The Unseen Trauma: Rethinking Infant Circumcision in Light of New Pain Research

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What if cutting deeply into and permanently altering the most sensitive part of an infant's genital organs without pain relief caused lifelong trauma and harm--would this be acceptable, or an ethical breach that should be challenged?

Recent groundbreaking research has significantly advanced our understanding of how infants perceive pain. A study using functional Magnetic Resonance Imaging (fMRI) revealed that the brain activity in newborns in response to pain stimuli closely resembles that of adults.1 This finding, highlighted in an eLife 2022 publication, challenges the longstanding belief that infants have a limited capacity to experience pain. Lead researcher Rebeccah Slater's team observed significant activity in 18 of the 20 brain regions studied, indicating a highly developed pain processing capability in infants.2

Historical Perspective on Infant Pain Management

For decades, medical procedures on infants were conducted without adequate pain relief. This practice stemmed from the misconception that infants' pain responses were merely reflexive and not indicative of actual pain experience.3 However, this new study contradicts such assumptions, suggesting that unmanaged pain in infants could be deeply traumatizing. Despite these findings, pain management for infants in many medical procedures, including circumcision, often remains inadequate.4

The Concerns Surrounding Infant Circumcision

Circumcision, a common medical procedure involving the removal of the foreskin from the penis, is often performed without anesthesia. This exposes non-consenting infants to potentially excruciating pain.5 Research has indicated that circumcision can lead to behavioral changes in infants, which are indicative of trauma.6 Furthermore, the procedure results in the loss of sensitive erogenous tissue, which is linked to long-term sexual dysfunction and harm. Studies have reported that circumcised men have a significantly higher rate of erectile dysfunction, decreased penile sensitivity, and an increased incidence of premature ejaculation compared to their uncircumcised counterparts.7,8,9,10

The Emotional Impact of Pain on Infants

The recent study led by Rebeccah Slater sheds light on the emotional processing of pain in infants. Slater noted the unexpected extent to which pain stimuli activated areas of the brain involved in emotional processing. This finding suggests that infants not only experience pain similarly to adults but also emotionally process this pain, which can have long-lasting traumatic effects.2

The Questionable Historical Origin of Circumcision

According to the introduction of Boyle's paper, circumcision was adopted by the 19th century medical establishment for what in today's terms would appear to be superstitious reasons: 

"Non-therapeutic infant male circumcision is "the most commonly performed surgery in the United States".1 It is most often performed for cultural or religious reasons, although it is also frequently performed in hospital settings as a routine procedure, at least in the United States (in contrast to other developed nations),2 where it was adopted by the medical establishment in the late 1800s as a "cure" for masturbation, along with other perceived physical and/or spiritual ailments.3,4 In recent decades, the circumcision of infants and other young boys in the absence of disease or deformity has increasingly been recognized as being in conflict with well-establish- ed principles of medical ethics5-7 and even human rights.8-10 As Dekkers et al. (p. 180)11 noted, both male and female circumcision constitute "an invasive intervention in the external genital organs" without valid medical indication.

Moreover, it is discussed that aspects of circumcision may fall within the category of child sexual abuse: 

According to Peterson (2001, p. 285), "no person has the right to surgically inflict their religious, sexual, or cosmetic preferences on another person… Parents have a duty to protect their children from harmful practices, and no tradition should be enforced by the permanent alteration or disfigurement of the body of an individual who is legally incapable of providing informed consent."12

Indeed, as several authors have argued, such an extreme interference with a child's genitals would ordinarily be viewed as a form of child sexual abuse--Bigelow (1995, p. 97).13-15 The irreversible cutting and removal of part of a child's sexual organ is a very serious interference.16"

Ethical Considerations and Conclusions

Given the anatomical realities and our enhanced understanding of infant pain perception, subjecting infants to circumcision without clear medical necessity raises serious ethical concerns. Evidence indicates that the potential lifelong sexual harm caused by circumcision far outweighs any minor health benefits that have been claimed. As articulated by Boyle and other researchers, infant circumcision is an "ethically impermissible, sexually harmful procedure" that violates children's fundamental rights to bodily integrity and autonomy.11,12

In conclusion, the integration of new insights into infant pain perception with existing research on the consequences of circumcision strengthens the ethical case against this practice. Recognizing and respecting the bodily integrity and autonomy of infants demand a reevaluation of non-therapeutic, non-consensual infant genital cutting practices.

Learn more about the downsides of infant circumcision on our database on the topic here.


References

1. "fMRI reveals neural activity overlap between adult and infant pain," eLife, 2022. This study utilized functional Magnetic Resonance Imaging to compare brain activity in newborns and adults in response to pain, revealing significant similarities in 18 out of 20 brain regions.

2. Rebeccah Slater, interview, Time, 2022. Slater, as the lead researcher in the aforementioned study, provided insights into the surprising level of development in infants' processing of pain.

3. "fMRI reveals neural activity overlap between adult and infant pain," eLife, 2022. This reference supports the historical context regarding misconceptions about infant pain perception.

4. Ibid. This source is cited again to highlight the current state of infant pain management in medical procedures.

5. Ibid. This reference is repeated to underscore the lack of adequate pain management specifically in the context of infant circumcision.

6. Ibid. The same study is cited to provide evidence of the behavioral changes in infants post-circumcision, indicative of trauma.

7. Boyle, "Does Male Circumcision Impair Sexual Function and Cause Other Health Complications? A Comprehensive Review," Journal of Health Psychology, 2015. Boyle's research provides detailed analysis on the loss of erogenous tissue due to circumcision and its link to sexual dysfunction.

8. Bollinger and Van Howe, "Alexithymia and Circumcision Trauma: A Preliminary Investigation," International Journal of Men's Health, 2011. This study discusses the increased rate of erectile dysfunction among circumcised men.

9. Bronselaer et al., "Male Circumcision Decreases Penile Sensitivity as Measured in a Large Cohort," BJU International, 2013. This research provides evidence of decreased penile sensitivity in circumcised men.

10. Van Howe, "A Meta-Analysis of the Sexual, Reproductive, and Mental Health Effects of Circumcision," personal communication. This source offers insights into the increased incidence of premature ejaculation among circumcised men.

11. Earp and Darby, "Does Science Support Infant Circumcision? A Critical Review of the Literature," The Skeptic, 2017. This article reviews the claimed health benefits of circumcision and compares them with the ethical considerations.

12. Boyle, "Does Male Circumcision Impair Sexual Function and Cause Other Health Complications? A Comprehensive Review," Journal of Health Psychology, 2015. Boyle argues against infant circumcision from an ethical standpoint, focusing on the violation of children's rights to bodily integrity and autonomy.

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