Why Is Circumcision So Common in the U.S.?

Circumcision remains a highly controversial procedure here in the U.S. and abroad. For many, the act is a religious custom, while others may choose to circumcise their children out of habit or expectation. Medical experts, doctors, and nurses continue to debate the value of the procedure. There’s also the question of whether the parents should have the right to choose for their children.

Regardless of where you stand on the issue, America is the only country in the developed world where circumcision is done as a medical procedure. In Israel and Muslim-majority countries, circumcision is performed as a religious custom.

The CDC estimates that around 64.7% of all male babies are circumcised, but the rate tends to vary drastically by region, community, and socio-economic status. The National Institute of Health estimates that between 36.7% and 38.7% of males are circumcised worldwide. So, why does the U.S. circumcise so many babies compared to other countries?

The History of Circumcision

The CDC shows that the rate of circumcision has stayed relatively the same over the last 40-plus years. For decades, the procedure was more common among white boys compared to black boys, but the rate is now about the same for both groups.

In some countries, circumcision is billed as a way of preventing genital infection and HIV. The CDC adds that male circumcision can reduce a man’s risk of acquiring HIV infection by 50-60% during sex with HIV-infected female partners. The procedure is now part of HIV prevention programs worldwide.

Some experts have also suggested the procedure can help with self-care and hygiene.

What Science Says

No medical organization or association recommends the procedure for medical purposes. There is no clear evidence to suggest the procedure will benefit the child.

The American Academy of Pediatrics stated in the 1970s that there was no medical indication for routine circumcision. It revised its findings in the 80s to say that there were some health benefits to the procedure, but changed its policy again in the 90s to say that the “the health benefits…outweigh the risks” while adding that “existing scientific evidence is not sufficient to recommend routine circumcision.”

There’s also no evidence to suggest that circumcised penises are more hygienic. Critics of the procedure also point out that uncircumcised boys are usually taught to wash underneath the foreskin.

What’s Driving the Trend?

Without clear evidence to support the benefits of the procedure, many Americans still choose to have the procedure performed on their children.

A recent survey from Intact America, which opposes listing circumcision as a medical procedure, shows that 78% of mothers chose to have their child circumcised when asked by the provider compared to just 45% of mothers who were not asked. They also found that even non-verbal tasks such as requesting the patient to sign a consent form for the procedure can increase the rate of circumcision by 137%.

Of the mothers that opted to have the procedure performed on their sons, 21% said they wished they had done more research before consenting, while 10% said they regretted it all together.

The results show new mothers were asked on average eight times whether they wanted the procedure performed.

“For years, we’ve heard from parents, especially mothers, about having been pressured or coerced by doctors and nurses to circumcise their sons, but the impact and scope of solicitation has never been measured before,” said Georganne Chapin, executive director of Intact America. “The survey shows solicitation directly and dramatically drives up the infant circumcision rate. Soliciting this unnecessary surgery has to end.”

He says it’s common for providers and parents to think that most people want their children circumcised, but the survey suggests most women don’t make up their minds ahead of time.

“Doctors tell us they circumcise boys only because parents want it, but this survey proves otherwise. Both doctors and nurses (including nurse midwives) give mothers the impression that circumcision is, if not necessary, ‘normal’ or desirable, so parents agree to permanently alter their sons’ genitals. But they don’t tell parents the whole story: that circumcision is painful, reduces sexual sensitivity for the man the baby will become, and can lead to lifelong trauma,” Chaplain added.

Listing circumcision as a medical procedure is also big business in the U.S. It’s not clear exactly how many times the procedure is performed each year, but based on the statistics above, 1.5 million boys are circumcised annually in the U.S.

Pediatric circumcision costs around $2,097 on average in the U.S. Insurers usually don’t cover medically unnecessary procedures, but most companies cover circumcision, including most states’ Medicaid programs.

Critics argue the procedure can lead to a loss of sensitivity, scarring, and even death in rare circumstances. The AAP adds that “the true incidence of complications…is unknown.” They also argue the foreskin provides natural lubrication and can even protect against bacterial infection.

Providers may play a role in advocating for the procedure, whether they realize it or not. Good or bad, the U.S. remains one of the most circumcised countries in the world.