The US government has released data from National Health and Nutrition Examination Surveys (NHANES) on the circumcision status of males born from 1999 to 2002. The aggregate (or overall) rate is 79% with a rate of 41% for Mexican Americans, 78% for non-Hispanic blacks, and 89% for non-Hispanic whites. I suspect by the time this age cohort reaches adulthood the overall rate will be about 85%.
Contrast these NHANES rates with the often quoted--but very incomplete--National Hospital Discharge Survey (NHDS) rates of 60% or less. It is the latter rates that appear on anti-circ websites (to give the appearance of an anti-circ trend). It is also the latter rates that most journalists quote because they fail to do their homework. It is so much easier to simply reprint material from the websites. And besides it looks so official (coming from the government and all).
The difference between the NHANES rates (based on random surveys) and the NHDS rates (highly limited in nature) gives further evidence the often quoted 60% rate is about twenty points too low. Neonatal circumcision remains extremely popular in the United States. New studies on health benefits should increase rates still further.
Status of Male
Circumcision in the United States
Center for Disease Control and Prevention
U.S. Department of Health and Human Services
In a national probability sample of adults in 1992, the National Health and Social Life Survey found that 77% of men reported being circumcised including 81% of white men, 65% of black men, and 54% of Hispanic men . It is important to note that reported circumcision status may be subject to misclassification. In a study of adolescentsł only 69% of circumcised and 65% of uncircumcised young men correctly identified their circumcision status as verified by physical exam .
According to the National Hospital Discharge Survey (NHDS), 65% of newborns were circumcised in 1999 and the overall proportion of newborns circumcised was stable from 1979 to 1999 . Notably, the proportion of black newborns circumcised rose over this reporting period (58% to 64%), while the proportion of white infants circumcised remained stable (66%). In addition, the proportion of newborns who were circumcised in the Midwest increased over the 20-year period from 74% in 1979 to 81% in 1999, while the proportion of infants born in the West who were circumcised decreased from 64% in 1979 to 37% in 1999. In another survey, the National Inpatient Sample (NIS), circumcision rates increased from 48% during 1988-1991 to 61% during 1997-2000. Circumcision was more common among newborns born to families of higher socioeconomic status, in the Northeast or Midwest, and who were black .
In 1999, the American Academy of Pediatrics (AAP) changed from routinely recommending circumcision to a neutral stance on circumcision, noting that: “It is legitimate for the parents to take into account cultural, religious, and ethnic traditions, in addition to medical factors, when making this choice.”  This position was re-affirmed by the Academy in 2005. This change in policy may influence reimbursement for and practice of neonatal circumcision. In a 1995 review, 61% of circumcisions were paid by private insurance, 36% were paid for by Medicaid, and 3% were self-paid by the parents of the infant . Since 1999, 16 states have eliminated Medicaid payments for circumcisions that were not deemed medically necessary .
The above is an excerpt from their full text (PDF) on Male Circumcision and Risk for HIV Transmission: Implications for the United States
Release date: January 16, 2008
Rates of circumcision vary widely across the nation, a phenomenon likely linked to regional variations in racial, ethnic and immigrant populations, as well as insurance coverage, according to the latest News and Numbers from the Agency for Healthcare Research and Quality (AHRQ).
Circumcision is the surgical removal of foreskin from the penis of an infant boy. The operation is usually performed for cultural, religious, or cosmetic reasons rather than for medical reasons. Some organizations, including the American Academy of Pediatrics, maintain there is insufficient evidence that routine circumcision is medically necessary. However, there is research suggesting that some health benefits may be gained, including a slightly decreased risk of developing penile cancer, a lower chance of urinary tract infections in newborns, and a potentially lessened risk of HIV transmission.
AHRQ's new report is an analysis of hospital-based circumcisions in 2005. Among its findings:
This AHRQ News and Numbers is based on data in Circumcision Performed in U.S. Community Hospitals, 2005. The report uses statistics from the Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of inpatient stays in all short-term, non-Federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type, as well as the uninsured.
For other information, or to speak with an AHRQ data expert, please contact Bob Isquith at Bob.Isquith@ahrq.hhs.gov or call (301) 427-1539.
