Circumcision

{{Short description|Removal of the human foreskin}} {{Distinguish|Female circumcision}} {{For|the paintings|The Circumcision (disambiguation){{!}}''The Circumcision''}} {{pp-vandalism|small=yes}}  {{Use dmy dates|date=March 2026}} {{cs1 config|name-list-style=vanc|display-authors=6}} {{Infobox medical intervention | Name = Circumcision | Image = Circumcision illustration.jpg | Caption = Circumcision surgery with hemostats and scissors | ICD10 = Z41.2 | ICD9 = {{ICD9|V50.2}} | ICD9_mult = | MeshID = D002944 | OPS301 = {{OPS301|5–640}}.2 | OtherCodes = | MedlinePlus = 002998 | eMedicine = 1015820 }}

'''Circumcision''' is a surgical procedure that removes the foreskin from the human penis. In the procedure's most common form, the foreskin is extended with forceps, then a circumcision device may be placed, after which the foreskin is excised. Topical or locally injected anesthesia is generally used to reduce pain and physiologic stress.<ref name=AAP_2012 /> Circumcision is undertaken for religious, cultural, social, and medical reasons.<ref name=WHO_2007_GTDPSA /> It may be medically necessary in cases of phimosis, chronic urinary tract infections (UTIs),<ref name="lissauer_2012" /><ref name="hay_2012" /> and other pathologies of the penis that do not resolve with other treatments. The procedure is contraindicated in cases of certain genital structure abnormalities or poor general health.<ref name="hay_2012" /><ref name=rudolph_2011 />

The procedure is associated with reduced rates of urinary tract infections and sexually transmitted infections<ref name="yuan" /> including incidence of cancer-causing forms of human papillomavirus (HPV) and reducing HIV transmission among heterosexual men in high-risk populations by up to 60%;<ref name="AAP_2012" /><ref name="rehmeyer_2011" /><ref name="larke_HPV_2011" /> <ref name="Chikutsa-2015" /><ref>{{Cite journal |last1=Sharma |first1=Adhikarimayum Lakhikumar |last2=Hokello |first2=Joseph |last3=Tyagi |first3=Mudit |date=25 June 2021 |title=Circumcision as an Intervening Strategy against HIV Acquisition in the Male Genital Tract |journal=Pathogens |volume=10 |issue=7 |page=806 |doi=10.3390/pathogens10070806 |doi-access=free |pmc=8308621 |pmid=34201976}}</ref> its prophylactic efficacy against HIV transmission in the developed world or among men who have sex with men is debated.<ref>{{Cite journal |last1=Auvert |first1=Bertran |last2=Taljaard |first2=Dirk |last3=Lagarde |first3=Emmanuel |last4=Sobngwi-Tambekou |first4=Joëlle |last5=Sitta |first5=Rémi |last6=Puren |first6=Adrian |date=November 2005 |title=Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial |journal=PLOS Medicine |volume=2 |issue=11 |pages=e298 |doi=10.1371/journal.pmed.0020298 |doi-access=free |issn=1549-1676 |pmc=1262556 |pmid=16231970}}</ref><ref name="WHO-2010b" /><ref name="siegfried_Cochrane_2009" /><ref name="Merson-2017" /> Neonatal circumcision decreases the risk of penile cancer.<ref name="Thomas_2021" /> Complication rates increase significantly with age.<ref name="weiss_2010_complications" /> Bleeding, infection, and the removal of either too much or too little foreskin are the most common acute complications, while meatal stenosis is the most common long-term.<ref name="Selekman-2020" /> There are various cultural, social, legal, and ethical views on circumcision. Major medical organizations hold differing views on circumcision's prophylactic efficacy in developed countries. Some medical organizations take the position that it carries prophylactic health benefits that outweigh the risks, while others hold that its medical benefits are not sufficient to justify it.<ref name="Gable-2007" /><ref name="WHO-2010a" /><ref name="Bolnick_2012_ch1" /><ref name="caga-anan_2011" />

Circumcision is one of the world's most common and oldest medical procedures, with 37–39% of men globally circumcised.<ref name="WHO_2007_GTDPSA" /><ref>{{Cite journal |last1=Morris |first1=Brian J. |last2=Wamai |first2=Richard G. |last3=Henebeng |first3=Esther B. |last4=Tobian |first4=Aaron Ar |last5=Klausner |first5=Jeffrey D. |last6=Banerjee |first6=Joya |last7=Hankins |first7=Catherine A. |date=2016 |title=Estimation of country-specific and global prevalence of male circumcision |journal=Population Health Metrics |volume=14 |article-number=4 |doi=10.1186/s12963-016-0073-5 |doi-access=free |pmc=4772313 |pmid=26933388}}</ref> Prophylactic usage originated in England during the 1850s and has since spread globally, becoming established as a way to prevent sexually transmitted infections.<ref name="Al-Salem-2016" /><ref name = "Afshar_2018" /> Beyond use as a prophylactic or treatment option in healthcare, circumcision plays a major role in many of the world's cultures and religions, most prominently Judaism and Islam. Circumcision is among the most important commandments in Judaism and considered obligatory.<ref name="Mark-2003a" /><ref name="Hamilton-1990" /> In some African and Eastern Christian denominations male circumcision is required.<ref name="N. Stearns 2008 179" /><ref>{{cite book|title=Cultural Encyclopedia of the Body [2 volumes]|first=Victoria |last=Pitts-Taylor|year= 2008| isbn= 978-1-56720-691-3| page =394|publisher=ABC-CLIO|quote=For most part, Christianity does not require circumcision of its followers. Yet, some Orthodox and African Christian groups do require circumcision. These circumcisions take place at any point between birth and puberty.}}</ref> It is widespread in the United States, South Korea, the Philippines, Israel, Muslim-majority countries, and most of Africa.<ref name="WHO_2007_GTDPSA" /> It is relatively rare for non-religious reasons in Latin America, Europe, Australia, most of Asia, and parts of Southern Africa.<ref name="WHO_2007_GTDPSA" /> The origin of circumcision is not known with certainty, but the oldest documentation comes from ancient Egypt.<ref name="WHO_2007_GTDPSA" /><ref name="Doy2005" /><ref name="alanis_2004" /><ref>{{Cite journal |last1=Morris |first1=Brian J. |last2=Wamai |first2=Richard G. |last3=Henebeng |first3=Esther B. |last4=Tobian |first4=Aaron AR |last5=Klausner |first5=Jeffrey D. |last6=Banerjee |first6=Joya |last7=Hankins |first7=Catherine A. |date=1 March 2016 |title=Estimation of country-specific and global prevalence of male circumcision |journal=Population Health Metrics |volume=14 |issue=1 |pages=1–13 |article-number=4 |doi=10.1186/s12963-016-0073-5 |pmid=26933388 |pmc=4772313 |doi-access=free }}</ref>

== Uses ==

=== Disease prevention === Approximately half of all circumcisions worldwide are performed for reasons of prophylactic healthcare.<ref name="hay_2012" />

==== Prophylactic usage in high-risk populations ==== [[File:South Africa 1 millionth Voluntary Medical Male Circumcision (40944402290).jpg|thumb|Actor Melusi Yeni became the 1 millionth VMMC against HIV/AIDS transmission in the province of KwaZulu-Natal, South Africa.<ref>{{Cite web | vauthors = Seeth A |date=1 June 2018 |title='It's hassle-free,' says actor Melusi Yeni about his medical circumcision |url=https://www.news24.com/citypress/news/its-hassle-free-says-actor-melusi-yeni-about-his-medical-circumcision-20180601 |access-date=5 May 2022 |website=News24 |quote=Actor Melusi Yeni was the millionth man to undergo voluntary male medical circumcision at the Sivananda Clinic in KwaZulu-Natal. |archive-date=5 May 2022 |archive-url=https://web.archive.org/web/20220505072202/https://www.news24.com/citypress/news/its-hassle-free-says-actor-melusi-yeni-about-his-medical-circumcision-20180601 |url-status=live }}</ref>]] There is a consensus among the world's major medical organizations and in the academic literature that circumcision is an efficacious intervention for HIV prevention in high-risk populations if carried out by medical professionals under safe conditions.<ref name="WHO-PrevHIV">{{cite web |year=2020 |title=Preventing HIV Through Safe Voluntary Medical Male Circumcision For Adolescent Boys And Men In Generalized HIV Epidemics |url=https://www.who.int/publications/i/item/978-92-4-000854-0 |url-status=live |archive-url=https://web.archive.org/web/20211122140037/https://www.who.int/publications/i/item/978-92-4-000854-0 |archive-date=22 November 2021 |access-date=24 May 2021 |publisher=World Health Organization}}</ref><ref name="siegfried_Cochrane_2009" /><ref name="Chikutsa-2015">For sources on this, see: * {{Cite book | vauthors = Bell K |title=Health and Other Unassailable Values: Reconfigurations of Health, Evidence and Ethics |publisher=Taylor & Francis |year=2016 |isbn=978-1-317-48203-1 |page=106 |quote=...defending the casual relation between male circumcision and reduced HIV transmission has become essentially hegemonic in the academic literature.}} * {{Cite book | vauthors = Merson M, Inrig S |title=The AIDS Pandemic: Searching for a Global Response |publisher=Springer International Publishing |year=2017 |isbn=978-3-319-47133-4 |page=379}}</ref>

In 2007, the WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended adolescent and adult circumcision as part of a comprehensive program for prevention of HIV transmission in areas with high endemic rates of HIV, as long as the program includes "informed consent, confidentiality, and absence of coercion"—known as voluntary medical male circumcision, or VMMC.<ref name="WHO-PrevHIV" /> In 2010, this expanded to routine neonatal circumcision, as long as the infant's parents consented.<ref name="WHO-2010a" /> In 2020, the WHO again concluded that male circumcision is an efficacious intervention for HIV prevention and that male circumcision is an essential strategy, in addition to other measures, to prevent heterosexually acquired HIV infection in men. Eastern and southern Africa had a particularly low prevalence of circumcised males. This region has a disproportionately high HIV infection rate, with a significant number of infections stemming from heterosexual transmission. As a result, the promotion of prophylactic circumcision has been a priority intervention in that region since the WHO's 2007 recommendations.<ref name="WHO-PrevHIV" /><ref name="WHO-2010a" /> The International Antiviral Society–USA also suggests circumcision be discussed with men who have insertive anal sex with men, especially in regions where HIV is common.<ref name="Marrazzo et al. 2014" /> There is evidence that circumcision is associated with a reduced risk of HIV infection for such men, particularly in low-income countries.<ref name="yuan">{{cite journal | vauthors = Yuan T, Fitzpatrick T, Ko NY, Cai Y, Chen Y, Zhao J, Li L, Xu J, Gu J, Li J, Hao C, Yang Z, Cai W, Cheng CY, Luo Z, Zhang K, Wu G, Meng X, Grulich AE, Hao Y, Zou H | title = Circumcision to prevent HIV and other sexually transmitted infections in men who have sex with men: a systematic review and meta-analysis of global data | journal = The Lancet. Global Health | volume = 7 | issue = 4 | pages = e436–e447 | date = April 2019 | pmid = 30879508 | pmc = 7779827 | doi = 10.1016/S2214-109X(18)30567-9 | type = Mata-analysis }}</ref>

The finding that circumcision significantly reduces female-to-male HIV transmission has prompted medical organizations serving communities affected by endemic HIV/AIDS to promote circumcision as a method of controlling the spread of HIV.<ref name="Bolnick_2012_ch1" />

==== Prophylactic usage in developed countries ==== [[File:Elizabeth Mataka, 2009 World Economic Forum on Africa.jpg|thumb|Elizabeth Mataka, UN Secretary-General's Special Envoy for AIDS in Africa, speaking at the session "From Evidence to Implementation: Promoting Male Circumcision in Africa" during the World Economic Forum on Africa 2009 in Cape Town, South Africa, 11 June 2009.]] Major medical organizations hold varying positions on the prophylactic efficacy of the elective circumcision of minors in developed countries.<ref name="Bolnick_2012_ch1" /> Literature on the matter is polarized, with the cost-benefit analysis highly dependent on the kinds and frequencies of health problems in the population under discussion and how circumcision affects them.<ref name="caga-anan_2011" /><ref name="pinto_2012" /><ref name="Wapner-2015">{{Cite web| vauthors = Wapner J |date=24 February 2015|title=The Troubled History of Foreskin|url=https://mosaicscience.com/story/troubled-history-foreskin/|website=Mosaic Science|quote=In the decades since, medical practice has come to rely increasingly on evidence from large research studies, which, as many American doctors see it, have supported the existing rationale... How can experts who have undergone similar training evaluate the same studies and come to opposing conclusions? I've spent months scrutinising the medical literature in an attempt to decide which side is right. The task turned out to be nearly impossible. That's partly because there is so much confused thinking around the risks and benefits of circumcision, even among trained practitioners.|access-date=3 February 2022|archive-date=26 December 2021|archive-url=https://web.archive.org/web/20211226154538/https://mosaicscience.com/story/troubled-history-foreskin/|url-status=live}}</ref>

The World Health Organization (WHO), UNAIDS, and American medical organizations take the position that its prophylactic health benefits outweigh the risks, while European, Australian, and New Zealand medical organizations generally hold that its medical benefits are insufficient to justify it.<ref name="Gable-2007" /><ref name="WHO-2010a" /><ref name="Bolnick_2012_ch1" /><ref name="caga-anan_2011" /> Advocates of circumcision recommend performing it during the neonatal period when it is less expensive and has a lower risk of complications.<ref name="pinto_2012">{{cite journal | vauthors = Pinto K | title = Circumcision controversies | journal = Pediatric Clinics of North America | volume = 59 | issue = 4 | pages = 977–986 | date = August 2012 | pmid = 22857844 | doi = 10.1016/j.pcl.2012.05.015 }}</ref> The American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and Centers for Disease Control and Prevention have said that circumcision's potential benefits outweigh the risks.<ref name="AAP_2012" /><ref name="Press 2024">{{cite journal |vauthors=Press B, Jalfon M, Solomon D, Hittelman AB |title=Clinical and environmental considerations for neonatal, office-based circumcisions compared with operative circumcisions |journal=Frontiers in Urology |volume=4 |date=July 2024 |article-number=1380154 |doi=10.3389/fruro.2024.1380154 |pmid=40777091 |pmc=12327250 |doi-access=free |quote=Neonatal circumcision is supported by both the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG) due to the belief that the health benefits outweigh the minimal risk of the procedure.}}</ref><ref>{{Cite web |title=Background, Methods, and Synthesis of Scientific Information Used to Inform "Information for Providers to Share with Male Patients and Parents Regarding Male Circumcision and the Prevention of HIV Infection, Sexually Transmitted Infections, and other Health Outcomes" |url=https://stacks.cdc.gov/view/cdc/58457 |access-date=12 October 2023 |website=stacks.cdc.gov |date=22 August 2018 |archive-date=22 October 2023 |archive-url=https://web.archive.org/web/20231022115215/https://stacks.cdc.gov/view/cdc/58457 |url-status=live }}</ref>

In 2010, the World Health Organization said:<ref name="WHO-2010a" />

{{Blockquote|There are significant benefits in performing male circumcision in early infancy, and programmes that promote early infant male circumcision are likely to have lower morbidity rates and lower costs than programmes targeting adolescent boys and men.<ref name="WHO-2010a" /> }}

=== Pathologies === Circumcision is also used to treat various pathologies. These include pathological phimosis, refractory balanoposthitis and chronic or recurrent urinary tract infections (UTIs).<ref name="lissauer_2012" /><ref name="hay_2012" />

== Contraindications == Circumcision is contraindicated in certain cases.<ref name="rudolph_2011" /><ref name="hay_2012" /><ref name="Jhpiego-2009" />

These include infants with certain genital structure abnormalities, such as a misplaced urethral opening (as in hypospadias and epispadias), curvature of the head of the penis (chordee), or ambiguous genitalia, because the foreskin may be needed for reconstructive surgery. Circumcision is contraindicated in premature infants and those who are not clinically stable and in good health.<ref name="rudolph_2011" /><ref name="hay_2012" /><ref name="Jhpiego-2009" />

If a person is known to have or has a family history of serious bleeding disorders such as hemophilia, it is recommended that the blood be checked for normal coagulation properties before the procedure is attempted.<ref name="hay_2012" /><ref name="Jhpiego-2009" />

==Technique== {{Main|Circumcision surgical procedure}}

[[File:Adult circumcision before and after.jpg|thumb|Before (left) and after (right) an adult circumcision that was undertaken to treat phimosis. After the operation, the glans is exposed even when the penis is flaccid.]]

The foreskin is the double-layered fold of tissue at the distal end of the human penis that covers the glans and the urinary meatus.<ref name=WHO_2007_GTDPSA/> Different amounts of skin can be removed during circumcision. The practice is differentiated from other surgeries for the treatment of phimosis or treatment-resistant infection by the complete removal of the preputial orifice. thumb|Erect comparison of the penis, one (left) is uncircumcised, while the other (right) is circumcised For adult medical circumcision, superficial wound healing takes up to a week, and complete healing 4 to 6 months.<ref>{{Cite web |title=What to Expect After Circumcision: "Most of the swelling will be gone within a month but it takes up to 6 months for all of the swelling to go away." |url=https://umc.edu/Childrens/Childrens%20Urology/Patient%20Resources/What-to-Expect-After-Circumcision.html |access-date=14 May 2025 |website=University of Mississippi Medical Center}}</ref> For infants, healing is usually complete within one week.<ref name="Medline 2023">{{cite web |title=Circumcision - series—Aftercare |website=A.D.A.M. Medical Encyclopedia |date=6 November 2023 |url=https://medlineplus.gov/ency/presentations/100081_4.htm |access-date=31 March 2026 |quote=For both newborns and older children, circumcision is considered a very safe procedure with complete healing expected. Healing time for newborns usually takes about 1 week.}}</ref><ref name="Jhpiego-2009">{{cite web | author1 =World Health Organization | author2 = UNAIDS | author3 = Jhpiego (Johns Hopkins Program for International Education in Gynecology and Obstetrics) |date=December 2009 |title=Manual for Male Circumcision Under Local Anaesthesia |url=https://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=15 January 2012 |publisher= |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. |author1-link=World Health Organization |author2-link=UNAIDS |author3-link=Jhpiego }} [https://www.scribd.com/document/186396682/Who-Mc-Local-Anaesthesia Alt URL] {{Webarchive|url=https://web.archive.org/web/20230330035156/https://www.scribd.com/document/186396682/Who-Mc-Local-Anaesthesia |date=30 March 2023 }}</ref>

===Removal of the foreskin=== thumb|Different circumcision results based on cut placement and skin tension (left to right): high & loose, high & tight, low & loose, low & tight. For infant circumcision, devices such as the Gomco clamp, Plastibell and Mogen clamp are commonly used in the USA.<ref name=AAP_2012/> These follow the same basic procedure. First, the amount of foreskin to be removed is estimated. The practitioner opens the foreskin via the preputial orifice to reveal the glans underneath and ensures it is normal before bluntly separating the inner lining of the foreskin (preputial epithelium) from its attachment to the glans. The practitioner then places the circumcision device (this sometimes requires a dorsal slit), which remains until blood flow has stopped. Finally, the foreskin is amputated.<ref name=AAP_2012/> For older babies and adults, circumcision is often performed surgically without specialized instruments,<ref name="Jhpiego-2009" /> and alternatives such as Unicirc, Shang ring or stapler circumcision are available.<ref name=WHO_adult_devices_2012/>Depending on the specific surgical technique or anatomical requirements, the frenulum—an elastic band of tissue on the underside of the penis—may be either preserved or excised during the surgery. If this tissue is removed concurrently, the adjunctive procedure is known as a penile frenulectomy.<ref name="Campbell2020">{{cite book |editor-last=Partin |editor-first=Alan W. |title=Campbell-Walsh-Wein Urology |publisher=Elsevier |year=2020 |edition=12th |volume=1 |isbn=978-0323546423 |chapter=Chapter 61: Penile and Urethral Reconstructive Surgery |pages=1325–1326}}</ref><ref name="WHO2009_Circ">{{cite book |title=Manual for male circumcision under local anaesthesia |publisher=World Health Organization |year=2009 |isbn=978-9241597401 |url=https://iris.who.int/handle/10665/44145 |pages=44–50 |access-date=25 March 2026}}</ref>

