | volume= 20 | issue= 4 | pages= 253-61 | pmid=10475600 | doi=10.1097/00004703-199908000-00008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10475600  }} </ref>

FGM is usually carried out by non-medical practitioners, often without proper sterile tools, although this is not always the case.<ref name="nhs-fgm" /> While circumcision in United States usually takes place in hygienic medical settings by medical practitioners, the same cannot be said of male circumcision in some other groups (see [[Circumcision#Lack_of_safety|Lack of safety]]).

According to the NHS, the Metropolitan Police, and the World Health Organization, FGM confers "no health benefits".<ref name="nhs-fgm" /><ref name="met-police-fgm" /><ref name="who-fgm">[https://www.who.int/news-room/fact-sheets/detail/female-genital-mutilation Female genital mutilation], World Health Organization</ref>. However, bioethicist Brian D. Earp contends it would be more accurate to say "we actually don’t know if certain minor, sterilised forms of FGM have health benefits, because it is unethical – and would be illegal – to find out."<ref>[https://aeon.co/essays/are-male-and-female-circumcision-morally-equivalent Are male and female circumcision morally equivalent?], Brian D. Earp</ref> Meanwhile, the health benefits conferred by male circumcision (see [[Circumcision#Purported_prophylactic_benefits|Purported prophylactic benefits]]) are ultimately quite minor and are not substantial enough to justify surgical alterations to a child's genitalia without consent - just as all forms of FGM would rightfully still be illegal and unethical if it were found that certain forms conferred minor benefits.

Some authors contend that FGM and male circumcision shouldn't be compared because the former is primarily motivated by oppressive or misogynistic intent, such as sexual control, whereas the latter is primarily motivated by benign intentions, such as perceived health or hygiene benefits.{{cn}} However, in societies where FGM is practised frequently, it is often actually women rather than men who control it<ref name="pmid-23138367">{{cite journal | author=Public Policy Advisory Network on Female Genital Surgeries in Africa | title=Seven things to know about female genital surgeries in Africa | journal=The Hastings Center Report | volume=42 | issue=6 | date=2012 | issn=0093-0334 | pmid=23138367 | doi=10.1002/hast.81 | pages=19–27}}</ref>, who often cite remarkably similar reasons for performing FGM as some parents do for male circumcision such as cosmetic enhancement<ref name="pmid-23138367" />, tradition and conformity<ref>[https://www.guttmacher.org/journals/ipsrh/1997/09/female-circumcision-rite-passage-or-violation-rights Female Circumcision: Rite of Passage Or Violation of Rights?] Frances A. Althaus </ref>, supposed hygiene benefits<ref>[https://www.reuters.com/article/idUSKCN12D04E/ Factbox: The hidden cut: female genital mutilation in Asia], Emma Batha</ref>{{Better source}}, or perceived religious obligation<ref name="Rashid Iguchi Afiqah 2020 p. e1003303">{{cite journal | last=Rashid | first=Abdul | last2=Iguchi | first2=Yufu | last3=Afiqah | first3=Siti Nur | title=Medicalization of female genital cutting in Malaysia: A mixed methods study | journal=PLoS medicine | volume=17 | issue=10 | date=2020 | issn=1549-1676 | pmid=33108371 | pmc=7591112 | doi=10.1371/journal.pmed.1003303 | page=e1003303}}</ref>.