An earlier message inquired as to how Dr. Schoen in his new book on circumcision discusses the relationship between circumcision and HIV transmission. In fact he devotes an entire chapter to the subject with the title "An Ignored Weapon Against HIV/AIDS." He surveys the more than forty studies published in professional journals that associate lack of circumcision with the transmission of HIV/AIDS and does so in lay language that ordinary people can understand. Of course his book was published just before the news about the new study in South Africa--with its sophisticated methodology--confirming the earlier forty or so studies linking foreskin with HIV/AIDS transmission.
Dr. Schoen also has a chapter with the title "American Academy of Pediatrics--Not Its Finest Hour." Dr. Schoen provides an insider's view of policy making at the American Academy of Pediatrics and in so many words--I believe--says they decided to pursue a political and cultural agenda rather than a medical one by failing to explicitly and clearly state that the health benefits of circumcision far outweigh any potential problems.
Dr. Schoen also refers to an interesting 2005 survey of parents by the magazine AMERICAN BABY that found 82% saying they had circumcised their newborn sons. There is little doubt that the 82% figure is much closer to contemporary American reality than the percentage figures from the National Center for Health Statistics based on limited and incomplete surveys (though it is the latter that are usually quoted in articles about circumcision).
I certainly recommend Schoen's new circumcision book to anyone as an informative and enjoyable read. And a quick one at that!
This new book on circumcision is a "MUST READ" for all parents.
Ed Schoen, Md On Circumcision: Timely Information For Parents And Professionals From America's #1 Expert On Circumcision
144 pages, Rdr Books, $11.53. ISBN 1571431233
Those of us in the UK can order it at £8.18.
Dr Schoen is a brilliant writer, and I look forward to reading his work. While the anti-circ crap has been available for eons, relatively little level-headed books on circumcision are easily available. True, there is Brian Morris' excellent In Favour of Circumcision, but that's damn hard to get hold o
Circumcision in the United States
American Journal of Public Health, August 1985
Ann Reid Slaby and Terrence Drizd.
The authors of the above paper investigated the prevalence of circumcision in boys 12 through 17 years of age in the U.S. using data from cycle III of the National Health Examination Survey. They didn't attempt to learn at what age circumcision was done. The assumption is that majority, as noted above, were circumcised in infancy, which would mean 1953 +/- 2 years. However, when comparing these figures to those above, it is apparent that a significant number of males in the United States are circumcised sometime after birth but before adulthood.
For a quick summary of the article: about 76% of the boys in the study had been circumcised; 80% of the whites and 45% of the blacks. Other non-whites were so few they were not considered in the racial breakdown.
For whites, circumcision correlated strongly with family income, from a low of 39% to a high of 94.1% This correlation did not exist for blacks.
Circumcision for both races is strongly correlated with education level of the head of the family. For whites it ranged from 35.6% for family heads with 1-4 years of schooling to 94.4% for those with more than four years of college. For blacks it ranged from 33.4% for those with the least education to 62.7% for those with 12 years of school - there are no figures for those with more schooling.
97% of white boys were born in hospitals, and of these 84% were circumcised. For those not born in hospitals 32.9% were circumcised. 89% of black boys were born in hospitals. The corresponding circumcision figures are 54% and 19.6%
Circumcision Rates by Region and
Boys 12-17 years of age, U.S.A.
Last weekend my good friend and I were discussing my adult circumcision and his routine infant circumcision. I asked him when he found out about circumcision and his answer really surprised me.
He was raised in a upper middle class suburb north of San Francisco. In high school during showers he would, like us all, glimpse other guys cocks and only saw bare knobs. He was in the Navy but again noticed no foreskins. He had heard the word circumcision but it just had no meaning to him. His son was circumcised. All guys looked the same to him.
Several years later during a cold February, he helped me put a new clutch in my car. When we were done, we cleaned our hands, warmed up my sauna, and got good and warm. After the sauna I suggested we shower off the sweat and he agreed. I showered first and was toweling off as he was stepping into the shower. He glimpsed my cock, then took a longer look at my foreskin and asked, "You are circumcised aren't you?" I answered that I was not. As he was showering he asked more about having a foreskin. We ended up doing a show and tell
Several years later when I decided to get circumcised he took me into the doctor's office for the circumcision, as the doctor did not want me to drive. So when I asked him "When did you first find out about circumcision?" He replied that it was when we worked on my car. He was 35 years old at the time. Yes, it was quite a surprise.