===Pain management=== The circumcision procedure causes pain, and for neonates this pain may interfere with mother-infant interaction or cause other behavioral changes,<ref name=perera_2010/> so the use of analgesia is advocated and required by law in some countries.<ref name=AAP_2012/><ref name=CPSBC_2009/> Ordinary procedural pain may be managed in pharmacological and non-pharmacological ways. Pharmacological methods, such as localized or regional pain-blocking injections and topical analgesic creams, are safe and effective.<ref name=AAP_2012/><ref name=lonngvist_2010/><ref name=shockley_2011/> The ring block and dorsal penile nerve block (DPNB) are the most effective at reducing pain, and the ring block may be more effective than the DPNB. They are more effective than EMLA (eutectic mixture of local anesthetics) cream, which is more effective than a placebo.<ref name=lonngvist_2010/><ref name=shockley_2011/> Topical creams have been found to irritate the skin of low birth weight infants, so penile nerve block techniques are recommended in this group.<ref name=AAP_2012/> Circumcision is contraindicated for premature babies partially because of complications with anesthesia.<ref name="hay_2012" /><ref name="rudolph_2011" /> thumb|right|upright=0.8|An open Mogen Clamp. In use the foreskin would be pulled through the opening and then the clamp closed and locked, crushing the foreskin. For infants, non-pharmacological methods such as the use of a comfortable, padded chair and a sucrose or non-sucrose pacifier are more effective at reducing pain than a placebo,<ref name=shockley_2011/> but the American Academy of Pediatrics (AAP) states that such methods are insufficient alone and should be used to supplement more effective techniques.<ref name=AAP_2012/> A quicker procedure reduces duration of pain; use of the Mogen clamp was found to result in a shorter procedure time and less pain-induced stress than the use of the Gomco clamp or the Plastibell.<ref name=shockley_2011/> The available evidence does not indicate that post-procedure pain management is needed.<ref name=AAP_2012/> Some doctors recommend the use of petroleum jelly to prevent blood from adhering the genitals to the diaper during healing. For adults, topical anesthesia, ring block, dorsal penile nerve block (DPNB) and general anesthesia are all options,<ref name=wolter_2008/> and the procedure requires four to six weeks of abstinence from masturbation or intercourse to allow the wound to heal.<ref name="Jhpiego-2009" />

=== Healing and tissue remodeling === thumb|right|upright=0.8|Before (left) and after (right) comparison of the penile appearance following the procedure. The healed state (right) illustrates the physical results of structural tissue remodeling. Following the excision of the foreskin, the surgical wound undergoes the standard physiological phases of healing: hemostasis, inflammation, cellular proliferation, and tissue remodeling. Because circumcision severs the dense network of superficial blood vessels and lymphatic channels within the prepuce and dartos fascia, normal fluid drainage is temporarily interrupted. This disruption to the lymphatic system typically results in localized post-operative edema (swelling) around the incision line and the remaining mucosal collar.<ref name="Fahmy2020_Anatomy">{{cite book |last1=Fahmy |first1=MA |title=Normal and Abnormal Prepuce |publisher=Springer |year=2020 |isbn=978-3-030-37620-8 |chapter=Chapter 2: Anatomy of the Prepuce |pages=15–25 |doi=10.1007/978-3-030-37621-5}}</ref>

During the proliferative and remodeling phases of recovery, the body undergoes angiogenesis (the formation of new blood vessels) and lymphangiogenesis. The vascular and lymphatic networks are gradually reconstructed to establish new collateral drainage pathways across the surgical boundary.<ref name="StatPearls_WoundHealing">{{cite book |last1=Wallace |first1=Heather A. |last2=Basehore |first2=Brandon M. |last3=Zito |first3=Patrick M. |title=StatPearls |date=2026 |publisher=StatPearls Publishing |chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK470443/ |chapter=Wound Healing Phases |pmid=29262065 }}</ref> As this structural tissue remodeling matures over the weeks following the procedure, the post-operative swelling resolves and physiological fluid balance is restored to the penile skin.<ref name="Campbell2020_Recon">{{cite book |editor-last=Partin |editor-first=Alan W. |title=Campbell-Walsh-Wein Urology |publisher=Elsevier |year=2020 |edition=12th |volume=1 |isbn=978-0323546423 |chapter=Chapter 61: Penile and Urethral Reconstructive Surgery |pages=1325–1330}}</ref>

==Effects== ===Sexually transmitted infections===

====Human immunodeficiency virus==== {{See also|Circumcision in Africa#Circumcision to prevent the spread of human immunodeficiency virus in Africa}} {{excerpt|Circumcision and HIV|paragraphs=1-2}}

====Human papillomavirus==== Human papillomavirus (HPV) is the most commonly transmitted sexually transmitted infection, affecting both men and women. While most infections are asymptomatic and are cleared by the immune system, some types of the virus cause genital warts, and other types, if untreated, cause various forms of cancer, including cervical cancer and penile cancer. Genital warts and cervical cancer are the two most common problems resulting from HPV.<ref name=CDC_HPV/>

Circumcision is associated with a reduced prevalence of oncogenic types of HPV infection, meaning that a randomly selected circumcised man is less likely to be infected with cancer-causing types of HPV than an uncircumcised man.<ref name=hpv_prevalence_ref_bundle/><ref name=zhu>{{cite journal | vauthors = Zhu YP, Jia ZW, Dai B, Ye DW, Kong YY, Chang K, Wang Y | title = Relationship between circumcision and human papillomavirus infection: a systematic review and meta-analysis | journal = Asian Journal of Andrology | volume = 19 | issue = 1 | pages = 125–131 | date = 8 March 2016 | pmid = 26975489 | pmc = 5227661 | doi = 10.4103/1008-682X.175092 | doi-access = free }}</ref> It also decreases the likelihood of multiple infections.<ref name=rehmeyer_2011/> {{As of|2012}}, there was no strong evidence that it reduces the rate of new HPV infection,<ref name=larke_HPV_2011/><ref name=rehmeyer_2011/><ref name=albero_2012/> but the procedure is associated with increased clearance of the virus by the body,<ref name=larke_HPV_2011/><ref name=rehmeyer_2011/> which can account for the finding of reduced prevalence.<ref name=rehmeyer_2011/> HPV vaccination is the best method to prevent infection from HPV.<ref>{{cite web |title=Human papillomavirus and cancer |url=https://www.who.int/news-room/fact-sheets/detail/human-papilloma-virus-and-cancer |website=www.who.int |publisher=World Health Organisation |access-date=14 November 2025}}</ref>

Although genital warts are caused by a type of HPV, there is no statistically significant relationship between being circumcised and the presence of genital warts.<ref name=larke_HPV_2011/><ref name=zhu/><ref name=albero_2012/>

====Other infections==== Studies evaluating the effect of circumcision on the rates of other sexually transmitted infections have, generally, found it to be protective. A 2006 meta-analysis found that circumcision was associated with lower rates of syphilis, chancroid, and possibly genital herpes.<ref name=weiss_2006_syphilis /> A 2010 review found that circumcision reduced the incidence of HSV-2 (herpes simplex virus, type 2) infections by 28%.<ref name=wetmore_2010 /> The researchers found mixed results for protection against trichomonas vaginalis and chlamydia trachomatis, and no evidence of protection against gonorrhea or syphilis.<ref name=wetmore_2010/> It may also possibly protect against syphilis in MSM.<ref name=templeton_2010 />

===Phimosis, balanitis and balanoposthitis=== Phimosis is the inability to retract the foreskin over the glans penis.<ref name="hayashi_2011">{{cite journal | vauthors = Hayashi Y, Kojima Y, Mizuno K, Kohri K | title = Prepuce: phimosis, paraphimosis, and circumcision | journal = TheScientificWorldJournal | volume = 11 | pages = 289–301 | date = February 2011 | pmid = 21298220 | pmc = 5719994 | doi = 10.1100/tsw.2011.31 | doi-access = free }}</ref> At birth, the foreskin cannot be retracted due to adhesions between the foreskin and glans, and this is considered normal (physiological phimosis).<ref name="hayashi_2011"/> Over time the foreskin naturally separates from the glans, and a majority of boys are able to retract the foreskin by age three.<ref name="hayashi_2011"/> Less than one percent are still having problems at age 18.<ref name="hayashi_2011"/> If the inability to do so becomes problematic (pathological phimosis) circumcision is a treatment option.<ref name=lissauer_2012/><ref name=becker_2011/> A preputioplasty, where the foreskin is surgically widened instead of removed, is another possible surgical treatment option for phimosis.<ref>{{cite journal | vauthors = Balaji BS, Jacob TJ, Gowri MS | title = Acceptability and outcomes of foreskin preservation for phimosis: An Indian perspective | journal = Journal of Family Medicine and Primary Care | volume = 9 | issue = 5 | pages = 2297–2302 | date = May 2020 | pmid = 32754491 | pmc = 7380800 | doi = 10.4103/jfmpc.jfmpc_49_20 | doi-access = free }}</ref><ref name="pmid12949202">{{cite journal | vauthors = Barber NJ, Chappell B, Carter PG, Britton JP | title = Is preputioplasty effective and acceptable? | journal = Journal of the Royal Society of Medicine | volume = 96 | issue = 9 | pages = 452–53 | date = September 2003 | pmid = 12949202 | pmc = 539601 | doi = 10.1177/014107680309600909 }}</ref> This pathological phimosis may be due to scarring from the skin disease balanitis xerotica obliterans (BXO), repeated episodes of balanoposthitis or forced retraction of the foreskin.<ref name=":1">{{cite journal | vauthors = Moreno G, Ramirez C, Corbalán J, Peñaloza B, Morel Marambio M, Pantoja T | title = Topical corticosteroids for treating phimosis in boys | journal = The Cochrane Database of Systematic Reviews | volume = 1 | issue = 1 | article-number = CD008973 | date = January 2024 | pmid = 38269441 | pmc = 10809033 | doi = 10.1002/14651858.CD008973.pub3 }}</ref> Steroid creams are also a reasonable option and may prevent the need for surgery including in those with mild BXO.<ref name=":1" /><ref>{{cite journal | vauthors = Celis S, Reed F, Murphy F, Adams S, Gillick J, Abdelhafeez AH, Lopez PJ | title = Balanitis xerotica obliterans in children and adolescents: a literature review and clinical series | journal = Journal of Pediatric Urology | volume = 10 | issue = 1 | pages = 34–39 | date = February 2014 | pmid = 24295833 | doi = 10.1016/j.jpurol.2013.09.027 | doi-access = free }}</ref> The procedure may also be used to prevent the development of phimosis.<ref name=hay_2012/> Phimosis is also a complication that can result from circumcision.<ref name="Complications of circumcision">{{cite journal | vauthors = Krill AJ, Palmer LS, Palmer JS | title = Complications of circumcision | journal = TheScientificWorldJournal | volume = 11 | pages = 2458–2468 | date = 2011 | pmid = 22235177 | pmc = 3253617 | doi = 10.1100/2011/373829 | doi-access = free }}</ref>

An inflammation of the glans penis and foreskin is called balanoposthitis, and the condition affecting the glans alone is called balanitis.<ref name=leber_2006/><ref name=osipov_2006/> Most cases of these conditions occur in uncircumcised males,<ref name=aridogan_2011/> affecting 4{{endash}}11% of that group.<ref name=hayashi_2011/> The moist, warm space underneath the foreskin is thought to facilitate the growth of pathogens, particularly when hygiene is poor. Yeasts, especially ''Candida albicans'', are the most common penile infection and are rarely identified in samples taken from circumcised males.<ref name=aridogan_2011/> Both conditions are usually treated with topical antibiotics (metronidazole cream) and antifungals (clotrimazole cream) or low-potency steroid creams.<ref name=leber_2006/><ref name=osipov_2006/> Circumcision is a treatment option for refractory or recurrent balanoposthitis, but in the twenty-first century the availability of the other treatments has made it less necessary.<ref name=leber_2006/><ref name=osipov_2006/>

Phimosis also greatly increases the relative risk of penile cancer, and neonatal circumcision has been show to nearly eliminate this risk;<ref name="Thomas_2021" /><ref name="hayashi_2011" /> however, risk-benefit considerations around the use of circumcision as a cancer-preventive measure are a source of debate.<ref name=tpc>{{cite book |vauthors=Ottenhof SR, Bleeker MC, Heideman, DA, Snijders PJ, Meijer CJ, Horenblas S |chapter=Etiology of Penile Cancer |year=2016 |veditors=Muneer A, Horenblas S|title=Textbook of Penile Cancer |publisher=Springer |doi=10.1007/978-3-319-33220-8_2 |edition=2nd |pages=11–15 |isbn=978-3-319-33220-8}}</ref> Only 1% of males have phimosis by age 17.<ref name="hayashi_2011"/> The mitigating effect circumcision has on the risk factor introduced by the possibility of phimosis is secondary, in that the removal of the foreskin eliminates the possibility of phimosis. This can be inferred from study results that show uncircumcised men with no history of phimosis are equally likely to have penile cancer as circumcised men.<ref name=AAP_2012/><ref name=larke_penile_cancer_2011/>

===Urinary tract infections=== A UTI affects parts of the urinary system including the urethra, bladder, and kidneys. There is about a 1% risk of UTIs in boys under two years old, and most incidents occur in the first year of life. There is good but not ideal evidence that circumcision reduces the incidence of UTIs in boys under two, and there is fair evidence that the reduction in incidence is by a factor of 3 to 10 (100 circumcisions prevent one UTI).<ref name=AAP_2012/><ref name="MorrisWiswell2013">{{cite journal | vauthors = Morris BJ, Wiswell TE | title = Circumcision and lifetime risk of urinary tract infection: a systematic review and meta-analysis | journal = The Journal of Urology | volume = 189 | issue = 6 | pages = 2118–2124 | date = June 2013 | pmid = 23201382 | doi = 10.1016/j.juro.2012.11.114 }}</ref>{{COI source|sure=yes|date=March 2023}}<ref name=jagannath_2012/> Circumcision is most likely to benefit boys who have a high risk of UTIs due to anatomical defects<ref name=AAP_2012/> and may be used to treat recurrent UTIs.<ref name=lissauer_2012/>

There is a plausible biological explanation for the reduction in UTI risk after circumcision. The orifice through which urine passes at the tip of the penis (the urinary meatus) hosts more urinary system disease-causing bacteria in uncircumcised boys than in circumcised boys, especially in those under six months of age. As these bacteria are a risk factor for UTIs, circumcision may reduce the risk of UTIs through a decrease in the bacterial population.<ref name=AAP_2012/><ref name=jagannath_2012/>

===Other cancer causes=== The principal risks for penile cancer are HPV, Phimosis and smoking.<ref name="Giona 2022">{{cite book |vauthors=Giona S |title=Urologic Cancers |chapter=The Epidemiology of Penile Cancer |publisher=Exon Publications |date=12 September 2022 |isbn=978-0-6453320-5-6 |doi=10.36255/exon-publications-urologic-cancers-epidemiology-penile-cancer |doi-access=free |url=https://exonpublications.com/index.php/exon/article/download/epidemiology-of-penile-cancer/1143 |access-date=30 October 2025 |pages=131–139 |pmid=36343135 }}</ref> There is also an association between adult circumcision and an increased risk of invasive penile cancer; this is believed to be from men being circumcised as a treatment for penile cancer or a condition that is a precursor to cancer rather than a consequence of circumcision itself.<ref name="larke_penile_cancer_2011" />

There is some evidence that circumcision is associated with reduced risk of prostate cancer.<ref name=prost>{{cite journal | vauthors = Morris BJ, Matthews JG, Pabalan N, Moreton S, Krieger JN | title = Male circumcision and prostate cancer: a meta-analysis revisited | journal = The Canadian Journal of Urology | volume = 28 | issue = 4 | pages = 10768–10776 | date = August 2021 | pmid = 34378513 | doi = | type = Meta-analysis }}</ref><ref>{{Cite journal |last1=Pabalan |first1=N. |last2=Singian |first2=E. |last3=Jarjanazi |first3=H. |last4=Paganini-Hill |first4=A. |date=28 July 2015 |title=Association of male circumcision with risk of prostate cancer: a meta-analysis |journal=Prostate Cancer and Prostatic Diseases |volume=18 |issue=4 |pages=352–357 |doi=10.1038/pcan.2015.34 |pmid=26215783 }}</ref>

=== Women's health === A 2017 systematic review found consistent evidence that male circumcision before heterosexual contact was associated with a decreased risk of cervical cancer, cervical dysplasia, HSV-2, chlamydia, and syphilis among women. The evidence was less consistent in regard to an association of circumcision with women's risk of HPV and HIV.<ref>{{cite journal | vauthors = Grund JM, Bryant TS, Jackson I, Curran K, Bock N, Toledo C, Taliano J, Zhou S, Del Campo JM, Yang L, Kivumbi A, Li P, Pals S, Davis SM | title = Association between male circumcision and women's biomedical health outcomes: a systematic review | journal = The Lancet. Global Health | volume = 5 | issue = 11 | pages = e1113–e1122 | date = November 2017 | pmid = 29025633 | pmc = 5728090 | doi = 10.1016/S2214-109X(17)30369-8 }}</ref>

