Changes

The '''United States of America''' are also known as the '''United States''' or simply '''America''' or by acronyms initialism such as '''USA''' or '''US''' or '''U.S.A.''' or '''U.S.''' (Please note that ''America'' also is the name of two geological continents: ''North America'' and ''South America'' which include many more countries than just the ''United States of America'' which are the topic of this article. See also: [[:Category:Americas]].)

America is predominantly an English-speaking nation. As in other English-speaking nations, non-therapeutic [[circumcision]] of boys was popularized in the late nineteenth century. Due to the rates of infant circumcision that formerly approached 90 percent, however, the vast majority of [[Circumcised doctors| male doctors were neonatally circumcised]] and have no real knowledge of a normal body part. Such doctors frequently give poor advice to parents on the care of the [[intact]] [[penis]].<ref name="goldman2005">{{REFjournal |last=Goldman |first=Ronald |init=R |author-link=Ronald Goldman |etal=no |title=Circumcision policy: a psychosocial perspective |trans-title= |language= |journal=Paediatrics & Child Health (Ottawa) |location= |date=2005-11 |volume=9 |issue=9 |pages=630-3 |url=https://academic.oup.com/pch/article/9/9/630/2648566?login=true |quote= |pubmedID=19675851 |pubmedCID=2724127 |DOI=10.1093/pch/9.9.630 |accessdate=2020-03-16}}</ref> They are also much more likely to injure [[intact]] boys during office visits by premature [[Forced foreskin retraction| forcible foreskin retraction]] (PFFR).<ref>{{REFjournal |last=Narvaez |first=Darcia |init=D |author-link= |last2=Geisheker |first2=John V. |init2=JV |author2-link=John V. Geisheker |url=https://www.psychologytoday.com/us/blog/moral-landscapes/201110/what-is-the-greatest-danger-uncircumcised-boy |title=What Is the Greatest Danger for an Uncircumcised Boy? |journal=Psychology Today |date=2011-10-23 |volume= |issue= |pages= |accessdate=2021-10-31}}</ref>  The United States is unique in having a [[circumcision industry]] that aggressively promotes the practice of medically-unnecessary, non-therapeutic , harmful infant [[circumcision of boys is now in decline]]. The decline of the unnecessary practice has been slowed by continual encouragement and promotion of circumcision by the medical [[circumcision industry]]. However, the practice of non-therapeutic [[circumcision]] of boys is now in decline. Despite the financially self-serving promotional efforts of the [[circumcision industry]], the incidence of non-therapeutic [[circumcision]] of infant boys was reported to have continued its slow decline to 52.1 percent in 2016.<ref name="jacobson2021">{{REFjournal |last=Jacobson |first=Deborah L. |init= |author-link= |last2=Balmert |first2=Lauren C. |init2= |author2-link= |last3=Holl |first3=Jane L. |init3= |author3-link= |last4=Rosoklija |first4=Ilina |init4= |author4-link= |last5=Davis |first5=Matthew M. |init5= |author5-link= |last6=Johnson |first6Emilie K. |init6= |author6-link= |etal=no |title=Nationwide Circumcision Trends: 2003 to 2016 |trans-title= |language= |journal=J Urol |location= |date=2021-01 |volume=205 |issue=1 |article= |pages=257-63 |url=https://www.auajournals.org/doi/abs/10.1097/JU.0000000000001316 |pubmedID=32716676 |pubmedCID= |DOI=10.1097/JU.0000000000001316 |accessdate=2021-10-15}}</ref>

Jews have lived in America since before the Revolutionary War. They have always practiced [[Jewish circumcision| ritual circumcision]], ([[Brit Milah]]), of boys on the eighth day of life in accordance with the [[Abrahamic covenant]], however this was only for a very small percentage of the population.<ref name="self2016">{{REFjournal |url=https://journals.troy.edu/index.php/test/article/view/386/302 |title=The Rise of Circumcision in Victorian America |first=Eleanor |last=Self |author-link=Eleanor Self |journal=The Alexandrian |volume=5 |issue=1 |date=2016 |accessdate=2022-09-02 |format=PDF}}</ref> One may be certain that the eighteenth century [https://www.nationalgeographic.org/article/founding-fathers/ Founding Fathers of the United States] of America were men with [[intact]] [[foreskin]]s as were the [[foreskinned]] men who fought the American Civil War (1861-1865).

One may be certain that the eighteenth century Founding Fathers of the United States of America were men with Non-therapeutic [[intactcircumcision]] of males for non-religious reasons originated with [[Foreskin| foreskinsClaude François Lallemand]] as were in 1836 in France but soon spread to the [[foreskinnedUnited Kingdom]] men who fought in the American Civil War (1861early nineteenth century, from which it eventually spread to other English-1865)speaking nations.