While some report the circumcision rate is between 60%-80%, it appears that in some areas of the country that the rate is approaching 100%. Obviously if you are one of the few who are not circumcised in the USA, you try to keep your foreskin hidden. (If you don't believe me, ask any uncut teen boy... if you can find one!) For those who were circumcised at birth, it is quite possible that they may never see a foreskin during their youth or possibly in their life in the United States. This is as true today as it was 30 years ago.
From some one who sits on the board of the largest Catholic hospital in my state, I can tell you from reports that our CIRCUMCISION RATE REMAINS VERY HIGH. The rate has never been below 93% for almost forty years in this area; presently the rate is over 95%. Circumcision has become a custom that is strongly engrained among Americans--and is identified with being American as a matter of fact in the opinion of many. We are a strongly Northern European state & region. Circumcision continues to be practiced by the overwhelming number of parents having sons--and I do not believe that the trend is going to be reversed. Even in our rural hospitals, they are staffed by doctors from Moslem countires--and they certainly promote circumcision--and know how to do them! State reports show that circumcision is, however, the lowest among our native American population--and is the lowest among parents who are Hispanic in culture. Otherwise, circumcision remains strong & extremely healthy here in the Midwest.
V. Lee (Midwest, USA)
Southern Blacks Embrace Circumcision
According to hospital records gathered for the Journal of the American Medical Association (JAMA) , September 2000 issue, circumcision among blacks in the South is very high indeed--approaching over 8O%!! For those of us who were born & raised in the South, Chris, being black meant many things in popular opinion, true or untrue: uneducated, backward, & uncut. As blacks have made great strives economically & educationally, they now are circumcising their sons to match the sons of their white neighbors & friends. Actually, the rate of circumcision in the South, Midwest, has ALWAYS REMAINED HIGH. The lowest rate is in the West, in particular, they say in California. Not all the West follows this tend. For example, the circumcision rate among the Mormons in Utah is over 9O%!! All sociological studies have revealed that education has always played an important decision of parents to circumcise their sons. This is certainly true regarding infant circumcision among our black population both in the North & South. Americans, in general, have a strong attachment to the practice of circumcision. Women, in general, tend to favor the Democratic candidate for President; whereas, an overwhelming majority of men favor the Republican candidate. These are facts concerning the situation regarding how Americans think & act. Even in California the upper middle class & above continue the practice of circumcision. If you think otherwise, check it out for yourself & you will find that these observations are indeed true.
US Mormons Embrace Circumcision
I was born and raised in Salt Lake City, and still live here. My interest in circumcision started when I was a little kid. I was the only uncut of all of my friends and relatives. I noticed I was different by the time I was about 4 or 5. This interest had continued to this day. In jr. high school, out of about 200 boys, there were only about 10 of us that were uncircumcised. I was never teased, but did have a lot of questions from peers on how mine 'worked.' In the 3 years of high school the % was about the same. During the physicals, showers and swimming, which we did in the nude, I was one of about 12 of 400 or so boys, that still had a foreskin. At the university, there were a few more foreskins, but there were quite a few out of stators and foreigners, but the % of cuts was still around 85%.
The Mormon church has no 'policy' on circumcision. It is
not for it or against it, but obviously it is a tradition among most of the
members to 'do it.' By the way, I have three children..2 girls and one
boy. I had him circumcised. I had many discussions with the OB, and he did a
perfect circ on him. Good and tight. My wife left the decision completely up
Tony (Salt Lake City, Utah, USA)
I was in Salt Lake City recently on business. A lot of us went out to dinner afterwards. They were a bunch of Mormons of course. One young guy said his wife was expecting a boy soon. Should he be circumcised? What did I think? Well all the men and my sons are, I said. I am not a Mormon. I live in the Boston area. By that time a number of other Mormons at the table chimed in. Just about every boy in Utah and in other Mormon areas is they said. Is it a religious circumcision, I asked. Yes, but Mormons also believe in good hygiene. So it is also medical. So circumcision appears to be almost universal among Mormons.