===Sexual effects=== The accumulated data show circumcision has no adverse physiological effect on sexual pleasure, function, desire, or fertility.<ref name=bless>{{cite journal | vauthors = Bañuelos Marco B, García Heil JL | title = Circumcision in childhood and male sexual function: a blessing or a curse? | journal = International Journal of Impotence Research | volume = 33 | issue = 2 | pages = 139–148 | date = March 2021 | pmid = 32994555 | pmc = 7985026 | doi = 10.1038/s41443-020-00354-y }}</ref><ref name="sexual_function">The American Academy of Pediatrics Task Force on Circumcision "Technical Report" (2012) addresses sexual function, sensitivity and satisfaction without qualification by age of circumcision. Sadeghi-Nejad ''et al.'' "Sexually transmitted diseases and sexual function" (2010) addresses adult circumcision and sexual function. Doyle ''et al.'' "The Impact of Male Circumcision on HIV Transmission" (2010) addresses adult circumcision and sexual function. Perera ''et al.'' "Safety and efficacy of nontherapeutic male circumcision: a systematic review" (2010) addresses adult circumcision and sexual function and satisfaction. * {{cite journal | vauthors = Dave S, Afshar K, Braga LH, Anderson P | title = Canadian Urological Association guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants (full version) | journal = Canadian Urological Association Journal | volume = 12 | issue = 2 | pages = E76–E99 | date = February 2018 | pmid = 29381458 | pmc = 5937400 | doi = 10.5489/cuaj.5033 | quote = There is lack of any convincing evidence that neonatal circumcision will impact sexual function or cause a perceptible change in penile sensation in adulthood. }} * {{cite journal | vauthors = Shabanzadeh DM, Düring S, Frimodt-Møller C | title = Male circumcision does not result in inferior perceived male sexual function - a systematic review | journal = Danish Medical Journal | volume = 63 | issue = 7 | date = July 2016 | pmid = 27399981 | type = Systematic review }} * {{cite journal | vauthors = Friedman B, Khoury J, Petersiel N, Yahalomi T, Paul M, Neuberger A | title = Pros and cons of circumcision: an evidence-based overview | journal = Clinical Microbiology and Infection | volume = 22 | issue = 9 | pages = 768–774 | date = September 2016 | pmid = 27497811 | doi = 10.1016/j.cmi.2016.07.030 | doi-access = free }} * {{Cite web |last=Staff |title=Statement on Newborn Male Circumcision |url=https://www.acog.org/en/womens-health/faqs/newborn-male-circumcision |access-date=21 March 2023 |website=American College of Obstetricians and Gynecologists |quote=Some parents also may worry that circumcision harms a man's sexual function, sensitivity, or satisfaction. However, current evidence shows that it does not. |archive-date=21 March 2023 |archive-url=https://web.archive.org/web/20230321004554/https://www.acog.org/en/womens-health/faqs/newborn-male-circumcision |url-status=live }} * {{cite journal | vauthors = Sorokan ST, Finlay JC, Jefferies AL | title = Newborn male circumcision | journal = Paediatrics & Child Health | volume = 20 | issue = 6 | pages = 311–320 | date = 8 September 2015 | pmid = 26435672 | pmc = 4578472 | doi = 10.1093/pch/20.6.311 | quote = ...medical studies do not support circumcision as having a negative impact on sexual function or satisfaction in males or their partners. }} * {{cite web |last1=World Health Organization |last2=UNAIDS |last3=Jhpiego |date=December 2009 |title=Manual for Male Circumcision Under Local Anaesthesia |url=https://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=15 January 2012 |publisher= |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. |author1-link=World Health Organization |author2-link=UNAIDS |author3-link=Jhpiego }} [https://www.scribd.com/document/186396682/Who-Mc-Local-Anaesthesia Alt URL] {{Webarchive|url=https://web.archive.org/web/20230330035156/https://www.scribd.com/document/186396682/Who-Mc-Local-Anaesthesia |date=30 March 2023 }}</ref> There is some evidence that circumcision has no effect on pain with intercourse, premature ejaculation, intravaginal ejaculation latency time, erectile dysfunction, or difficulties with orgasm.<ref name=Tian2013>{{cite journal | vauthors = Tian Y, Liu W, Wang JZ, Wazir R, Yue X, Wang KJ | title = Effects of circumcision on male sexual functions: a systematic review and meta-analysis | journal = Asian Journal of Andrology | volume = 15 | issue = 5 | pages = 662–666 | date = September 2013 | pmid = 23749001 | pmc = 3881635 | doi = 10.1038/aja.2013.47 | type = Systematic review }}</ref> There are popular misconceptions that circumcision benefits or adversely affects the sexual pleasure of the circumcised person.<ref name="sexual_function" />

According to a 2014 review, the effect of circumcision on sexual partners' experiences is unclear as it has not been well studied.<ref name="bossio_2014" /> According to a policy statement by the Canadian Paediatric Society that was reaffirmed in 2021,<ref>{{Cite web |title=Newborn male circumcision | work = Canadian Paediatric Society |url=https://cps.ca/en/documents/position/circumcision |access-date=10 April 2023 |archive-date=11 April 2023 |archive-url=https://web.archive.org/web/20230411220045/https://cps.ca/en/documents/position/circumcision |url-status=live }}</ref> "medical studies do not support circumcision as having an impact on sexual function or satisfaction for partners of circumcised individuals".<ref name="sexual_function" />

==Adverse effects== Neonatal circumcision is generally a safe, low-risk procedure when done by an experienced practitioner.<ref>{{cite journal |vauthors=Friedman B, Khoury J, Petersiel N, Yahalomi T, Paul M, Neuberger A |date=September 2016 |title=Pros and cons of circumcision: an evidence-based overview |journal=Clinical Microbiology and Infection |volume=22 |issue=9 |pages=768–774 |doi=10.1016/j.cmi.2016.07.030 |pmid=27497811 |doi-access=free}}</ref><ref name="AUA_2007" /><ref name="KrillPalmer2011" />

The most common acute complications are excessive bleeding, infection and the removal of either too much or too little foreskin.<ref name="AAP_2012" /><ref name="AAFP_2013" /> These complications occur in approximately 0.13% of procedures, with bleeding being the most common acute complication in the United States.<ref name="AAFP_2013" /> Minor complications are reported to occur in approximately 3.8%.<ref>{{cite journal |last1=Shabanzadeh |first1=Daniel Mønsted |last2=Clausen |first2=Signe |last3=Maigaard |first3=Katrine |last4=Fode |first4=Mikkel |title=Male Circumcision Complications – A Systematic Review, Meta-Analysis and Meta-Regression |journal=Urology |date=2021 |volume=152 |pages=25–34 |doi=10.1016/j.urology.2021.01.041 |pmid=33545206 }}</ref> Severe complications are rare.<ref name="Complications of circumcision" /> A specific complication rate is difficult to determine due to inconsistencies in classification.<ref name="AAP_2012" /> Complication rates are greater when the procedure is performed by an inexperienced operator, in unsterile conditions, and older patient age.<ref name="weiss_2010_complications" /> In patients circumcised after the neonatal period and into adolescence, minor complication rates rise from approximately 1.5% in neonates to about 6% in adolescents. This increase is believed to be a result of increased foreskin vascularity.<ref name="pmid35651438">{{cite journal |vauthors=Gologram M, Margolin R, Lomiguen CM |title=Need for Increased Awareness of International Male Circumcision Variations and Associated Complications: A Contemporary Review |journal=Cureus |volume=14 |issue=4 |article-number=e24507 |date=April 2022 |pmid=35651438 |pmc=9135584 |doi=10.7759/cureus.24507 |doi-access=free }}</ref> Significant acute complications happen rarely,<ref name="AAP_2012" /><ref name="weiss_2010_complications" /> occurring in about 1 in 500 newborn procedures in the United States.<ref name="AAP_2012" /> Severe to catastrophic complications, including death, are so rare that they are reported only as individual case reports.<ref name="AAP_2012" /><ref name="KrillPalmer2011" /> Where a Plastibell device is used, the most common complication is the retention of the device occurring in around 3.5% of procedures.<ref name="Selekman-2020" /> Other possible complications include buried penis, chordee, phimosis, skin bridges, urethral fistulas, and meatal stenosis.<ref name="KrillPalmer2011" /> These complications may be partly avoided with proper technique, and are often treatable without requiring surgical revision.<ref name="KrillPalmer2011">{{cite journal | vauthors = Krill AJ, Palmer LS, Palmer JS | title = Complications of circumcision | journal = TheScientificWorldJournal | volume = 11 | pages = 2458–2468 | year = 2011 | pmid = 22235177 | pmc = 3253617 | doi = 10.1100/2011/373829 | doi-access = free }}</ref> The most common long-term complication is meatal stenosis, this is almost exclusively seen in circumcised children, it is thought to be caused by ammonia producing bacteria coming into contact with the meatus in circumcised infants.<ref name="Selekman-2020" /> It can be treated by meatotomy.<ref name="Selekman-2020" />

Effective pain management should be used during the procedure.<ref name="AAP_2012" /> Inadequate pain relief may carry the risks of heightened pain response for newborns.<ref name=perera_2010/> Newborns that experience pain due to being circumcised have different responses to vaccines given afterwards, with higher pain scores observed.<ref>{{cite journal | vauthors = Sorokan ST, Finlay JC, Jefferies AL | title = Newborn male circumcision | journal = Paediatrics & Child Health | volume = 20 | issue = 6 | pages = 311–320 | date = 8 September 2015 | pmid = 26435672 | pmc = 4578472 | doi = 10.1093/pch/20.6.311 }}</ref> For adult men who have been circumcised, there is a risk that the circumcision scar may be tender.<ref name="crit">{{cite journal | vauthors = Morris BJ, Moreton S, Krieger JN | title = Critical evaluation of arguments opposing male circumcision: A systematic review | journal = Journal of Evidence-Based Medicine | volume = 12 | issue = 4 | pages = 263–290 | date = November 2019 | pmid = 31496128 | pmc = 6899915 | doi = 10.1111/jebm.12361 | type = Systematic review }}</ref> There is no good evidence that circumcision affects cognitive abilities.<ref name="nhs">{{cite web |date=22 February 2016 |title=Circumcision in men |url=https://www.nhs.uk/conditions/circumcision-in-men/ |publisher=National Health Service |access-date=30 October 2018 |archive-date=29 June 2020 |archive-url=https://web.archive.org/web/20200629155854/https://www.nhs.uk/conditions/circumcision-in-men/ |url-status=live }}</ref>

==History== {{Main|History of circumcision}}

thumb|Adult circumcision scene from the tomb of Ankhmahor, Saqqara, Egypt (c. 2345–2333 BCE). Oldest known depiction of circumcision. The word circumcision is from Latin {{Lang|la|circumcidere}}, meaning "to cut around".<ref name="WHO_2007_GTDPSA" /> Circumcision is the oldest known surgical procedure.<ref name=":0">{{cite book | vauthors = Cox G, Morris BJ |title=Surgical Guide to Circumcision |publisher=Springer Science & Business Media |year=2012 |isbn=978-1-4471-2858-8 | veditors = Bolnick D, Koyle M, Yosha A |chapter=Why Circumcision? From Prehistory to the Twenty-First Century |pages=243–244}}</ref> Depictions of circumcised penises are found in Paleolithic art,<ref>{{cite journal | vauthors = Angulo JC, García-Díez M | title = Male genital representation in paleolithic art: erection and circumcision before history | journal = Urology | volume = 74 | issue = 1 | pages = 10–14 | date = July 2009 | pmid = 19395004 | doi = 10.1016/j.urology.2009.01.010 | hdl-access = free | hdl = 10400.26/23819 }}</ref> predating the earliest signs of trepanation.<ref name=":0" /><ref>{{cite journal | vauthors = Faria MA | title = Neolithic trepanation decoded- A unifying hypothesis: Has the mystery as to why primitive surgeons performed cranial surgery been solved? | journal = Surgical Neurology International | volume = 6 | page = 72 | date = 7 May 2015 | pmid = 25984386 | pmc = 4427816 | doi = 10.4103/2152-7806.156634 | doi-access = free }}</ref>

The history of the migration and evolution of circumcision is known mainly from the cultures of two regions. In the lands south and east of the Mediterranean, starting with Central Sahara, Sudan and Ethiopia, the procedure was practiced by the ancient Egyptians and the Semites, and then by the Jews and Muslims. In Oceania, circumcision is practiced by the Australian Aboriginals and Polynesians.<ref name="gollaher_2001_ch1" /> There is also evidence that circumcision was practiced among the Aztec and Mayan civilizations in the Americas,<ref name="WHO_2007_GTDPSA" /> but little is known about that history.<ref name="Doy2005" /><ref name="alanis_2004" />

It has been speculated that circumcision originated as a substitute for castration of defeated enemies or as a religious sacrifice.<ref name="alanis_2004" /> In many traditions, it acts as a rite of passage marking a boy's entrance into adulthood.<ref name="alanis_2004" />

===Middle East, Africa and Europe=== {{Further|Circumcision in Africa}}

thumb|upright|right|Circumcision knife from the Congo; wood, iron; late 19th/early 20th centuryAt Oued Djerat, in Algeria, engraved rock art with masked bowmen, which feature male circumcision and may be a scene involving ritual, have been dated to earlier than 6000 BP amid the Bubaline Period;<ref name="Campbell">{{cite journal |last1=Campbell |first1=Alec |last2=Coulson |first2=David |title=Big hippo site, Oued Afar, Algeria |journal=Sahara: Prehistory and History of the Sahara |date=2010 |issue=21 |pages=81–92 |id={{INIST|23112468}} |oclc=931467462 |url=https://www.saharajournal.com/21/pages/abs_21.html }}</ref> more specifically, while possibly dating much earlier than 10,000 BP, rock art walls from the Bubaline Period have been dated between 9200 BP and 5500 BP.<ref name="Soukopova">{{cite journal | vauthors = Soukopova J |title=Central Saharan rock art: Considering the kettles and cupules |journal=Journal of Arid Environments |date=August 2017 |volume=143 |page=12 |doi=10.1016/j.jaridenv.2016.12.011 |bibcode=2017JArEn.143...10S }}</ref> The cultural practice of circumcision may have spread from the Central Sahara, toward the south in Sub-Saharan Africa and toward the east in the region of the Nile.<ref name="Campbell" /> Based on engraved evidence found on walls and evidence from mummies, circumcision has been dated to at least as early as 6000 BCE in ancient Egypt.<ref name="Al-Salem">{{cite book |last1=Al-Salem |first1=Ahmed H. |title=An Illustrated Guide to Pediatric Urology |chapter=Male Circumcision |date=2017 |pages=477–499 |doi=10.1007/978-3-319-44182-5_22 |isbn=978-3-319-44181-8 }}</ref> Some ancient Egyptian mummies, which have been dated as early as 4000 BCE, show evidence of circumcision.<ref name="gollaher_2001_ch1" />{{rp|2–3}}<ref name="Dobanovački">{{cite journal | vauthors = Dobanovački D, Milovanović L, Slavković A, Tatić M, Mišković-Skeledžija S, Škorić-Jokić S, Pećanac M |title=Surgery Before Common Era (B.C.E.*) |journal=Archive of Oncology |date=2012 |volume=20 |issue=1–2 |page=29 |doi=10.2298/AOO1202028D |doi-access=free }}</ref>

Evidence suggests that circumcision was practiced in the Middle East by the fourth millennium BCE, when the Sumerians and the Semites moved into the area that is modern-day Iraq from the North and West.<ref name=Doy2005/> The earliest historical record of circumcision comes from Egypt, in the form of an image of the circumcision of an adult carved into the tomb of Ankh-Mahor at Saqqara, dating to about 2400{{endash}}2300 BCE. Circumcision was possibly done by the Egyptians for hygienic reasons, but also was part of their obsession with purity and was associated with spiritual and intellectual development. No well-accepted theory explains the significance of circumcision to the Egyptians, but it appears to have been endowed with great honor and importance as a rite of passage, performed in a public ceremony emphasizing the continuation of family generations and fertility. It may have been a mark of distinction for the elite: the Egyptian ''Book of the Dead'' describes the sun god Ra as having circumcised himself.<ref name=alanis_2004/><ref name=gollaher_2001_ch1/> [[File:Artemision-penis.jpg|thumb|left|upright|Detail of the Artemision Bronze; the Greeks abhorred circumcision, making life difficult for circumcised Jews living among the Greeks.]]

Circumcision is prominent in the Hebrew Bible.<ref>{{cite book | vauthors = McNutt PM |title=Reconstructing the Society of Ancient Israel |url=https://archive.org/details/reconstructingso0000mcnu |url-access=registration |page=[https://archive.org/details/reconstructingso0000mcnu/page/41 41] |quote=Abraham patriarchal known history. |year=1999 |publisher=Westminster John Knox Press |isbn=978-0-664-22265-9 }}</ref> In addition to proposing that circumcision was adopted by the Israelites purely as a religious mandate, scholars have suggested that Judaism's patriarchs and their followers adopted circumcision to make penile hygiene easier in hot, sandy climates; as a rite of passage into adulthood; or as a form of blood sacrifice.<ref name="Doy2005" /><ref name="gollaher_2001_ch1" /><ref name="encyc_judaica_2006" />

Historical campaigns of ethnic, cultural, and religious persecution frequently included bans on circumcision as a means of forceful assimilation, conversion, and ethnocide.<ref name="Antisemitism">For sources, see: * {{Cite book | vauthors = Livingston M |title=Dreamworld or Dystopia: The Nordic Model and Its Influence in the 21st Century |publisher=Cambridge University Press |year=2021 |isbn=978-1-108-75726-3 |page=87 |quote=In Jewish history, the banning of circumcision (brit mila) has historically been a first step toward more extreme and violent forms of persecution. |author-link=Michael Livingston}} * {{Cite book | vauthors = Wilson R |title=The Contested Place of Religion in Family Law |publisher=Cambridge University Press |year=2018 |isbn=978-1-108-41760-0 |page=174 |quote=Jews have a long history of suffering punishment at the hands of government authorities for engaging in circumcision. Muslims have also experienced suppression of their identities through suppression of this religious practice.}} * {{cite journal | vauthors = Miller GP |date=Spring 2002 |title=Circumcision: Cultural-Legal Analysis |journal=Virginia Journal of Social Policy & the Law |volume=9 |pages=497–585 |doi=10.2139/ssrn.201057 |ssrn=201057 |doi-access=free }} * {{Cite book | vauthors = Silverman E |title=From Abraham to America: A History of Jewish Circumcision |publisher=Rowman & Littlefield |year=2006 |isbn=978-0-7425-1669-4 |pages=161–162 |chapter=Circumcision, Anti-Semitism, and Christ's Foreskin |quote=Ancient [Greek and Roman] authors praised Jewish wisdom, courage, temperance, and justice. Still, they always denounced circumcision. The anonymous authors of Historiae Augustae, writing in the late fourth century, ttributed a Jewish revolt against Rome in 132-135, called the Bar Kokhba rebellion, to a ban on circumcision enacted by the emperor Hadrian... The prohibition was part of a broad campaign to "civilize" ethnic groups...}} * {{Cite book | vauthors = Rosner F |title=Encyclopedia of Jewish Medical Ethics |publisher=Feldheim Publishers |year=2003 |isbn=978-1-58330-592-8 |page=196 |quote=Several eras in subsequent Jewish history were associated with forced conversions and with prohibitions against ritual circumcision... Jews endangered their lives during such times and exerted strenuous efforts to nullify such edicts. When they succeeded, they celebrated by declaring a holiday. Throughout most of history, Jews never doubted their obligation to observe circumcision... [those who attempted to reverse it or failed to perform the ritual were called] voiders of the covenant of Abraham our father, and they have no portion in the World to Come.}}</ref> Alexander the Great conquered the Middle East in the fourth century BCE, and in the following centuries ancient Greek cultures and values came to the Middle East. The Greeks abhorred circumcision, making life for circumcised Jews living among the Greeks and later the Romans very difficult.<ref name="Antisemitism" /> Restrictions on the Jewish practice by European governments have occurred several times in world history, including the Seleucid Empire under Antiochus IV and the Roman Empire under Hadrian, where it was used as a means of forceful assimilation and conversion.<ref name="Antisemitism" /> Antiochus IV's restriction on Jewish circumcision was a major factor in the Maccabean Revolt.<ref name="Antisemitism" /> Hadrian's prohibition has also been considered by some to have been a contributing cause of the Bar Kokhba revolt.<ref name="Antisemitism" /> According to Silverman (2006), these restrictions were part of a "broad campaign" by the Romans to "civilize" the Jewish people, viewing the practice as repulsive and analogous to castration.<ref name="Antisemitism" /> His successor, Antoninus Pius, altered the edict to permit {{transliteration|he|Brit Milah}}.<ref name="Antisemitism" /> During this period in history, Jewish circumcision called for the removal of only a part of the prepuce, and Hellenized Jews often attempted to look uncircumcised and potentially restore their foreskins by stretching the extant parts of their foreskins with a specialized device called a pondus Judaeus. This was considered by the Jewish leaders to be a serious problem, and during the second century CE they changed the requirements of Jewish circumcision to call for the complete removal of the foreskin,<ref>{{cite encyclopedia|vauthors=Hirsch EG, Kohler K, Jacobs J, Friedenwald A, Broydé I|date=1906|title=Circumcision|url=http://www.jewishencyclopedia.com/articles/4391-circumcision|encyclopedia=Jewish Encyclopedia|quote=In order to prevent the obliteration of the 'seal of the covenant' on the flesh, as circumcision was henceforth called, the Rabbis, probably after the war of Bar Kokba (see Yeb. l.c.; Gen. R. xlvi.), instituted the 'peri'ah' (the laying bare of the glans), without which circumcision was declared to be of no value (Shab. xxx. 6).|access-date=8 March 2018|archive-date=4 August 2011|archive-url=https://web.archive.org/web/20110804221009/http://www.jewishencyclopedia.com/view.jsp?artid=514&letter=C&search=circumcision|url-status=live}}</ref> emphasizing the Jewish view of circumcision as intended to be not just the fulfillment of a Biblical commandment but also an essential and permanent mark of membership in a people.<ref name="gollaher_2001_ch1" /><ref name="encyc_judaica_2006" />

