We critically evaluate an online “Global survey of circumcision harm” that gauged beliefs of men who thought that their neonatal circumcision had harmed them. Sequential evaluation of the survey data and claims reveal numerous serious flaws that are at odds with strong scientific evidence. Moreover, the one-sided study design and “loaded” survey title meant the findings were not representative of the general population of circumcised males. None of the participants’ claimed physical problems were confirmed by a health practitioner. Belief in this seriously flawed survey has potential to cause psychological harm to vulnerable men influenced by anti-circumcision claims, and as such has serious detrimental implications for male sexual health. The survey appears driven less by empiricism and more by psychological forces, as we show in de-tail. The overwhelming body of high quality medical scientific evidence finds no adverse effect of male circumcision on sexual function and pleasure, but strong evidence for a wide array of lifetime benefits in protection against infections, dermatological problems, and genital cancers. Consistent with the United Nations Convention on the Rights of the Child, children are entitled to low risk procedures that are beneficial to their health. In conclusion, the survey and its uncritical presentation do a disservice to evidence-based medicine, sexual health, mental health, public health, human rights, and pediatric policy development. It should therefore be dismissed as unreliable.
References
[1]
Cox, G. and Morris, B.J. (2012) Why Circumcision: From Pre-History to the Twenty-First Century. In: Bolnick, D.A., Koyle, M.A. and Yosha, A., Eds., Surgical Guide to Circumcision, Springer, London, Chapter 21, 243-259.
https://doi.org/10.1007/978-1-4471-2858-8_21
https://www.researchgate.net/publication/278660669_Why_Circumcision_From_Prehistory_ to_the_Twenty-First_Century
[2]
Angulo, J.C. and Garcia-Diez, M. (2009) Male Genital Representation in Paleolithic Art: Erection and Circumcision before History. Urology, 74, 10-14.
https://doi.org/10.1016/j.urology.2009.01.010
[3]
Morris, B.J., Wamai, R.G., Henebeng, E.B., et al. (2016) Estimation of Country-Specific and Global Prevalence of Male Circumcision. Population Health Metrics, 14, Article 4. https://doi.org/10.1186/s12963-016-0073-5
[4]
Morris, B.J., Wamai, R.G., Henebeng, E.B., et al. (2016) Erratum to: Estimation of Country-Specific and Global Prevalence of Male Circumcision. Population Health Metrics, 14, Article 11. https://doi.org/10.1186/s12963-016-0080-6
[5]
Cox, G. (1995) De Virginibus, Puerisque. The Function of the Human Foreskin Considered from an Evolutionary Perspective. Medical Hypotheses, 45, 617-621.
https://doi.org/10.1016/0306-9877(95)90248-1
[6]
Introcaso, C.E., Xu, F., Kilmarx, P.H., et al. (2013) Prevalence of Circumcision among Men and Boys Aged 14 to 59 Years in the United States, National Health and Nutrition Examination Surveys 2005-2010. Sexually Transmitted Diseases, 40, 521-525. https://doi.org/10.1097/01.OLQ.0000430797.56499.0d
[7]
American Academy of Pediatrics Task Force on Circumcision (2012) Circumcision Policy Statement. Pediatrics, 130, 585-586. https://doi.org/10.1542/peds.2012-1989
[8]
American Academy of Pediatrics Task Force on Circumcision (2012) Male Circumcision. Pediatrics, 130, e756-e785. https://doi.org/10.1542/peds.2012-1990
[9]
Centers for Disease Control and Prevention (2018) Male Circumcision.
https://www.cdc.gov/hiv/risk/male-circumcision.html
[10]
El Bcheraoui, C., Zhang, X., Cooper, C.S., et al. (2014) Rates of Adverse Events Associated with Male Circumcision in US Medical Settings, 2001 to 2010. JAMA Pediatrics, 168, 625-634. https://doi.org/10.1001/jamapediatrics.2013.5414
[11]
Morris, B.J., Moreton, S. and Krieger, J.N. (2019) Critical Evaluation of Arguments Opposing Male Circumcision: A Systematic Review. Journal of Evidence-Based Medicine, E-Pub Ahead of Final 8 Sep 2019.
https://onlinelibrary.wiley.com/doi/10.1111/jebm.12361
[12]
Hammond, T. and Carmack, A. (2017) Long-Term Adverse Outcomes from Neonatal Circumcision Reported in a Survey of 1,008 Men: An Overview of Health and Human Rights Implications. International Journal of Human Rights, 21, 189-218.
https://doi.org/10.1080/13642987.2016.1260007
[13]
Hammond, T. (2013) Survey Reveals Harm from Male Circumcision: Canadian Paediatric Society Alerted. Bonobo 3D.
https://www.youtube.com/watch?v=IVUWXjYlbT8
[14]
Hammond, T. (1999) A Preliminary Poll of Men Circumcised in Infancy or Childhood. BJU International, 83, 85-92.
https://doi.org/10.1046/j.1464-410x.1999.0830s1085.x
[15]
Hammond, T. (2013) Updating the CPS Neonatal Circumcision Policy Statement.
http://circumcisionharm.org/CPS.pdf
[16]
Hutchinson, J. (1855) On the Influence of Circumcision in Preventing Syphilis. Medical Times and Gazette, 32, 542-543.
[17]
Anonymous (1874) Circumcision. Edinburgh Medical Journal, 20, 282.
[18]
Sayre, L.A. (1888) On the Deleterious Effects of a Narrow Prepuce and Preputial Adhesions. Transactions of the 9th International Medical Congress, Vol. 3, 20.
https://collections.nlm.nih.gov/ext/dw/101283080/PDF/101283080.pdf
[19]
Hutchinson, J. (1890) A Plea for Circumcision. Archives of Surgery, 215.
[20]
Freeland, E.H. (1900) Circumcision as a Preventative of Syphilis and Other Disorders. The Lancet, 156, 1869-1871. https://doi.org/10.1016/S0140-6736(01)82836-1
[21]
Wolbarst, A.L. (1914) Universal Circumcision as a Sanitary Measure. JAMA, 62, 92-97. https://doi.org/10.1001/jama.1914.02560270008003
[22]
Silby, F.A. (1913) Part II: Boys. In: Scharlieb, M. and Silby, F.A., Eds., Youth and Sex. Dangers and Safeguards for Girls and Boys, Dodge Publishing Co., London, 44-92.