Non-therapeutic [[Edward Dixon (1847) recommended circumcision]] of males for non-religious reasons originated with Claude-Francois Lallemand in 1832 in France but soon spread to prevent the [[United Kingdom]] in the early nineteenth century, from which it eventually spread to other English-speaking nationsof syphilis.<ref name="self2016" />

The late nineteenth century was characterized by various prominent medical doctors advancing all sorts of absurd reasons for the performance of non-therapeutic circumcision, including the prevention of venereal disease.<ref name="self2016" />

The first recorded non-religious circumcision of a boy in the United States occurred in 1870 when [[Lewis Albert Sayre]], a prominent New York City doctor, [[circumcised ]] a boy of five years of age for paralysis. <ref name="gollaher1994">{{GollaherDL 1994}}</ref> [[Lewis Albert Sayre|Sayre]] then continued to advocate circumcision for numerous reasons until his death in 1900. According to [[Lewis Albert Sayre|Sayre]], circumcision was recommended for paralysis, epilepsy, hernia, lunacy, curvature of the spine, and clubfoot.

[[M. J. Moses ]] (1871) advocated [[circumcision ]] to prevent [[masturbation]].<ref name="moses1871">{{REFjournal |last=Moses |init=MJ |title=The value of circumcision as a hygienic and therapeutic measure |journal=New York Medical Journal |date=1871-11 |volume=14 |issue=4 |pages=368-74 |url= |quote= |pubmedID= |pubmedCID= |DOI= |accessdate=Moses1871}}</ref>

[[H. H. Kane]] (1879) 'discovers' that [[circumcision ]] cures nocturnal emissions and abdominal neuralgia.<ref>{{Kane1879}}</ref>

Seventh-day Adventist [[John Harvey Kellogg]], {{MD}}, of Battle Creek, Michigan, was an important 19th century promoter of male circumcision. Although masturbation is never mentioned in the Bible, Dr. Kellogg believed that [[masturbation]] was immoral, sinful, and caused one to dream "impure dreams", which he believed was harmful to the mental faculties, resulting in mental disorders, such as feeblemindness.<ref name="kellogg1879kellogg1888">{{REFbook |url=https://www.gutenberg.org/files/19924/19924-h/19924-h.htm |title=Plain Facts for Old and Young: Natural History and Hygiene of Organic Life (Sex, Marriage & Society Series) |last=Kellogg |first=John Harvey |author-link=John Harvey Kellogg |publisher=Ayer Publishing |website=Gutenberg |year=1888 |accessdate=2021-10-03Kellogg1888}}</ref> He believed that the urge to masturbate could be prevented by eating bland foods, for which purpose, he and his brother invented corn flakes.<ref name="self2016" />

Dr. Kellogg (1879) also recommended [[circumcision]] in cases "in which irritation is produced by retained secretions".<ref name="kellogg1879kellogg1888" />

Dr. Kellogg perhaps is most famous for his book, ''Plain facts for young and old'' (1879), in which he advocated circumcision of boys as punishment for masturbation.<ref name="kellogg1879kellogg1888" />

[[William G. Eggleston]], {{MA}}, {{MD}}, from Chicaco, {{USSC|IL}}, (1886) stated in 1886, that [[foreskin ]] of minors and the natural "phimosis" in minors would cause crossed eyes.<ref name="eggleston1886">{{Eggleston1886}}

Dr. [[William D. Gentry]] (1890) alleged that [[Retraction of the foreskin| phimosis in boys ]] produces serious nervous derangements.<ref name="gentry1890">{{REFjournal

[[Elizabeth Blackwell]], {{MD}}, ({{LifeData|1821|1910}}), was born in England, but attended medical school in the United States. She was the first woman to become a medical doctor in the United States. Blackwell thought [[masturbation ]] was immoral but that [[circumcision ]] was not the way to correct it. She wrote against it in her 1894 book:

|lastinit=BlackwellE

|pages=35-366

[[Peter Charles Remondino]], {{MD}}, <ref name="gollaher1994" /> was a San Diego, California physician, who was born in Turin (''Torino'') in 1846, but migrated with his family to the United States at the age of eight. There is some reason to believe that he was of Sephardic Jewish descent and had been [[circumcised ]] while still in Turin, however this is uncertain.