We conclude that although FGM and male circumcision are not identical issues, and FGM is typically the more severe of the two practices, it is a double standard to condemn all forms of nonconsensual FGM, regardless of age, surgical conditions, severity of harm, or reasons for the practice, while accepting medically unnecessary nonconsensual male circumcision; every child has the rights to genital autonomy and integity, and hence the right not to be subjected to medically unnecessary, nonconsensual genital cutting, and to afford these rights to only one sex constitutes [[discrimination]]. Interestingly, while many countries have banned FGM, none have banned non-therapeutic circumcision of boys. This is a touchy point with [[Men's rights movement|men's rights activists]] because they believe that outrage over FGM and acceptance of circumcision is proof of anti-male bias{{cn}}. This is despite the fact that many feminists and human rights activists, such as  Gloria Steinem and [[Ayaan Hirsi Ali]], have condemned the procedure in addition to condemning female genital mutilation.<ref>[https://www.al.com/wire/2014/02/feminist_leader_gloria_steinem.html Women's liberation icon Gloria Steinem to speak at Auburn University this month], Evan Belanger</ref><ref>[https://thelibertarianrepublic.com/think-male-circumcision-worse-incision-girl-aayan-hirsi-ali/ “I think male circumcision is worse than an incision of the girl.” -Ayaan Hirsi Ali], Austin Petersen</ref>. After all, bodily autonomy is a key principle of feminism, and feminists recognise that patriachy can harm boys and men, but it isn't suprising that feminists should focus on the more severe of the practices, and to combat the disadvantages that women and girls face. Political scientist Rebecca Steinfeld contends that reasons for this double standard include [[ethnocentrism]] (as male circumcision is culturally normalised in the West, especially the United States, while FGM is not, the latter is "more liable to be seen as barbaric") and [[sexism]] (under patriarchy, "vulnerability is gendered.")<ref>[https://theconversation.com/like-fgm-cut-foreskins-should-be-a-feminist-issue-20328 Like FGM, cut foreskins should be a feminist issue], Rebecca Steinfeld </ref>

Notably, this comparison may also be invoked the other way by ''supporters'' of FGM - indeed, in certain religious or cultural groups, FGM is seen as a parallel ritual to male circumcision{{cn}}. Of course, the best response to this is that medically unnecessary genital cutting of children, regardless of sex, is unacceptable.

===Vaccinations===
Some proponents of non-therapeutic childhood circumcision justify the practice by comparing it to routine childhood vaccinations, as they both are painful procedures performed on children who are too young to consent but (supposedly) confer prophylactic benefits that outweigh any associated risk.<ref>[https://www.youtube.com/watch?v=OS19p-bYsss  CDC Circumcision Verdict: Benefits Outweigh Risks], David Pakman Show on YouTube</ref><ref>[https://pubmed.ncbi.nlm.nih.gov/17935209/ Why circumcision is a biomedical imperative for the 21(st) century], Brian J. Morris</ref>

Claims of health benefits are far more compelling for vaccination than circumcision, both in terms of credibility and in terms of the magnitude of the benefits. If circumcision ''were'' comparable to vaccination, the United States would've all but eradicated the diseases that circumcision purportedly protects against, such as HIV, penile cancer, and male UTIs. This is quite clearly not the case, as the US actually has higher rates of some of these diseases than European countries where circumcision isn't the norm.<ref name="cdc-hiv" /><ref name="denmark-hiv" /><ref name="ncbi"/> Vaccinations are also more imminently needed, as many diseases that have been virtually eradicated by vaccination would otherwise infect many children before they are old enough to consent to being vaccinated, whereas many supposed health benefits of circumcision do not apply prior to adolescence or adulthood, such as sexually-transmitted diseases or penile cancer which mostly affects older men.<ref name="cancer-research-uk-penile-cancer" /> Many diseases supposedly prevented by circumcision have another means of prevention or treatment that is both more effective and less invasive, such as safe sexual practices, proper washing of the penis, or steroid creams, whereas vaccination has no reasonable alternative to prevent diseases that would otherwise be highly contagious and deadly in children.

Every major medical organisation strongly recommends routine childhood vaccination against diseases such as rubella, meningitis, and rotavirus, whereas none outright recommend routine childhood male circumcision.

Circumcision constitutes a considerably greater invasion of a child's bodily autonomy and integrity than vaccination, as vaccination doesn't permanently ablate a significant part of a child's most intimate body part. Circumcision is probably also far more painful than vaccination, and some vaccinations don't involve a painful injection at all, but instead may be introduced nasally<ref>[https://www.nhs.uk/conditions/vaccinations/child-flu-vaccine/ Children's flu vaccine], National Health Service</ref> or orally.<ref>[https://www.nhs.uk/conditions/vaccinations/rotavirus-vaccine/ Rotavirus vaccine overview], National Health Service</ref>

In short, routine childhood circumcision confers much more marginal health benefits than vaccination, while much more seriously violating their bodily autonomy and integrity, and therefore it is ethical to routinely vaccinate children, but not to routinely circumcise boys.