[23]
Rivin, B.E., Diekema, D.E., Mastroianni, A.C., et al. (2016) Critical Evaluation of Adler’s Challenge to the CDC’s Male Circumcision Recommendations. International Journal of Child Rights, 24, 265-303. https://doi.org/10.1163/15718182-02402004
[24]
Morris, B.J., Krieger, J.N., Klausner, J.D. and Rivin, B.E. (2017) The Ethical Course Is to Recommend Infant Male Circumcision—Arguments Disparaging American Academy of Pediatrics Affirmative Policy Do Not Withstand Scrutiny. Journal of Law, Medicine & Ethics, 45, 647-663. https://doi.org/10.1177/1073110517750603
[25]
International NGO Council on Violence against Children (2012) Violating Children’s Rights: Harmful Practices Based on Tradition, Culture, Religion or Superstition. https://resourcecentre.savethechildren.net/node/7212/pdf/7212.pdf
[26]
Royal Dutch Medical Association (KNMG) (2010) Non-Therapeutic Circumcision of Male Minors. Royal Dutch Medical Association (KNMG), Utrecht.
https://www.knmg.nl/circumcision/
[27]
District Court, Cologne (2012) Landgericht Koln. 7 May 2012 Urteil 151 Ns 169/11.
[28]
District Court of Cologne (2012) Judgement of 7 May 2012 on Male Circumcision for Religious Reasons. Durham University News.
https://www.dur.ac.uk/ilm/news/?itemno=14984
[29]
DW News-Service (2012) Circumcision Remains Legal in Germany.
http://www.dw.de/circumcision-remains-legal-in-germany/a-16399336
[30]
Stafford, N. (2012) German Ethics Council Backs Religious Circumcision If Specific Conditions Met. BMJ, 345, e5789. https://doi.org/10.1136/bmj.e5789
[31]
Royal Courts of Justice (2015) Sir James Munby President of the Family Division. In the Matter of B and G (Children) (No. 2).
https://www.judiciary.gov.uk/wp-content/uploads/2015/01/BandG_2_.pdf
[32]
Morris, B.J., Bailis, S.A. and Wiswell, T.E. (2014) Circumcision Rates in the United States: Rising or Falling? What Effect Might the New Affirmative Pediatric Policy Statement Have? Mayo Clinic Proceedings, 89, 677-686.
https://doi.org/10.1016/j.mayocp.2014.01.001
[33]
Morris, B.J., Kennedy, S.E., Wodak, A.D., et al. (2017) Early Infant Male Circumcision: Systematic Review, Risk-Benefit Analysis, and Progress in Policy. World Journal of Clinical Pediatrics, 6, 89-102. https://doi.org/10.5409/wjcp.v6.i1.89
[34]
Auvert, B., Taljaard, D., Lagarde, E., et al. (2005) Randomized, Controlled Intervention Trial of Male Circumcision for Reduction of HIV Infection Risk: The ANRS 1265 Trial. PLoS Medicine, 2, e298. https://doi.org/10.1371/journal.pmed.0020298
[35]
Bailey, R.C., Moses, S., Parker, C.B., et al. (2007) Male Circumcision for HIV Prevention in Young Men in Kisumu, Kenya: A Randomised Controlled Trial. The Lancet, 369, 643-656. https://doi.org/10.1016/S0140-6736(07)60312-2
[36]
Gray, R.H., Kigozi, G., Serwadda, D., et al. (2007) Male Circumcision for HIV Prevention in Men in Rakai, Uganda: A Randomised Trial. The Lancet, 369, 657-666.
https://doi.org/10.1016/S0140-6736(07)60313-4
[37]
World Health Organization and UNAIDS (2007) New Data on Male Circumcision and HIV Prevention: Policy and Programme Implications.
http://who.int/hiv/mediacentre/MCrecommendations_en.pdf
[38]
Weiss, H.A., Halperin, D., Bailey, R.C., et al. (2008) Male Circumcision for HIV Prevention: From Evidence to Action? AIDS, 22, 567-574.
https://doi.org/10.1097/QAD.0b013e3282f3f406
[39]
Siegfried, N., Muller, M., Deeks, J.J. and Volmink, J. (2009) Male Circumcision for Prevention of Heterosexual Acquisition of HIV in Men. Cochrane Database Systemetic Reviews, No. 2, CD003362. https://doi.org/10.1002/14651858.CD003362.pub2
[40]
PEPFAR, U.S. President’s Emergency Plan for AIDS Relief (2018) Fact Sheet. PEPFAR Latest Global Results.
https://www.pepfar.gov/documents/organization/287811.pdf
[41]
Fauci, A.S. and Eisinger, R.W. (2018) PEPFAR—15 Years and Counting the Lives Saved. New England Journal of Medicine, 378, 314-316.
https://doi.org/10.1056/NEJMp1714773
[42]
Hines, J.Z., Ntsuape, O.C., Malaba, K., et al. (2017) Scale-Up of Voluntary Medical Male Circumcision Services for HIV Prevention—12 Countries in Southern and Eastern Africa, 2013-2016. MMWR Morbidity and Mortality Weekly Report, 66, 1285-1290. https://doi.org/10.15585/mmwr.mm6647a2
[43]
Tobian, A.A.R., Kacker, S. and Quinn, T.C. (2014) Male Circumcision: A Globally Relevant But Under-Utilized Method for the Prevention of HIV and Other Sexually Transmitted Infections. Annual Review of Medicine, 65, 293-306.
https://doi.org/10.1146/annurev-med-092412-090539
[44]
Benatar, M. and Benatar, D. (2003) Between Prophylaxis and Child Abuse: The Ethics of Neonatal Male Circumcision. American Journal of Bioethics, 3, 35-48.
https://doi.org/10.1162/152651603766436216
[45]
Benatar, D. and Benatar, M. (2003) How Not to Argue about Circumcision. American Journal of Bioethics, 3, W1-W9. https://doi.org/10.1162/152651603102387820
[46]
Bates, M.J., Ziegler, J.B., Kennedy, S.E., et al. (2013) Recommendation by a Law Body to Ban Infant Male Circumcision Has Serious Worldwide Implications for Pediatric Practice and Human Rights. BMC Pediatrics, 13, Article No. 136.
https://doi.org/10.1186/1471-2431-13-136
[47]
Benatar, D. (2013) Evaluations of Circumcision Should Be Circumscribed by the Evidence. Journal of Medical Ethics, 39, 431-432.
https://doi.org/10.1136/medethics-2013-101519
[48]
Jacobs, A.J. (2013) The Ethics of Circumcision of Male Infants. Israel Medical Association Journal, 15, 60-65.
