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Jacobson Jacobsen et al. (2021) collected circumcision statistics used data from 2003 through 2016 from the KidsKid' s Inpatient Database from 2002 of the Agency for Healthcare Research and Quality to 2016compare [[intact]] with [[circumcised]] boys in the first 28 days of life. They The authors reported that a gradual declining trend in the incidence of neonatal non-therapeutic neonatal circumcision has "decreased significantly over time" with 55 percent being circumcised, which translates to a [[genital integritycircumcision]] (intact) rate of 45 percentthroughout the study period. The previous intact rate for the nation had been reported to be 41overall incidence of circumcision decreased from 57.7 4 percent in 2010, so this represents an improvement of 72003 to 52.9 1 percent in 2016 over the number 13 year study period or 5.3 percentage points for an average decrease of intact boys0.4 percentage point per year. The authors noted "neonatal circumcision rates decreased significantly over time."<ref name="jacobson2021" /> There was significant variation in the incidence of circumcision for by region with the entire United States had declined to 52.1 Midwest reporting an incidence of 75 percent at the end (three out of four) for the study period (2016), which indicates that 47while boys in the West were most likely to preserve their [[foreskin]] as the West reported an incidence of only 25.9 percent of boys born or about 1 boy in that year are 4 being [[intactcircumcised]].<ref name="jacobson2021" /> One should also note that the [[American Academy of Pediatrics]] [[medical trade association]] vacated its fraudulent 2012 Circumcision Policy Statement by allowing it to expire in 2017 without being re-affirmed.
[[Category:USA]]
→Intactness is the new norm: Add text and citation.
}}</ref>
The United States is unique in having a medical [[circumcision industry ]] that aggressively promotes the practice of medically-unnecessary, non-therapeutic, harmful infant [[circumcision]]. 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.
}}</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.
===Early twentieth century===
[[Ernest G. Mark]] (1901) noted that the "pleasurable sensations that are elicited from the extremely sensitive" [[Ridged band|inner lining]] of the [[foreskin]] may encourage a child to [[Masturbation|masturbate]], which is why he recommended circumcision since it "lessens the sensitiveness of the organ".<ref>{{Mark1901}}</ref>
Brimhall (1902) reported an [[amputation]] of a [[penis ]] after circumcision.<ref name="brimhall1902">{{REFjournal
|last=Brimhall
|init=JB
|url=https://jamanetwork.com/journals/jama/article-abstract/453164
|accessdate=2021-10-04
}}</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).
M. S. Reuben (1916) (1917) reported additional cases of tuberculosis after ritual circumcision.<ref name="reuben1916">{{REFjournal
}}</ref>
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
|last=Brennermann
|init=J
<b>World War II.</b> America entered the war after the Empire of Japan attacked the American naval base at Pearl Harbor, Hawaii on 7 December 1941. This was followed by Germany declaring war on the United States.
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
[[Abraham Ravich]] (1942) falsely claimed that circumcision prevents [[prostate cancer]].<ref name="ravich1942">{{Ravich1942}}</ref>
'''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.
Laumann et al. (1997) reported an incidence of non-therapeutic circumcision of boys of 85 percent in 1948.<ref name="laumann1997" />
}}</ref>
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.
===Late twentieth century===
The late twentieth century was characterized by increasing opposition to non-therapeutic circumcision of boys by [[intactivists]] and increasing efforts by the circumcision industry to protect [[third-party payment]] for performance of non-therapeutic circumcision of non-consenting boys; and by increasing recognition that newborn boys intensely feel [[pain]] and that non-therapeutic male [[circumcision]] is a [[trauma| horribly traumatic experience]].
[[Abraham Ravich]] (1951) falsely claimed that [[circumcision]] prevents [[cervical cancer]] in women.<ref name="ravitch1951">{{Ravich1951}}</ref>
}}</ref>
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:
<blockquote>Routine circumcision of the newborn is an unnecessary procedure. It provides questionable benefits and is associated with a small but definite incidence of complications and hazards. These risks are preventable if the operation is not performed unless truly medically indicated. Circumcision of the newborn is a procedure that should no longer be considered routine.<ref>{{REFjournal
Laumann et al. reported an incidence of newborn circumcision of 78 percent in 1971.
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:
<blockquote>
<b>There are no valid medical indications for circumcision in the neonatal period.</b><ref>{{REFbook
|year=1971
|title=Standards and Recommendation for Hospital Care of Newborn infants
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" />
The 1975 statement served as the AAP's position statement until 1989.
Grimes concluded:
<blockquote> However, until the benefits of [[Routine Infant Circumcision| routinecircumcision]] 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" />
</blockquote>
The American circumcision industry appears to have totally ignored Grimes' concerns.
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 [[circucisedcircumcised]] 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
|last=Boczo
|first=Stanley
}}</ref>
Anand & Hickey (1987) published a paper in the ''New England Journal of Medicine'' that conclusively proved that newborn infants are capable of feeling [[pain]]. After publication of this landmark paper, no doubt about the existence of pain sensation in infants remained. The article stated:
<blockquote>
<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
|year=2008
|title=Ch. 10: American Law and the Circumcision of Children
|url=https://www.i2researchhub.org/articles/ch-10-american-law-and-the-circumcision-of-children-doc-genital-integrity-statement/
|work=Genital Integrity Policy
|editor=
[[Doctors Opposing Circumcision (D.O.C.)]] issued a Genital Integrity Policy in June 2008.<ref name-"doc2008">{{REFdocument
|title=Genital Integrity Policy
|url=https://www.i2researchhub.org/wp-content/uploads/2015/05/GenitalIntegrityStatement.pdf
|contribution=
|last=Hill
}}</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
* [https://www.medicare.gov/ Medicare] − Covers persons who have reached 65 years of age.