Remondino is famous for his 346 page book, ''The History of Circumcision''(1891).<ref name="remondino1891">{{REFbook

}}</ref> <ref name="gollaher1994" />

[[H. L. Rosenberry]], {{MD}}, (1894) published a paper "proving" that circumcision cures urinary and rectal incontinence.<ref name="self2016" /> <ref name="rosenberry1894">{{Rosenberry1894}}</ref>

Dr. [[E. J. Spratling]] (1895) provided information for other doctors.<ref name="self2016" /><ref>{{REFjournal |last=Spratling |init=EJ |title=Masturbation in the Adult |journal=Medical Record |volume=24 |issue= |pages=442-443 |url=https://www.proquest.com/openview/9a247c3410d34390e418dc970faa3b87/1?pq-origsite=gscholar&cbl=40146 |quote= |date=1895 |accessdate=2022-08-30}}</ref> By the end of the nineteenth century, America had at least one prominent physician and surgeon on the east coast promoting circumcision and another prominent physician and surgeon on the west coast promoting circumcision. There was no real medical science with which to dispute and discredit their false claims. Non-therapeutic [[circumcision ]] of males was now well-established in the United States.

Brimhall (1902) reported an [[amputation ]] of a [[penis ]] after circumcision.<ref name="brimhall1902">{{REFjournal

|pagespage=490

|pages=92-977

}}</ref> Wolbarst's paper appeared shortly before the start of World War I. It is thought that Wolbarst's false claims inspired some military commanders to require men under their command to be [[circumcised ]] so as to reduce venereal disease (VD).

J. Brennermann (1921) reported that [[Meatal stenosis| meatal disease ]] occurs only in [[circumcised ]] boys who lack the protection of the [[foreskin]].<ref name="brennermann2021>{{REFjournal

[[Abraham L. Wolbarst|Wolbarst]] (1926) made his claim for the first time that male circumcision prevents [[penile cancer]].<ref name="wolbarst1926!>{{REFjournal

[[Abraham L. Wolbarst|Wolbarst]] (1932) put forward his claim again that [[circumcision]] would prevent [[penile cancer]] in the British journal, ''The Lancet''.<ref name="Wolbarst 1932">{{REFjournal |last=Wolbarst |init=AL |author-link=Abraham L. Wolbarst |title=Circumcision and penile cancer |journal=Lancet |volume=1 |issue=5655 |date=1932-01-16 |pages=150-153Wolbarst1932}}</ref> In those long ago days, the true causes of cancer were unknown so it was impossible to disprove Wolbarst's falsehoods.

[[Hiram S. Yellen ]] and [[Aaron Goldstein ]] invented the [[Gomco]] clamp in 1934-51935. The clamp, by crushing the foreskin in an intensely painful procedure, reduced the risk of hemorrhage,<ref name="yellen1935">{{REFjournal |last=Yellen |first=Hiram |init= |date=1935 |title=Bloodless circumcision of the newborn |journal=American Journal of Obstetrics and Gynecology |volume=30 |issue= |pages=146-7 |url=http://www.historyofcircumcision.net/index.php?option=content&task=view&id=43#yel |quote= |accessdate=2021-10-05GoldsteinYellen1935}}</ref> but increased the [[pain]].<ref name="sinkey2015">{{REFjournal

Brown (1937) reported restoration of the [[skin ]] of the [[penis ]] after a denudation complication of circumcision.<ref name="brown1837">{{REFjournal

The information on military circumcision in WWII is sketchy and anecdotal. It appears that many [[foreskinned]] American men were encouraged and, in some cases, forced to be [[circumcised]]. It seems that the American military's [[foreskin]]-phobia and circumcision policy persisted through the Korean War (1950-52) but was discontinued by a change in policy thereafter.

The "Sand Myth" circulated among English-speaking armies. According to the [http://www.circumstitions.com/sand.htm Sand Myth], [[foreskinned ]] men who fought in the Saharan desert had medical issues due to sand collecting under the [[foreskin]]. [[Intact]] Italian and German men who fought in the same desert had no such problems.<ref>{{REFjournal

'''Post-war era.''' In the post-war era after WWII, the popularity of non-therapeutic [[circumcision]] increased, driven by medical promotion by doctors seeking a nice [[Financial incentive| surgical fee]] as an alleged preventive of penile cancer and by the [[Adamant father syndrome| adamant request of circumcised men home from the war who became fathers]].

Non-therapeutic, medically-unnecessary [[circumcision ]] of boys had become a "routine" surgical operation that usually was performed automatically on newborn boys even without consent from anyone.

[[Eugene H. Hand]], {{MD}}, (1949) falsely claimed that circumcision would prevent cancer of the tongue and [[Circumcision and STDs| venereal disease]].<ref name="HandEH1949">{{REFjournal

The publication of a landmark article by [[Douglas Gairdner]] (1949) in the [[United Kingdom]] showing that infant circumcision is non-therapeutic, unnecessary, causes deaths, and which called for preservation of the [[foreskin]]<ref name="gairdner1949">{{GairdnerDM 1949}}</ref> was totally ignored by the [[circumcision industry ]] in the United States.