[49]
Jacobs, A.J. and Arora, K.S. (2015) Ritual Male Infant Circumcision and Human Rights. American Journal of Bioethics, 15, 30-39.
https://doi.org/10.1080/15265161.2014.990162
[50]
Bester, J.C. (2015) Ritual Male Infant Circumcision: The Consequences and the Principles Say Yes. American Journal of Bioethics, 15, 56-58.
https://doi.org/10.1080/15265161.2014.990164
[51]
Moreton, S. (2012) Sabotage Studies. Screenshots from “The WHOLE Network”. CircFacts.org. Real Facts about Male Circumcision.
http://circfacts.org/cyber-bullying/#cyber13
[52]
Bossio, J.A., Pukall, C.F. and Bartley, K. (2015) You Either Have It or You Don’t: The Impact of Male Circumcision Status on Sexual Partners. Canadian Journal of Human Sexuality, 24, 104-119. https://doi.org/10.3138/cjhs.242-A2
[53]
Bossio, J.A., Pukall, C.F. and Steele, S.S. (2016) Examining Penile Sensitivity in Neonatally Circumcised and Intact Men Using Quantitative Sensory Testing. Journal of Urology, 195, 1848-1853. https://doi.org/10.1016/j.juro.2015.12.080
[54]
Stern, M.J. (2013) How Circumcision Broke the Internet. Slate.
https://slate.com/technology/2013/09/intactivists-online-a-fringe-group-turned-the-internet- against-circumcision.html
[55]
Task Force on Circumcision (2013) Cultural Bias and Circumcision: The AAP Task Force on Circumcision Responds. Pediatrics, 131, 801-804.
https://doi.org/10.1542/peds.2013-0081
[56]
Morris, B.J., Tobian, A.A., Hankins, C.A., et al. (2014) Veracity and Rhetoric in Paediatric Medicine: A Critique of Svoboda and Van Howe’s Response to the AAP Policy on Infant Male Circumcision. Journal of Medical Ethics, 40, 463-470.
https://doi.org/10.1136/medethics-2013-101614
[57]
Morris, B.J., Krieger, J.N. and Klausner, J.D. (2016) Critical Evaluation of Unscientific Arguments Disparaging Affirmative Infant Male Circumcision Policy. World Journal of Clinical Pediatrics, 5, 251-261. https://doi.org/10.5409/wjcp.v5.i3.251
[58]
Morris, B.J. and Krieger, J.N. (2015) The Literature Supports Policies Promoting Neonatal Male Circumcision in North America. Journal of Sexual Medicine, 12, 1305. https://doi.org/10.1111/jsm.12855
[59]
Centers for Disease Control and Prevention (2014) Recommendations for Providers Counseling Male Patients and Parents Regarding Male Circumcision and the Prevention of HIV Infection, STIs, and Other Health Outcomes. Federal Register, 79, 71433.
https://www.federalregister.gov/documents/2014/12/02/2014-27814/recommendations-for- providers-counseling-male-patients-and-parents-regarding-male-circumcision-and
[60]
Centers for Disease Control and Prevention (2014) Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, TB Prevention. Background, Methods, and Synthesis of Scientific Information Used to Inform the “Recommendations for Providers Counseling Male Patients and Parents Regarding Male Circumcision and the Prevention of HIV Infection, STIs, and Other Health Outcomes.” http://arclaw.org/sites/default/files/CDC-2014-0012-0002.pdf
[61]
Morris, B.J. and Krieger, J.N. (2013) Does Male Circumcision Affect Sexual Function, Sensitivity, or Satisfaction?—A Systematic Review. Journal of Sexual Medicine, 10, 2644-2657. https://doi.org/10.1111/jsm.12293
[62]
Centers for Disease Control and Prevention (2018) Summary of Public Comments and CDC Responses to Public Comments for Information for Providers Counseling Male Patients and Parents Regarding Male Circumcision and the Prevention of HIV Infection, Sexually Transmitted Infections, and Other Health Outcomes.
https://www.cdc.gov/hiv/pdf/risk/MC-HISA-Public-Comments-and-Responses.pdf
[63]
Morris, B.J. (2015) Commentary: Do the Benefits of Male Circumcision Outweigh the Risks? A Critique of the Proposed CDC Guidelines. Frontiers in Pediatrics, 3, Article 88. https://doi.org/10.3389/fped.2015.00088
[64]
Morris, B.J., Krieger, J.N. and Klausner, J.D. (2017) CDC’s Male Circumcision Recommendations Represent a Key Public Health Measure. Global Health, Science and Practice, 5, 15-27. https://doi.org/10.9745/GHSP-D-16-00390
[65]
Morris, B.J., Waskett, J.H., Banerjee, J., et al. (2012) A “Snip” in Time: What Is the Best Age to Circumcise? BMC Pediatrics, 12, Article 20.
https://doi.org/10.1186/1471-2431-12-20
[66]
Bollinger, D. (2010) Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths. Thymos: Journal of Boyhood Studies, 4, 78-90.
https://doi.org/10.3149/thy.0401.78
[67]
Morris, B.J., Bailey, R.C., Klausner, J.D., et al. (2012) Review: A Critical Evaluation of Arguments Opposing Male Circumcision for HIV Prevention in Developed Countries. AIDS Care, 24, 1565-1575.
https://doi.org/10.1080/09540121.2012.661836
[68]
Elhaik, E. (2019) Neonatal Circumcision and Prematurity Are Associated with Sudden Infant Death Syndrome (SIDS). Journal of Clinical and Translational Research, 4, 136-151. https://doi.org/10.18053/jctres.04.201802.005
[69]
Earp, B.D., Allareddy, V., Allareddy, V. and Rotta, A.T. (2018) Factors Associated with Early Deaths Following Neonatal Male Circumcision in the United States, 2001 to 2010. Clinical Pediatrics (Philadelphia), 57, 1532-1540.