== Some statistical Statistical data ==
=== Prevalence of circumcision ===
'''Prevalence of circumcision''' is the percentage of all males of all ages in the population who have been [[circumcised]].
[[Intact America]] carried out a survey in 2022 that claims that 73 percent of all American men were [[circumcised]],<ref>{{REFweb
|url=https://www.intactamerica.org/newsroom-gender-equality/
|title=Intact Facts
|last=
|first=
|init=
|publisher=Intact America
|date=2022
|accessdate=2023-03-29
}}</ref> however no documentation has been provided so it is not clear in what region it was carried out or what age groups were surveyed. The prevalence of [[circumcision]] varies by age, region, race, and religion. On another webpage, Intact America claims 78 percent are circumcised so Intact America is uncertain of its claims.
Peter Moore (2015) reported that 62 percent of all American males reported being [[circumcised]],<ref name="moore2015">{{REFweb
|url=https://today.yougov.com/topics/lifestyle/articles-reports/2015/02/03/younger-americans-circumcision
=== Incidence of circumcision ===
'''Incidence of circumcision''' is the percentage of newborn boys who currently are being [[circumcised]].====Long-term declining trend====The incidence of non-therapeutic neonatal [[circumcision ]] hit its peak at 85-90 percent in 1980. It has been slowly declining ever since.
Peter Moore (2015) reported that the incidence of circumcision was 55 percent.<ref name="moore2015"/>
====Midwest====
The Midwest has been called the 'circumcision capital of America' because of its higher rates of circumcision. Nevertheless, the popularity of circumcision is declining even in the Midwest.
In the Midwest, the incidence of [[circumcision]] has declined to 75 percent, which translates to a [[genital integrity]] rate increase to 25 percent or 1 in 4 boys having an [[intact]] foreskin.<ref name="jacobson2021" /> The previous report from 2010 was one boy in five being intact,<ref name="bollinger2017" /> and before that it was 1 in 10 boys being [[intact]], so this in an increase of 250 percent (0.25/0.10 X 100 = 250%) in the rate of [[Intact| intactness]] for the Midwest.The still high incidence of circumcision in the Midwest is counterbalanced by the low incidence in the West. === Intactness is the new norm ===
Intactness had previously been shamed in the United States,<ref name="garrett2023-12-21">{{REFweb |url=https://intactamerica.org/foreskin-phobia-intact-penis-shamed/ |title=Foreskin Phobia: How The Intact Penis Has Been Shamed |last=Garrett |first=Change in popularityConnor |init= |author-link=Connor Judson Garrett |publisher=Intact AmericaThe popularity of non |date=2023-12-circumcision of boys has increased to the point that non21 |accessdate=2024-circumcision has become the NORM in many sections of the United States. if long05-term trends have continued, it is possible 15}}</ref> but that non-circumcision or "intactness" era has become the NORM in the United Statesended.
Intact America called attention to the existence of a "tipping point", when public opinion would shift toward [[intactness]] in 2016.<ref>{{REFweb |url=https://intactamerica.org/do-you-know-about-the-tipping-point/ |title=ParityDo You Know: About the “Tipping Point? |last=Anonymous |first= |init= |author-link= |publisher=Intact America |date=2016-11-01 |accessdate=2024-06-03}}</ref> Public opinion in the United States in 2024 has now reached that tipping point.
The percentage of American boys being [[circumcised]] has been slowly declining for a long time, while the number of boys with [[intact]] [[foreskin]] has correspondingly increased.<ref name="jacobson2021" /> A state of parity has now been reached where the The percentage of [[intact]] newborn boys is about equal to now exceeds the percentage of [[circumcised]] newborn boys.
As the present trend continues, it is expected that being [[intactintactness]] will shortly become is becoming the more usual, normal , and expected condition for young infant boys in America, if it has not already done so.
==American [[genital integrity]] organizations==
The United States of America now have numerous [[genital integrity]] ([[intactivist]]) organizations working to promote and encourage the protection of the [[physical integrity]] of American boys.
{{SEEALSO}}
* [[Financial incentive]]
* [[Intact-friendly]]
* [https://en.intactiwiki.org/index.php/Main_Page Home page]
{{LINKS}}
* {{REFweb
|url=https://www.cirp.org/library/legal/USA/
|title=Legality of Circumcision: The United States of America
|last=Hill
|first=George
|init=
|publisher=Circumcision Reference Library
|date=2013-07-31
|accessdate=2023-08-26
}}
These documents by [[Dan Bollinger]] are included here because they contain significant information about the United States:
* {{REFweb
[[Category:BSM]]
[[Category:Male circumcision]]
[[Category:Circumcision]]
[[Category:History]]
[[Category:USA]]
[[de:Vereinigte Staaten von Amerika]]