78-508: Sex assignment (also known as gender assignment ) is the discernment of an infant's sex, typically made at birth based on an examination of the baby's external genitalia by a healthcare provider such as a midwife, nurse, or physician. In the vast majority of cases (99.95%), sex is assigned unambiguously at birth. However, in about 1 in 2000 births, the baby's genitalia may not clearly indicate male or female, necessitating additional diagnostic steps, and deferring sex assignment. In most countries
156-481: A dorsal slit ), which remains until blood flow has stopped. Finally, the foreskin is amputated . For older babies and adults, circumcision is often performed surgically without specialized instruments, and alternatives such as Unicirc or the Shang ring are available. The circumcision procedure causes pain, and for neonates this pain may interfere with mother-infant interaction or cause other behavioral changes, so
234-483: A 17-month-old boy whose penis was destroyed during circumcision . However, this claim was later shown to be largely false. The subject, David Reimer , later identified as a man. The number of births with ambiguous genitals is in the range of 1 in 2,000 to 1 in 4,500 (0.05% to 0.02%). Typical examples would be an unusually prominent clitoris in an otherwise apparently typical girl, or complete cryptorchidism in an otherwise apparently typical boy. In most of these cases,
312-528: A 2014 review, the effect of circumcision on sexual partners' experiences is unclear as this has not been well studied. According to a policy statement from the Canadian Paediatric Society that was reaffirmed in 2021, "medical studies do not support circumcision as having an impact on sexual function or satisfaction for partners of circumcised individuals". There are popular misconceptions that circumcision benefits or adversely impacts
390-405: 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. In 2010, this was expanded to routine neonatal circumcision, as long as those undergoing the procedure received assent from their parents. In 2020,
468-569: A contributing cause of the Bar Kokhba revolt . 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 . His successor, Antoninus Pius , altered the edict to permit Brit Milah . During this period in history, Jewish circumcision called for the removal of only
546-488: A hermaphrodite had to be classed as either male or female. The 12th-century Decretum Gratiani states that "Whether a hermaphrodite may witness a testament, depends on which sex prevails". The foundation of common law, the 16th Century Institutes of the Lawes of England , described how a hermaphrodite could inherit "either as male or female, according to that kind of sexe which doth prevaile." Legal cases where sex assignment
624-668: A mark of distinction for the elite: the Egyptian Book of the Dead describes the sun god Ra as having circumcised himself. Circumcision is prominent in the Hebrew Bible . 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
702-408: A part of the prepuce, and Hellenized Jews often attempted to look uncircumcised by stretching the extant parts of their foreskins. 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, emphasizing the Jewish view of circumcision as intended to be not just
780-671: A placebo, but the American Academy of Pediatrics (AAP) states that such methods are insufficient alone and should be used to supplement more effective techniques. 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. The available evidence does not indicate that post-procedure pain management
858-436: A reduced risk of cervical cancer (which is caused by a type of HPV) in female partners of men. There is some evidence that circumcision is associated with reduced risk of prostate cancer . A 2017 systematic review found consistent evidence that male circumcision prior to heterosexual contact was associated with a decreased risk of cervical cancer, cervical dysplasia , HSV-2, chlamydia, and syphilis among women. The evidence
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#1732780967382936-606: A rite of passage into adulthood; or as a form of blood sacrifice. Historical campaigns of ethnic, cultural, and religious persecution frequently included bans on circumcision as a means of forceful assimilation, conversion, and ethnocide . 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
1014-423: A sex is tentatively assigned and the parents told that tests will be performed to confirm the apparent sex. Typical tests in this situation might include a pelvic ultrasound to determine the presence of a uterus , a testosterone or 17α-hydroxyprogesterone level, and/or a karyotype . In some of these cases a pediatric endocrinologist is consulted to confirm the tentative sex assignment. The expected assignment
1092-449: A sex of rearing, but also began to include surgical treatment. Undescended testes could be retrieved. A greatly enlarged clitoris could be amputated to the usual size, but attempts to create a penis were unsuccessful. John Money and others controversially believed that children were more likely to develop a gender identity that matched sex of rearing than might be determined by chromosomes, gonads, or hormones. The resulting medical model
1170-453: A significant number of those 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. 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. There
1248-428: 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. While the circumcision of Jesus is celebrated as a feast day in the liturgical calendar of many Christian denominations . Although it is not explicitly mentioned in