The Congress of the United States created the [https://www.medicaid.gov/ Medicaid program ] in 1965. Medicaid is a joint federal/state program that pays the medical expenses of low-income Americans. Medicaid covers about 45 percent of births in the United States. Medicaid pays for medically-unnecessary, non-therapeutic circumcision in most 32 states, although it appears to be a violation of law to do so.<ref name="adler2011">{{REFjournal

|pages=335-35353

California Medicaid (Medi-Cal) announced in 1968 that non-therapeutic circumcision would not be a covered benefit.<ref>{{REFweb |url=https://insuremekevin.com/california-health-plans-cover-new-born-circumcision/ |title=Medi-Cal won’t cover circumcision |last= |first= |accessdate=2021-10-05}}</ref> W. K. C. Morgan, a Canadian medical doctor , then on the faculty of the {{UNI|University of Maryland|UMD}} [https://www.medschool.umaryland.edu/ University of Maryland School of Medicine], in a highly critcal letter pubished by ''JAMA'' (1965), slammed the practice of non-therapeutic circumcision of boys as it had developed in the United States.<ref>{{REFjournal

Preston (1970) considered the matter of infant [[circumcision]]. He examined and debunked claims that male circumcision could prevent cancer of the [[cervix ]] in women, cancer of the [[penis ]] and cancer of the prostate in men. Preston concluded:

The [[American Academy of Pediatrics]] (AAP) is not an "academy" at all. It is a [[medical trade association ]] that protects and advances the business and financial interests of its pediatrician "fellows". Influenced by Preston's paper, the AAP published a manual on the hospital care of newborn infants in 1971. The manual included the statement:

|pagespage=110 |location=Evanston, {{USSC|IL}} |publisher=American Academy of Pediatrics.

The statement in the 1971 manual was good medical science, then and now, but it did not sit well with the membership of the AAP because it provided no basis on which to promote non-therapeutic circumcision for profit. A four-member "ad hoc" task force was formed to produce a new statement to fit the desires of the membership , which was published in ''Pediatrics'' in 1975.<ref name="aap1975">{{REFjournal

The statement falsely claimed facilitation of hygiene, prevention of [[phimosis]], and prevention of [[penile cancer]] as reasons that parents may elect non-therapeutic infant circumcision.<ref name="aap1975" />

The statement expressed no concern for the [[pain]] and [[trauma]] of circumcision, nor did it provide information on the functions and value of the [[foreskin]] nor did it recognize the child as a person with domestic and international rights to self-determination and [[physical integrity]]. The statement carefully avoided recommending [[circumcision]] and placed the responsibility for the certain [[amputation ]] injury on the parents rather than on the attending physician.<ref name="aap1975" />

<blockquote>There are no medical indications for [[Routine Infant Circumcision|routine circumcisions]], and the procedure cannot be considered an essential component of health care. If an infant is circumcised, the procedure must be delayed until the infant is at least 24 hours old and stable, without [[bleeding ]] tendency or any other illness. Circumcision must never be done at time of delivery.<ref>{{REFbook |last= |first=

|location=Evanston, {{USSC|IL}}

Infant circumcision traditionally had been carried out without any kind of anesthesia or analgesia because of the false belief that infants could not feel [[pain]]. Researchers started to investigate the [[Pain| pain of circumcision]] in the 1970s. The American Cancer Society estimated that there are about 460 deaths per year in the United States from penile cancer.<ref>{{REFweb |url=https://www.cancer.org/cancer/penile-cancer/about/key-statistics.html |title=Key Statistics for Penile Cancer |last= |first= |date=2021-01-12 |accessdate=2021-10-17}}</ref> Sidney S. Gellis, {{MD}} (1978) estimated that the number of deaths from infant circumcision exceeded the number of deaths from [[penile cancer]].<ref name="gellis1978">{{REFjournal |last=Gellis |first= |init= |author-link= |etal=no |title=Circumcision |trans-title= |language= |journal=Am J Dis Child |location= |date=1978-12 |volume=132 |issue= |article= |page= |pages=1168-9 |url=http://www.cirp.org/library/general/gellis1/ |pubmedID=717329 |pubmedCID= |DOI=10.1001/archpedi.1978.02120370016003 |accessdate=2021-10-17}}</ref>

David Grimes, {{MD}}, (1978), recognized the increasing controversy regarding the practice of non-therapeutic infant [[circumcision]]. Grimes discussed several concerns including:

<blockquote> However, until the benefits of [[routine ]] circumcision of the neonate can be proved worth the risk and cost, medical resources probably should be allocated to measures of demonstrated value.<ref name="grimes1978" />

It was at about this time that several small organizations that opposed non-therapeutic circumcision of boys started to appear. They were the first [[intactivists]], although that word had not yet been coined. One such organization was the Remain Intact Organization of Larchwood, Iowa, which was lead by Rev. [[George Zangger| Russell George Zangger]]. From the 1970s to the 1990s Zangger sent out cards with New Testament quotations that said the outward sign of circumcision is of no value. [[Jeffrey R. Wood]] formed [[INTACT Educational Foundation| INTACT]] (Infants Need to Avoid Circumcision [[Trauma]]), founded in 1976 as a local resource serving Western Massachusetts, and "Dedicated to Preserving Freedom of Choice." The organization gained recognition and had members across the nation.