[[File:Ludovico Mazzolino - Circumcision - WGA14715.jpg|thumb|upright|The Circumcision of Jesus Christ, by Ludovico Mazzolino|left]]A narrative in the Christian Gospel of Luke makes a brief mention of the circumcision of Jesus, but physical circumcision is not part of the received teachings of Jesus. Circumcision has played an important role in Christian history and theology. Paul the Apostle reinterpreted circumcision as a spiritual concept, arguing literal circumcision to be unnecessary for Gentile converts to Christianity. The teaching that circumcision was unnecessary for membership in a divine covenant was instrumental to the separation of Christianity from Judaism.<ref name="Jacobs-2012">{{Cite book | vauthors = Jacobs A |title=Christ Circumcised: A Study in Early Christian History and Difference |publisher=University of Pennsylvania Press |year=2012 |isbn=978-0-8122-0651-7 |location=United States |pages=}}</ref><ref name="Bolnick-2012">{{Cite book | vauthors = Bolnick D, Koyle M, Yosha A |title=Surgical Guide to Circumcision |publisher=Springer |year=2012 |isbn=978-1-4471-2858-8 |location=United Kingdom |pages=290–298 |chapter=Circumcision in the Early Christian Church: The Controversy That Shaped a Continent |quote=In summary, circumcision has played a surprisingly important role in Western history. The circumcision debate forged a Gentile identity to the early Christian church which allowed it to survive the Jewish Diaspora and become the dominant religion of Western Europe. Circumcision continued to have a major cultural presence throughout Christendom even after the practice had all but vanished.... the circumcision of Jesus... celebrated as a religious holiday... [has been] examined by many of the greatest scholars and artists of the Western tradition.}}</ref> While the circumcision of Jesus is celebrated as a feast day in the liturgical calendar of many Christian denominations.<ref name="Bolnick-2012"/>

Although it is not explicitly mentioned in the Quran (early seventh century CE), circumcision is considered essential to Islam, and it is nearly universally performed among Muslims. The practice of circumcision spread across the Middle East, North Africa, and Southern Europe with Islam.<ref name="gollaher_2001_ch2" />

Genghis Khan and the following Yuan Emperors in China forbade Islamic practices such as halal butchering and circumcision.<ref name="Leslie-1998">{{cite web|url=http://www.islamicpopulation.com/asia/China/China_integration%20of%20religious%20minority.pdf |title=The Integration of Religious Minorities in China: The Case of Chinese Muslims | vauthors = Leslie DD |year=1998 |page=12 |publisher=The Fifty-ninth George Ernest Morrison Lecture in Ethnology |access-date=30 November 2010 |archive-url=https://web.archive.org/web/20101217112014/http://islamicpopulation.com/asia/China/China_integration%20of%20religious%20minority.pdf |archive-date=17 December 2010 }}</ref><ref name="Elverskog-2010">{{cite book|url=https://archive.org/details/buddhismislamons0000elve|url-access=registration|title=Buddhism and Islam on the Silk Road| vauthors = Johan E |year=2010|publisher=University of Pennsylvania Press|edition=illustrated|pages=[https://archive.org/details/buddhismislamons0000elve/page/228 228]|isbn=978-0-8122-4237-9|access-date=28 June 2010}}</ref>

The practice of circumcision is thought to have been brought to the Bantu-speaking tribes of Africa by either the Jews after one of their many expulsions from European countries, or by Muslim Moors escaping after the 1492 reconquest of Spain. In the second half of the first millennium CE, inhabitants from the Northeast of Africa moved south and encountered groups from Arabia, the Middle East, and West Africa. These people moved south and formed what is known today as the Bantu. Bantu tribes were observed to be upholding what was described as Jewish law, including circumcision, in the 16th century. Circumcision and elements of Jewish dietary restrictions are still found among Bantu tribes.<ref name=Doy2005/>

===Indigenous peoples of the Americas and Oceania=== thumb|Slate blade circumcision knife with bone handle, North America. Wellcome Collection . Circumcision is practiced by some groups amongst Australian Aboriginal peoples, Polynesians, and Native Americans.<ref name="WHO_2007_GTDPSA" /><ref name="Doy2005" />

For Aboriginal Australians and Polynesians, circumcision likely started as a blood sacrifice and a test of bravery and became an initiation rite with attendant instruction in manhood in more recent centuries. Often seashells were used to remove the foreskin, and the bleeding was stopped with eucalyptus smoke.<ref name=Doy2005/><ref name=gollaher_2001_ch3/>

Christopher Columbus reported circumcision being practiced by Native Americans.<ref name=alanis_2004/> It probably started among South American tribes as a blood sacrifice or ritual to test bravery and endurance, and later evolved into a rite of initiation.<ref name=Doy2005/>

=== East and Southeast Asia === thumb|''An 18th-century print depicting the circumcision of the king of Bantam (in present-day Indonesia). Engraving by Jakob van der Schley, published by Pieter de Hondt, 1747. Atlas of Mutual Heritage.'' In Japan, the pre-Yamato indigenous inhabitants, the Ainu, practiced circumcision, though the practice did not persist among the broader Japanese population, possibly due to Buddhist influence.<ref>{{cite book |editor-first1=David A. |editor-first2=Martin |editor-first3=Assaf |editor-last1=Bolnick |editor-last2=Koyle |editor-last3=Yosha |title=Surgical Guide to Circumcision |date=2012 |doi=10.1007/978-1-4471-2858-8 |isbn=978-1-4471-2857-1 }}</ref>

In Southeast Asia, evidence suggests that indigenous forms of genital cutting predate the arrival of Islam. In the Indonesian archipelago, a traditional incision practice existed prior to Islamization; scholarly research has shown that this was progressively replaced by full circumcision following the adoption of Islam, a process accelerated in the late 19th century when Meccan jurists issued fatwas disapproving of the older local practice. In the Philippines, the traditional practice of ''tuli'' historically involved a dorsal slit rather than full circumcision, a form similar to practices among Pacific Islanders, suggesting an indigenous origin distinct from Islamic influence. The antiquity of circumcision in the region is further evidenced by the fact that Makassan traders from Sulawesi are recorded as having introduced circumcision to Aboriginal communities in Arnhem Land, Australia. With the spread of Islam across the archipelago from the 13th century onward, indigenous cutting practices were largely absorbed into or replaced by Islamic circumcision.<ref>{{Cite journal |last=Lee |first=Romeo B. |date=2006 |title=Filipino experience of ritual male circumcision: knowledge and insights for anti-circumcision advocacy |journal=Culture, Health & Sexuality |volume=8 |issue=3 |pages=225–234 |doi=10.1080/13691050600761243 |pmid=16801224 }}</ref><ref>{{cite journal |last1=Lee |first1=Romeo B. |title=Filipino experience of ritual male circumcision: Knowledge and insights for anti-circumcision advocacy |journal=Culture, Health & Sexuality |date=2006 |volume=8 |issue=3 |pages=225–234 |doi=10.1080/13691050600761243 |pmid=16801224 }}</ref>

=== Prophylactic circumcision ===

==== Anglophonic adoption (1855–1918) ==== [[File:Jonathan Hutchinson.jpg|thumb|The first medical professional to recommend circumcision as a ''prophylaxis'' against disease was the British physician Jonathan Hutchinson in 1855. By the late 19th century, the belief that circumcision acted as an effective prophylactic against disease was held by a majority of the core Anglosphere's medical communities and doctors, such as the prominent Lewis Sayre, president of the American Medical Association, subsequently leading to its widespread adoption.<ref name="Al-Salem-2016">{{Cite book | vauthors = Al-Salem A |title=An Illustrated Guide to Pediatric Urology |publisher=Springer Publishing |year=2016 |isbn=978-3-319-44182-5 |page=481}}</ref>]] Circumcision began to be advocated as a means of ''prophylaxis'' in 1855, primarily as a means of preventing the transmission of sexually transmitted infections. At this time, British physician Jonathan Hutchinson published his findings that, among his venereal disease patients, Jews had a lower prevalence of syphilis.<ref name="darby_2005" /><ref name="Hutchinson1855">{{cite journal | vauthors = Hutchinson J |title=On the influence of circumcision in preventing syphilis |journal=Medical Times and Gazette |date=1855 |volume=32 |pages=542–543}}</ref> Hutchinson suggested that circumcision lowers the risk of contracting syphilis.<ref name="Hutchinson1855"/> He also believed that circumcision would prevent masturbation. In an 1893 article, ''On circumcision as a preventive of masturbation'' he wrote: "I am inclined to believe that [circumcision] may often accomplish much, both in breaking the habit [of masturbation] as an immediate result, and in diminishing the temptation to it subsequently."<ref>"On circumcision as a preventive of masturbation", ''Archives of surgery'', Vol. II, 1890, p. 267-9</ref> Pursuing a successful career as a general practitioner, Hutchinson went on to advocate circumcision for the next fifty years,<ref name="darby_2005" /> eventually earned a knighthood for his contributions to medicine. His viewpoint that circumcision was prophylactic against disease was adopted by other medical professionals.<ref name="matthew_2004" />

In 1870, orthopedic surgeon Lewis Sayre, a founder of the American Medical Association, introduced circumcision in the United States as a purported cure for several cases of young boys presenting with paralysis and other significant gross motor problems. He thought the procedure ameliorated such problems based on the then prominent "reflex neurosis" theory of disease, thinking that a tight foreskin inflamed the nerves and caused systemic problems.<ref name="Chubak-2013">{{Cite journal | vauthors = Chubak B |date=1 April 2013 |title=1101 the orthopedic origin of popular male circumcision in america |url= |journal=Journal of Urology |volume=189 |issue=4S |pages=e451 |doi=10.1016/j.juro.2013.02.693 |quote=Male circumcision was first popularized in late 19th-century America by Lewis Sayre, a renowned orthopedic surgeon, public-health activist, and creator of the Journal of the American Medical Association. On the basis of a few orthopedic case reports, Sayre used his influence to promote male circumcision as systemic therapy, rather than a local anatomic alteration. This redefinition was consistent with the contemporary reflex neurosis theory of disease, as well as the historic humoral-mechanical understanding of the human body.}}</ref> The use of circumcision to promote good health also fit the germ theory of disease, which saw validation during the same period: the foreskin was thought to harbor infection-causing smegma.<ref name="gollaher_2001_ch4"/>{{rp|106}} Sayre published works on the subject and promoted it in speeches.<ref name="Chubak-2013" /> Many contemporary physicians also believed it could cure, reduce, or otherwise prevent a wide-ranging array of perceived medical problems and social ills. Its popularity spread with publications such as Peter Charles Remondino's ''History of Circumcision''.<ref name="gollaher_2001_ch4" /><ref name="darby_2003" /><ref>{{cite journal | vauthors = Laumann EO, Masi CM, Zuckerman EW | title = Circumcision in the United States. Prevalence, prophylactic effects, and sexual practice | journal = JAMA | volume = 277 | issue = 13 | pages = 1052–1057 | date = April 1997 | pmid = 9091693 | doi = 10.1001/jama.1997.03540370042034 }}</ref> By the late 19th century, circumcision had become common throughout the Anglophonic world—Australia, Canada, the United States, and the United Kingdom—as well as the Union of South Africa. In the United Kingdom and United States, it was universally recommended.<ref name="Al-Salem-2016" /><ref name="gollaher_2001_ch4" />

==== Interwar period and World War II (1918–1945) ==== During the interwar period, medical organizations and doctors in mainland Europe experimented with the idea of routine circumcision for prophylactic reasons as well, alongside developments in the Anglophonic world. In France, the medical profession went so far as to recommend universal routine circumcision. However, prevalence in France and mainland Europe remained low.<ref name="Bolnick_2012_ch1" /> There is a lack of consensus in the academic literature on why this occurred.<ref name="Bolnick_2012_ch1" /> thumb|The Cohen family gathered to celebrate a Brit Milah in Eveleth, Minnesota, United States, 1908. The mohel wears a tallit and kippah. ''Yosha & Bolnick & Koyle'' (2012) have suggested that a factor in its Anglophonic adoption and dismissal in mainland Europe relates to attitudes towards Judaism and Jewish practices. While many of these Anglophonic polities would not be considered tolerant by modern standards: the United Kingdom had Benjamin Disraeli—a Jew—as Prime Minister; Jews in the United States were prominent and generally well-respected; while in Australia "the racial issues of the time involved primarily Aborigines and Chinese immigration, and Jews were essentially below the radar". They argue that once "a substantial proportion of the male population [was] circumcised, the idea that it [was] a Jewish practice [became] no longer relevant. In Britain this was aided by the fact that circumcision was well known to be as much a practice of the nobility as a Jewish religious rite, so that the racial-religious nexus was broken." These factors were absent in continental Europe.<ref name="Bolnick_2012_ch1" />

Rates in the Anglophonic world began to sharply diverge after 1945.<ref name="alanis_2004" /> ==== Mid-20th century (1945–1985) ==== After the end of World War II, Britain implemented a National Health Service. Douglas Gairdner's 1949 article "The Fate of the Foreskin" argued that the evidence showed that the risks outweighed the benefits, leading to a significant reduction in circumcision incidence within the United Kingdom.<ref>{{cite journal | vauthors = Gairdner D | title = The fate of the foreskin, a study of circumcision | journal = British Medical Journal | volume = 2 | issue = 4642 | pages = 1433–7, illust | date = December 1949 | pmid = 15408299 | pmc = 2051968 | doi = 10.1136/bmj.2.4642.1433 }}</ref>{{Primary source inline|reason=This is the paper referred to, but that does not verify the encyclopaedic statement that this paper led to a significant reduction in incidence (which is nevertheless probably true)|date=December 2025}}[[File:Benjamin McLane Spock (1976) 02.jpg|thumb|Pediatrician and political activist Benjamin Spock originally recommended circumcision in his influential work ''The Common Sense Book of Baby and Child Care'', one of the best-selling books of the twentieth century.<ref name="Paige 2021 263">{{Cite book | vauthors = Paige J, Paige K |title=The Politics of Reproductive Ritual |publisher=University of California Press |year=2021 |isbn=978-0-520-30674-5 |page=263 |chapter=Summary and Implications for Complex Societies}}</ref> ]]

In contrast to Gairdner, American pediatrician Benjamin Spock argued in favor of circumcision in his popular ''The Common Sense Book of Baby and Child Care'' which led to rates in the United States significantly rising. In the 1970s, national medical associations in Australia and Canada issued recommendations against routine infant circumcision, leading to drops in the rates of both of those countries. The United States made similar statements in the 1970s but stopped short of recommending against it.<ref name="alanis_2004" />

During the same period, South Korea underwent one of the most rapid and distinctive shifts in circumcision practice recorded anywhere in the world. Throughout their long history, Koreans did not circumcise males until 1945, when Korea gained its independence after 36 years of Japanese occupation. Independence brought trusteeship by the American military in the southern half of the country, and 1950 can be safely regarded as the year when widescale circumcision started in South Korea.<ref>{{Cite web |title=Male circumcision: a South Korean perspective |url=https://www.cirp.org/library/cultural/kim1/ |access-date=17 March 2026 |website=www.cirp.org}}</ref>

==== Modernity (since 1985) ==== An association between circumcision and reduced heterosexual HIV infection rates was first suggested in 1986.<ref name="alanis_2004" />

Experimental evidence was needed to establish a causal relationship, so three randomized controlled trials were commissioned to exclude other confounding factors.<ref name="siegfried_Cochrane_2009" /> Trials took place in South Africa, Kenya and Uganda.<ref name="siegfried_Cochrane_2009" /> All three trials were stopped early by their monitoring boards because those in the circumcised group had a substantially lower rate of HIV contraction than the control group, so it was considered unethical to withhold the procedure, in light of strong evidence of prophylactic efficacy.<ref name="siegfried_Cochrane_2009" /><ref>{{cite journal | vauthors = Hankins C, Forsythe S, Njeuhmeli E | title = Voluntary medical male circumcision: an introduction to the cost, impact, and challenges of accelerated scaling up | journal = PLOS Medicine | volume = 8 | issue = 11 | article-number = e1001127 | date = November 2011 | pmid = 22140362 | pmc = 3226452 | doi = 10.1371/journal.pmed.1001127 | doi-access = free }}</ref> WHO assessed these as "gold standard" studies and found "strong and consistent" evidence from later studies that confirmed the results of the studies.<ref name="WHO-PrevHIV" /> A scientific consensus subsequently developed that circumcision reduces heterosexual HIV infection rates in high-risk populations;<ref name="Merson-2017" /><ref name="Chikutsa-2015" /><ref name="Bell-2016">{{Cite book | vauthors = Bell K |title=Health and Other Unassailable Values: Reconfigurations of Health, Evidence and Ethics |publisher=Taylor & Francis |year=2016 |isbn=978-1-317-48203-1 |page=106 |quote=...defending the casual relation between male circumcision and reduced HIV transmission has become essentially hegemonic in the academic literature.}}</ref> the WHO, along with other major medical organizations, have since promoted circumcision of high-risk populations as part of the program to reduce the spread of HIV.<ref name="WHO-PrevHIV" /> The ''Male Circumcision Clearinghouse'' website was created in 2009 by WHO, UNAIDS, FHI and AVAC to provide evidence-based guidance, information, and resources to support the delivery of safe male circumcision services in countries that choose to scale up the procedure as one component of comprehensive HIV prevention services.<ref name="NYTimes_2009" /><ref name="AVAC_2015" />

==Society and culture== thumb|right| A circumcision being performed in Central Asia, {{circa|1865–1872}}

Circumcision is one of the oldest surgical procedures in human history, and remains a highly emotional and controversial issue.<ref>{{cite book |editor1-last=Bolnick |editor1-first=David A. |editor2-last=Koyle |editor2-first=Martin |editor3-last=Yosha |editor3-first=Assaf |date=2012 |publisher=Springer Science & Business Media |isbn=978-1-4471-2857-1 |page=xxi |url=https://books.google.com/books?id=w7zyKB9mdMwC |title=Surgical Guide to Circumcision}}</ref> Many societies hold a wide ranging perspectives and different cultural, ethical, or social views on circumcision.<ref name="Bolnick_2012_ch1" /> In some cultures, males are generally required to be circumcised shortly after birth, during childhood or around puberty as part of a rite of passage.<ref name="glass_1999"/>