1326-423: A strong protective effect against penile cancer in later life. Penile cancer is a rare disease in the developed world but much more prevalent in the developing world . The penile tissue removed during circumcision is a potential origin for penile cancer. Risk-benefit considerations around the use of circumcision as a cancer-preventive measure are a source of debate. Penile cancer development can be detected in
1404-467: Is contraindicated in cases of certain genital structure abnormalities or poor general health. The procedure is associated with reduced rates of sexually transmitted infections and urinary tract infections . This includes reducing the incidence of cancer-causing forms of human papillomavirus (HPV) and significantly reducing HIV transmission among heterosexual men in high-risk populations; its prophylactic efficacy against HIV transmission in
1482-489: 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. In 2007, the WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) stated that they recommended adolescent and adult circumcision as part of
1560-473: Is a risk that the circumcision scar may be tender. There is no good evidence that circumcision affects cognitive abilities. Circumcision is the oldest known surgical procedure. Depictions of circumcised penises are found in Paleolithic art , predating the earliest signs of trepanation . The history of the migration and evolution of circumcision is known mainly from the cultures of two regions. In
1638-405: Is also used to treat various pathologies. These include pathological phimosis , refractory balanoposthitis and chronic or recurrent urinary tract infections (UTIs). Circumcision is contraindicated in certain cases. These include infants with certain genital structure abnormalities, such as a misplaced urethral opening (as in hypospadias and epispadias ), curvature of the head of
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#17327809673821716-635: Is an "objective biological reality" determined at conception and observed at birth, rather than assigned. They say that using "assigned" terminology, which they view as an example of "social constructionism gone amok", distorts scientific facts and could undermine trust in medical institutions. There is a consensus in the use of the term "sex assignment" for newborns with intersex conditions; observed chromosomal sex and assigned sex may intentionally differ for medical reasons (based upon predictions of psychosocial and psychosexual health in later life). Observation or recognition of an infant's sex may be complicated in
1794-442: Is evidence that circumcision is associated with a reduced risk of HIV infection for such men, particularly in low-income countries. 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 an additional method of controlling the spread of HIV. Major medical organizations hold varying positions on
1872-547: 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 . Circumcision is generally electively performed , most commonly done as a form of preventive healthcare , as a religious obligation , or as a cultural practice . It is also an option for cases of phimosis , other pathologies that do not resolve with other treatments, and chronic urinary tract infections (UTIs). The procedure
1950-504: Is known about that history. It has been speculated that circumcision originated as a substitute for castration of defeated enemies or as a religious sacrifice . In many traditions, it acts as a rite of passage marking a boy's entrance into adulthood . At 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
2028-573: 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. It can be treated by meatotomy . Effective pain management should be used during the procedure. Inadequate pain relief may carry the risks of heightened pain response for newborns. Newborns that experience pain due to being circumcised have different responses to vaccines given afterwards, with higher pain scores observed. For adult men who have been circumcised, there
2106-531: Is necessary for, or directly related to, one or more of the agency's functions or activities" Sex registration was introduced in the Netherlands in 1811 due to gender-specific rights and responsibilities, such as military conscription. Many gender-specific provisions in legislation no longer exist, but the provisions remain for rationales that include "speed of identification procedures". Birth certificate Too Many Requests If you report this error to
2184-417: Is needed. For adults, topical anesthesia , ring block, dorsal penile nerve block (DPNB) and general anesthesia are all options, and the procedure requires four to six weeks of abstinence from masturbation or intercourse to allow the wound to heal. Male circumcision reduces the risk of human immunodeficiency virus (HIV) transmission from HIV positive women to men in high risk populations. In 2020,
2262-407: Is the inability to retract the foreskin over the glans penis. At birth, the foreskin cannot be retracted due to adhesions between the foreskin and glans, and this is considered normal (physiological phimosis). Over time the foreskin naturally separates from the glans, and a majority of boys are able to retract the foreskin by age three. Less than one percent are still having problems at age 18. If
2340-422: Is usually confirmed within hours to a few days in these cases. Some infants are born with enough ambiguity that assignment becomes a more drawn-out process of multiple tests and intensive education of the parents about sexual differentiation . In some of these cases, it is clear that the child will face physical difficulties or social stigma as they grow up, and deciding upon the sex of assignment involves weighing
