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These comprised 11,173 total males, 4340 circumcised in infancy and 6908 uncircumcised. Nineteen were rated 1+, 2++ or 2+, and 5 were rated 2\u2013 by SIGN criteria. Neonatal circumcision, particularly without anesthetic, increased vaccination pain response, but had little effect on breastfeeding or cognitive ability. Studies reporting associations with sudden infant death syndrome, autism, alexithymia and impaired sexual function and pleasure had design flaws and were rated 2\u2013. Sexual arousal, touch, pain, and warmth thresholds measured by quantitative sensory testing were not diminished in neonatally circumcised men. Neonatal circumcision was not associated with empathy in men, contradicting the hypothesis that procedural pain causes central nervous system changes. After correcting all associations with socioaffective processing parameters for multiple testing only higher sociosexual desire, dyadic sexual libido\/drive, and stress remained significant. The relatively greater sexual activity found in circumcised men might reflect reduced sexual activity in uncircumcised men overall owing to pain and psychological aversion in those with foreskin\u2010related medical conditions (reverse causality). Most studies employed case\u2010control designs with limited follow\u2010up. Studies beyond childhood were prone to confounding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The highest quality evidence suggest that neonatal and later circumcision has limited or no short\u2010term or long\u2010term adverse psychological effects.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jebm.12482","type":"journal-article","created":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T08:35:09Z","timestamp":1656923709000},"page":"123-135","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Critical evaluation of contrasting evidence on whether male circumcision has adverse psychological effects: A systematic review"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2468-3566","authenticated-orcid":false,"given":"Brian J.","family":"Morris","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health School of Medical Sciences University of 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