Boczko & Freed (1979) collected cases of [[penile cancer ]] in circucised [[circumcised]] men and by so doing, disproved the false belief propagated since 1932 by [[Abraham L. Wolbarst]] that circumcision was protective against penile cancer.<ref name="boczko1979">{{REFjournal

Robert Leon Baker, {{MD}} (1979) estimated 229 [[Tim HammondDeath| deaths]] organized per year in the [United States from circumcision complications.<ref name="baker1979">{{REFjournal |last=Baker |first=Robert L. |init= |author-link= |etal=no |title=Newborn male circumcision: needless and dangerous |trans-title= |language= |journal=Sexual Medicine Today |location= |date=1979 |volume=3 |issue=11 |article= |pages=35-6 |url=http://www.noharmmcirp.org/ National Organization to Halt library/general/baker1/ |accessdate=2021-10-17}}</ref> [[Edward Wallerstein]] (1980) published his book, ''[[Circumcision: An American Health Fallacy]]''.<ref name="wallerstein1980">{{WallersteinE 1980}}</ref> Bollinger (2017) reported the Abuse and Routine Mutilation incidence of infant non-therapeutic circumcision peaked at about 85 percent of Malesall infant boys in 1982.<ref name="bollinger2017">{{REFweb |url=https://www.academia.edu/23494197/Infant_Male_Genital_Cutting_Incidence_Worldwide |title=Infant male genital cutting incidence worldwide |last=Bollinger |first=Dan |author-link=Dan Bollinger |publisher=Academia |website= |date=2017-05-19 |accessdate=2021-10-27 |format=PDF |quote=}}</ref> [[John A. Erickson]] (1982) started to work individually to advance [[genital integrity]] in 1992.

Professor Lowell R. King (1982), who had been a member of the 1975 "ad hoc" task force on circumcision of the AAP, felt compelled to defend the reasoning of the task force.<ref name="king1982">{{REFjournal

|pagespage=337

Anand & Hickey (1987) published a paper in the ''New England Journal of Medicine'' that conclusively proved that newborn infants are capable of feeling intense [[pain]]. After publication of this landmark paper, no doubt about the existence of pain sensation in infants remained. The article stated:

<i>Numerous lines of evidence suggest that even in the human [[fetus]], pain pathways as well as cortical and subcortical centers necessary for pain perception are well developed late in gestation, and the neurochemical systems now known to be associated with pain transmission and modulation are intact and functional. Physiologic responses to painful stimuli have been well documented in neonates of various gestational ages and are reflected in hormonal, metabolic, and cardiorespiratory changes similar to but greater than those observed in adult subjects. Other responses in newborn infants are suggestive of integrated emotional and behavioral responses to pain and are retained in memory long enough to modify subsequent behavior patterns.</i><ref name="anand1987">{{REFjournal

The July/August 1989 edition of <i>[[The Truth Seeker]]</i> was dedicated to circumcision. It featured the core proceedings from the First International Symposium.

* failure to call for analgesia to ease the intense [[pain]] of the [[amputation]].

* attempting to shift responsibility for the performance of an injurious and harmful [[amputation ]] from the medical operator to the parents.

The advocacy of [[circumcision ]] to prevent [[UTI ]] spurred a debate in the medical literature until the AAP published a new statement in 1999 that softened the claims.

|pagespage=107

Professor [[George C. Denniston]], {{MD}}, {{MPH}}, explained some [[Foreskin#Physiological_functions| functions of the foreskin]], said circumcision was both unnecessary and harmful because of the deprivation of functions, so should not be performed.<ref name-"denniston1992">{{REFjournal |last=Denniston |first=George C. |init= |author-link=George C. Denniston |etal=no |title=Unnecessary Circumcision |trans-title= |language= |journal=Female Patient |location= |date=1992-07 |volume=17 |issue= |article= |pages=13-4 |url= |accessdate=}}</ref> The [[Third International Symposium]] on Circumcision convened at the {{UNI|University of Maryland|UMD}}, College Park, Maryland{{USSC|MD}}, USA on 23-25 May 1994.  Professor [[George C. Denniston]], {{MD}}, {{MPH}}, organized [[Doctors Opposing Circumcision (D.O.C.)]] in 1995. Three registered nurses in Santa Fe, {{USSC|NM}}, who conscientiously objected to assisting with foreskin [[amputation]] operations, formed [[Nurses for the Rights of the Child]] in 1995.