2418-966: The Bubaline Period ; 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. 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 . 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 . Some ancient Egyptian mummies , which have been dated as early as 4000 BCE, show evidence of circumcision. Evidence suggests that circumcision
Sex assignment - Misplaced Pages Continue
2496-681: The Diagnostic and Statistical Manual of Mental Disorders (DSM) maintained by the American Psychiatric Association . Initially, the third edition of the DSM referred to "anatomic sex". By the fourth edition in 1994, the term "assigned sex" was introduced, with subsequent editions also using "biological sex" and "natal gender". The latest revision in 2022 streamlined the language to consistently use "sex assignment". A 2006 consensus statement on intersex conditions also adopted
2574-486: The World Health Organization (WHO) reiterated that male circumcision is an efficacious intervention for HIV prevention if carried out by medical professionals under safe conditions. 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
2652-488: The developed world or among men who have sex with men is debated. Neonatal circumcision decreases the risk of penile cancer . Complication rates increase significantly with age. 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. There are various cultural, social , and ethical views on circumcision. Major medical organizations hold variant views on
2730-413: The prophylactic efficacy of the elective circumcision of minors in the context of developed countries . Literature on the matter is polarized, with the cost-benefit analysis being highly dependent on the kinds and frequencies of health problems in the population under discussion and how circumcision affects them. The World Health Organization (WHO), UNAIDS , and American medical organizations take
2808-535: The 1850s and subsequently widely spread, becoming predominately established as a way to prevent sexually transmitted infections. 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 . It is widespread in Australia, Canada,
2886-403: The 1950s, assignment was based almost entirely on the appearance of the external genitalia. Although physicians recognized that there were conditions in which the apparent secondary sexual characteristics could develop contrary to the person's sex, and conditions in which the gonadal sex did not match that of the external genitalia, their ability to understand and diagnose such conditions in infancy
2964-506: The DPNB. They are more effective than EMLA (eutectic mixture of local anesthetics) cream, which is more effective than a placebo . Topical creams have been found to irritate the skin of low birth weight infants, so penile nerve block techniques are recommended in this group. 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
3042-497: 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
3120-733: The Greeks and later the Romans very difficult. 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 . Antiochus IV's restriction on Jewish circumcision was a major factor in the Maccabean Revolt . Hadrian 's prohibition has also been considered by some to have been
3198-472: The USA. 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
Sex assignment - Misplaced Pages Continue
3276-529: The United States, South Korea, most of Africa, and parts of Asia. It is relatively rare for non-religious reasons in parts of Southern Africa, Latin America, Europe, and parts of Asia. The origin of circumcision is not known with certainty, but the oldest documentation comes from ancient Egypt . Around half of all circumcisions worldwide are performed for reasons of prophylactic healthcare. There
3354-518: The United States. Minor complications are reported to occur in three percent of procedures. Severe complications are rare. A specific complication rate is difficult to determine due to scant data on complications and inconsistencies in their classification. Complication rates are greater when the procedure is performed by an inexperienced operator, in unsterile conditions, or when the child is at an older age. Significant acute complications happen rarely, occurring in about 1 in 500 newborn procedures in
3432-579: The United States. Severe to catastrophic complications, including death, are so rare that they are reported only as individual case reports. Where a Plastibell device is used, the most common complication is the retention of the device occurring in around 3.5% of procedures. Other possible complications include buried penis , chordee , phimosis, skin bridges , urethral fistulas, and meatal stenosis . These complications may be partly avoided with proper technique, and are often treatable without requiring surgical revision. The most common long-term complication
3510-489: The Wikimedia System Administrators, please include the details below. Request from 172.68.168.151 via cp1112 cp1112, Varnish XID 944837407 Upstream caches: cp1112 int Error: 429, Too Many Requests at Thu, 28 Nov 2024 08:02:47 GMT Circumcision Circumcision is a procedure that removes the foreskin from the human penis . In the most common form of the operation, the foreskin
3588-528: The World Health Organization again concluded that male circumcision is an efficacious intervention for HIV prevention and that the promotion of male circumcision is an essential strategy, in addition to other preventive measures, for the prevention of 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
3666-462: The advantages and disadvantages of either assignment. Intersex activists have criticised "normalising" procedures performed on infants and children, who are unable to provide informed consent. In European societies, Roman law , post-classical canon law , and later common law , referred to a person's sex as male, female, or hermaphrodite , with legal rights as male or female depending on the characteristics that appeared most dominant. Under Roman law,
