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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

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="kellogg1888">{{Kellogg1888}}</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" />

[[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

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

}}</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

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.

'''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.

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 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]].

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:

<b>There are no valid medical indications for circumcision in the neonatal period.</b><ref>{{REFbook

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

<blockquote> However, until the benefits of [[Routine Infant Circumcision| 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

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

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:

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.

Rhinehart (1999) was a practicing psychiatrist who described his patients later-life problems stemming from the psychic [[trauma]] of their neonatal [[circumcision]].<ref name="rhinehart1999">{{REFjournal

|url=https://www.i2researchhub.org/articles/ch-10-american-law-and-the-circumcision-of-children-doc-genital-integrity-statement/

|url=https://www.i2researchhub.org/wp-content/uploads/2015/05/GenitalIntegrityStatement.pdf

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.

== Some statistical Statistical data ==

'''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

}}</ref> which increases the prevalence of [[intact]] [[foreskin]] to 38 percent of living American males of all ages. This percentage is expected to gradually but constantly decline, while the percentage of males who are [[intact ]] due to the declining incidence of newborn boys receiving medically-unnecessary, non-therapeutic [[circumcision]] is expected to increase. The percentage of males with [[intact]] [[foreskin]] is lowest with senior citizens and highest in the youngest age groups.

'''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.

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" />

In One should also note that the Midwest, the incidence of [[circumcisionAmerican Academy of Pediatrics]] had declined to 75 percent, which translates to a [[genital integritymedical trade association]] rate increase vacated its fraudulent 2012 Circumcision Policy Statement by allowing it to 25 percent or 1 in 4 boys having an [[intact]] foreskin.<ref name="jacobson2021" /> The previous report from 2010 was one boy expire in five 2017 without 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 populularity of nonre-circumcision of boys has increased to the point that non-circumcision has become the NORM in many sections of the United Statesaffirmed.

==Parity==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.

The percentage In the Midwest, the incidence of American boys being [[circumcisedcircumcision]] has been slowly declining for declined to 75 percent, which translates to a long time, while the number of boys with [[intactgenital integrity]] rate increase to 25 percent or 1 in 4 boys having an [[foreskinintact]] has correspondingly increasedforeskin.<ref name="jacobson2021" /> A state of parity has now been reached where the percentage of 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]] boys is about equal to , so this in an increase of 250 percent (0.25/0.10 X 100 = 250%) in the percentage rate of [[circumcisedIntact| intactness]] boysfor 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=Connor |init= |author-link=Connor Judson Garrett |publisher=Intact America |date=2023-12-21 |accessdate=2024-05-15}}</ref> but that era has ended. 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=Do 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" /> The percentage of [[intact]] newborn boys 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.

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.