https://doi.org/10.1177/0009922818790060
[70]
Kigozi, G., Watya, S., Polis, C.B., et al. (2008) The Effect of Male Circumcision on Sexual Satisfaction and Function, Results from a Randomized Trial of Male Circumcision for Human Immunodeficiency Virus Prevention, Rakai, Uganda. BJU International, 101, 65-70. https://doi.org/10.1111/j.1464-410X.2007.07369.x
[71]
Krieger, J.N., Mehta, S.D., Bailey, R.C., et al. (2008) Adult Male Circumcision: Effects on Sexual Function and Sexual Satisfaction in Kisumu, Kenya. Journal of Sexual Medicine, 5, 2610-2622. https://doi.org/10.1111/j.1743-6109.2008.00979.x
[72]
Tian, Y., Liu, W., Wang, J.Z., et al. (2013) Effects of Circumcision on Male Sexual Functions: A Systematic Review and Meta-Analysis. Asian Journal of Andrology, 15, 662-666. https://doi.org/10.1038/aja.2013.47
[73]
Yang, Y., Wang, X., Bai, Y. and Han, P. (2018) Circumcision Does Not Have Effect on Premature Ejaculation: A Systematic Review and Meta-Analysis. Andrologia, 50, e12851. https://doi.org/10.1111/and.12851
[74]
Shabanzadeh, D.M., Düring, S. and Frimont-Moller, C. (2016) Male Circumcision Does Not Result in Inferior Perceived Male Sexual Function—A Systematic Review. Danish Medical Journal, 63, A5245.
[75]
Homfray, V., Tanton, C., Mitchell, K.R., et al. (2015) Examining the Association between Male Circumcision and Sexual Function: Evidence from a British Probability Survey. AIDS, 29, 1411-1416. https://doi.org/10.1097/QAD.0000000000000745
[76]
Cox, G., Krieger, J.N. and Morris, B.J. (2015) Histological Correlates of Penile Sexual Sensation: Does Circumcision Make a Difference? Sexual Medicine, 3, 76-85.
https://doi.org/10.1002/sm2.67
Schober, J.M., Meyer-Bahlburg, H.F. and Dolezal, C. (2009) Self-Ratings of Genital Anatomy, Sexual Sensitivity and Function in Men Using the “Self-Assessment of Genital Anatomy and Sexual Function, Male” Questionnaire. BJU International, 103, 1096-1103. https://doi.org/10.1111/j.1464-410X.2008.08166.x
[80]
Halata, Z. and Munger, B.L. (1986) The Neuroanatomical Basis for the Protopathic Sensibility of the Human Glans Penis. Brain Research, 371, 205-230.
https://doi.org/10.1016/0006-8993(86)90357-4
[81]
Szasz, G. and Carpenter, C. (1989) Clinical Observations in Vibratory Stimulation of the Penis of Men with Spinal Cord Injury. Archives of Sexual Behavior, 18, 461-474. https://doi.org/10.1007/BF01541673
[82]
Sarkarati, M., Rossier, A.B. and Fam, B.A. (1987) Experience in Vibratory and Electro-Ejaculation Techniques in Spinal Cord Injury Patients: A Preliminary Report. Journal of Urology, 138, 59-62. https://doi.org/10.1016/S0022-5347(17)42988-0
[83]
Kigozi, G., Wawer, M., Ssettuba, A., et al. (2009) Foreskin Surface Area and HIV Acquisition in Rakai, Uganda (Size Matters). AIDS, 23, 2209-2213.
https://doi.org/10.1097/QAD.0b013e328330eda8
[84]
Darwin, C. (1859) The Origin of Species by Means of Natural Selection. John Murray, London.
[85]
Moreton, S. (2019) Circumcision Removes Half the Penile Skin. Circfacts.org. Real Facts about Male Circumcision.
http://circfacts.org/function-sensation/#sens12
[86]
Moreton, S. (2019) Circumcision Removes Half the Skin of the Penis. CircFacts.org. Real Facts about Male Circumcision.
http://circfacts.org/function-sensation/#sens12
[87]
Wamai, R.G., Morris, B.J., Waskett, J.H., et al. (2012) Criticisms of African Trials Fail to Withstand Scrutiny: Male Circumcision Does Prevent HIV Infection. Journal of Law and Medicine, 20, 93-123.
[88]
de Witte, L., Nabatov, A., Pion, M., et al. (2007) Langerin Is a Natural Barrier to HIV-1 Transmission by Langerhans Cells. Nature Medicine, 13, 367-371.
https://doi.org/10.1038/nm1541
[89]
Schwartz, O. (2007) Langerhans Cells Lap up HIV-1. Nature Medicine, 13, 245-246.
https://doi.org/10.1038/nm0307-245
[90]
Morris, B.J. and Wamai, R.G. (2012) Biological Basis for the Protective Effect Conferred by Male Circumcision against HIV Infection. International Journal of STD &AIDS, 23, 153-159. https://doi.org/10.1258/ijsa.2011.011228
[91]
Moreton, S. (2019) The Foreskin Has Immunological Functions. CircFacts.org. Real Facts about Male Circumcision.
http://circfacts.org/function-sensation/#sens13
[92]
Wei, C., Raymond, H.F., McFarland, W., et al. (2011) What Is the Potential Impact of Adult Circumcision on the HIV Epidemic among Men Who Have Sex with Men in San Francisco? Sexually Transmitted Diseases, 38, 353-355.
https://doi.org/10.1097/OLQ.0b013e3181fe6523
[93]
Westercamp, N. and Bailey, R.C. (2007) Acceptability of Male Circumcision for Prevention of HIV/AIDS in Sub-Saharan Africa: A Review. AIDS and Behavior, 11, 341-355. https://doi.org/10.1007/s10461-006-9169-4
[94]
Gasasira, R.A., Sarker, M., Tsague, L., et al. (2012) Determinants of Circumcision and Willingness to Be Circumcised by Rwandan Men, 2010. BMC Public Health, 12, 134. https://doi.org/10.1186/1471-2458-12-134
[95]
Peltzer, K., Onoya, D., Makonko, E. and Simbayi, L. (2014) Prevalence and Acceptability of Male Circumcision in South Africa. African Journal of Traditional, Complementary, and Alternative Medicines, 11, 126-130.
