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US Circumcision Rate On The Decline

Circumcision is back in the headlines: According to a federal researcher, circumcision rates in America have gone down from about two thirds of all baby boys to less than half.

Though these data come from the Centers of Disease Control and Prevention (CDC), the organization has stated that the numbers are not definitive.

Yesterday NPR ran a story explaining why the numbers are likely a little exaggerated. Part of the reason may be that circumcisions not covered by insurance and/or performed in religious settings were excluded from the new CDC data. This is significant as Medicaid and some insurance companies stopped covering circumcision after a statement issued about ten years ago by the American Academy of Pediatricians claimed that routine circumcision was not medically necessary.

Even if the numbers are a bit extreme, experts seem to agree there has been a decrease in infant circumcision in recent years.

Speaking to NPR, Dr. Douglas Diekema, a pediatrics bioethicist at the University of Washington said, “I think all of us agree there probably is a decrease in the number of circumcisions over time…”

He sites the neutral AAP stance, resultant lack of Medicaid/insurance funding for circumcision, and an increasingly Hispanic population– Hispanics traditionally do not circumcise. There’s also the influence of “Intactivists,” vocal opponents of circumcision.

I find it really hard to get good coverage of the issues surrounding circumcision. Even NPRs story came off as a little biased. Dr. Diekema called the anti-circumcision arguments “largely emotional,” but presented a case for circumcision in rational, scientific terms. I have come across intactivists who are largely emotional, so I know what he’s talking about. But I’ve also heard some fairly irrational arguments from circumcision advocates.

In general I try to steer away from advice including words like, “mutilation” (on one side) and “unclean” (on the other). I encourage those of you trying to make a decision about circumcision to read up on both options; there are way too many myths and emotional biases floating around, homework is often necessary.

Still, this can be a hard decision. Making it can involve considerations about religious identity, cultural pressure, family tradition, social norms, parental instincts, fear of doing the wrong thing… which is a lot to put on your plate before you even have a baby! But this topic can also provide an opportunity for parents to have productive, even philosophical conversations. It can even create a useful template for future discussions about parenting.

Read the New York Times coverage here.

Listen to the NPR story here.

photo: Sugar Pond/Flickr

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