3744-673: The carcinoma in situ (CIS) cancerous precursor stage and at the more advanced invasive squamous cell carcinoma stage. There is 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. Penile cancer has been observed to be nearly eliminated in populations of males circumcised neonatally. Important risk factors for penile cancer include phimosis and HPV infection, both of which are mitigated by circumcision. The mitigating effect circumcision has on
3822-496: The case of intersex infants and children and in cases of early trauma. In such cases, the infant may be assigned male or female, and may receive intersex surgery to confirm that assignment. These medical interventions have increasingly been seen as a human rights violation due to their unnecessary nature and the potential for lifelong complications. Cases of trauma include the famous John/Joan case , where sexologist John Money claimed successful reassignment from male to female of
3900-408: The development of phimosis. Phimosis is also a complication that can result from circumcision. An inflammation of the glans penis and foreskin is called balanoposthitis, and the condition affecting the glans alone is called balanitis . Most cases of these conditions occur in uncircumcised males, affecting 4–11% of that group. The moist, warm space underneath the foreskin is thought to facilitate
3978-598: The fulfillment of a Biblical commandment but also an essential and permanent mark of membership in a people. 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
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#17327809673824056-566: The gender identity that most people with a similar intersex condition develop, although such assignments may be revised as the individual matures. The use of surgical or hormonal interventions to reinforce sex assignments in intersex individuals without informed consent is considered a violation of human rights, according to the Office of the United Nations High Commissioner for Human Rights. Sex assignment refers to
4134-445: 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. Both conditions are usually treated with topical antibiotics (metronidazole cream) and antifungals (clotrimazole cream) or low-potency steroid creams. Circumcision is a treatment option for refractory or recurrent balanoposthitis, but in
4212-582: The healthcare provider's determination, along with other details of the birth, is by law recorded on an official document and submitted to the government for later issuance of a birth certificate and for other legal purposes. The prevalence of intersex conditions , where a baby's sex characteristics do not conform strictly to typical definitions of male or female, ranges between 0.018% and 1.7%. While some intersex conditions result in genital ambiguity (approximately 0.02% to 0.05% of births), others present genitalia that are distinctly male or female, which may delay
4290-486: The identification of an infant's sex at birth, typically based on observable physical characteristics. This is also known as gender assignment. In clinical and medical contexts, terms such as "birth-assigned sex" or "birth-assigned gender" are used to describe the sex identified at birth, while "assigned sex" and "assigned gender" may also refer to any subsequent reassignments, especially common among intersex individuals. The terminology has evolved across various editions of
4368-454: The inability to do so becomes problematic (pathological phimosis) circumcision is a treatment option. 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. Steroid creams are also a reasonable option and may prevent the need for surgery including in those with mild BXO. The procedure may also be used to prevent
4446-513: The incidence of UTIs in boys under two years of age, and there is fair evidence that the reduction in incidence is by a factor of 3–10 times (100 circumcisions prevents one UTI). Circumcision is most likely to benefit boys who have a high risk of UTIs due to anatomical defects, and may be used to treat recurrent UTIs. There is a plausible biological explanation for the reduction in UTI risk after circumcision. The orifice through which urine passes at
4524-771: 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 . There is also evidence that circumcision was practiced among the Aztec and Mayan civilizations in the Americas, but little
4602-413: The likelihood of multiple infections. As of 2012 , there was no strong evidence that it reduces the rate of new HPV infection, but the procedure is associated with increased clearance of the virus by the body, which can account for the finding of reduced prevalence. Although genital warts are caused by a type of HPV, there is no statistically significant relationship between being circumcised and
4680-559: The neonatal period when it is less expensive and has a lower risk of complications. The American Academy of Pediatrics and Centers for Disease Control and Prevention stated that the potential benefits of circumcision outweigh the risks. The World Health Organization in 2010 stated: 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. Circumcision
4758-426: 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. If an individual 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
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#17327809673824836-408: The position that it carries prophylactic health benefits which outweigh the risks, while European medical organizations generally hold the belief that in these situations its medical benefits are not counterbalanced by risk. Advocates of circumcision consider it to have a net health benefit, and therefore feel that increasing the circumcision rate is "imperative". They recommend performing it during