===Intersex Genital Mutilation===
Medically unnecessary surgeries performed on intersex children who are too young to consent, also known as Intersex Genital Mutilation (IGM)<ref>Vera Papisova and Evaan Kheraj (June 29, 2017), [https://www.teenvogue.com/story/intersex-genital-mutilation Why Intersex Genital Mutilation Needs to Stop], ''Teen Vogue''</ref>, have also faced opposition by intactivists, who believe that IGM violates bodily autonomy and integrity similarly to circumcision.<ref name='circumstitions' /><ref>[https://intactamerica.org/why-intact-america-loves-pride/ Why Intact America Loves Pride], Georganne Chapin and David Grant (Jun 24, 2016)</ref>{{Better source}}

===Trans healthcare===
Provision of trans healthcare (Puberty Blockers (PBs), Hormone Replacement Therapy (HRT), and Gender Affirming Surgeries (GAS)) to minors has been compared to the circumcision of minors, often to accuse people of [[hypocrisy]] for supporting one practice but not the other.<ref>Earp, Brian. (2022). [https://www.researchgate.net/publication/363770958_Protecting_Children_or_Policing_Gender Protecting Children or Policing Gender?.]</ref><ref>[[Ben Shapiro|Daily Wire]] on [[Twitter|X]] (19 Oct 2023): [https://archive.ph/JVHgX "Student tries to compare trans surgeries for kids to circumcision"] (archived)</ref><ref>Norm Cohen (11 Jan 2023) [https://intactivist.org/wisdom/what-every-intactivist-must-know-about-transgender-ideology/ What Every Intactivist Must Know About Transgender Ideology]</ref><ref name="lempert-npc" /> While critics of the former practice often argue that "minors cannot consent", this is not necessarily true: for example, in the United Kingdom, 16-17 year olds are presumed capable of consenting to their own medical treatment, while minors under 16 may be able to consent if deemed ''Gillick competent''.<ref>[https://www.nhs.uk/conditions/consent-to-treatment/children/  Children and young people], National Health Service.</ref> Trans healthcare is typically provided to adolescents who ardently request the treatment of their own accord and sometimes can and do consent to it, whereas circumcision is usually imposed on children who absolutely can't consent, and often don't have a say in the procedure whatsoever (as is the case for babies.) Just as importantly, while both procedures are performed in the abscence of a ''physical'' health indication, trans healthcare is indeed a therapeutic treatment and quite arguably a medically necessary one: it is indicated by persistent [[Gender dysphoria| dysphoria]]. To that end, it is very effective<ref name="pmid34920935">{{cite journal| author=Green AE, DeChants JP, Price MN, Davis CK| title=Association of Gender-Affirming Hormone Therapy With Depression, Thoughts of Suicide, and Attempted Suicide Among Transgender and Nonbinary Youth. | journal=J Adolesc Health | year= 2022 | volume= 70 | issue= 4 | pages= 643-649 | pmid=34920935 | doi=10.1016/j.jadohealth.2021.10.036 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34920935  }} </ref>, and unparalleled by solely psychological treatment.<ref name="pmid26556015">{{cite journal| author=Costa R, Dunsford M, Skagerberg E, Holt V, Carmichael P, Colizzi M| title=Psychological Support, Puberty Suppression, and Psychosocial Functioning in Adolescents with Gender Dysphoria. | journal=J Sex Med | year= 2015 | volume= 12 | issue= 11 | pages= 2206-14 | pmid=26556015 | doi=10.1111/jsm.13034 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26556015  }} </ref> Meanwhile, most circumcisions are performed on children who have no physical or mental distress indicating surgical intervention, and many if not most circumcisions are done primarily for religious or cultural reasons, unlike trans healthcare.