===Religious views on circumcision=== {{See also|Religious male circumcision}}Circumcision is commonly practiced in the Jewish,<ref name="glass_1999">{{cite journal | vauthors = Glass JM | title = Religious circumcision: a Jewish view | journal = BJU International | volume = 83 | issue = Suppl 1 | pages = 17–21 | date = January 1999 | pmid = 10349410 | doi = 10.1046/j.1464-410x.1999.0830s1017.x }}</ref> Islamic,<ref name="clark_2011">{{cite book |author=Clark M |url=https://books.google.com/books?id=zPXu561ZpvgC&pg=PA178 |title=Islam For Dummies |date=10 March 2011 |publisher=John Wiley & Sons |isbn=978-1-118-05396-6 |page=170 |archive-url=https://web.archive.org/web/20160118224324/https://books.google.com/books?id=zPXu561ZpvgC&pg=PA178 |archive-date=18 January 2016 |url-status=live}}</ref><ref name="alsabbagh_1996" /> and Druze faiths, and among the members of Coptic Church, the Ethiopian Orthodox Church and the Eritrean Orthodox Tewahedo Church.<ref name="Columbia_encyc_2011_circ">{{cite encyclopedia |year=2011 |title=Circumcision |encyclopedia=Columbia Encyclopedia |publisher=Columbia University Press |url=http://www.infoplease.com/encyclopedia/science/circumcision.html |archive-url=https://web.archive.org/web/20150924051012/http://www.infoplease.com/encyclopedia/science/circumcision.html |archive-date=24 September 2015 |url-status=live}}</ref><ref name="encyc_religion_2005" /><ref name="riggs_2006" /> In contrast, other religions, such as Mandaeism, Hinduism and Sikhism, strongly prohibit the practice of routine circumcision.<ref name="Drower" /><ref name="Clarence-Smith_2008" /><ref name="Cherry-2013" />

====Judaism==== {{Main|Brit milah}} [[File:Circumcision set.jpg|thumb|Circumcision set and trunk belonging to Gershom Mendes Seixas's family, ca. eighteenth century]] Circumcision is near-universal among Jews.<ref name="Cohen-Almagor-2020">{{Cite journal | vauthors = Cohen-Almagor R |date=9 November 2020 |title=Should liberal government regulate male circumcision performed in the name of Jewish tradition? |journal=SN Social Sciences |volume=1 |issue=1 |article-number=8 |doi=10.1007/s43545-020-00011-7 |quote=Protagonists and critics of male circumcision agree on some things and disagree on many others... They also do not underestimate the importance of male circumcision for the relevant communities.... Even the most critical voices of male circumcision do not suggest putting a blanket ban on the practice as they understand that such a ban, very much like the 1920–1933 prohibition laws in the United States, would not be effective... Protagonists and critics of male circumcision debate whether the practice is morally acceptable... They assign different weights to harm as well as to medical risks and to non-medical benefits. The different weights to risks and benefits conform to their underlying views about the practices... Protagonists and critics disagree about the significance of medical reasons for circumcision... |doi-access=free }}</ref> The ''mitzvah'' of circumcision on the eighth day of life is considered among the most important commandments in Judaism. Barring extraordinary circumstances, failure to undergo the rite is seen by followers of Judaism as leading to a state of ''Kareth'': the extinction of the soul and denial of a share in the world to come.<ref name="Mark-2003a" /><ref name="Hamilton-1990" /><ref name="Antisemitism" /> Reasons for biblical circumcision include to show off "patrilineal descent, sexual fertility, male initiation, cleansing of birth impurity, and dedication to God".<ref name=":92">{{cite book |last1=Hendel |first1=Ronald |title=Remembering Abraham |chapter=Israel Among the Nations |date=2005 |pages=3–30 |doi=10.1093/0195177967.003.0001 |isbn=0-19-517796-7 }}</ref> [[File:Abraham and Ishmael are circumcised (Egerton Genesis).jpg|thumb|Abraham and Ishmael are circumcised. Egerton Genesis Picture Book (Egerton MS., 1894), fol. 9v. Norfolk, England, c. 1375. The British Library, London.]] The basis for its observance is found in the Torah of the Hebrew Bible, in Genesis chapter 17, in which a covenant of circumcision is made with Abraham and his descendants. God states circumcision is "a sign of the covenant between me and you".<ref>{{bibleverse|Genesis|17:11|ESV}}: English Standard Version</ref> Jewish circumcision is part of the {{transliteration|he|brit milah}} ritual, to be performed by a trained ritual circumciser, a {{transliteration|he|mohel}}, on the eighth day of a newborn son's life, with certain exceptions for poor health. Jewish law requires that circumcision leaves the glans bare when the penis is flaccid. Mainstream Judaism foresees serious negative spiritual consequences if it is neglected.<ref name="glass_1999" /><ref name="Bolnick_2012_ch23" />

thumb|Preparing for a Jewish ritual circumcision In Genesis 17:12-13, God also specifies that slaves must be circumcised,<ref>{{bibleverse|Genesis|17:12-13}}</ref> but Rabbinic Judaism condemns forced conversion, so gentiles are only required to be circumcised if they show genuine interest in joining the Jewish nation. If an improper circumcision has already been performed, it is required that a drop of blood be drawn as a symbolic circumcision.<ref name=":2">{{cite web |year=2007 |title=The Conversion Process |url=http://www.jewishcalgary.org/page.html?ArticleID=63645 |archive-url=https://web.archive.org/web/20081227065531/http://www.jewishcalgary.org/page.html?ArticleID=63645 |archive-date=27 December 2008 |access-date=3 November 2007 |publisher=Calgary Jewish Community Council |vauthors=Epstein L}}</ref> There are certain exceptions for those with poor health.<ref>{{Cite book |author-link=Amy-Jill Levine |title=The Jewish Annotated New Testament |vauthors=Levine A, Zvi Brettler M |author-link2=Marc Zvi Brettler |publisher=Oxford University Press |year=2017 |page=673 |quote=With rare exceptions (e.g. matters of health), Judaism requires circumcision for all male children on their eighth day of birth.}}</ref> The Reform and Reconstructionist movements generally do not require a circumcision as part of the conversion process.<ref name=":2" />

According to traditional Jewish law, in the absence of an adult free Jewish male expert, a woman, a slave, or a child who has the required skills is also authorized to perform the circumcision, provided that they are Jewish.<ref>Talmud Avodah Zarah 26b; Menachot 42a; Maimonides' Mishneh Torah, Milah, ii. 1; Shulkhan Arukh, Yoreh De'ah, l.c.</ref> However, most streams of non-Orthodox Judaism allow female {{transliteration|he|mohels}}, called {{transliteration|he|mohalot}} ({{langx|he|מוֹהֲלוֹת}}, the plural of {{lang|he|מוֹהֶלֶת}} {{transliteration|he|mohelet}}, feminine of {{transliteration|he|mohel}}), without restriction. In 1984 Deborah Cohen became the first certified Reform {{transliteration|he|mohelet}}; she was certified by the Berit Mila program of Reform Judaism.<ref>{{Cite web|date=7 October 2013|title=Berit Mila Program of Reform Judaism|url=http://beritmila.org/|access-date=20 July 2022|archive-url=https://web.archive.org/web/20131007073323/http://beritmila.org/ |archive-date=7 October 2013 }}</ref> All major rabbinical organizations recommend that male infants should be circumcised. The issue of converts remains controversial in Reform and Reconstructionist Judaism.<ref>{{cite web| url = https://reformjudaism.org/learning/torah-study/torah-commentary/brit-milah-jewish-answer-modernity| title = B'rit Milah: A Jewish Answer to Modernity| access-date = 11 March 2017| vauthors = Glickman M | work = Reform Judaism| date = 12 November 2005| publisher = Reform Judaism| url-status = live| archive-url = https://web.archive.org/web/20170312052827/http://www.reformjudaism.org/learning/torah-study/lech-lcha/brit-milah-jewish-answer-modernity| archive-date = 12 March 2017}}</ref><ref>{{cite web|url=http://www4.jrf.org/showdt&rid=322&pid=15 |title=Bo: Defining Boundaries |access-date=3 November 2007 | vauthors = Cohen H |date=20 May 2002 |publisher=Jewish Reconstructionist Federation |archive-url=https://web.archive.org/web/20071009173021/http://www4.jrf.org/showdt%26rid%3D322%26pid%3D15 |archive-date=9 October 2007 }}</ref>

Brit shalom (Hebrew: ברית שלום; "Covenant of Peace"), also called ''alternative brit'' to the practice of brit milah, is a naming ceremony for Jews that does not involve circumcision. The first known ceremony is said to have been celebrated around 1970 by Rabbi Sherwin Wine, the founder of the Society for Humanistic Judaism.<ref name="Lowenfeld2011">{{cite news |last=Lowenfeld |first=Jonah |date=2 August 2011 |title=Little-known non-cutting ritual appeals to some who oppose circumcision |newspaper=The Jewish Journal of Greater Los Angeles |location=LA |url=https://jewishjournal.com/news/los_angeles/community/94746/ |url-status=live |access-date=11 March 2020 |archive-url=https://web.archive.org/web/20180825220603/http://jewishjournal.com/news/los_angeles/community/94746/ |archive-date=25 August 2018 |quote=According to Gottfried, the earliest known brit shalom ceremony was performed around 1970 by her mentor, Rabbi Sherwin Wine, the founder of the Society for Humanistic Judaism.}}</ref> Although increasingly many U.S. Jews have chosen not to circumcise their sons, a study by The Jewish Journal in the Greater Los Angeles area found brit shalom to be extremely rare.<ref>{{cite news |url= https://www.reuters.com/article/domesticNews/idUSN22970720071003?pageNumber=1 |title= Jewish "intactivists" in U.S. stop circumcising |access-date= 3 November 2007 | vauthors = Chernikoff H |date= 3 October 2007 |newspaper= Reuters |url-status= live |archive-url= https://web.archive.org/web/20081227025338/http://www.reuters.com/article/domesticNews/idUSN22970720071003?pageNumber=1 |archive-date= 27 December 2008 }}</ref><ref>{{Cite web |last=Lowenfeld |first=Jonah |date=2 August 2011 |title=Little-known non-cutting ritual appeals to some who oppose circumcision |url=https://jewishjournal.com/community/94746/ |access-date=7 February 2026 |website=Jewish Journal |language=en-US}}</ref>

====Islam==== {{Main|Khitan (circumcision)}}

[[File:De besnijdenis van een man in Indonesië, KITLV 40379.tiff|thumb|''Khitan'' in the Dutch East Indies (present-day Indonesia), colonial era.]] [[File:Circumcision ceremony, Skopje 2013 (2).jpg|thumb|Circumcision celebration in Skopje, North Macedonia, 2013]] Islamic scholars have diverse opinions on the obligatory nature of male circumcision, with some considering it mandatory (''wājib''), while others view it as only being recommended (''sunnah'').<ref name="pmid36006531">{{cite journal | vauthors = Dabbagh H | title = Is Circumcision "Necessary" in Islam? A Philosophical Argument Based on Peer Disagreement | journal = Journal of Religion and Health | volume = 61 | issue = 6 | pages = 4871–4886 | date = December 2022 | pmid = 36006531 | pmc = 9569283 | doi = 10.1007/s10943-022-01635-0 }}</ref> According to historians of religion and scholars of religious studies, the Islamic tradition of circumcision was derived from the Pagan practices and rituals of pre-Islamic Arabia.<ref>{{cite journal | vauthors = Abu-Sahlieh SA | title = To mutilate in the name of Jehovah or Allah: legitimization of male and female circumcision | journal = Medicine and Law | volume = 13 | issue = 7–8 | pages = 575–622 | date = 1994 | pmid = 7731348 | publisher = World Association for Medical Law | author-link = Sami Aldeeb }}; {{cite journal | vauthors = Aldeeb Abu-Sahlieh SA |date=1995 |url=https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1036&context=twls |title=Islamic Law and the Issue of Male and Female Circumcision |journal=Third World Legal Studies |volume=13 |pages=73–101 |publisher=Valparaiso University School of Law |access-date=13 February 2020 |archive-url=https://web.archive.org/web/20191112162823/https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1036&context=twls |archive-date=12 November 2019 |url-status=live }}</ref> Although there is some debate within Islam over whether it is a religious requirement or mere recommendation, circumcision (called ''khitan'') is practiced nearly universally by Muslim males. Islam bases its practice of circumcision on the Genesis 17 narrative, the same Biblical chapter referred to by Jews. The procedure is not explicitly mentioned in the Quran, however, it is a tradition established by Islam's prophet Muhammad directly (following Abraham), and so its practice is considered a ''sunnah'' (prophet's tradition) and is very important in Islam. For Muslims, circumcision is also a matter of cleanliness, purification and control over one's baser self (''nafs'').<ref name="clark_2011" /><ref name="alsabbagh_1996" /><ref name="Bolnick_2012_ch24" />

There is no agreement across the many Islamic communities about the age at which circumcision should be performed. It may be done from soon after birth up to about age 15; most often it is performed at around six to seven years of age. The timing can correspond with the boy's completion of his recitation of the whole Quran, with a coming-of-age event such as taking on the responsibility of daily prayer or betrothal. Circumcision may be celebrated with an associated family or community event. Circumcision is recommended for, but is not required of, converts to Islam.<ref name="clark_2011" /><ref name="alsabbagh_1996" /><ref name="Bolnick_2012_ch24" />

Quranists (less than 1% of all Muslims) reject hadith, and because circumcision is not mentioned in the Quran they do not consider it to be an Islamic practice.<ref>{{Cite web|author=Siraj Islam |date=13 December 2024|url=https://lampofislam.wordpress.com/2024/12/14/circumcision-is-an-unquranic-practice-of-genital-mutilation/|title=Circumcision is an unquranic practice of genital mutilation}}</ref>{{better source needed|date=March 2026}}

====Christianity==== {{Main|Religious male circumcision#In Christianity}}

Traditionally, circumcision has not been practiced by Christians for religious reasons. The practice was viewed as succeeded by Baptism and the New Testament chapter Acts 15 recorded that Christianity did not require circumcision from new converts.<ref>{{Cite book | vauthors = Mark E |title=The Covenant of Circumcision: New Perspectives on an Ancient Jewish Rite |publisher=Brandeis University Press |year=2003 |isbn=978-1-58465-307-3 |page=xxiii}}</ref> Christian denominations generally hold a neutral position on circumcision for prophylactic, cultural, and social reasons, while strongly opposing it for religious reasons. This includes the Catholic Church, which explicitly banned the practice of religious circumcision in the Council of Florence,<ref name="CoF">{{cite book| author = Pope Eugenius IV| author-link = Pope Eugene IV| veditors = Tanner NP | title = Decrees of the ecumenical councils| orig-date = 1442| access-date = 25 April 2007| series = 2 volumes| year = 1990| publisher = Georgetown University Press| location = Washington, D.C.| isbn = 978-0-87840-490-2| language = el, la| chapter = Ecumenical Council of Florence (1438–1445): Session 11—4 February 1442; Bull of union with the Copts| chapter-url = http://www.ewtn.com/library/COUNCILS/FLORENCE.HTM#5| quote = it denounces all who after that time observe circumcision| lccn = 90003209| archive-date = 25 April 2009| archive-url = https://web.archive.org/web/20090425150516/http://www.ewtn.com/library/COUNCILS/FLORENCE.HTM#5| url-status = live}}</ref> and maintains a neutral position on the practice of circumcision for other reasons.<ref name="Slosar">{{cite journal | vauthors = Slosar JP, O'Brien D | title = The ethics of neonatal male circumcision: a Catholic perspective | journal = The American Journal of Bioethics | volume = 3 | issue = 2 | pages = 62–64 | year = 2003 | pmid = 12859824 | doi = 10.1162/152651603766436306 }}</ref> A majority of other Christian denominations take a similar position on circumcision, prohibiting it for religious observance, but neither explicitly supporting or forbidding it for other reasons.<ref name="Slosar" /> [[Image:Coptic Children wearing traditional circumcision costumes.jpg|thumb|right |Coptic Children wearing traditional circumcision costumes]] Thus, circumcision rates of Christians are predominately determined by the surrounding cultures which they live in. In some African and Eastern Christian denominations circumcision is an established practice,<ref name="N. Stearns 2008 179">{{Cite book | vauthors = Stearns PN |title=The Oxford Encyclopedia of the Modern World |publisher=Oxford University Press |year=2008 |isbn=978-0-19-517632-2 |page=179 |quote=Uniformly practiced by Jews, Muslims, and the members of Coptic, Ethiopian, and Eritrean Orthodox Churches, male circumcision remains prevalent in many regions of the world, particularly Africa, South and East Asia, Oceania, and Anglosphere countries.}}</ref><ref>{{cite book|title=Cultural Encyclopedia of the Body [2 volumes]| vauthors = Pitts-Taylor V |year= 2008| isbn= 978-1-56720-691-3| page =394|publisher=ABC-CLIO|quote=For most part, Christianity does not require circumcision of its followers. Yet, some Orthodox and African Christian groups do require circumcision. These circumcisions take place at any point between birth and puberty.}}</ref> and generally boys undergo circumcision shortly after birth as part of a rite of passage.<ref name="N. Stearns 2008 179" /> Circumcision is near-universal among Coptic Christians,<ref>{{cite book|title= American Evangelicals in Egypt: Missionary Encounters in an Age of Empire| vauthors = Sharkey HJ |year= 2015| isbn=978-0-691-16810-4 | page =30|publisher=Princeton University Press}}</ref> and they practice circumcision as a rite of passage.<ref name="WHO_2007_GTDPSA" /><ref name="Columbia_encyc_2011_circ" /><ref name="riggs_2006" /><ref name="Bolnick_2012_ch26" /> The Ethiopian Orthodox Church calls for circumcision, with near-universal prevalence among Orthodox men in Ethiopia.<ref name="WHO_2007_GTDPSA" /> Eritrean Orthodox practice circumcision as a rite of passage, and they circumcise their sons "anywhere from the first week of life to the first few year".<ref>{{Cite book| vauthors = DeMello M |title=Encyclopedia of Body Adornment|publisher=ABC-Clio|year=2007|isbn=978-0-313-33695-9 |page=66|quote=Coptic Christians, Ethiopian Orthodox, and Eritrean Orthodox churches on the other hand, do observe the ordainment, and circumcise their sons anywhere from the first week of life to the first few years.}}</ref> Some Christian churches in South Africa disapprove of the practice, while others require it of their members.<ref name="WHO_2007_GTDPSA" />