Professor A group of [[George C. Dennistonintactivist]]s assembled at Evanston, MD, MPH, organized [[Doctors Opposing Circumcision]] {{USSC|IL}} in 1996 for a meeting and then protested and demonstrated before the AAP convention in 1995nearby Chicago.

A group of [[intactivistJohn A. Erickson]]s assembled at Evanston, IL in (1996) self-published ''Deeper into Circumcision: A Invitation to Awareness'' (196 pages).<ref name="erickson1996">{{REFbook |last=Erickson |first=John A. |init=JA |author-link=John A. Erickson |year=1996 for a meeting and then protested and demonstrated before the AAP convention in nearby Chicago |title=Deeper into Circumcision: An Invitation to Awareness |url=http://www. foreskin.org/je-dic.htm |publisher=Self-published (196 page pamphlet) |location=Biloxi, Mississippi}}</ref>

Ross Povenmire (1998) questioned the authority of parents to grant consent for non-therapeutic circumcision of children.<ref name="povenmire1998">{{REFjournal |last=Povenmire |init=R |author-link= |last2= |init2= |author2-link= |url=http://www.cirp.org/library/legal/povenmire/ |title=Do Parents Have the Legal Authority to Consent to the Surgical Amputation of Normal, Healthy Tissue From Their Infant Children?: The Practice of Circumcision in the United States |journal=Journal of Gender, Social Policy & the Law |date=1998 |volume=7 |issue= |page=87 |accessdate=2021-10-14}}</ref> [[Christopher Fletcher]], M.D., (1998) conducted a survey of doctors in the United States who perform non-therapeutic circumcision of boys. Dr. Fletcher concluded his report in part:<blockquote>This study reveals that, across the country, American specialties that perform circumcisions are ignorant of the medical facts regarding the penile foreskin and in conjunction with hospitals and misinformed patients, attempt to justify and rationalise newborn male circumcision. In many cases, despite personal beliefs that circumcision is more harmful than beneficial, some physicians are unwilling to give up their participation in this almost uniquely American custom which many of them have personally experienced as infants.<ref name="fletcher1998!>{{REFbook |last=Fletcher |first=Christopher R. |init=CR |url=https://link.springer.com/chapter/10.1007/978-0-585-39937-9_19 |chapter=[https://link.springer.com/chapter/10.1007/978-0-585-39937-9_19 Circumcision in America in 1998: Attitudes, Beliefs and Charges of American Physicians] |publisher=Kluwer/Plenum |title=Male and Female Circumcision |pages=259-71 |editors=George C. Denniston, Frederick Mansfield Hodges, Marilyn Fayre Milos |year=1998 |accessdate=2021-10-21}}</ref></blockquote>The American Academy of Pediatrics had been acutely embarrassed by the faults of [[Edgar J. Schoen]]'s [http://www.cirp.org/library/statements/aap/#a1989 horrific circumcision policy statement], so a new task force was convened under the direction of Carole Marie Lannon, {{MD}}, {{MPH}}, to produce a new, more appropriate, and less embarrassing policy statement on non-therapeutic child circumcision. The new task force produced the [[American_Academy_of_Pediatrics#Fourth_policy_.281999.29|Fourth Circumcision Policy Statement]].<ref name="aap1999">{{REFjournal

|init=CM

|init2=AGD

|init3=AR

|init4=GW |author4-link=George W. Kaplan

|init5=CT

|init6=JT

|init7=D

The twenty-first century has been characterized by greater opposition to non-therapeutic circumcision of boys in the general population, the utter failure of the circumcision industry's vaunted new circumcision policy, and much more attention to legal matters and ethical issues relating to non-therapeutic circumcision of boys.

[[J. Steven Svoboda|Svoboda]], [[Robert S. Van Howe|Van Howe ]] & [[James G. Dwyer|Dwyer ]] (2000) discussed legal issues inherent with consent for non-therapeutic circumcision of boys.<ref name="svoboda2000">{{REFjournal

[[George Hill]] (2003) questioned the authority of anyone to grant consent for the non-therapeutic alteration of a child's body.<ref name="hill2010">{{REFjournal |last=Hill |first=George |init= |author-link=George Hill |etal=no |title=Can Anyone Authorize the Nontherapeutic Permanent Alteration of a Child's Body? |trans-title= |language= |journal=Am J Bioeth |location= |date=2003-03 |volume=3 |issue=2 |article= |page=W6 |url=https://www.tandfonline.com/doi/abs/10.1162/152651603766436342 |pubmedID=14635628 |pubmedCID= |DOI=10.1162/152651603766436342 |accessdate=2021-10-14}}</ref> [[Petrina Fadel]] founded [[Catholics Against Circumcision]]. Thomas et al. (2004) studied the incidence of [[HIV ]] in circumcision and intact men in a United States Navy population. A slightly higher incidence of [[HIV ]] infection was found in circumcised men (84.9%) as compared with intact men (81.8%). The authors concluded:

Although there may be other medical or cultural reasons for male circumcision, it is not associated with [[HIV ]] or STI prevention in this U.S. military population.<ref name="thomas2004">Thomas AG, Bakhireva LN, Brodine SK, Shaffer RA. [http://www.cirp.org/library/disease/HIV/thomas1/ Prevalence of male circumcision and its association with [[HIV ]] and sexually transmitted infections in a U.S. Navy population]. Abstract no. TuPeC4861. Presented at the XV International [[AIDS ]] Conference, Bangkok, Thailand, July 11-16, 2004.</ref>

|publisher=[[Doctors Opposing Circumcision(D.O.C.)]]

[[Doctors Opposing Circumcision (D.O.C.)]] issued a Genital Integrity Policy in June 2008.<ref name-"doc2008">{{REFdocument

|publisher=[[Doctors Opposing Circumcision(D.O.C.)]]

[[Robert S. Van Howe|Van Howe]] & Svoboda (2008) said of the American practice of medically-unnecessary, non-therapeutic infant circumcision:<blockquote>Once all factors are revealed, itis impossible to consider circumcision a minor issue,but rather circumcision comes to symbolize one of thegreatest ongoing systemic ethical violations for whichmodern medicine has been responsible.<ref name="vanhowe2008">{{REFjournal |last=Van Howe |first=Robert S. |init=RS |author-link=Robert S. Van Howe |last2=Svoboda |first2=J. Steven |init2=JS |author2-link=J. Steven Svoboda |etal=no |title=Neonatal pain relief and the Helsinki Declaration |journal=Journal of Law, Medicine, and Ethics |location= |date=2008-12 |volume=36 |issue=4 |article= |pages=803-23 |url=https://www.academia.edu/download/33981944/27_Van_Howe.pdf |pubmedID=19094008 |pubmedCID= |DOI=10.1111/j.1748-720X.2008.00339.x |accessdate=2021-10-31}}</ref></blockquote> The British journal, ''The Lancet'', published reports of two randomized controlled trials (RCTs) that were carried out in sub-Saharan Africa which purported to prove that male circumcision was protective against infection with [[HIV]]. The American Academy of Pediatrics consulted with the American College of Obstetricians and Gynecologists ([[ACOG]]) and the American College of Family Physicians ([[AAFP]]) (those being the medical trade associations that represent the specialties that perform most non-therapeutic infant circumcisions and make most of the money from the performance of the non-therapeutic [[amputation]]). The three associations determined to make common cause to produce a position statement that would promote male circumcision based on its alleged protection against [[HIV ]] infection. The AAP was to take the lead, but ACOG and AAFP provided representatives to the new [[AAP Circumcision Task Force 2012| AAP task force]], of which New York Jewess [[Susan Blank]], {{MD}}, {{MPH}}, was the chairwoman. This new task force did not publish a statement until 2012.The AAP declined to re-affirm the statement so it expired in August 2017. [[Dan Bollinger|Bollinger]] (2010) estimated approximately 117 neonatal circumcision-related deaths occur annually in the United States.<ref name="bollinger2010">{{BollingerD 2010}}</ref> [[Anthony Losquadro]] formed [[Intaction]], an [[intactivist]] organization in 2010. The Centers for Disease Control and Prevention ([[CDC]]) reported an incidence of newborn circumcision of 58.3 percent in 2010.<ref name="cdc2015">{{REFweb |url=https://www.cdc.gov/nchs/data/hestat/circumcision_2013/circumcision_2013.htm |title=Trends in Circumcision for Male Newborns in U.S. Hospitals: 1979–2010 |publisher=Centers for Disease Control and Prevention |website=cdc.gov |date=2015-11-06 |accessdate=2021-10-16}}</ref>