Listen to the words of Christ, your Redeemer, your Lord and your God. Behold, I came into the world not to call the righteous but sinners to repentance; the whole need no physician, but they that are sick; wherefore, little children are whole, for they are not capable of committing sin; wherefore the curse of Adam is taken from them in me, that it hath no power over them; and the law of circumcision is done away in me. [MORONI 8.8]
Revelation given to Joseph Smith the Prophet, at Hiram, Ohio, January 1832. HC 1: 242. The Prophet writes, "… During this period I … received the following, as an explanation of 1 Corinthians 7: 14." Now, in the days of the apostles the law of circumcision was had among all the Jews who believed not the gospel of Jesus Christ. And it came to pass that there arose a great contention among the people concerning the law of circumcision, for the unbelieving husband was desirous that his children should be circumcised and become subject to the claw of Moses, which law was fulfilled. And it came to pass that the children, being brought up in subjection to the law of Moses, gave heed to the traditions of their fathers and believed not the gospel of Christ, wherein they became unholy. Wherefore, for this cause the apostle wrote unto the church, giving unto them a commandment, not of the Lord, but of himself, that a believer should not be aunited to an unbeliever; except the law of Moses should be done away among them, That their children might remain without circumcision; and that the tradition might be done away, which saith that little children are unholy; for it was had among the Jews; But little children are holy, being sanctified through the atonement of Jesus Christ; and this is what the scriptures mean. [DOCTRINE AND COVENANTS 74 prologue & 74.2-7]
I gather that the first selection is actually from the book of Mormon, while the second is from supplementary writings of joseph smith. this doesn't explain how the change occurred, though, unless it was simply Mormons going along with general trends in America. might I presume that circumcision was uncommon in the states in the 1830's, so that joseph smith was "doing away with" something that wasn't actually being very widely practiced?
I was recently reading an article on circumcision in the Ft Wayne Indiana News Journal. They said the newborn circ rate at the three major hospitals there was between 88% and 90% of all boys born in those hospitals. The USA, and particularly the midwest, continue to be a bastion for routine infant circumcision.
Gary (Indiana, USA)
I use a freehand method i was taught in med school in California....i am very comfortable with it and find it personally to be quite efficient for all concerned. After some tracking, about 86% of the infants born in the hospital I deliver in leave circumcised. About 1/2 of the remaining 14% come back in to be circ either in my office or the pediatricians. The primary reason for leaving the hospital uncircumcised is economical, as circ generally is not covered by insurance as it considered "not medically necessary and cosmetic". The cost, in cash at the time of the procedure, is 190 US dollars. The remaining infants not circ in the hospital is due to religious or traditional reasons. I practice in Portland, Oregon.
I just returned from a water park vacation with my nephews. We toured numerous water parks throughout the Midwest. This required us to change into and out of our swimsuits with literally hundreds of other men and boys, from infants to retirees. I can attest that circumcision is nearly uniform across all races, classes and ages. Most every man and boy that we observed was nicely circumcised. Some were loose, some were high and tight, but next to no one had a foreskin. Of all of the little toddler lads, not one was uncircumcised. This appeared true even for boys who seemed to be of Hispanic descent with Spanish speaking fathers. Several Asian families were seen, and they too were circumcised. I couldn’t tell if they were Filipino (who usually circumcise anyway) or some other nationality. I would estimate that 70% were White, 10% Black, 10% Hispanic, 10% Asian.
Foreskin was as rare as hens’ teeth and of the hundreds we observed; we counted only 6 with foreskin. One was a late teen and trying to hide it, the others were all middle or older aged men. There must have been more foreskin than this; even if the circ rate was 90% we should have seen 20 or so skinheads. Of course, I think those that have not had the pleasure of being circumcised are often embarrassed that they still sport that little elephant trunk and try to hide it. I don’t know what else could account for such a high circumcision rate. But there it is…. And me and my nephews (all now proudly circumcised) were glad to be part of this American tradition and proudly showed of our recently circumcised members. I’m pleased to report that circumcision appears more popular than ever in the Midwest.
David (Chicago, IL)
A recent web based survey of teen males revealed a continued high rate of circumcision in the United States, supporting the findings and suppositions in the above chart.
I'm surprised to read that in the Great Melting Pot of the USA, the American-born Poles, at least the first USA born generation, are often not circumcised. I've met LOTS of Polish-descent-but-born-in-North America guys up here in Canada and they are almost all cut, if they are above the age of 25. Same with the guys of Ukrainian descent
I have a Polish American friend who is definitely circumcised. He had his son circumcised as well when he was born a couple of years ago. My friend bitched to me about how the insurance company had initially refused payment for RIC for his son. He said that they finally gave in and paid for the operation though.