Circumcision is practiced in many predominantly Christian countries.<ref name="Gruenbaum 2015 61">{{cite book | vauthors = Gruenbaum E |title=The Female Circumcision Controversy: An Anthropological Perspective |publisher=University of Pennsylvania Press |year=2015 |isbn=978-0-8122-9251-0 |page=61 |quote=Christian theology generally interprets male circumcision to be an Old Testament rule that is no longer an obligation ... though in many countries (especially the United States and Sub-Saharan Africa, but not so much in Europe) it is widely practiced among Christians}}</ref><ref>{{cite book|title=Essential Case Studies in Public Health: Putting Public Health Into Practice| vauthors = Hunting K |year= 2012| isbn=978-1-4496-4875-6| pages =23–24 |publisher=Jones & Bartlett Publishers|quote= Neonatal circumcision is the general practice among Jews, Christians, and many, but not all Muslims.}}</ref><ref name="R. Wylie 2015 101">{{cite book | vauthors = Wylie KR |title=ABC of Sexual Health |publisher=John Wiley & Sons |year=2015 |isbn=978-1-118-66569-5 |page=101 |quote=Although it is mostly common and required in male newborns with Moslem or Jewish backgrounds, certain Christian-dominant countries such as the United States also practice it commonly.}}</ref> Christian communities in Africa,<ref>{{cite book | vauthors = Creighton S, Liao LM |title=Female Genital Cosmetic Surgery: Solution to What Problem? |date=2019 |publisher=Cambridge University Press|isbn=978-1-108-43552-9 |page=63 |quote=Christians in Africa, for instance, often practise infant male circumcision.}}</ref><ref>{{cite web |first =Armelle |last =Nga |url =https://www.africanews.com/2019/12/30/the-ritual-of-circumcision-in-africa-the-case-of-south-africa/ |title =The Ritual of Circumcision in Africa: The Case of South Africa |date =30 December 2019 |publisher =Africanews |quote =This practice is old and widespread among African Christians with very close links to their beliefs. It can be executed traditionally or in hospital. |access-date =8 November 2022 |archive-date =6 December 2022 |archive-url =https://web.archive.org/web/20221206235611/http://www.africanews.com/2019/12/30/the-ritual-of-circumcision-in-africa-the-case-of-south-africa/ |url-status =live }}</ref> some Anglosphere countries, the Philippines, the Middle East,<ref>{{cite book | vauthors = Bakos GT |title=On Faith, Rationality, and the Other in the Late Middle Ages:: A Study of Nicholas of Cusa's Manuductive Approach to Islam |date=2011 |publisher=Wipf and Stock Publishers|isbn= 978-1-60608-342-0|page=228 |quote=Although it is stated that circumcision is not a sacrament necessary for salvation, this rite is accepted for the Ethiopian Jacobites and other Middle Eastern Christians.}}</ref><ref>{{cite book | vauthors =Sharkey HJ |title=A History of Muslims, Christians, and Jews in the Middle East|date=2017 |publisher=Cambridge University Press|isbn=978-0-521-76937-2|page=63 |quote= On the Coptic Christian practice of male circumcision in Egypt, and on its practice by other Christians in western Asia.}}</ref> South Korea and Oceania have high circumcision rates,<ref name="Associated Press">{{cite web |date=30 March 2008 |title=Circumcision protest brought to Florence |url=https://apnews.com/article/19456997e17c4a12a24abb9d11c01dba |publisher=Associated Press |quote=However, the practice is still common among Christians in the United States, Oceania, South Korea, the Philippines, the Middle East and Africa. Some Middle Eastern Christians actually view the procedure as a rite of passage. |access-date=2 August 2022 |archive-date=26 March 2023 |archive-url=https://web.archive.org/web/20230326234939/https://apnews.com/article/19456997e17c4a12a24abb9d11c01dba |url-status=live }}</ref><ref>{{cite book |title= Religion and Violence: An Encyclopedia of Faith and Conflict from Antiquity to the Present | vauthors = Ross JI |year= 2015| isbn=978-1-317-46109-8| page =169|publisher=Routledge|quote=For instance, the majority of South Koreans, Americans, and Filipinos, as well as African Christians, practice circumcision.}}</ref> while Christian communities in Europe and South America have low circumcision rates, although none of these are performed out of perceived religious obligation.<ref name="N. Stearns 2008 179" /><ref name="R. Peteet 2017 97–101">{{cite book | vauthors = Peteet JR |title=Spirituality and Religion Within the Culture of Medicine: From Evidence to Practice |publisher=Oxford University Press |year=2017 |isbn=978-0-19-027243-2 |pages=97–101 |quote=male circumcision is still observed among Ethiopian and Coptic Christians, and circumcision rates are also high today in the Philippines and the US.}}</ref> Scholar Heather L. Armstrong writes that, {{as of|lc=y|2021|post=,}} about half of Christian males worldwide are circumcised, with most of them being located in Africa, Anglosphere countries, and the Philippines.<ref name="Armstrong">{{cite book | vauthors = Armstrong HL |title=Encyclopedia of Sex and Sexuality: Understanding Biology, Psychology, and Culture [2 volumes] |publisher=ABC-CLIO |year=2021 |isbn=978-1-61069-875-7 |pages=115–117}}</ref>

====Druze faith==== [[Image:Preparing for a ritual circumcision to a Druze child.jpg|thumb|right |Preparing for a ritual circumcision to a Druze child]] Circumcision is widely practiced by the Druze,<ref name="Ubayd-2006a">{{cite book|title=The Druze and Their Faith in Tawhid| vauthors = Ubayd A |year= 2006| isbn=978-0-8156-3097-5| page =150|publisher=Syracuse University Press|quote=Male circumcision is standard practice, by tradition, among the Druze}}</ref> who practice Druzism, an Abrahamic,<ref name="BritishLibrary">{{cite web | vauthors = Abulafia AS |author-link=Anna Abulafia |date=23 September 2019 |url=https://www.bl.uk/sacred-texts/articles/the-abrahamic-religions |title=The Abrahamic religions |website=www.bl.uk |publisher=British Library |location=London |access-date=9 March 2021 |url-status=live |archive-url=https://web.archive.org/web/20200712150432/https://www.bl.uk/sacred-texts/articles/the-abrahamic-religions |archive-date=12 July 2020}}</ref><ref name="TheDruze">{{cite book| vauthors = Obeid A |title=The Druze & Their Faith in Tawhid|url=https://books.google.com/books?id=FejqBQAAQBAJ&pg=PT1|year=2006|publisher=Syracuse University Press|isbn=978-0-8156-5257-1|page=1}}</ref> monotheistic, syncretic, and ethnic religion. The procedure is a cultural tradition and has no religious significance in Druzism.<ref>{{cite book|title=Israel and the Palestinian Territories: The Rough Guide| vauthors = Jacobs D |year= 1998| isbn=978-1-85828-248-0| page =147|publisher=Rough Guides|quote=Circumcision is not compulsory and has no religious significance.}}</ref><ref>{{cite book|title=The History of Galilee, 1538–1949: Mysticism, Modernization, and War| vauthors = Silver MM |year= 2022| isbn= 978-1-7936-4943-0 | page =97|publisher=Rowman & Littlefield|quote=Muslim men are circumcised, whereas this is not a religious obligation among the Druze}}</ref> There is no special date for it; male infants are usually circumcised shortly after birth,<ref name="Dana_2003" /> but some remain uncircumcised until age ten or older.<ref name="Dana_2003" /> Some Druze do not circumcise their male children and refuse to observe this "common Muslim practice".<ref>{{cite book|title=The Sunni-Shi'a Divide: Islam's Internal Divisions and Their Global Consequences | vauthors = Brenton RB |year= 2013| isbn=978-1-61234-523-9| page =56|publisher=Potomac Books, Inc.|quote=There are many references to the Druze refusal to observe this common Muslim practice, one of the earliest being the rediscoverer of the ruins of Petra, John Burckhardt. "The Druses do not circumcise their children}}</ref>

====Samaritanism==== Like Judaism, the religion of Samaritanism requires ritual circumcision on the eighth day of life.<ref name="Mark-2003">{{Cite book | vauthors = Mark E |title=The Covenant of Circumcision: New Perspectives on an Ancient Jewish Rite |publisher=University Press of New England |year=2003 |isbn=978-1-58465-307-3 |pages=94–95}}</ref>

====Mandaeism==== Circumcision is forbidden in Mandaeism,<ref name="Drower">{{cite book| vauthors = Drower ES |title=The Mandaeans of Iraq and Iran|publisher=Oxford At The Clarendon Press|year=1937}}</ref> and Mandaeans consider it abhorrent.<ref>{{cite book|title=Beyond ISIS: History and Future of Religious Minorities in Iraq| vauthors = Schmidinger T |year= 2019| isbn=978-1-912997-15-2| page =82|publisher=Transnational Press London|quote=}}</ref> According to Mandaean doctrine, a circumcised man cannot serve as a Mandaean priest.<ref>{{cite book|title=Guardians of the Gate: Angelic Vice-regency in the Late Antiquity| vauthors = Deutsch N |year= 1999| isbn=978-90-04-10909-4| page =105|publisher=BRILL|quote=}}</ref> ====Yazidism==== Circumcision is not required in Yazidism, but is practised by some Yazidis due to regional customs.<ref>{{cite web | vauthors = Parry OH |title=Six months in a Syrian monastery; being the record of a visit to the head quarters of the Syrian church in Mesopotamia, with some account of the Yazidis or devil worshippers of Mosul and El Jilwah, their sacred book |url=https://archive.org/stream/sixmonthsinasyr00parrgoog/sixmonthsinasyr00parrgoog_djvu.txt |publisher=London : H. Cox |date=1895}}</ref> The ritual is usually performed soon after birth; it takes place on the knees of the kerîf (approximately "godfather"), with whom the child will have a lifelong formal relationship.<ref>{{Cite book| vauthors = Kreyenbroek PG |title=Yezidism in Europe: Different Generations Speak about Their Religion|date=2009|publisher=Otto Harrassowitz Verlag|isbn=978-3-447-06060-8}}</ref>

===Indian religions===  {{See also|Indian religions}}

====Hinduism==== [[File:Linga from Shivalaya Devipuram.jpg|thumb|Sculptural representation of lingam, male sex organ-placed on yoni, female sex organ. In Hinduism, lingam and yoni represent the masculine and the feminine creative principles respectively.<ref>{{cite book |last1=Narayanan |first1=Vasudha |last2=Urban |first2=Hugh B. Urban |editor1-last=Riggs |editor1-first=Thomas |title=Worldmark Encyclopedia of Religious Practices, Volume 1 |date=2006 |publisher=Thomson Gale |isbn=978-0-7876-6612-5 |pages=316, 334 |chapter=Hinduism - Shaivism}}</ref>]]

In Hinduism, the ''Upanishads'' say that the nature of the higher self (Brahman), in essence, is ''bliss'' (''ānanda''), which the self in each being (Atman) experiences during dreamless deep sleep but remains unconscious of, consciously experiencing it during sensual activity.<ref name="Hume" />{{rp|48}} The Upanishads say that in humans, just as eyes correspond to the experience of sight, nose with smell, ears with sound, and tongue with taste, the genitals correspond to "bliss, delight and procreation".<ref name="Hume">{{cite book |last1=Hume |first1=Robert Ernest |author-link=Robert Ernest Hume |title=The Thirteen Principal Upanishads |orig-date=1921 |date=2018 |publisher=Oxford University Press |isbn=978-0-342-19970-9 |pages=324–326 }}</ref> The ''Brihadaranyaka Upanishad'' says that in humans, genitals are the "single locus of pleasure (''ānanda'')".<ref>{{cite book |last1=Feuerstein |first1=Georg |author-link=Georg Feuerstein |title=Tantra: the path of ecstasy |date=1998 |publisher=Random House |isbn=1-57062-304-X |page=230}}</ref> In Sanskrit literature, the penis is called ''Upastha'' ("that which stands up") and is traditionally considered a "source of great power or vitality (''ojas'')."<ref>{{cite book |last1=Feuerstein |first1=Georg |author-link=Georg Feuerstein |title=The Encyclopedia of Yoga and Tantra |date=2011 |publisher=Shambhala Publications |isbn=978-1-59030-879-0 |page=384}}</ref> In Yoga physiology, the penis corresponds with svadhishthana chakra, and channels the flow of nadis, which enable higher sensations and consciousness.<ref name="Moto">{{cite book |last1=Motoyama |first1=Hiroshi |author-link=Hiroshi Motoyama |title=Theories of the Chakras: bridge to higher consciousness |date=2003 |publisher=New Age Books |isbn=978-81-7822-023-9 |pages=136-137, 164, 187 |url=https://archive.org/details/theoriesofchakra0000moto_t3u5/page/136/mode/1up?q=Penis}}</ref> Consequently, circumcision, or even an interference with a tight foreskin, is strictly forbidden in Hindu traditions.<ref>{{cite book |last1=Cox |first1=Guy |last2=Morris |first2=Brian J. |editor1-last=Bolnick |editor1-first=David A. |editor2-last=Koyle |editor2-first=Martin |editor3-last=Yosha |editor3-first=Assaf |title=Surgical Guide to Circumcision |date=2012 |publisher=Springer Science & Business Media |isbn=978-1-4471-2857-1 |page=251 |url=https://books.google.com/books?id=w7zyKB9mdMwC |chapter=Why Circumcision: From Prehistory to the Twenty-First Century |quote=The traditions of Hinduism prohibit circumcision, and even any interference with a tight foreskin.}}</ref>

====Buddhism==== Buddhism neither requires nor prohibits circumcision, and it contains no canonical injunction regarding circumcision; the Pali Vinaya, which governs monastic conduct in detail, makes no mention of the practice. The 10th of the 32 attributes of an enlightened person is possibly a reference to circumcision: "His sexual organs are concealed in a sheath and exude a pleasant odor similar to vanilla."<ref name="Springer" />

====Sikhism==== Sikhism does not require circumcision of its followers and strongly criticizes the practice.<ref name="Cherry-2013">{{Cite book| vauthors = Cherry M |title=Religious Perspectives on Bioethics|publisher=Taylor & Francis|year=2013|isbn=978-90-265-1967-3|page=213}}</ref><ref>{{cite book | vauthors = Cole WO, Sambhi PS |date=1995 |title=The Sikhs: Their Religious Beliefs and Practices |publisher=Sussex Academic Press |isbn=978-1-898723-13-4 |pages=155–156}}</ref> The Guru Granth Sahib criticizes circumcision in a hymn.<ref>{{Cite web|url=http://www.srigranth.org/servlet/gurbani.gurbani?Action=Page&Param=477|title=Sri Granth: Sri Guru Granth Sahib|website=www.srigranth.org}}</ref> The holy book of Sikhs, dating to 1708, bans circumcision as an Islamic custom, saying: "If God wished me to be a Muslim, it would be cut off by itself."<ref name="Springer">{{cite book |last1=Cox |first1=Guy |last2=Morris |first2=Brian J. |editor1-last=Bolnick |editor1-first=David A. |editor2-last=Koyle |editor2-first=Martin |editor3-last=Yosha |editor3-first=Assaf |title=Surgical Guide to Circumcision |date=2012 |publisher=Springer Science & Business Media |isbn=978-1-4471-2857-1 |page=251 |url=https://books.google.com/books?id=w7zyKB9mdMwC |chapter=Why Circumcision: From Prehistory to the Twenty-First Century}}</ref>

===Cultural views on circumcision=== {{Main article|Cultural views on circumcision}}

==== African cultures ==== thumb|Freshly circumcised boys in Mali celebrating the event. [[File:ASC Leiden - W.E.A. van Beek Collection - Dogon markets 39 - Eleven boys in white clothing with bonnets at Tireli market, just after circumcision, Mali 1990.jpg|thumb|Boys in white clothing with bonnets at Tireli market, just after circumcision, Mali, 1990]]{{excerpt|Circumcision in Africa|paragraphs=1}}

====Australian cultures==== Some Aboriginal Australian groups use circumcision as a test of bravery and self-control as a part of a rite of passage into manhood, which results in full societal and ceremonial membership. It may be accompanied by body scarification and the removal of teeth, and may be followed by penile subincision. Circumcision is one of many trials and ceremonies required before a youth is considered to have become knowledgeable enough to maintain and pass on the cultural traditions. During these trials, the maturing youth bonds in solidarity with the men. Circumcision is also strongly associated with a man's family, and it is part of the process required to prepare a man to take a wife and produce his own family.<ref name="encyc_religion_2005" />

==== Turkic cultures ==== Among Turkic peoples, circumcision (''sünnet'' in Turkish, ''sünnət'' in Azerbaijani, ''sunnat'' in Uzbek, ''сүндет/sündet'' in Kazakh) is viewed as both a religious obligation and a significant rite of passage for boys. The practice is nearly universal among Turkic Muslim populations in Turkey, Azerbaijan, Uzbekistan, Kazakhstan, Kyrgyzstan, Turkmenistan, and among Turkic minorities such as the Uyghurs in China.<ref>{{Cite journal |last1=Musaeva |first1=Majsarat K. |last2=Solovyova |first2=Lubov T. |date=23 June 2022 |title=The Rite of Circumcision Among the Peoples of the Caucasus |journal=History, Archeology and Ethnography of the Caucasus |volume=18 |issue=2 |pages=497–518 |doi=10.32653/ch182497-518 |doi-access=free }}</ref><ref>{{Cite web |title=Khatna-kilish (circumcision party) |url=https://uzbek-travel.com/about-uzbekistan/traditions/khatna-kilish/ |access-date=17 January 2026 |website=uzbek-travel.com}}</ref>thumb|right | Children in Turkey wearing traditional circumcision costumesThe ceremony, known as ''sünnet düğünü'' (circumcision celebration) in Turkey, is typically one of the most important events in a boy's life, often rivaling weddings in scale and expense. Boys are usually circumcised between the ages of 2 and 14, with the timing varying by region and family preference. The celebration commonly includes the boy wearing special ceremonial attire, often resembling a prince's costume or military uniform, and parading through the community on horseback or in a decorated vehicle.<ref>{{cite book |last1=Başaran |first1=Oyman |title=Circumcision and Medicine in Modern Turkey |date=2023 |publisher=University of Texas Press |isbn=978-1-4773-2702-9 |jstor=10.7560/327029 |doi=10.7560/327029 }}{{pn|date=May 2026}}</ref><ref>{{cite journal |last1=Alimen |first1=Nazlı |last2=Askegaard |first2=Søren |title=Religious ritual and sociopolitical ideologies: Circumcision costumes in the Turkish marketplace |journal=International Journal of Fashion Studies |date=2020 |volume=7 |issue=2 |pages=211–236 |doi=10.1386/infs_00027_1 }}</ref> Among the Uyghurs, the tradition is called ''xetne toyi'' and remains an important rite of passage. In traditional practice, the ceremony was accompanied by feasting, music, and gift-giving, serving as an important occasion for community bonding and the affirmation of cultural identity.<ref>{{Cite web |date=10 March 2013 |title=喀什的主要少数民族——【维吾尔族】 |url=https://www.kstq.gov.cn/kashi/msfq/201303/8be98dc38c874108be539e10f36fcf36.shtml |website=中华人民共和国新疆维吾尔自治区人民政府网 (The People's Government of the Xinjiang Uygur Autonomous Region of the People's Republic of China)}}</ref>[[File:Exterior of the Circumcision Room (Topkapı Palace)-.jpg|thumb|Exterior of the Circumcision Room in Topkapı Palace|250x250px]] ====Filipino culture==== {{Main|Tuli (rite)}}

In the Philippines, circumcision is known as "tuli" and is generally viewed as a rite of passage.<ref name=Tuli2011/> An overwhelming majority of Filipino men are circumcised.<ref name="Tuli2011">{{cite web|title=Tuli a rite of passage for Filipino boys|url=http://www.gmanetwork.com/news/story/219779/news/nation/tuli-a-rite-of-passage-for-filipino-boys|access-date=6 December 2015|date=6 May 2011|url-status=live|archive-url=https://web.archive.org/web/20151208183045/http://www.gmanetwork.com/news/story/219779/news/nation/tuli-a-rite-of-passage-for-filipino-boys|archive-date=8 December 2015}}</ref>{{efn| The most commonly-done procedure is in actuality not a ''circumcision'' but a dorsal slit, where no foreskin is actually removed. When the foreskin is removed, it is commonly known locally as a "German cut" in reference to the introduction of the modern surgical technique by the founder of plastic and reconstructive surgery, Johann Friedrich Dieffenbach.<ref>[https://books.google.com/books?id=hpNlnylhRKsC&pg=PA435 ''Zirkumzision nach Dieffenbach.''] {{Webarchive|url=https://web.archive.org/web/20220902032825/https://books.google.com/books?id=hpNlnylhRKsC&pg=PA435 |date=2 September 2022 }} (vgl. Schumpelick u. a., S. 434 ff.)</ref>}} Often this occurs in April and May, when Filipino boys are taken by their parents. The practice dates back to the arrival of Islam in 1450. Pressure to be circumcised is even in the language: one Tagalog profanity for "uncircumcised" is ''supot'', meaning "coward". A circumcised eight- or ten-year-old is no longer considered a boy and is given more adult roles in the family and society.<ref>{{cite news |title='Circumcision season': Philippine rite puts boys under pressure |url=https://www.channelnewsasia.com/news/asia/-circumcision-season---philippine-rite-puts-boys-under-pressure--11640442 |access-date=20 June 2019 |work=Channel News Asia |agency=Agence France-Presse |date=19 June 2019 |archive-date=20 June 2019 |archive-url=https://web.archive.org/web/20190620140705/https://www.channelnewsasia.com/news/asia/-circumcision-season---philippine-rite-puts-boys-under-pressure--11640442 }}</ref>

