For our parents’ generation, circumcision was mostly a no-brainer. Boys born in the United States in between the 1950s and 1980s were routinely circumcised as newborns, with rates approaching 90% nationwide (and much higher in some communities) in 1965. Uncircumcised men joining the armed forces in the early- to mid-20th century were often circumcised as adults, allegedly as part of an effort to fight venereal disease among troops. According to some historians, the rising rates of hospital birth, along with childcare experts who advocated for it on the grounds of both cleanliness and conformity, helped make routine infant circumcision the norm in the United States. Regional, cultural and ethnic differences always existed, however. In particular, rates were highest among whites and lower among African Americans and Latinos (although it’s unclear whether those rate differences in mid-century reflected the fact that hospital birth was still not universal among poorer populations).
Circumcision has a long human history. Egyptian tombs from the Sixth Dynasty (2345-2181 BCE) contain a bas-relief illustration of the procedure being performed on an adolescent; it is believed that circumcision was typically performed by a priest as a public mass rite with a stone knife. The ritual spread throughout the Middle East and Africa (although it is possible that the procedure arose in different parts of the world simultaneously). Other ancient cultures, notably the Greeks, eschewed circumcision and even regarded it as an abomination. According to the Jewish faith, circumcision is the visible sign of the Abrahamic covenant that binds a people to their god. While not explicitly mandated in the Quran, circumcision is also an Islamic rite. The baby Jesus was circumcised, according to legend, and the remaining foreskin was such a popular item among medieval Christians that more than a dozen churches claimed to have one in their reliquaries; the most likely “real” one went missing in 1983; one theory is that it was stolen by the Vatican.
In the West, circumcision became popular in Europe and the United States as a part of the wave of scientific modernism that swept in at the turn of the 20th century. Circumcision seemed to promise cleanliness, modernity, and even a cure, some said, for masturbation, syphilis and other degradations. Although it is very hard to pin down exact statistics, most historians say that the number of boys routinely circumcised climbed slowly through the first few decades of the century before a sharp rise around the start of World War II. Just as the U.S. wholeheartedly embraced newborn circumcision – paid for by insurance and endorsed by childcare experts such as Dr. Spock (himself uncircumcised, he later reversed his position) – most of Europe, in desperate economic straits following the war, never saw rates climb as high as the U.S.
American men of the baby boom generation, then, were almost all circumcised (while most European men were not: a source of much discovery when women of that generation went for junior year abroad). It wasn’t long before a backlash emerged. Men protested that they had been forced to undergo a traumatic, painful procedure – an amputation, in the words of some activists – leaving them forever injured. In response to rising voices of dissent, the medical establishment began to administer anesthesia to babies undergoing circumcision (Jewish mohels, who follow a different, much quicker procedure, typically do not use anesthesia). Beyond the issue of pain at the moment, anti-circumcision activists argue that the procedure had removed the most sensitive part of the penis, resigning them to a life of less sexual pleasure than they might have enjoyed if left intact. Others simply question the need to perform any genital surgery on a child too young to give consent.
Anti-circumcision arguments began to have an impact, both on the medical establishment and on the numbers of baby boys undergoing the procedure. In 1971, the American Academy of Pediatrics stated that “no valid medical indications for circumcision in the neonatal period” exist. Rates of newborn circumcisions began to slowly decline (they now hover around 60% nationwide). Much of the debate over the ethics of circumcision has come from male voices, but mothers, too, have raised questions about the procedure. The AAP issued a policy statement in March 1999, which they re-affirmed in 2005, that while circumcision may offer some health benefits, they could no longer recommend routine newborn circumcision for all boys. Citing the drop in rates and the AAP recommendations, Medicaid in 16 states no longer pays for it. Rates vary widely by region and population, with the highest prevalence in the Midwest and South, lowest in the West Coast. Recently a study claimed that only about a third of US newborn boys were circumcised in 2009, though the study’s methodology has itself been questioned, according to the New York Times (it did not include circumcisions performed out of hospitals, as for instance by a mohel, or those not paid for by insurance). Still, it’s clear that in many coastal cities and suburbs, more than half of newborn boys are not circumcised – a major change in just one generation, and one that has removed, in most places, the common argument for circumcision, that it will save a boy from locker-room embarrassment at being “different.”
No longer the universal default, circumcision is viewed by parents today as a choice, one they make based on their own history, culture and values. Even some Jewish parents are seeking and finding alternatives to circumcision. At the same time, some anti-circumcision activism has begun to seem over-the-top, as when male circumcision is compared to female genital mutilation, in which the entire clitoris is often removed. Other men, citing deep psychological distress, have sought to have their foreskins restored, either surgically or through do-it-yourself methods. And some anti-circumcision activism, when confronted with question about Judaism, has a decidedly anti-Semitic tone (validating, at least a bit, Freud’s argument that anti-Semitism stems from the castration complex). Showing the difficulty of this choice, the documentary Partly Private, chronicles one couple’s quest to untangle the modern dilemma born from the ancient rite.
Recent studies linking adult circumcision in Africa to protection from sexually transmitted diseases, including HIV, have added to the confusion some parents feel. Unlike the choice to breastfeed or cloth diaper, a circumcision literally reshapes your child; the stakes are high enough to leave some parents almost paralyzed with indecision. That’s the bad news. The good news is that, at least for now, your son will have company no matter what you decide.