Immigrant Sons Circumcised
A lot of Italian people immigrated here in the late 19th century and early 20th century. My grandmother came here when she was 6 months old and learned to speak English without an accent even though her parents and others in the family continued to speak Italian. She broke with Italian traditions early on. She encouraged my mother to have her sons circumcised. And we were. Among the second generation of Italians, who my family knew in Upstate NY before the 1940s,were seldom circumcised. My father whose family came here in the 18th century from Germany was circumcised at birth in the 1930's. As an adolescent he used to swim nude with all other kids at the YMCA. He remarked to me once that the Italians had the largest penises and were not circumcised. But in post WWII days the third generation began to be circumcised. And by the time I was in high school I never knew any Italian boys who were not circumcised.
I think the third generation of immigrants these days are gradually being circumcised, including many of the Mexicans on the West Coast and Puerto Ricans on the East Coast. Hard core uncut men include the Cubans in FL who rarely allow their male children to be cut. Orientals have adopted the circumcision custom. A few years ago by an outdoor beach shower in Hawaii, a woman from Vietnam was using a table nearby to change the diaper on her infant son. I observed that he was circumcised. Recently a Caucasian friend in FL, circumcised in NYC in the 1960's, later married a young Chinese woman from Vietnam. Her family was a victim of the war there and lost everything in fleeing the country among the boat people. .They have since prospered here in the U. S. My friend told me a couple of years ago that he and his wife made the decision together to have their biracial son circumcised.
This is the best source of statistical info for any medical procedure in The States:
It comes to mind that there was a study in Alaska that evidenced 'only' 60% of the new born boys were circumcised in hospital before they went home. But, it also reported that another 30% were circumcised in doctors offices within a very short time. In other words, the new born circ rate in Alaska is still at 90%.
I would speculate that the move to circumcising new borns in doctors offices is the result of the now shorter stays of mom and baby in the hospital. A conversation with my urologist confirms this as he told me he "does a lot of little boys." I see lots of little circumcised penises in the health club showers on family hours, including orientals.
The NOCIRCers do not seem to want to let out the real news that we will continue to be a very circumcised country. They only want to look at the in hospital stastics.
Tonsillectomy & Circumcision For Boys Common
One has to be careful about being too rigid in one's definition of "routine circumcision." In my assembling of almost 400 case histories I have stumbled on a most remarkable pattern in the state of Maine (USA). It seems that for a couple of decades there routine infant circumcision was not really the norm. However, a combination of tonsillectomy and circumcision in mid boyhood was very common. I have at least a half dozen sources who were caught up in this so-called T&C syndrome.
Circumcision: A Riddle of American Culture
The alternative, ethnographic explanation for circumcision appeals to circumcision's symbolic function as a permanent, dramatic and public demonstration to all parties involved of the loyalty and subordination of the father and the son to the interests of a fraternal interest group.
In this concluding section, I will clarify how these two, seemingly antithetical explanations, are in fact intimately connected and pertinent to understanding the issue of circumcision in our own society.
The ritual of circumcision results in exposure of the glans penis to permanent public view, set off by an irreversible, and highlighting, frame of scar tissue. This is a mark of more than just a biological transformation; biologically it is, in fact, irrelevant. Rather circumcision is a powerful, multimessage, therefore symbolic, and only symbolic, statement of social and cultural transformation.
Circumcision creates a biological boundary and simultaneously a sociocultural boundary; the scarring separates males of a society into two categories, into dichotomously opposed categories: the circumcised and the uncircumcised. Circumcision simultaneously creates a social boundary, creates two opposed social groups, and creates a specified relationship between these two groups. The scar is emblematic of this sociocultural division, and of the proper relationship between the categories it creates. We can discover more of the cultural meaning, and the implications og circumcision by identifying the significant and contrasting features of these dichotomous social categories.
The circumcised belong to the group which is fully male, dominant, public, and legitimate. The uncircumcised belong to a group characterized by the opposites of these traits; they are other than properly male, subordinate, private and not yet legitimate.
