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United States of America

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Intact is the new norm: Add text and citation.
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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
|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===
|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
[[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.
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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===
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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>
There are no valid medical indications for circumcision in the neonatal period.<ref>{{REFbook
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.
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
* [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 of all ages 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
|accessdate=2022-02-07
}}</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.
 
[[Intact America]] carried out a survey in 2022 that found that 73 percent of all American men were [[circumcised]], however it has not been documented and it is not clear in what region it was carried out. The prevalence of circumcision varies by region, race, and religion.
=== 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"/>
Jacobsen et al. (2021) used data from 2003 through 2016 from the Kid's Inpatient Database of the Agency for Healthcare Research and Quality from 2003 through 2016 to compare [[intact]] with [[circumcised]] boys in the first 28 days of life. The authors reported a gradual declining trend in the incidence of neonatal non-therapeutic [[circumcision]] throughout the study period. The overall incidence of circumcision decreased from 57.4 percent in 2003 to 52.1 percent in 2016 over the 13 year study period or 5.3 percentage points for an average decrease of 0.4 percentage point per year. The author authors noted "neonatal circumcision rates decreased significantly over time."<ref name="jacobson2021" /> There was significant variation in the incidence of circumcision by region with the Midwest reporting an incidence of 75 percent (three out of four) for the period, while boys in the West were most likely to preserve their [[foreskin]] as the West reported an incidence of only 25.9 percent or about 1 boy in 4 being [[circumcised]].<ref name="jacobson2021" />
There was significant variation in One should also note that the incidence [[American Academy of circumcision by region with the Midwest reporting an incidence of 75 percent (three out of four) for the period, while boys in the West were most likely to preserve their Pediatrics]] [[foreskinmedical trade association]] as the West reported an incidence of only 25.9 percentvacated its fraudulent 2012 Circumcision Policy Statement by allowing it to expire in 2017 without being re-affirmed.
====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.
===Intact is the new norm =Change in popularity====The popularity of non-circumcision of boys has increased to the point that non-circumcision has become the NORM in many sections of the United States. if long-term trends have continued, it is possible that non-circumcision or "intactness" has become the NORM in the United States.
[[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=ParityPublic 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" /> 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 [[intact]] will shortly become is now the more usual, normal 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}}
{{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:USA]]
[[Category:Male circumcision]]
[[Category:Circumcision]]
[[Category:History]]
[[de:Vereinigte Staaten von Amerika]]
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