https://doi.org/10.4314/ajtcam.v11i4.19
[96]
Moreton, S. (2017) Men Rarely Choose to Be Circumcised. Circfacts.org. Real Facts about Male Circumcision. http://circfacts.org/general-information/#med4
[97]
MacLaren, D., Tommbe, R., Mafile’o, T., et al. (2013) Foreskin Cutting Beliefs and Practices and the Acceptability of Male Circumcision for HIV Prevention in Papua New Guinea. BMC Public Health, 13, 818.
https://doi.org/10.1186/1471-2458-13-818
[98]
Huang, J., Jiang, J., Abdullah, A.S., et al. (2013) Factors Associated with Acceptability of Circumcision among Male Drug Users in Western China: A Cross-Sectional Study. International Journal of STD & AIDS, 24, 541-547.
https://doi.org/10.1177/0956462412473893
[99]
Jiang, J., Huang, J., Yang, X., et al. (2013) Acceptance of Male Circumcision among Male Rural-to-Urban Migrants in Western China. AIDS Research and Human Retroviruses, 29, 1582-1588. https://doi.org/10.1089/aid.2013.0156
[100]
Wang, Z., Feng, T., Lau, J.T. and Kim, Y. (2016) Acceptability of Voluntary Medical Male Circumcision (VMMC) among Male Sexually Transmitted Diseases Patients (MSTDP) in China. PLoS ONE, 11, e0149801.
https://doi.org/10.1371/journal.pone.0149801
[101]
Jiang, J., Su, J., Yang, X., et al. (2015) Acceptability of Male Circumcision among College Students in Medical Universities in Western China: A Cross-Sectional Study. PLoS ONE, 10, e0135706. https://doi.org/10.1371/journal.pone.0135706
[102]
Figueroa, J.P. and Cooper, C.J. (2010) Attitudes towards Male Circumcision among Attendees at a Sexually Transmitted Infection Clinic in Kingston, Jamaica. West Indian Medical Journal, 59, 351-355.
[103]
Hudson, F.P., Miller, W.C., Rao, S., et al. (2018) Prevalence and Predictors of Uncircumcised, Kenyan Men’s Desire for Circumcision for Their Infant Sons. AIDS and Behavior, 22, 471-478. https://doi.org/10.1007/s10461-017-1681-1
[104]
Grund, J.M., Bryant, T.S., Toledo, C., et al. (2019) Association of Male Circumcision with Women’s Knowledge of Its Biomedical Effects and with Their Sexual Satisfaction and Function: A Systematic Review. AIDS and Behavior, 23, 1104-1114.
https://doi.org/10.1007/s10461-018-2313-0
[105]
Morris, B.J., Hankins, C.A., Lumbers, E.R., et al. (2019) Sex and Male Circumcision: Women’s Preferences across Different Cultures and Countries: A Systematic Review. Sexual Medicine, 7, 145-161. https://doi.org/10.1016/j.esxm.2019.03.003
[106]
Wiswell, T.E. and Geschke, D.W. (1989) Risks from Circumcision during the First Month of Life Compared with Those for Uncircumcised Boys. Pediatrics, 83, 1011-1015.
[107]
Ben Chaim, J., Livne, P.M., Binyamini, J., et al. (2005) Complications of Circumcision in Israel: A One Year Multicenter Survey. Israel Medical Association Journal, 7, 368-370.
[108]
Moreton, S. (2016) Gliding along. Circfacts.org. Real Facts about Male Circumcision. http://circfacts.org/function-sensation/#sens4
[109]
CircumcisionChoice (2017) The 16 Foreskin Functions—A Critical Analysis. CircumcisionCoice.com.
https://www.circumcisionchoice.com/single-post/16Functions
[110]
Nordstrom, M.P., Westercamp, N., Jaoko, W., et al. (2017) Medical Male Circumcision Is Associated with Improvements in Pain during Intercourse and Sexual Satisfaction in Kenya. Journal of Sexual Medicine, 14, 601-612.
https://doi.org/10.1016/j.jsxm.2017.02.014
[111]
Chmel, R., Novackova, M., Fait, T., et al. (2019) Clitoral Phimosis: Effects on Female Sexual Function and Surgical Treatment Outcomes. Journal of Sexual Medicine, 16, 257-266. https://doi.org/10.1016/j.jsxm.2018.12.012
[112]
McDonald, C.F. (1958) Circumcision of the Female. GP, 18, 98-99.
https://doi.org/10.1353/frc.1958.0004
[113]
Rathmann, W.G. (1959) Female Circumcision, Indications and a New Technique. GP, 20, 115-120.
[114]
Hodgkinson, D.J. and Hait, G. (1984) Aesthetic Vaginal Labioplasty. Plastic and Reconstructive Surgery, 74, 414-416.
https://doi.org/10.1097/00006534-198409000-00015
[115]
Dobbeleir, J.M., Landuyt, K.V. and Monstrey, S.J. (2011) Aesthetic Surgery of the Female Genitalia. Seminars in Plastic Surgery, 25,130-141.
https://doi.org/10.1055/s-0031-1281482
[116]
Morris, B.J. and Krieger, J.N. (2017) Does Circumcision Increase Meatal Stenosis Risk?—A Systematic Review and Meta-Analysis. Urology, 110, 16-26.
https://doi.org/10.1016/j.urology.2017.07.027
[117]
Morris, B.J. and Krieger, J.N. (2018) Re: 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. Surgeon, 16, 126-129. https://doi.org/10.1016/j.surge.2017.08.001
[118]
Moreton, S. (2017) Lying. Circfacts.org. Real Facts about Male Circumcision.
http://circfacts.org/cyber-bullying/#cyber10
[119]
Sorrells, M.L., Snyder, J.L., Reiss, M.D., et al. (2007) Fine-Touch Pressure Thresholds in the Adult Penis. BJU International, 99, 864-869.
https://doi.org/10.1111/j.1464-410X.2006.06685.x
[120]
Waskett, J.H. and Morris, B.J. (2007) Fine-Touch Pressure Thresholds in the Adult Penis. BJU International, 99, 1551-1552.
https://doi.org/10.1111/j.1464-410X.2007.06970_6.x
[121]
Moreton, S. (2016) “10,000, 20,000, 70,000 Nerve Endings”: A Myth That Keeps on Growing. Circfacts.org. Real Facts about Male Circumcision.
http://circfacts.org/function-sensation/#sens1
[122]
Richters, J., Gerofi, J. and Donovan, B. (1995) Are Condoms the Right Size(s)? A Method for Self-Measurement of the Erect Penis. Venereology, 8, 77-81.