4914-729: The presence of genital warts. 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 . A 2010 review found that circumcision reduced the incidence of HSV -2 (herpes simplex virus, type 2) infections by 28%. The researchers found mixed results for protection against trichomonas vaginalis and chlamydia trachomatis , and no evidence of protection against gonorrhea or syphilis. It may also possibly protect against syphilis in MSM. Phimosis
4992-513: The procedure is attempted. 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 . For adult medical circumcision, superficial wound healing takes up to a week, and complete healing 4 to 6 months. For infants, healing is usually complete within one week. For infant circumcision, devices such as the Gomco clamp , Plastibell and Mogen clamp are commonly used in
5070-419: The recognition of an intersex condition until later in life. Societally and medically, it is generally assumed that a person's gender identity will align with the sex assigned at birth, making them cisgender . However, for a minority, assigned sex and gender identity do not coincide, leading to transgender identity experiences. When assigning sex to intersex individuals, some healthcare providers may consider
5148-407: 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. Circumcision is also associated with a reduced prevalence of cancer-causing types of HPV in men and
5226-403: The sexual pleasure of the circumcised person. Neonatal circumcision is generally a safe, low-risk procedure when done by an experienced practitioner. The most common acute complications are bleeding, infection and the removal of either too much or too little foreskin. These complications occur in approximately 0.13% of procedures, with bleeding being the most common acute complication in
5304-524: The strength of circumcision's prophylactic efficacy in developed countries. Some medical organizations take the position that it carries prophylactic health benefits which outweigh the risks, while other medical organizations generally hold the belief that in these situations its medical benefits are not counterbalanced by risk. Circumcision is one of the world's most common and oldest medical procedures. Prophylactic usage originated in England during
5382-399: The terms "assigned sex" and "assigned gender". Sex is assigned as either male or female, leading to specific terms: More visible adoption of the terminology of sex assignment has led to public debate and criticism. Mathematician Alan Sokal and biologist Richard Dawkins have argued against the "assigned at birth" terminology. In a 2024 op-ed for The Boston Globe , they contended that sex
5460-432: 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. Not being circumcised is the primary risk factor for penile cancer . Pre-adolescent circumcision has
5538-404: The twenty-first century the availability of the other treatments has made it less necessary. A UTI affects parts of the urinary system including the urethra , bladder , and kidneys . There is about a one percent risk of UTIs in boys under two years of age, and the majority of incidents occur in the first year of life. There is good but not ideal evidence that circumcision of babies reduces
5616-407: The use of analgesia is advocated. 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. 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
5694-492: 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. 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 found infected with cancer-causing types of HPV than an uncircumcised man. It also decreases
5772-470: Was less consistent in regards to the potential association of circumcision with women's risk of HPV and HIV. The accumulated data show circumcision does not have an adverse physiological effect on sexual pleasure, function, desire, or fertility. 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 . According to
5850-442: Was placed in doubt have been described over the centuries. With the medicalization of intersex, criteria for assignment have evolved over the decades, as clinical understanding of biological factors and diagnostic tests have improved, as surgical techniques have changed and potential complications have become clearer, and in response to the outcomes and opinions of adults who have grown up with various intersex conditions. Before
5928-568: 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. 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 2400–2300 BCE. Circumcision was possibly done by
6006-613: Was termed the "Optimal gender model". In recent years, the perceived need to legally assign sex is increasingly being challenged by transgender, transsexual, and intersex people. A report for the Dutch Ministry of Security and Justice states "Gender increasingly seems to be perceived as a 'sensitive' identity feature, but so far is not regarded, nor protected as such in privacy regulations". Australian government guidelines state that "departments and agencies that collect sex and/or gender information must not collect information unless it
6084-534: Was too poor to attempt to predict future development in most cases. In the 1950s, endocrinologists developed a basic understanding of the major intersex conditions such as congenital adrenal hyperplasia (CAH), androgen insensitivity syndrome , and mixed gonadal dysgenesis . The discovery of cortisone allowed survival of infants with severe CAH for the first time. New hormone tests and karyotypes allowed more confident diagnosis in infancy and prediction of future development. Sex assignment became more than choosing
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