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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

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>

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.

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" />

[[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.

[[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

}}</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.

===Government financial support for non-therapeutic circumcision===

==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

}}</ref> which increases the prevalence of [[intact]] [[foreskin]] to 38 percent of living American malesof 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==='''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 41.7 percent in 2010, so this represents an improvement overall incidence of 7circumcision decreased from 57.9 4 percent in the number of intact boys. The incidence of circumcision for the entire United States had declined 2003 to 52.1 percent at the end of in 2016 over the 13 year study period (2016), which indicates that 47or 5.9 percent 3 percentage points for an average decrease of boys born in that 0.4 percentage point per year are intact.The authors noted "neonatal circumcision rates decreased significantly over time."<ref name="jacobson2021" />

In There was significant variation in the incidence of circumcision by region with the Midwest, the reporting an incidence of circumcision had declined to 75 percent(three out of four) for the period, which translates while boys in the West were most likely to a preserve their [[genital integrityforeskin]] rate increase to as the West reported an incidence of only 25 .9 percent or about 1 boy in 4 boys having an being [[intactcircumcised]] 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.

====Midwest====The percentage of American boys being [[circumcised]] Midwest has been slowly declining for a long time, while called the number 'circumcision capital of boys with [[intact]] [[foreskin]] has correspondingly increasedAmerica' because of its higher rates of circumcision.<ref name="jacobson2021" /> A state of parity has now been reached where Nevertheless, the percentage popularity of [[intact]] boys circumcision is about equal to declining even in the percentage of [[circumcised]] boysMidwest.

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. === Intact is the new norm === [[Intact America]] argues that public opinion regarding non-therapeutic [[circumcision]] of children is approaching or at a "tipping point" at which [[intact]] genitals would be preferred over the [[circumcised]] variety.<ref>{{REFweb |url=https://intactamerica.org/public-opinion-on-circumcision/ |title=Public Opinion on Circumcision: Can Intactivists Hit A Tipping Point? |last=Anonymous |first= |init= |publisher=Intact America |date=2024-03-23 |accessdate=2024-04-09}}</ref>  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 [[intact]] will shortly become is now the more usual, normal 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.