title: Circumcision does not alter long-term glucocorticoids accumulation or psychological effects associated with trauma- and stressor-related disorders.
abstract: Male infants and boys through early adolescence can undergo circumcision either for the sake of upholding religious traditions or for medical reasons. According to both, Jewish as well as Islamic tenets, circumcision is a religious rite symbolizing the bond with God. The World Health Organization (WHO), the United Nations Council (UNC) as well as the American Academy of Pediatrics (AAP), and the Centers for Disease Control and Prevention (CDC) strongly recommend circumcision to promote hygiene and prevent disease. This procedure has frequently been criticized by various communities claiming that circumcision in infancy and early adolescence were psychologically traumatizing with medical implications up into old age. Due to the lack of evidence concerning an alleged increase in vulnerability, we measured objective and subjective stress and trauma markers, including glucocorticoids from hair samples, in circumcised and non-circumcised males. We found no differences in long-term limbic-hypothalamic-pituitary-adrenal axis activity, subjective stress perception, anxiety, depressiveness, physical complaints, sense of coherence and resilience. Rather, an increase in the glucocorticoid levels indicated a healthy lifestyle and appropriate functioning. Thus, our findings provide evidence that male circumcision does not promote psychological trauma. Moreover, a qualitative approach, the ambivalence construct, was used for the discussion, aiming at a discourse devoid of biases.
authors.affiliation: Department of Medicine, TU Dresden, Carl Gustav Carus, Dresden, Germany.|Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Leipzig, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Ullmann
authors.affiliation: Mind and Brain Theme, South Australian Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Licinio
authors.affiliation: Department of Medicine, TU Dresden, Carl Gustav Carus, Dresden, Germany.|Endokrinologikum RUHR, Bochum, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Barthel
authors.affiliation: German Sport University, Cologne, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Petrowski
authors.affiliation: Department of Medicine, TU Dresden, Carl Gustav Carus, Dresden, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Oratovski
authors.affiliation: Department of Psychology, TU Dresden, Dresden, Germany.|Clinical Psychology, University of Siegen, Siegen, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Stalder
authors.affiliation: Department of Psychology, TU Dresden, Dresden, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Kirschbaum
authors.affiliation: Department of Medicine, TU Dresden, Carl Gustav Carus, Dresden, Germany.|Faculty of Life Sciences & Medicine, Endocrinology and Diabetes, Kings College London, London, UK.
authors.forename: S R
authors.initials: SR
authors.lastname: Bornstein
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002944:Circumcision, Male / Q000523:psychology*; D003348:Cortisone / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005938:Glucocorticoids / Q000378:metabolism; D006197:Hair / Q000737:chemistry; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008297:Male; D000067073:Psychological Trauma / Q000378:metabolism / Q000523:psychology*; D013315:Stress, Psychological / Q000378:metabolism / Q000523:psychology*; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D003348:Cortisone; D006854:Hydrocortisone