===Ethics=== {{excerpt|Ethics of circumcision|paragraphs=2}} ===Regulations=== Worldwide, most polities have no laws about circumcision of males,<ref name=WHO_2007_GTDPSA/> with religious infant circumcision legal in every country.<ref name="Cohen-Almagor-2020" /><ref name=RACP_2010/> A few countries have passed legislation on the procedure: Germany allows routine circumcision,<ref name=DW_2012/> while non-religious routine neonatal circumcision is regulated in South Africa and Sweden.<ref name=WHO_2007_GTDPSA/><ref name=RACP_2010/> No major medical organization recommends circumcising all males, and no major medical organization recommends banning the procedure.<ref name="Bolnick_2012_ch1" /><ref name="Basaran-2023">{{Cite book | vauthors = Basaran O |title=Circumcision and Medicine in Modern Turkey |publisher=University of Texas Press |year=2023 |isbn=978-1-4773-2702-9 |pages=156–157 |quote=Regardless of their ethical stances, scholars of both camps tend to agree that a blanket criminalization of male circumcision would be unhelpful and harmful to boys...}}</ref><ref name="Cohen-Almagor-2020" />

In the academic literature, there is general agreement among both supporters and opponents of the practice that an outright ban would be predominately ineffective and "harmful".<ref name="Bolnick_2012_ch1" /><ref name="Cohen-Almagor-2020" /><ref name="knmg.nl">{{cite web |title=Non-therapeutic circumcision of male minors | work = KNMG Viewpoint | location = Utrecht, The Netherlands | publisher = Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst (KNMG) (Royal Dutch Society for the Promotion of Medicine)| date = May 2010 |url=https://www.knmg.nl/advies-richtlijnen/knmg-publicaties/publications-in-english.htm |access-date=7 March 2018 |archive-date=8 March 2018 |archive-url=https://web.archive.org/web/20180308231353/https://www.knmg.nl/advies-richtlijnen/knmg-publicaties/publications-in-english.htm |url-status=live }}</ref><ref name="Basaran-2023" /> A consensus to keep the procedure within the purview of medical professionals is found across all major medical organizations, which advise medical professionals to yield to some degree to parental preferences in their decision to circumcise.<ref name="Bolnick_2012_ch1" /><ref name="Cohen-Almagor-2020" /> The Royal Dutch Medical Association, which expresses some of the strongest opposition to routine neonatal circumcision, argues that while there are valid reasons for banning it, doing so could lead parents who insist on it to turn to poorly trained practitioners instead of medical professionals.<ref name="Bolnick_2012_ch1" /><ref name=RACP_2010/>

During the 2010s, several right-wing nationalist parties prominently called for the banning of circumcision.<ref>{{Cite book | vauthors = Bruns A, Bu Y, Merkt H |title=Legal Theory and Interpretation in a Dynamic Society |publisher=Nomos Verlagsgesellschaft |year=2021 |isbn=978-3-7489-2584-2 |page=352}}</ref> Randi Gressgård, Researcher at the Centre for Women's and Gender Research (SKOK) at the University of Bergen, argued that politicians that supported Norway's proposed circumcision ban debated circumcision in a manner which constituted "ethnocentrism".<ref>{{Cite book | vauthors = Gressgård R |title=Multicultural Dialogue: Dilemmas, Paradoxes, Conflicts |publisher=Berghahn Books |year=2012 |isbn=978-0-85745-648-9 |pages=7, 94}}</ref>

===Economic considerations=== The cost-effectiveness of circumcision has been studied to determine whether a policy of circumcising all newborns or a policy of promoting and providing inexpensive or free access to circumcision for all adult men who choose it would result in lower overall societal healthcare costs. As HIV/AIDS is an incurable disease that is expensive to manage, significant effort has been spent studying the cost-effectiveness of circumcision to reduce its spread in parts of Africa that have a relatively high infection rate and low circumcision prevalence.<ref name=doyle_2010/> Several analyses have concluded that circumcision programs for adult men in Africa are cost-effective and in some cases cost-saving.<ref name=uthman_2010/><ref>{{cite journal | vauthors = Grimes CE, Henry JA, Maraka J, Mkandawire NC, Cotton M | title = Cost-effectiveness of surgery in low- and middle-income countries: a systematic review | journal = World Journal of Surgery | volume = 38 | issue = 1 | pages = 252–263 | date = January 2014 | pmid = 24101020 | doi = 10.1007/s00268-013-2243-y }}</ref> In Rwanda, circumcision has been found to be cost-effective across a wide range of age groups from newborn to adult,<ref name=albero_2012/><ref name=binagwaho_2010/> with the greatest savings achieved when it is performed in the newborn period due to the lower cost per procedure and greater timeframe for HIV infection protection.<ref name="kim_2010">{{cite journal | vauthors = Kim HH, Li PS, Goldstein M | title = Male circumcision: Africa and beyond? | journal = Current Opinion in Urology | volume = 20 | issue = 6 | pages = 515–519 | date = November 2010 | pmid = 20844437 | doi = 10.1097/MOU.0b013e32833f1b21 }}</ref><ref name=binagwaho_2010/> Circumcision to prevent HIV transmission in adults has also been found to be cost-effective in South Africa, Kenya, and Uganda, with cost savings estimated in the billions of US dollars over 20 years.<ref name=doyle_2010/> Hankins ''et al.'' (2011) estimated that a $1.5 billion investment in circumcision for adults in 13 high-priority African countries would yield $16.5 billion in savings.<ref name=hankins_2011/>

The overall cost-effectiveness of neonatal circumcision has also been studied in the United States, which has a different cost setting from Africa in areas such as public health infrastructure, availability of medications, and medical technology and the willingness to use it.<ref name=xu_2009/> A CDC study suggests that newborn circumcision is societally cost-effective in the U.S., based on its efficacy against the transmission of HIV alone during coitus, without considering any other benefits.<ref name=AAP_2012/> The American Academy of Pediatrics (2012) recommends that neonatal circumcision in the U.S. be covered by third-party payers such as Medicaid and insurance.<ref name=AAP_2012/> A 2014 review that considered reported benefits of circumcision such as reduced risks of HIV, HPV, and HSV-2 stated that circumcision is cost-effective in the U.S. and Africa and may result in health care savings.<ref>{{cite journal | vauthors = Tobian AA, Kacker S, Quinn TC | title = Male circumcision: a globally relevant but under-utilized method for the prevention of HIV and other sexually transmitted infections | journal = Annual Review of Medicine | volume = 65 | pages = 293–306 | date = 2014 | pmid = 24111891 | pmc = 4539243 | doi = 10.1146/annurev-med-092412-090539 }}</ref> A 2014 literature review found significant gaps in the literature on male and female sexual health that must be addressed for the literature to be applicable to North American populations.<ref name = bossio_2014/>

== References == {{Reflist|refs=  <ref name=AAFP_2013>{{cite web |title=Neonatal Circumcision |access-date=3 August 2015 |year=2013 |publisher=American Academy of Family Physicians |url=http://www.aafp.org/about/policies/all/neonatal-circumcision.html |url-status=live |archive-url=https://web.archive.org/web/20150721022442/http://www.aafp.org/about/policies/all/neonatal-circumcision.html |archive-date=21 July 2015 }}</ref>

<ref name=AAP_2012>{{cite journal | vauthors = ((American Academy of Pediatrics Task Force on Circumcision)) | title = Male circumcision | journal = Pediatrics | volume = 130 | issue = 3 | pages = e756–e785 | date = September 2012 | pmid = 22926175 | doi = 10.1542/peds.2012-1990 | doi-access = free }}</ref>

<ref name = "Afshar_2018">{{Cite book | vauthors = Afshar K, Kazemi B, MacNeily A |title=Diagnostics to Pathogenomics of Sexually Transmitted Infections |publisher=Wiley |year=2018 |isbn=978-1-119-38084-9 | veditors = Singh S |pages=28–34 |chapter=The Role of Circumcision in Preventing Sexually Transmitted Infections}}</ref>

<ref name=albero_2012>{{cite journal | vauthors = Albero G, Castellsagué X, Giuliano AR, Bosch FX | title = Male circumcision and genital human papillomavirus: a systematic review and meta-analysis | journal = Sexually Transmitted Diseases | volume = 39 | issue = 2 | pages = 104–113 | date = February 2012 | pmid = 22249298 | doi = 10.1097/OLQ.0b013e3182387abd | doi-access = free }}</ref>

<ref name="alanis_2004">{{cite journal | vauthors = Alanis MC, Lucidi RS | title = Neonatal circumcision: a review of the world's oldest and most controversial operation | journal = Obstetrical & Gynecological Survey | volume = 59 | issue = 5 | pages = 379–395 | date = May 2004 | pmid = 15097799 | doi = 10.1097/00006254-200405000-00026 }}</ref>

<ref name=alsabbagh_1996>{{cite book |author=al-Sabbagh, Muhammad Lutfi |title=Islamic ruling on male and female circumcision |page=[https://archive.org/details/islamicrulingonm0000alsa/page/16 16] |year=1996 |publisher=World Health Organization |isbn=978-92-9021-216-4 |url=https://archive.org/details/islamicrulingonm0000alsa/page/16 }}</ref>

<ref name=aridogan_2011>{{cite journal | vauthors = Aridogan IA, Izol V, Ilkit M | title = Superficial fungal infections of the male genitalia: a review | journal = Critical Reviews in Microbiology | volume = 37 | issue = 3 | pages = 237–244 | date = August 2011 | pmid = 21668404 | doi = 10.3109/1040841X.2011.572862 }}</ref>

<ref name=AUA_2007>{{cite web|url=http://www.auanet.org/about/policy-statements/circumcision.cfm|title=Circumcision|access-date=2 November 2008|author=American Urological Association|archive-url=https://web.archive.org/web/20130825011022/http://www.auanet.org/about/policy-statements/circumcision.cfm|archive-date=25 August 2013}}</ref>

<ref name=AVAC_2015>{{cite web|title=Clearinghouse on Male Circumcision for HIV Prevention Redesigned|url=http://www.avac.org/blog/clearinghouse-male-circumcision-hiv-prevention-redesigned|website=AVAC|date=May 2015|access-date=11 March 2017|url-status=live|archive-url=https://web.archive.org/web/20170312065747/http://www.avac.org/blog/clearinghouse-male-circumcision-hiv-prevention-redesigned|archive-date=12 March 2017}}</ref>

<ref name=becker_2011>{{cite journal | vauthors = Becker K | title = Lichen sclerosus in boys | journal = Deutsches Ärzteblatt International | volume = 108 | issue = 4 | pages = 53–58 | date = January 2011 | pmid = 21307992 | pmc = 3036008 | doi = 10.3238/arztebl.2011.0053 }}</ref>

<ref name=binagwaho_2010>{{cite journal | vauthors = Binagwaho A, Pegurri E, Muita J, Bertozzi S | title = Male circumcision at different ages in Rwanda: a cost-effectiveness study | journal = PLOS Medicine | volume = 7 | issue = 1 | article-number = e1000211 | date = January 2010 | pmid = 20098721 | pmc = 2808207 | doi = 10.1371/journal.pmed.1000211 | veditors = Kalichman SC | doi-access = free }}</ref>

<ref name="Bolnick_2012_ch1">{{cite book |title=Surgical Guide to Circumcision |vauthors=Jacobs M, Grady R, Bolnick DA |publisher=Springer |year=2012 |isbn=978-1-4471-2857-1 |veditors=Bolnick DA, Koyle M, Yosha A |location=London |pages=3–8, 255–257 |chapter=Current Circumcision Trends and Guidelines |doi=10.1007/978-1-4471-2858-8_1 |quote=Outside of strategic regions in sub-Saharan Africa, no call for routine circumcision has been made by any established medical organizations or governmental bodies. Positions on circumcision include "some medical benefit/parental choice" in the United States, "no medical benefit/parental choice" in Great Britain, and "no medical benefit/physical and psychological trauma/parental choice" in the Netherlands. |author2-link=}}</ref>

<ref name=Bolnick_2012_ch23>{{cite book | vauthors = Bolnick DA, Katz KE |year= 2012 |chapter= Jewish Ritual Circumcision| veditors = Bolnick DA, Koyle M, Yosha A |title=Surgical Guide to Circumcision |location= London |publisher=Springer |pages=265–274 |doi=10.1007/978-1-4471-2858-8_23 |isbn=978-1-4471-2857-1 }}</ref>

<ref name=Bolnick_2012_ch24>{{cite book | vauthors = El-Sheemy MS, Ziada AM |year= 2012 |chapter= Islam and Circumcision| veditors = Bolnick DA, Koyle M, Yosha A |title=Surgical Guide to Circumcision |location= London |publisher=Springer |pages=275–280 |doi=10.1007/978-1-4471-2858-8_24 |isbn=978-1-4471-2857-1 }}</ref>

<ref name=Bolnick_2012_ch26>{{cite book | vauthors = Adams G, Adams K |year= 2012 |chapter= Circumcision in the Early Christian Church: The Controversy That Shaped a Continent| veditors = Bolnick DA, Koyle M, Yosha A |title=Surgical Guide to Circumcision |location= London |publisher=Springer |pages=291–298 |doi=10.1007/978-1-4471-2858-8_26 |isbn=978-1-4471-2857-1 }}</ref>

<ref name=bossio_2014>{{cite journal | vauthors = Bossio JA, Pukall CF, Steele S | title = A review of the current state of the male circumcision literature | journal = The Journal of Sexual Medicine | volume = 11 | issue = 12 | pages = 2847–2864 | date = December 2014 | pmid = 25284631 | doi = 10.1111/jsm.12703 }}</ref>

<ref name=CDC_HPV>{{cite web |url=https://www.cdc.gov/std/HPV/STDFact-HPV.htm |title=STD facts – Human papillomavirus (HPV) |publisher=CDC |access-date=12 September 2012 |url-status=live |archive-url=https://web.archive.org/web/20120911095019/http://www.cdc.gov/STD/HPV/STDFact-HPV.htm |archive-date=11 September 2012 }}</ref>

<ref name=CPSBC_2009>{{cite report |title=Professional Standards and Guidelines – Circumcision (Infant Male) |work=College of Physicians and Surgeons of British Columbia |date=September 2009 }}</ref>

<ref name="caga-anan_2011">{{cite book |url=https://books.google.com/books?id=C1T6NrSPD_AC&pg=PA43 |title=Clinical Ethics in Pediatrics: A Case-Based Textbook |vauthors=Caga-anan EC, Thomas AJ, Diekema DS, Mercurio MR, Adam MR |date=8 September 2011 |publisher=Cambridge University Press |isbn=978-0-521-17361-2 |page=43 |archive-url=https://web.archive.org/web/20160118224324/https://books.google.com/books?id=C1T6NrSPD_AC&pg=PA43 |archive-date=18 January 2016 |url-status=live}}</ref>

<ref name = "Clarence-Smith_2008">{{cite journal | vauthors = Clarence-Smith WG |date=2008 |title=Islam and Female Genital Cutting in Southeast Asia: The Weight of the Past |url= http://www.etmu.fi/fjem/pdf/FJEM_2_2008.pdf |archive-url=https://web.archive.org/web/20090306050235/http://www.etmu.fi/fjem/pdf/FJEM_2_2008.pdf |archive-date=6 March 2009 |journal=Finnish Journal of Ethnicity and Migration |volume=3 |issue=2: Special Issue: Female Genital Cutting in the Past and Today |pages=14–22 }}</ref>

<ref name = "Dana_2003">{{cite book | vauthors = Dana N |year=2003 |title=The Druze in the Middle East: Their Faith, Leadership, Identity and Status| isbn=978-1-903900-36-9| page =56|publisher=University of Michigan Press|quote=}}</ref>

<ref name=darby_2003>{{cite journal| vauthors = Darby R |title=The Masturbation Taboo and the Rise of Routine Male Circumcision: A Review of the Historiography|journal=Journal of Social History|date=Spring 2003|volume=36|issue=3|pages=737–757|doi=10.1353/jsh.2003.0047 |jstor=3790737}}</ref>

<ref name=darby_2005>{{cite book| vauthors = Darby R |title=A surgical temptation: the demonization of the foreskin and the rise of circumcision in Britain|publisher=University of Chicago Press|location=Chicago|year=2005|isbn=978-0-226-13645-5|pages=262–}}</ref>

<ref name="Doy2005">{{cite journal | vauthors = Doyle D | title = Ritual male circumcision: a brief history | journal = The Journal of the Royal College of Physicians of Edinburgh | volume = 35 | issue = 3 | pages = 279–285 | date = October 2005 | doi = 10.1177/1478271520053503005 | pmid = 16402509 }}</ref>

<ref name=doyle_2010>{{cite journal | vauthors = Doyle SM, Kahn JG, Hosang N, Carroll PR | title = The impact of male circumcision on HIV transmission | journal = The Journal of Urology | volume = 183 | issue = 1 | pages = 21–26 | date = January 2010 | pmid = 19913816 | doi = 10.1016/j.juro.2009.09.030 }}</ref>

<ref name=DW_2012>{{cite news | url=http://www.dw.de/circumcision-remains-legal-in-germany/a-16399336 | title=Circumcision remains legal in Germany | work=Deutsche Welle | date=12 December 2012 | access-date=11 September 2013 | url-status=live | archive-url=https://web.archive.org/web/20131026154156/http://www.dw.de/circumcision-remains-legal-in-germany/a-16399336 | archive-date=26 October 2013 }}</ref>

<ref name=encyc_religion_2005>{{cite encyclopedia |year=2005 |title=Circumcision |encyclopedia=Encyclopedia of Religion |edition=2 |publisher=Gale}}</ref>

<ref name=encyc_judaica_2006>{{cite encyclopedia | veditors = Skolnik F, Berenbaum M |year=2006 |title=Circumcision |encyclopedia=Encyclopaedia Judaica |edition=2nd |publisher=Macmillan Reference |location=USA |isbn=978-0-02-865928-2}}</ref>

<ref name="Gable-2007">{{Cite book| vauthors = Gable L, Gamharter K, Gostin L, Hodge Jr J, Puymbroeck R |title=Legal Aspects of HIV/AIDS: A Guide for Policy and Law Reform |publisher=World Bank Publications|year=2007|isbn=978-0-8213-7105-3|pages=38–39|chapter=1.12 Male Circumcision}}</ref>