[123]
Park, J.K., Doo, A.R., Kim, J.H., et al. (2016) Prospective Investigation of Penile Length with Newborn Male Circumcision and Second to Fourth Digit Ratio. Canadian Urological Association Journal, 10, E296-E299.
https://doi.org/10.5489/cuaj.3590
[124]
Frisch, M. and Simonsen, J. (2018) 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. Surgeon, 16, 107-118. https://doi.org/10.1016/j.surge.2016.11.002
[125]
Payne, K., Thaler, L., Kukkonen, T., et al. (2007) Sensation and Sexual Arousal in Circumcised and Uncircumcised Men. Journal of Sexual Medicine, 4, 667-674.
https://doi.org/10.1111/j.1743-6109.2007.00471.x
[126]
Bleustein, C.B., Fogarty, J.D., Eckholdt, H., et al. (2005) Effect of Neonatal Circumcision on Penile Neurological Sensation. Urology, 65, 773-777.
https://doi.org/10.1016/j.urology.2004.11.007
[127]
Rhodin, J.A.G. (1974) Histology. A Text and Atlas. Oxford University Press, London, 893 p.
[128]
Winkelmann, R.K. (1956) The Cutaneous Innervation of Human Newborn Prepuce. Journal ofInvestigative Dermatology, 26, 53-67.
https://doi.org/10.1038/jid.1956.5
[129]
Yang, C.C. and Bradley, W.E. (1998) Peripheral Distribution of the Human Dorsal Nerve of the Penis. Journal of Urology, 159, 1912-1916.
https://doi.org/10.1016/S0022-5347(01)63194-X
[130]
Podnar, S. (2012) Clinical Elicitation of the Penilo-Cavernosus Reflex in Circumcised Men. BJU International, 109, 582-585.
https://doi.org/10.1111/j.1464-410X.2011.10364.x
[131]
Blaivas, J.G., Zayed, A.A. and Labib, K.B. (1981) The Bulbocavernosus Reflex in Urology: A Prospective Study of 299 Patients. Journal of Urology, 126, 197-199.
https://doi.org/10.1016/S0022-5347(17)54445-6
[132]
Taddio, A., Goldbach, M., Ipp, M., et al. (1995) Effect of Neonatal Circumcision on Pain Responses during Vaccination in Boys. The Lancet, 345, 291-292.
https://doi.org/10.1016/S0140-6736(95)90278-3
[133]
Taddio, A., Katz, J., Ilersich, A.L. and Koren, G. (1997) Effect of Neonatal Circumcision on Pain Response during Subsequent Routine Vaccination. The Lancet, 349, 599-603. https://doi.org/10.1016/S0140-6736(96)10316-0
[134]
Szabo, R. and Short, R.V. (2000) How Does Male Circumcision Protect against HIV Infection? BMJ, 320, 1592-1594. https://doi.org/10.1136/bmj.320.7249.1592
[135]
Moreton, S. (2016) Keratinization. Circfacts.org. Real Facts about Male Circumcision. http://circfacts.org/function-sensation/#sens3
[136]
Jack in the World (1997) Jackinworld Survey #2 Results.
http://old.jackinworld.com/library/surveys/survey2.html
[137]
Frisch, M., Lindholm, M. and Gronbaek, M. (2011) Male Circumcision and Sexual Function in Men and Women: A Survey-Based, Cross-Sectional Study in Denmark. International Journal of Epidemiology, 40, 1367-1381.
https://doi.org/10.1093/ije/dyr104
[138]
Morris, B.J., Waskett, J.H. and Gray, R.H. (2012) Does Sexual Function Survey in Denmark Offer Any Support for Male Circumcision Having an Adverse Effect? International Journal of Epidemiology, 41, 310-312. https://doi.org/10.1093/ije/dyr180
[139]
Meyrowitsch, D. (2019) The Myth of Male Circumcision and Sexual Dysfunction The Guardian.
https://www.theguardian.com/society/2019/jul/24/the-myth-of-male-circumcision-and-sexual-dysfunction
[140]
Murray, J. (2011) Male Circumcison. Interview of Dr Morten Frisch and Professor Michael King. Woman’s Hour (Podcast), BBC Radio 4.
http://www.bbc.co.uk/programmes/b011zzh8
[141]
Frisch, M. (2013) Circumcision and Sexual Function Difficulties. Bonobo 3D.
https://www.youtube.com/watch?v=yfGkZZ-KzpU
[142]
Fergusson, D.M., Lawton, J.M. and Shannon, F.T. (1988) Neonatal Circumcision and Penile Problems: An 8-Year Longitudinal Study. Pediatrics, 81, 537-541.
[143]
Fergusson, D.M., Boden, J.M. and Horwood, L.J. (2008) Neonatal Circumcision: Effects on Breastfeeding and Outcomes Associated with Breastfeeding. Journal of Paediatrics and Child Health, 44, 44-49.