[[Brother K]] formed the [[Bloodstained Men]] in 2012. The AAP, lead by the [[AAP Circumcision Task Force 2012]], finally published the [[American_Academy_of_Pediatrics#Fifth_policy_.282012.29| fifth circumcision policy statement]] in the September 2012 issue of ''Pediatrics''.The [[American_Academy_of_Pediatrics#Criticism| adverse criticism]] was overwhelming. [[Dan Bollinger|Bollinger]] (2012) estimated that the total cost of non-therapeutic male circumcision, including hospital costs, repair of botched circumcisions, treatment of complications, and so on is more than $3 billion per year,<ref name="bollinger2012">{{REFweb |url=https://www.academia.edu/6442587/High_Cost_of_Circumcision_3.6_Billion_Annually |title=High Cost of Circumcision: $3.6 Billion Annually |last=Bollinger |first=Dan |author-link=Dan Bollinger |publisher=Academia |date=2012 |accessdate=2020-11-25}}</ref> of which the beneficiary is the American circumcision industry. [[Doctors Opposing Circumcision (D.O.C.)]] (2013) provided evidence that the purpose of the 2012 AAP Circumcision Policy Statement was to get more money for doctors,<ref name="doc2013">{{REFdocument |title=Commentary on American Academy of Pediatrics 2012 Circumcision Policy Statemeni |url=https://www.doctorsopposingcircumcision.org/wp-content/uploads/2016/08/commentary-on-american-academy-of-pediatrics-2012-circumcision-policy-statement.pdf |contribution= |last= |first= |publisher=[[Doctors Opposing Circumcision (D.O.C.)]] |format=PDF |date=2013-04-01 |accessdate=2021-10-21}}</ref>

[[Doctors Opposing Circumcision (D.O.C.)]] commissioned a [https://www,doctorsopposingcircumcision.org new website] in 2016. [[J. Steven Svoboda]] argued against non-therapeutic circumcision.<ref name="svoboda2017">{{REFjournal |date=2017-08-01 |title=Nontherapeutic Circumcision of Minors as an Ethically Problematic Form of Iatrogenic Injury |journal=AMA Journal of Ethics |language=en |volume=19 |issue=8 |pages=815-24 |DOI=10.1001/journalofethics.2017.19.8.msoc2-1708 |pubmedID=28846521 |issn=2376-6980 |last1=Svoboda |first1=J.S.}}</ref> He stated that this decision should be considered in the context of benefit vs risk of harm, rather than simply risk-benefit due to the non-therapeutic nature of the procedure.<ref name="svoboda2017"/> He states that benefits do not outweigh the risks, and also claims that foreskin removal should be considered a sexual harm.<ref name="svoboda2017"/> He also went on to conclude that non-therapeutic circumcision largely violates the physician's duty to respect a patient's autonomy since many procedures take place before a patient is able to freely give consent himself.<ref name="svoboda2017"/> Reis-Dennis & Reis (2017) asked if physicians should be blamed for harm resulting from unnecessary genital surgeries, including infant circumcision.<ref name="reis-dennis2017">{{REFjournal |last=Reis-Dennis |first= |init= |author-link= |last2=Reis |first2= |init2= |author2-link= |etal=no |title=Are Physicians Blameworthy for Iatrogenic Harm Resulting from Unnecessary Genital Surgeries? |trans-title= |language= |journal=AMA Journal of Ethics |location= |date=2017 |volume=19 |issue=8 |article= |pages=825-33 |url= |pubmedID=28846522 |pubmedCID= |DOI=10.1001/journalofethics.2017.19.8.msoc3-1708 |accessdate=2021-10-14}}</ref> The ill-fated 2012 AAP Circumcision Policy Statement expired on August 31, 2017 in accordance with AAP policy, because it was not reaffirmed. The AAP has had ''no'' official circumcision policy since that time.  [[Dan Bollinger|Bollinger]] (2019) discussed circumcision as an adverse childhood experience,<ref name-"bollinger2019">{{REFdocument |title=Child genital cutting as an adverse childhood experience |url=http://adversechildhoodexperiences.net/CGC_as_an_ACE.pdf |last=Bollinger |first=Dan |author-link=Dan Bollinger |last2=Chapin |first2=Georganne |author2-link=Georganne Chapin |publisher=Intact America |location=Tarrytown |format=PDF |date=2019-08 |accessdate=2021-04-02}}</ref> [[Peter W. Adler|Adler]], [[Robert S. Van Howe|Van Howe]], Wisdom & Daase (2020) examined male non-therapeutic circumcision as fraud.<ref name="adler2020">{{REFjournal

|pages=207-22222

Navia et al. (2020) surveyed the incidence of non-therapeutic neonatal circumcision in four states. The incidence of circumcision in 2016 was found to be have declined to 54.5 percent, which translates to a an increase in [[genital integrity ]] and wholeness rate of to 45.5 percent.<ref>{{REFjournal

The Lavine family of New Jersey has brought a lawsuit against a New Jersey practitioner and the [[American Academy of Pediatrics]] that alleges fraud.<ref>{{REFweb |url=https://www.circumcisionisafraud.com/docket-mer-l-000272-21 |title=Circumcision is a Fraud |last= |first= |accessdate=2021-10-13}}</ref> A study by [[Intact America]] (2020) reveals how hospitals pressure mothers into granting consent for unneeded and unwanted injurious non-therapeutic [[circumcision]] of a newborn boy.<ref>{{REFweb