<ref name=gollaher_2001_ch1>{{cite book |vauthors=Gollaher D | chapter = Chapter 1: The Jewish Tradition | pages = 1–30 |title=Circumcision: A History of the World's Most Controversial Surgery |date=February 2001 |publisher=Basic Books |isbn=978-0-465-02653-1 |url=https://books.google.com/books?id=usEzSffvPBMC |archive-url=https://web.archive.org/web/20160118224324/https://books.google.com/books?id=usEzSffvPBMC |archive-date=18 January 2016 }}</ref>

<ref name=gollaher_2001_ch2>{{cite book |vauthors=Gollaher D | chapter = Chapter 2: Christians and Muslims | pages = 31–52 |title=Circumcision: A History of the World's Most Controversial Surgery |date=February 2001 |publisher=Basic Books |isbn=978-0-465-02653-1 |url=https://books.google.com/books?id=usEzSffvPBMC |archive-url=https://web.archive.org/web/20160118224324/https://books.google.com/books?id=usEzSffvPBMC |archive-date=18 January 2016 }}</ref>

<ref name=gollaher_2001_ch3>{{cite book |vauthors=Gollaher D | chapter = Chapter 3: Symbolic Wounds | pages = 53–72 |title=Circumcision: A History of the World's Most Controversial Surgery |date=February 2001 |publisher=Basic Books |isbn=978-0-465-02653-1 |url=https://books.google.com/books?id=usEzSffvPBMC |archive-url=https://web.archive.org/web/20160118224324/https://books.google.com/books?id=usEzSffvPBMC |archive-date=18 January 2016 }}</ref>

<ref name=gollaher_2001_ch4>{{cite book |vauthors=Gollaher D | chapter = Chapter 4: From Ritual to Science | pages = 73–108 |title=Circumcision: A History of the World's Most Controversial Surgery |date=February 2001 |publisher=Basic Books |isbn=978-0-465-02653-1 |url=https://books.google.com/books?id=usEzSffvPBMC |archive-url=https://web.archive.org/web/20160118224324/https://books.google.com/books?id=usEzSffvPBMC |archive-date=18 January 2016 }}</ref>

<ref name="Hamilton-1990">{{Cite book | vauthors = Hamilton V |title=The Book of Genesis, Chapters 1-17 |publisher=Eerdmans Publishing Company |year=1990 |isbn=978-0-8028-2521-6 |page=473 |quote=In fact, circumcision is only one of two performative commands, the neglect of which bring the kareth penalty. (The other is the failure to be cleansed from corpse contamination, umb. 19:11-22.) |author-link=Victor P. Hamilton}}</ref>

<ref name=hankins_2011>{{cite journal | vauthors = Hankins C, Forsythe S, Njeuhmeli E | title = Voluntary medical male circumcision: an introduction to the cost, impact, and challenges of accelerated scaling up | journal = PLOS Medicine | volume = 8 | issue = 11 | article-number = e1001127 | date = November 2011 | pmid = 22140362 | pmc = 3226452 | doi = 10.1371/journal.pmed.1001127 | veditors = Sansom SL | doi-access = free }}</ref>

<ref name="hay_2012">{{cite book |vauthors=Hay W, Levin M |title=Current Diagnosis and Treatment Pediatrics 21/E |pages=18–19 |date=25 June 2012 |publisher=McGraw Hill Professional |isbn=978-0-07-177971-5 |url=https://books.google.com/books?id=V8lMJniWK_QC |url-status=live |archive-url=https://web.archive.org/web/20160118224324/https://books.google.com/books?id=V8lMJniWK_QC |archive-date=18 January 2016 }}</ref>

<ref name=hpv_prevalence_ref_bundle>See: Larke ''et al.'' "Male circumcision and human papillomavirus infection in men: a systematic review and meta-analysis" (2011), Albero ''et al.'' "Male Circumcision and Genital Human Papillomavirus: A Systematic Review and Meta-Analysis" (2012), Rehmeyer "Male Circumcision and Human Papillomavirus Studies Reviewed by Infection Stage and Virus Type" (2011).</ref>

<ref name=jagannath_2012>{{cite journal | vauthors = Jagannath VA, Fedorowicz Z, Sud V, Verma AK, Hajebrahimi S | title = Routine neonatal circumcision for the prevention of urinary tract infections in infancy | journal = The Cochrane Database of Systematic Reviews | volume = 11 | issue = 5 | article-number = CD009129 | date = November 2012 | pmid = 23152269 | doi = 10.1002/14651858.CD009129.pub2 | veditors = Fedorowicz Z | pmc = 12186870 }}</ref>

<ref name=larke_penile_cancer_2011>{{cite journal | vauthors = Larke NL, Thomas SL, dos Santos Silva I, Weiss HA | title = Male circumcision and penile cancer: a systematic review and meta-analysis | journal = Cancer Causes & Control | volume = 22 | issue = 8 | pages = 1097–1110 | date = August 2011 | pmid = 21695385 | pmc = 3139859 | doi = 10.1007/s10552-011-9785-9 }}</ref>

<ref name="larke_HPV_2011">{{cite journal | vauthors = Larke N, Thomas SL, Dos Santos Silva I, Weiss HA | title = Male circumcision and human papillomavirus infection in men: a systematic review and meta-analysis | journal = The Journal of Infectious Diseases | volume = 204 | issue = 9 | pages = 1375–1390 | date = November 2011 | pmid = 21965090 | doi = 10.1093/infdis/jir523 | doi-access = free }}</ref>

<ref name=leber_2006>{{cite web |url=http://www.emedicine.com/derm/topic615.htm |title=Balanitis |access-date=14 October 2008 |vauthors=Leber M, Tirumani A |date=8 June 2006 |publisher=EMedicine |url-status=live |archive-url=https://web.archive.org/web/20081007002704/http://www.emedicine.com/DERM/topic615.htm |archive-date=7 October 2008 }}</ref>

<ref name="lissauer_2012">{{cite book|title=Illustrated Textbook of Paediatrics, Fourth edition|vauthors=Lissauer T, Clayden G|date=October 2011|publisher=Elsevier|isbn=978-0-7234-3565-5|pages=352–353|quote=}}</ref>

<ref name=lonngvist_2010>{{cite journal | vauthors = Lönnqvist PA | title = Regional anaesthesia and analgesia in the neonate | journal = Best Practice & Research. Clinical Anaesthesiology | volume = 24 | issue = 3 | pages = 309–321 | date = September 2010 | pmid = 21033009 | doi = 10.1016/j.bpa.2010.02.012 }}</ref>

<ref name="Mark-2003a">{{Cite book | vauthors = Mark E |title=The Covenant of Circumcision: New Perspectives on an Ancient Jewish Rite |publisher=Brandeis University Press |year=2003 |isbn=978-1-58465-307-3 |page=141 |chapter=Frojmovic/Travelers to the Circumcision |quote=Circumcision became the single most important commandment... the one without which... no Jew could attain the world to come.}}</ref>

<ref name = "Marrazzo et al. 2014">{{cite journal | vauthors = Marrazzo JM, del Rio C, Holtgrave DR, Cohen MS, Kalichman SC, Mayer KH, Montaner JS, Wheeler DP, Grant RM, Grinsztejn B, Kumarasamy N, Shoptaw S, Walensky RP, Dabis F, Sugarman J, Benson CA | title = HIV prevention in clinical care settings: 2014 recommendations of the International Antiviral Society-USA Panel | journal = JAMA | volume = 312 | issue = 4 | pages = 390–409 | date = 23–30 Jul 2014 | pmid = 25038358 | pmc = 6309682 | doi = 10.1001/jama.2014.7999 }}</ref>

<ref name=matthew_2004>{{cite book| vauthors = Matthew HC |title=Oxford dictionary of national biography: in association with the British Academy: from the earliest times to the year 2000|url=https://archive.org/details/isbn_0198613644|url-access=registration|publisher=Oxford University Press|location=Oxford New York|year=2004|isbn=978-0-19-861411-1}}</ref>

<ref name="Merson-2017">{{Cite book | vauthors = Merson M, Inrig S |title=The AIDS Pandemic: Searching for a Global Response |publisher=Springer Publishing |year=2017 |isbn=978-3-319-47133-4 |page=379 |quote=This led to a [medical] consensus that male circumcision should be a priority for HIV prevention in countries and regions with heterosexual epidemics and high HIV and low male circumcision prevalence.}}</ref>

<ref name=NYTimes_2009>{{cite news |title=AIDS: New Web Site Seeks to Fight Myths About Circumcision and H.I.V. | vauthors = McNeil Jr DG |author-link=Donald McNeil, Jr. |url=https://www.nytimes.com/2009/03/03/health/03glob.html |newspaper=The New York Times |date=3 March 2009 |page=D6 |access-date=1 February 2012 |url-status=live |archive-url=https://web.archive.org/web/20140108150300/http://www.nytimes.com/2009/03/03/health/03glob.html |archive-date=8 January 2014 }}</ref>

<ref name=osipov_2006>{{cite web |url=http://www.emedicine.com/derm/topic615.htm |title=Balanoposthitis |access-date=20 November 2006 |vauthors=Osipov V, Acker S |date=November 2006 |website=Reactive and Inflammatory Dermatoses |publisher=EMedicine |url-status=live |archive-url=https://web.archive.org/web/20061211115857/http://emedicine.com/DERM/topic615.htm |archive-date=11 December 2006 }}</ref>

<ref name=perera_2010>{{cite journal | vauthors = Perera CL, Bridgewater FH, Thavaneswaran P, Maddern GJ | title = Safety and efficacy of nontherapeutic male circumcision: a systematic review | journal = Annals of Family Medicine | volume = 8 | issue = 1 | pages = 64–72 | year = 2010 | pmid = 20065281 | pmc = 2807391 | doi = 10.1370/afm.1073 }}</ref>

<ref name=RACP_2010>{{cite web | url=https://www.racp.edu.au/docs/default-source/advocacy-library/circumcision-of-infant-males.pdf | title=Circumcision of Infant Males | publisher=The Royal Australasian College of Physicians | date=Sep 2010 | access-date=11 September 2013 | url-status=live | archive-url=https://web.archive.org/web/20150812092333/http://www.racp.edu.au/docs/default-source/advocacy-library/circumcision-of-infant-males.pdf | archive-date=12 August 2015 }}</ref>

<ref name="rehmeyer_2011">{{cite journal | vauthors = Rehmeyer CJ | title = Male circumcision and human papillomavirus studies reviewed by infection stage and virus type | journal = The Journal of the American Osteopathic Association | volume = 111 | issue = 3 Suppl 2 | pages = S11–S18 | date = March 2011 | pmid = 21415373 }}</ref>

<ref name=riggs_2006>{{cite book | vauthors = Riggs T |title=Worldmark Encyclopedia of Religious Practices: Religions and denominations |chapter=Christianity: Coptic Christianity |year=2006 |publisher=Thomson Gale |isbn=978-0-7876-6612-5 |chapter-url=https://books.google.com/books?id=uTMOAQAAMAAJ |url-status=live |archive-url=https://web.archive.org/web/20160118224324/https://books.google.com/books?id=uTMOAQAAMAAJ |archive-date=18 January 2016 }}</ref>

<ref name=rudolph_2011>{{cite book |vauthors=Rudolph C, Rudolph A, Lister G, First L, Gershon A |title=Rudolph's Pediatrics | edition = 22nd |page=188 |date=18 March 2011 |publisher=McGraw-Hill Companies, Incorporated |isbn=978-0-07-149723-7 |url=https://books.google.com/books?id=or15PgAACAAJ |url-status=live |archive-url=https://web.archive.org/web/20160118224324/https://books.google.com/books?id=or15PgAACAAJ |archive-date=18 January 2016 }}</ref>

<ref name="Selekman-2020">{{Cite book| vauthors = Selekman R, Copp H |title=Campbell Walsh Wein Urology|publisher=Elsevier|year=2020|isbn=978-0-323-67227-6| veditors = Partin A |edition=12th |pages=388–402 |chapter=Urologic Evaluation of the Child}}</ref>

<ref name="siegfried_Cochrane_2009">{{cite journal | vauthors = Siegfried N, Muller M, Deeks JJ, Volmink J | title = Male circumcision for prevention of heterosexual acquisition of HIV in men | journal = The Cochrane Database of Systematic Reviews | issue = 2 | article-number = CD003362 | date = April 2009 | volume = 2013 | pmid = 19370585 | doi = 10.1002/14651858.CD003362.pub2 | veditors = Siegfried N | pmc = 11666075 }}</ref>

<ref name=shockley_2011>{{cite journal | vauthors = Shockley RA, Rickett K | title = Clinical inquiries. What's the best way to control circumcision pain in newborns? | journal = The Journal of Family Practice | volume = 60 | issue = 4 | pages = 233a–233b | date = April 2011 | pmid = 21472156 }}</ref>

<ref name=templeton_2010>{{cite journal | vauthors = Templeton DJ, Millett GA, Grulich AE | title = Male circumcision to reduce the risk of HIV and sexually transmitted infections among men who have sex with men | journal = Current Opinion in Infectious Diseases | volume = 23 | issue = 1 | pages = 45–52 | date = February 2010 | pmid = 19935420 | doi = 10.1097/QCO.0b013e328334e54d }}</ref>

<ref name="Thomas_2021">{{cite journal | vauthors = Thomas A, Necchi A, Muneer A, Tobias-Machado M, Tran AT, Van Rompuy AS, Spiess PE, Albersen M | title = Penile cancer | journal = Nature Reviews. Disease Primers | volume = 7 | issue = 1 | article-number = 11 | date = February 2021 | pmid = 33574340 | doi = 10.1038/s41572-021-00246-5 | type = Review }}</ref>

<ref name=uthman_2010>{{cite journal | vauthors = Uthman OA, Popoola TA, Uthman MM, Aremu O | title = Economic evaluations of adult male circumcision for prevention of heterosexual acquisition of HIV in men in sub-Saharan Africa: a systematic review | journal = PLOS ONE | volume = 5 | issue = 3 | article-number = e9628 | date = March 2010 | pmid = 20224784 | pmc = 2835757 | doi = 10.1371/journal.pone.0009628 | veditors = Van Baal PH | doi-access = free | bibcode = 2010PLoSO...5.9628U }}</ref>

<ref name=weiss_2006_syphilis>{{cite journal | vauthors = Weiss HA, Thomas SL, Munabi SK, Hayes RJ | title = Male circumcision and risk of syphilis, chancroid, and genital herpes: a systematic review and meta-analysis | journal = Sexually Transmitted Infections | volume = 82 | issue = 2 | pages = 101–9; discussion 110 | date = April 2006 | pmid = 16581731 | pmc = 2653870 | doi = 10.1136/sti.2005.017442 }}</ref>

<ref name="weiss_2010_complications">{{cite journal | vauthors = Weiss HA, Larke N, Halperin D, Schenker I | title = Complications of circumcision in male neonates, infants and children: a systematic review | journal = BMC Urology | volume = 10 | article-number = 2 | date = February 2010 | pmid = 20158883 | pmc = 2835667 | doi = 10.1186/1471-2490-10-2 | doi-access = free }}</ref>

<ref name=wetmore_2010>{{cite journal | vauthors = Wetmore CM, Manhart LE, Wasserheit JN | title = Randomized controlled trials of interventions to prevent sexually transmitted infections: learning from the past to plan for the future | journal = Epidemiologic Reviews | volume = 32 | issue = 1 | pages = 121–136 | date = April 2010 | pmid = 20519264 | pmc = 2912604 | doi = 10.1093/epirev/mxq010 }}</ref>

<ref name=WHO_2007_GTDPSA>{{cite book |vauthors=Weiss H, Polonsky J, Bailey R, Hankins C, Halperin D, Schmid G |title=Male circumcision: global trends and determinants of prevalence, safety, and acceptability. |publisher=World Health Organization |publication-place=Geneva |date=2007 |isbn=978-92-4-159616-9 |oclc=425961131 |url=http://www.unaids.org/sites/default/files/media_asset/jc1360_male_circumcision_en_0.pdf |url-status=live |archive-url=https://web.archive.org/web/20151222194858/http://www.unaids.org/sites/default/files/media_asset/jc1360_male_circumcision_en_0.pdf |archive-date=22 December 2015 }}</ref>

<ref name="WHO-2010a">{{cite book |title=Manual for early infant male circumcision under local anaesthesia |date=2010 |publisher=World Health Organization |isbn=978-92-4-150075-3 |hdl=10665/44478 |hdl-access=free |quote=There are significant benefits in performing male circumcision in early infancy, and programmes that promote early infant male circumcision are likely to have lower morbidity rates and lower costs than programmes targeting adolescent boys and men. }}</ref>

<ref name="WHO-2010b">{{cite book |title=Manual for early infant male circumcision under local anaesthesia |date=2010 |publisher=World Health Organization |isbn=978-92-4-150075-3 |hdl=10665/44478 |hdl-access=free |quote=There are significant benefits in performing male circumcision in early infancy, and programmes that promote early infant male circumcision are likely to have lower morbidity rates and lower costs than programmes targeting adolescent boys and men. }}</ref>

<ref name=WHO_adult_devices_2012>{{cite web |year=2012 |title=Use of devices for adult male circumcision in public health HIV prevention programmes: Conclusions of the Technical Advisory Group on Innovations in Male Circumcision |website=World Health Organization |url=http://whqlibdoc.who.int/hq/2012/WHO_HIV_2012.7_eng.pdf |url-status=live |archive-url=https://web.archive.org/web/20130312062922/http://whqlibdoc.who.int/hq/2012/WHO_HIV_2012.7_eng.pdf |archive-date=12 March 2013 }}</ref>

<ref name=wolter_2008>{{cite book |vauthors=Wolter C, Dmochowski R |title=Handbook of Office Urological Procedures |chapter=Circumcision |pages=88– |year=2008 |publisher=Springer |isbn=978-1-84628-523-3 |chapter-url=https://books.google.com/books?id=-ek1wPWaUKkC&pg=PA88 |url-status=live |archive-url=https://web.archive.org/web/20160118224324/https://books.google.com/books?id=-ek1wPWaUKkC&pg=PA88 |archive-date=18 January 2016 }}</ref>

<ref name=xu_2009>{{cite journal | vauthors = Xu X, Patel DA, Dalton VK, Pearlman MD, Johnson TR | title = Can routine neonatal circumcision help prevent human immunodeficiency virus transmission in the United States? | journal = American Journal of Men's Health | volume = 3 | issue = 1 | pages = 79–84 | date = March 2009 | pmid = 19430583 | pmc = 2678848 | doi = 10.1177/1557988308323616 }}</ref>

}}

== Notes == {{notelist}}

== External links == {{sisterlinks|d=Q83345|c=Category:Circumcision|n=Category:Circumcision|q=Circumcision|b=no|v=no|voy=no|m=no|mw=no|s=no|wikt=no|species=no}} * Videos of infant circumcision: using a [https://med.stanford.edu/newborns/professional-education/circumcision/plastibell-technique.html Plastibell], a [https://med.stanford.edu/newborns/professional-education/circumcision/gomco-clamp-technique.html Gomco clamp] and a [https://med.stanford.edu/newborns/professional-education/circumcision/mogen-clamp-technique.html Mogen clamp] (all from Stanford Medical School) * A [https://www.youtube.com/watch?v=Zw-124t993c Xhosa circumcision] from National Geographic

{{Circumcision series}} {{Rites of passage}} {{Male genital procedures}} {{Infants and their care}} {{Authority control}}

Category:Circumcision Category:Human penis Category:Surgical removal procedures Category:Cosmetic surgery Category:Pediatric surgery Category:Male genital modification Category:Male genital procedures Category:Men's rights Category:Prevention of HIV/AIDS Category:Religion and children

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