[144]
Moreton, S. (2019) Circumcision Causes Psychological Damage. Circfacts.org. Real Facts about Male Circumcision.
http://circfacts.org/medical-benefits/risks-complications/#risk6
[145]
Morris, B.J. and Waskett, J.H. (2012) Claims That Circumcision Increases Alexithymia and Erectile Dysfunction Are Unfounded: A Critique of Bollinger and Van Howe’s “Alexithymia and Circumcision Trauma: A Preliminary Investigation”. International Journal of Men’s Health, 11, 177-181.
https://doi.org/10.3149/jmh.1102.177
[146]
Mohl, P.C., Adams, R., Greer, D.M. and Sheley, K.A. (1981) Prepuce Restoration Seekers: Psychiatric Aspects. Archives of Sexual Behavior, 10, 383-393.
https://doi.org/10.1007/BF01565542
[147]
Fenwick, A.S. and Sullivan, K.A. (2011) Potential Link between Body Dysmorphic Disorder Symptoms and Alexithymia in an Eating-Disordered Treatment-Seeking Sample. Psychiatry Research, 189, 299-304.
https://doi.org/10.1016/j.psychres.2011.07.011
[148]
Taylor, G.J., Bagby, R.M. and Parker, J.D.A. (1997) Disorders of Affect Regulation: Alexithymia in Medical and Psychiatric Illness. Cambridge University Press, Cambridge. https://doi.org/10.1017/CBO9780511526831
[149]
Rescorla, L.A., Achenbach, T.M., Ivanova, M.Y., et al. (2011) International Comparisons of Behavioral and Emotional Problems in Preschool Children: Parents’ Reports from 24 Societies. Journal of Clinical Child & Adolescent Psychology, 40, 456-467. https://doi.org/10.1080/15374416.2011.563472
[150]
Rescorla, L., Achenbach, T.M., Ivanova, M.Y., et al. (2007) Behavioral and Emotional Problems Reported by Parents of Children Ages 6 to 16 in 31 Societies. Journal of Emotional and Behavioral Disorders, 15, 130-142.
https://doi.org/10.1177/10634266070150030101
[151]
Mason, O., Tyson, M., Jones, C. and Potts, S. (2005) Alexithymia: Its Prevalence and Correlates in a British Undergraduate Sample. Psychology and Psychotherapy, 78, 113-125. https://doi.org/10.1348/147608304X21374
[152]
Bollinger, D. and Van Howe, R. (2012) Preliminary Results Are Preliminary, Not “Unfounded”: Reply to Morris and Waskett. International Journal of Men’s Health, 11, 181-184.
[153]
Circumcision Choice (2019) Intactivism Is a Mental Disorder. CircumcisionChoice.com. https://www.circumcisionchoice.com/single-post/MentalDisorder
[154]
Laumann, E.O., Masi, C.M. and Zuckerman, E.W. (1997) Circumcision in the United States. Prevalence, Prophyactic Effects, and Sexual Practice. Journal of the American Medical Association, 277, 1052-1057.
https://doi.org/10.1001/jama.1997.03540370042034
[155]
Crosby, R. and Charnigo, R.J. (2013) A Comparison of Condom Use Perceptions and Behaviours between Circumcised and Intact Men Attending Sexually Transmitted Disease Clinics in the United States. International Journal of STD & AIDS, 24, 175-178. https://doi.org/10.1177/0956462412472444
[156]
Crosby, R.A., Graham, C.A., Mena, L., et al. (2016) Circumcision Status Is Not Associated with Condom Use and Prevalence of Sexually Transmitted Infections among Young Black MSM. AIDS and Behavior, 20, 2538-2542.
https://doi.org/10.1007/s10461-015-1212-x
[157]
Moreton, S. (2017) Risk Compensation—An Intactivist Half-Truth. CircFacts.org. Real Facts about Male Circumcision.
http://circfacts.org/medical-benefits/hivaids/#hiv3
[158]
American Psychiatric Association (2013) Diagnostic & Statistical Manual 5th Revision (DSM-5). http://www.dsm5.org/Pages/Default.aspx
[159]
Kafka, M.P. (2010) The DSM Diagnostic Criteria for Paraphilia Not Otherwise Specified. Archives of Sexual Behavior, 39, 373-376.
https://doi.org/10.1007/s10508-009-9552-0
[160]
Schultheiss, D., Truss, M.C., Stief, C.G. and Jonas, U. (1998) Uncircumcision: A Historical Review of Preputial Restoration. Plastic and Reconstructive Surgery, 101, 1990-1998. https://doi.org/10.1097/00006534-199806000-00037
[161]
Yahoo Questions (2015) Should I Get Re-Circumcised after 20 Years and Restoring Improperly? Yahoo.com.
https://answers.yahoo.com/question/index?qid=20100401174412AARIqlC
[162]
Walter, G. and Streimer, J. (1990) Genital Self-Mutilation: Attempted Foreskin Reconstruction. British Journal of Psychiatry, 156, 125-127.
https://doi.org/10.1192/bjp.156.1.125
[163]
Hoffman, B.L., Felter, E.M., Chu, K.H., et al. (2019) It’s Not All about Autism: The Emerging Landscape of Anti-Vaccination Sentiment on Facebook. Vaccine, 37, 2216-2223. https://doi.org/10.1016/j.vaccine.2019.03.003
Circumcision Choice (2018) How Should Intactivists Respond If One of Their Own Bombs a Hospital. CircumcisionChoce.com.
https://www.circumcisionchoice.com/single-post/McVeigh
Williams, N. and Kapila, L. (1993) Complications of Circumcision. British Journal of Surgery, 80, 1231-1236. https://doi.org/10.1002/bjs.1800801005
[168]
Hung, Y.C., Chang, D.C., Westfal, M.L., et al. (2019) A Longitudinal Population Analysis of Cumulative Risks of Circumcision. Journal of Surgical Research, 233, 111-117. https://doi.org/10.1016/j.jss.2018.07.069
[169]
Darby, R. (2015) Risks, Benefits, Complications and Harms: Neglected Factors in the Current Debate on Non-Therapeutic Circumcision. Kennedy Institute of Ethics Journal, 25, 1-34. https://doi.org/10.1353/ken.2015.0004
[170]
Immerman, R.S. and Mackey, W.C. (1998) A Proposed Relationship between Circumcision and Neural Reorganization. Journal of Genetic Psychology, 159, 367-378.
https://doi.org/10.1080/00221329809596158
[171]
Ullmann, E., Licinio, J., Barthel, A., et al. (2017) Circumcision Does Not Alter Long-Term Glucocorticoids Accumulation or Psychological Effects Associated with Trauma- and Stressor-Related Disorders. Translational Psychiatry, 7, e1063.
https://doi.org/10.1038/tp.2017.23
[172]
Calnan, M., Douglas, J.W.B. and Goldstein, H. (1978) Tonsillectomy and Circumcision: Comparison of Two Cohorts. International Journal of Epidemiology, 7, 79-85.
