Ullmann E, Licinio J, Barthel A, Petrowski K, Oratovski B, Stalder T, Kirschbaum C, Bornstein S R
Department of Medicine, TU Dresden, Carl Gustav Carus, Dresden, Germany.
Department for Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University of Leipzig, Leipzig, Germany.
Transl Psychiatry. 2017 Mar 14;7(3):e1063. doi: 10.1038/tp.2017.23.
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.
男婴和青春期早期的男孩接受包皮环切术,既可以是为了遵循宗教传统,也可以是出于医学原因。根据犹太教和伊斯兰教的教义,包皮环切术是一种宗教仪式,象征着与上帝的联系。世界卫生组织(WHO)、联合国理事会(UNC)、美国儿科学会(AAP)以及疾病控制与预防中心(CDC)都强烈建议进行包皮环切术以促进卫生和预防疾病。这一手术经常受到各种团体的批评,他们声称婴儿期和青春期早期的包皮环切术会造成心理创伤,并对老年产生医学影响。由于缺乏关于所谓易感性增加的证据,我们测量了接受包皮环切术和未接受包皮环切术男性的客观和主观压力及创伤指标,包括毛发样本中的糖皮质激素。我们发现,长期的边缘系统 - 下丘脑 - 垂体 - 肾上腺轴活动、主观压力感知、焦虑、抑郁、身体不适、连贯感和恢复力方面没有差异。相反,糖皮质激素水平的升高表明生活方式健康且功能正常。因此,我们的研究结果证明男性包皮环切术不会造成心理创伤。此外,讨论采用了一种定性方法——矛盾心理结构,旨在进行无偏见的论述。