Americans today aren't as anti-foreskin as they were when Ronald Reagan was president: 58.3 percent of American baby boys in 2010 were circumcised compared to 64.5 percent in 1979. So while that's a high number compared to, say, Canada, where only 30 percent of boys are circumcised, there is increasing evidence that American parents are generally comfortable not tinkering with their sons' manhoods (even if, since 2007, there's been a slight upward trend in American parents making sure their baby boys are cut).
The numbers come from a 30-year study published this month by the National Center for Health Statistics, a branch of the CDC. The numbers indicate that the circumcision rate in the U.S. is close to the lowest it's ever been (the nadir for circumcision was in 2007).
So what do uncircumcised penises say about Americans? Is the stigma attached to foreskin finally at a breaking point? Are we at an aesthetic junction? Have all-things-nature hippies won?
The answer is complicated.
The NCHS discovered that Americans actually listen to their doctors (for the most part). The peaks and valleys throughout the years correspond to studies, recommendations, and walk-backs by medical task forces. The researchers write:
For example, American Academy of Pediatrics' (AAP) task force reports during the 1970s stated there was no medical indication for routine circumcision of the newborn; AAP revised its position in 1989, stating there were potential medical benefits to newborn circumcision; and then in 1999, an AAP policy statement said that, despite potential medical benefits of newborn male circumcision, there was insufficient evidence to recommend routine circumcision of newborns.
But that doesn't explain the all-time low in 2007, which came during a time when the World Health Organization was stating that circumcision could lower the risk of AIDS. Currently, the American Academy of Pediatrics says that circumcision benefits outweigh the procedure's risks — but does not endorse routine circumcisions.
What's also fascinating is that Americans' feeling on circumcision seem to be tied (unsurprisingly, perhaps) to insurance costs. The study found, for example, that American boys who are more likely to be uncut are from Western states, where parents only circumcise around 40 percent of boys. NPR's Scott Hensley explains that this isn't an example of hippy subterfuge, but rather an issue with insurance:
Insurance coverage for circumcision has fallen; that's one factor in the decline. In quite a few states, including Arizona, California, Oregon and Washington, Medicaid doesn't cover circumcision.
Circumcision is also not covered by Medicaid in Western states like Nevada, Colorada, Idaho, and Utah. Yet, as it turns out, Midwestern boys tend to go under the knife the most — despite states like Missouri, Minnesota, North Dakota and Montana not offering Medicaid funding:
Dr. Michael Brady, a pediatrics expert and physician-in-chief at Nationwide Children's Hospital in Columbus, Oh., told Live Science that the West Coast shift may also be due to a changing racial make up: Hispanics have lower rates of circumcision, and the Hispanic population has been growing in the west West.
And a lot of circumcision still happens because of religious belief, though that still doesn't explain its prevalence. Muslims, according to 2010 figures, make up only .8 percent of the American population, with around 2.6 million people. And the number of Jewish people in the United States is estimated to be around 6.5 million, or 1.8 percent of the population (Christianity remains neutral on circumcision). Taken together, therefore, religious groups that prefer circumcision are not enough to explain the 58.3 percent circumcision rate.
Finally, let's talk about sex and aesthetics. Scientists are still fighting about whether or not cutting off the foreskin reduces sensitivity. The question of circumcisions and sex was recently discussed by Shawnee Barton for The Atlantic as she pondered where to circumcise her baby boy. "Don’t you want him to get blow jobs some day?" a friend asked her. Fair point. Studies from the past 30 years (one in 1988, another in 1997) do say that women prefer circumcised penises, but as Slate's Amanda Hess discovered, there is oral-sex hope for uncut men.
Ultimately, to snip or not to snip is a question parents of boys inevitably face. And like any other parental decisions, there will be endless back and forth over the medical and social consequences. At least for now, neither decision — to keep or cut — looks like a horribly bad one.
Photo by Angela Waye via Shutterstock.