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Circumcision is near-universal in the United States, Israel, the Philippines, and most Arab Muslim nations. Circumcision is also considered a rite of passage in some African tribes. In these societies, a man who has not been circumcised is often considered to be inferior, and in some cases, a social outcast, so there is a strong incentive to circumcise one's self and/or one's children.

 Siegfried ''et al''. observed:<blockquote>Circumcision practices are largely culturally determined and as a result there are strong beliefs and opinions surrounding its practice. It is important to acknowledge that researchers' personal biases and the dominant circumcision practices of their respective countries may influence their interpretation of findings.<ref name="siegfried2003">Siegfried N, Muller M, Volmink J, Deeks J, Egger M, Low N, Weiss H, Walker S, Williamson P. [http://www.cirp.org/library/disease/HIV/cochrane2003/ Male circumcision for prevention of heterosexual acquisition of HIV in men] (Cochrane Review). In: ''The Cochrane Library'', Issue 3, 2003. Oxford: Update Software</ref></blockquote> Because the United States circumcises so many of its male infants, [[circumcision]] is often said to be an American cultural value, and it is accepted as “normal.” Cultural bias on this issue may be most obvious when considering the practice of female circumcision in Africa. Americans regard the practice with horror, the way Europeans, who do not cut the genitals of male or females, regard American circumcision.<ref name='CRC 2011"CRC2011-03-06'">{{REFweb

American bias in favor of circumcision could be attributed to a number of different factors. The history of circumcision in America goes back more than a centuryto the Nineteenth Century, when it began as a way to curb [[masturbation]] in boys and men.<ref name='Stay Free!'>{{REFweb

}}</ref> Thereafter American doctors began on a quest to medicalize the practice of circumcision as a preventor preventer of a myriad of diseases, and that endeavor continues to this day. ===Media bias===

Another factor that plays a role in instilling bias in favor of circumcision in America is the local media. American television and theater treats the presence of the [[foreskin]] with ridicule and disdain, and praises circumcision as "clean" and "healthy," and news outlets are always ready to publish the latest "study" (usually conducted by American "researchers") that shows circumcision might have some kind of "benefit." Editors may also believe that American audiences, who already believe circumcision is beneficial, will want to read stories reinforcing their cultural assumptions. By contrast, a study showing no benefit (or even negative findings), may not be considered "news" by editors if their audience is expected to have little interest. Tabloid-type media especially may not want anything other than simplistic stories. Discussions carefully evaluating the validity of conflicting findings may be off-puttingly complex and not especially interesting to the reader who already believes circumcision as healthy, and see no need for further debate. These stories therefore might be less likely to be published.  ===Medical literature bias=== There is a huge bias in favor of non-therapeutic and therapeutic circumcision in the American medical literature.<ref name="fleiss1999">{{REFbook |last=Fleiss |first=Paul |author-link= |last2= |first2= |author2-link= |year=1999 |title=An Analysis of Bias Regarding Circumcision in American Medical Literature |url=https://books.google.com/books?hl=en&lr=&id=ljZZ9ZvD_kQC&oi=fnd&pg=PA379&ots=GA2KpzMECk&sig=jFqDYQhV0sqAWil6LDZWXnQdJO8#v=onepage&q&f=false |work=Male and Female Circumcision: Medical, Legal, and Ethical Considerations in Pediatric Practice. |editor=Denniston, George C., Hodges, Frederick Mansfield, Milos, Marilyn |edition= |volume= |chapter= |pages=379-401 |location=New York |publisher=Kluwer Academic/Plenum Publishers |isbn=0-306-46131-5 |quote= |accessdate=2020-08-08 |note=}}</ref> As a result of the long history of doctors condemning the presence of the [[foreskin]] and expounding the virtues of circumcision, curriculum regarding the [[foreskin]] and its [[Foreskin#Physiological_functions| multiple functions]] remain largely absent from American medical literature. Information on the [[Retraction of the foreskin| proper development of the foreskin]] is largely absent, diagrams of male genitalia present the [[penis]] as circumcised, and if the foreskin is mentioned at all, it is in the context of circumcision. In short, most of what is taught in American medicine regarding the foreskin is how to cut it off. When circumcised doctors attempt to write a circumcision policy, the outcome is likely to heavily biased in favor of circumcision.<ref name="goldman2005">{{REFjournal

|journal=Paedatrics Paediatrics & Child Health

Another factor that plays a role in instilling Fleiss (1999) reported strong bias in favor the American medical literature regarding male circumcision. He reported: * Bias against studies critical of circumcision .* Bias in America is the local media. American television and theater treats the presence type of the [[foreskin]] with ridicule and disdain, and praises circumcision as "clean" and "healthy," and news outlets studies that are always ready to publish performed.* Bias in the latest "study" (usually conducted by American "researchers") that shows circumcision might have some kind acceptance of "benefitstudies before peer review." Editors may also believe that American audiences, who already believe circumcision is beneficial, will want to read stories reinforcing their cultural assumptions* Bias in peer reviewers. By contrast, * Proliferation of a study showing no benefit (or even negative findings), may not be considered "news" by editors if their audience is expected to have little interestfalse analogy between circumcision and immunization. Tabloid-type media especially may not want anything other than simplistic stories. Discussions carefully evaluating the validity of conflicting findings may be off-puttingly complex and not especially interesting to the reader who already believes * Bias in studies associating HIV infection with circumcision as healthy, and see no need for further debatestatus. These stories therefore might be less likely to be published* Bias in studies regarding penile cancer. <ref name="fleiss1999" />

{{Citation |Title= |Text=Circumcision practices are largely culturally determined and as a result there are strong beliefs and opinions surrounding its practice. It is important to acknowledge that American researchers' personal biases and the dominant circumcision practices who have written studies critical of their respective countries may influence their interpretation of findings. |Author=Siegfried ''et al''. |Source= |ref=<ref>{{REFjournal |last=Siegfried |etal=yes |title=Male male circumcision for prevention of heterosexual acquisition of HIV usually have had to publish in men |journal=Cochrane Library |volume=3 |date=2003}}</ref>}}the foreign medical literature.

Though American circumcision practice is generally believed to be independent of Jewish circumcision practice, they are connected; some of the most outspoken advocates for circumcision tend to be Jewish. The [[American Academy of Pediatrics]] has consistently disproportionately stuffed its "circumcision task forces" with Jewish doctors. It is believed that not a single member of an AAP Task Force on Circumcision has ever had a foreskin. This suggests a religious or cultural bias on the part of these advocates. Of course, there are also Jewish doctors that oppose circumcision, but they are disproportionately outnumbered by those who advocate circumcision. For example, of all the letters to the editor in response to the 1999 [[American Academy of Pediatrics ]] Circumcision Policy Statement, the most pro-circumcision responses were from Jewish doctors, including two whom also perform Jewish ritual circumcisions.<ref>{{REFjournal

}}</ref> According to a MEDLINE search, the late [[Edgar J. Schoen]], a strong Jewish advocate, has been was published 20 times in the medical literature on the subject of circumcision.