Note that circumcision is of course, an invasive, painful, and permanent surgical operation, meanwhile GAS are not ordinarily prescribed to minors<ref name="nhs-dysphoria">[https://www.nhs.uk/conditions/gender-dysphoria/treatment/ Gender dysphoria - Treatment], National Health Service</ref> per international standards<ref>[https://www.wpath.org/media/cms/Documents/SOC%20v8/SOC-8%20FAQs%20-%20WEBSITE2.pdf World Professional Association for Transgender Health Standards of Care for Transgender and Gender Diverse People, Version 8 Frequently Asked Questions (FAQs)]</ref>, and in the rare cases that they are it is likely to be on older adolescents presenting with severe, persistent dysphoria{{cn}}. HRT tends to be prescribed to older adolescents, typically at around an age they are likely to be able to consent,<ref name="nhs-dysphoria" /> and in the uncommon cases where it is prescribed to earlier adolescents, it is likely because they are found to be ''Gillick''-competent, or it is determined that postponing the treatment would be prejudical to the patient's health. PBs are believed to be largely physically reversible, particularly in terms of their intended physical effect<ref name="nhs-dysphoria" />, as opposed to circumcision whose intended effect is irreversible. PBs are a very time-sensitive treatment, as postponing the treatment not only causes harm by prolonging dysphoria, but effectively forces undesired (possibly even traumatic) physical changes that can never be undone (or may require surgery to do so) once the patient is older, unlike circumcision which can feasibly be postponed until late adolescence or adulthood, when the patient can consent. Indeed, because of this, PBs are ethical ironically for the very reason that nonconsensual circumcision is unethical: bodily autonomy.

It follows that provision of PBs and HRT to trans adolescents, if they demonstrate ''Gillick'' competence or if the treatment is otherwise demonstrably necessary for their mental health (due to persistent dysphoria) is not only ethically permissible, but ethically obligatory, while circumcision of ''Gillick''-incompetent minors in the abscence of a therapeutic indication is ethically impermissible. On the other hand, the fact that efforts to prohibit trans healthcare tend to turn a blind eye to childhood circumcision (often also IGM) or even specifically exempt it<ref>[https://billstatus.ls.state.ms.us/documents/2023/pdf/HB/1100-1199/HB1125SG.pdf HOUSE BILL NO. 1125], MISSISSIPPI LEGISLATURE</ref>, is rather telling of [[Transphobia|their true motives...]]

== Ways of restoring the foreskin ==

=== [[wp:Foreskin restoration#Non-surgical techniques|Non-surgical techniques]] ===

Accomplished by stretching tissue to stimulate mitosis. Can be done manually or with a device. Just make sure you know what the heck you're doing so you don't 
rip your dick off
 get sore.

=== [[wp:Foreskin restoration#Surgical techniques|Surgical]] ===

* Foreskin reconstruction
** Involves skin transplant
* Foreskin regeneration
** Regrowing the patient's foreskin — the organization ForeGen<ref name="ForeGen">http://www.foregen.org/update_from_the_foregen_labs_november_2016</ref> has professional assistance to prove out preliminary procedures needed, including the successful decellularization of a human foreskin scaffold.

== Uses for the foreskin ==
Historically, the main use of severed foreskins was in religious practice, with [[Holy Foreskin|holy foreskin]]s ostensibly from Jesus's wiener featuring in various Roman Catholic rituals. However, publications have reported that foreskins could be the next big beauty treatment. Epidermal growth factor from the foreskins of newborn boys reportedly helps "generate collagen and elastin, which can help to boost the radiance of your face".<ref>[https://www.theguardian.com/fashion/shortcuts/2018/nov/26/foreskin-facial-kate-beckinsale-serum-anti-ageing Does the ‘foreskin facial’ mark the end of the world?], The Guardian, 26 Nov 2018</ref><ref>[https://www.huffingtonpost.co.uk/entry/penis-facial_us_5b02df5be4b0463cdba4a6fa What Is The ‘Penis Facial’ That Sandra Bullock Gets?], Huffington Post, 22 May 2018</ref> "Neonatal foreskin fibroblast culture" features in the TNS range from SkinMedica of Carlsbad, CA, USA, and in one clinical trial showed a statistically significant improvement in the appearance of fine lines.<ref>Caroline Aldag et al, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5108505/ Skin rejuvenation using cosmetic products containing growth factors, cytokines, and matrikines: a review of the literature], Clin Cosmet Investig Dermatol. 2016; 9: 411–419.</ref>

== See also ==

*[[Holy Foreskin]]

==Notes==
{{reflist|group=note}}

==References==
{{reflist|2|90%}}

[[Category:Anatomy]]
[[Category:Islam]]
[[Category:Judaism]]
[[Category:Medicine]]
[[Category:Sexuality]]
[[Category:Purity culture]]

Categories: Anatomy, Islam, Judaism, Medicine, Sexuality, Purity culture