https://doi.org/10.1093/ije/7.1.79
[173]
Stenram, A., Malmfors, G. and Okmian, L. (1986) Circumcision for Phimosis—Indications and Results. Acta Paediatrica Scandinavica, 75, 321-323.
https://doi.org/10.1111/j.1651-2227.1986.tb10207.x
[174]
Stenram, A., Malmfors, G. and Okmian, L. (1986) Circumcision for Phimosis: A Follow-Up Study. Scandinavian Journal of Urology and Nephrology, 20, 89-92.
https://doi.org/10.3109/00365598609040554
[175]
Tinari, P.D. (2009) MRI Studies: The Brain Permanently Altered from Infant Circumcision. Peaceful Parenting.
http://www.drmomma.org/2009/10/mri-studies-brain-permanently-altered.html
[176]
Schaab, M.L. (2017) MRI Scans and Circumcision Brain Damage. The Lie That Just Won’t Die. http://circfacts.org/debunking-corner/#debk4
[177]
Marshall, R.E., Porter, F.L., Rogers, A.G., et al. (1982) Circumcision: II. Effects upon Mother-Infant Interaction. Early Human Development, 7, 367-374.
https://doi.org/10.1016/0378-3782(82)90038-X
[178]
United Nations Human Rights Office of the High Commissioner for Human Rights (1989) Convention on the Rights of the Child. 44/25 20 November 1989.
http://www.ohchr.org/en/professionalinterest/pages/crc.aspx
[179]
Clark, P.A., Eisenman, J. and Szapor, S. (2007) Mandatory Neonatal Male Circumcision in Sub-Saharan Africa: Medical and Ethical Analysis. Medical Science Monitor, 13, RA205-RA213.
[180]
Mazor, J. (2013) The Child’s Interests and the Case for the Permissibility of Male Infant Circumcision. Journal of Medical Ethics, 39, 421-428.
https://doi.org/10.1136/medethics-2013-101318
[181]
Brusa, M. and Barilan, Y.M. (2009) Cultural Circumcision in EU Public Hospitals—An Ethical Discussion. Bioethics, 23, 470-482.
https://doi.org/10.1111/j.1467-8519.2008.00683.x
[182]
Adler, P.W. (2016) The Draft CDC Circumcision Recommendations: Medical, Ethical, Legal, and Procedural Concerns. International Journal of Children’s Rights, 24, 237-262. https://doi.org/10.1163/15718182-02402001
[183]
Svoboda, J.S., Adler, P.W. and Van Howe, R.S. (2016) Circumcision Is Unethical and Unlawful. Journal of Law, Medicine & Ethics, 44, 263-282.
https://doi.org/10.1177/1073110516654120
[184]
Centers for Disease Control and Prevention (2014) Recommendations for Providers Counseling Male Patients and Parents Regarding Male Circumcision and the Prevention of HIV Infection, STIs, and Other Health Outcomes. Docket No. CDC-2014-0012-0002.
http://www.regulations.gov/#!documentDetail;D=CDC-2014-0012-0002
[185]
Svoboda, J.S. and Van Howe, R.S. (2013) Out of Step: Fatal Flaws in the Latest AAP Policy Report on Neonatal Circumcision. Journal of Medical Ethics, 39, 434-441.
https://doi.org/10.1136/medethics-2013-101346
[186]
Earp, B.D. (2015) Do the Benefits of Male Circumcision Outweigh the Risks? A Critique of the Proposed CDC Guidelines. Frontiers in Pediatrics, 3, 18.
https://doi.org/10.3389/fped.2015.00018
[187]
Johns Hopkins University (2015) Hippocratic Oath, Modern Version.
https://guides.library.jhu.edu/bioethics/codes
[188]
Hammond, T. (2016) Global Survey of Circumcision Harm.
http://www.circumcisionharm.org
[189]
Hammond, T. (2011) Global Survey of Circumcision Harm.
http://www.circumcisionharm.org/survey.htm
[190]
Morris, B.J., Krieger, J.N. and Kigozi, G. (2013) Male Circumcision Decreases Penile Sensitivity as Measured in a Large Cohort. BJU International, 111, E269-E270.
https://doi.org/10.1111/bju.12128_9
[191]
Bronselaer, G.A., Schober, J.M., Meyer-Bahlburg, H.F., et al. (2013) Male Circumcision Decreases Penile Sensitivity as Measured in a Large Cohort. BJU International, 111, 820-827. https://doi.org/10.1111/j.1464-410X.2012.11761.x
[192]
Risser, J.M., Risser, W.L., Eissa, M.A., et al. (2004) Self-Assessment of Circumcision Status by Adolescents. Americal Journal of Epidemiology, 159, 1095-1097.
https://doi.org/10.1093/aje/kwh149
[193]
Yahoo Answers (2011) Should I Hate My Parents for Circumcising Me?
https://answers.yahoo.com/question/index?qid=20110227140835AAsZGfE
[194]
Bay Area Intactivists (2016) Incredibly Sad News: Jonathon Conte Has Taken His Own Life. http://www.bayareaintactivists.org/node/334
[195]
Intaction (2017) In Memoriam Kevin Cagle. Young Man’s Anguish over Circumcision Ends in Suicide. The Death of Kevin Cagle.
http://intaction.org/kevin-cagle-circumcision-suicide
[196]
Conte, J. (2016) Motivations of an Intactivist.
http://intactnews.org/node/134/1318099689/jonathon-conte-motivations-intactivist
[197]
Hammond, T. (1999) A Preliminary Poll of Men Circumcised in Infancy or Childhood. BJU International, 83, 85-92.
https://www.ncbi.nlm.nih.gov/pubmed/?term=hammond+bju+int+1999
[198]
Intact America (2014) Intactivist of the Month: Dr. Adrian Carmack. IntactAmerica.org. http://www.intactamerica.org/iotm_october2014
[199]
Kabwama, S.N., Ssewanyana, D. and Berg-Beckhoff, G. (2018) The Association between Male Circumcision and Condom Use Behavior—A Meta-Analysis. Mater Sociomed, 30, 62-66. https://doi.org/10.5455/msm.2018.30.62-66
