However, in both medical and community-based settings, adolescents frequently reported limited understanding, indirect or direct pressure from family or community, or lack of opportunity to refuse. Public health circumcision campaigns sometimes introduced additional ethical concerns, including inadequate counseling, insufficient verification of parental consent, and incentivized recruitment. In ritual and traditional contexts, circumcision frequently symbolized social belonging and the transition to manhood, often overriding consideration of the child’s bodily autonomy.
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