The circumcised are tame and domesticated in the sense that they conform to the established cultural order. The uncircumcised are, by contrast, potentially wild, aggressive, rebellious and insubordinate of the established cultural order.
The circumcised are defined, set apart in their proper cultural place, hence, controlled and predictable. The uncircumcised are not so defined; they remain amorphous, unpredictable, indiscriminate, promiscuous, and without proper place, hence, potentially polluting and dirty, where the circumcised are clean.
These contrasts appeal to more than a merely social boundary; this is one expression of the boundary that distinguishes everything that is culture, man=82made, public, orderly, domesticated, sane and clean, from everything that is not culture, from nature that is disorderly, wild, insane and dirty. And circumcision moves the boy, irreversibly, from uncontrolled private nature into controlled public culture, into the role of legitimate participant. The individual's actual behavior is irrelevant. The categories are a priori characterizations, stereotypes, of a kind a person. The ritual and scar of circumcision imposes and communicates this distinction and meaning in every culture.
It is this symbolic significance of circumcision that explains why circumcision in so closely associated with the ban against masturbation, masturbation results in putting one's seed somewhere, anywhere other than into a culturally controlled and approved sexual, economic and political alliance. It explains why that "elsewhere" is categorically and unalterably dirty .
It explains why James, Peter and John so opposed Paul's version of Christianity. In rejecting circumcision, Paul openly rejected the legitimacy and authority of Judaism, particularly of the fraternal interest group that included Jesus' own kin, in proselytizing the new religion.
And it explains why the uncircumcised and the masturbators are stigmatized as prone to wild, rebellious, disruptive, generally improper, dirty and likely insane behavior. The ritual of circumcision removes this stigma and, symbolically though not at all practically, the potentials of such antisocial behaviors.
It is pertinent to note that this stigma is the stereotype that dominant American society has projected on ethnic minorities; that is, not only on Blacks, American Indians, Hispanics and other immigrants, but also on the born-at-home, rural, breast-fed and typically uncircumcised, as opposed to hospital=82born, urban, bottle-fed and typically circumcised. These distinctions illustrate continuation in our own society of the cross=82culturally invariant meaning of circumcision which ethnographically and historically has been used to set apart classes and ethnic groups to establish and maintain dominant and subordinate relations, both within and between societies.
The boundary imposed on nature by circumcision is an expression of man's effort (and here I use the gender specific term advisedly) to impose his control on nature, in particular on the natural tendencies of society. When man, and the fraternal interest group, perceives any loss of control of the part of nature, of that valued resource, of their own authority and legitimacy, the typical reaction is to attempt to intensify the traditional modes of control, in this case the desired control is moral commitment to the propriety and the social category distinctions drawn and reinforced by circumcision.
This control crisis reaction explains the `Onania mania' that accompanied the social transformations of the industrial Revolution. It was an effort, albeit an effort in vain, to control behaviors such as the break-up of the patrilineal, patrilocal rural household, that could not be otherwise effectively policed. And the argument was couched, not in terms of sin and taboo, but In their modern, more `rational' but still symbolic equivalents, insanity, conformity and hygiene.
It does not matter that the effort to intensify the traditional modes of control is counter-productive, that typically it more rapidly erodes the credibility of its proponents. The proponent's argument is about the symbolic propriety and cultural appropriateness of a gesture, and the particular kind of social and cultural order that gesture represents.
No amount of empirical, statistical evidence will dissuade the proponents. Statistical evidence argues from the position of, indeed it is, a description of nature. The intent of the circumcision argument is, antithetically, cultural. The argument over circumcision is, then, another face of that irresolvable argument that rages between religious fundamentalists and biological evolutionists, one is talking culture, the other nature.
This items was posted to our mailbox anonymously. While we rarely publish anonymous pieces, we felt it was of particular interest and noteworthy. We would enjoy reading and sharing the missing sections of this text if the author would care to come forward.
A recent study looked at the affects of parental education on circumcision of their children. The study found parental education had no real impact. The study was conducted in the USA in Texas. Medical indications have been shown previously to be of low importance when deciding for or against circumcision.[13,14] Rather, the act of circumcision appears to be based consistently in large part on tradition and culture. No previous study has investigated the impact of unbiased, published, easily accessible educational brochures on parental decision-making about circumcision. We conclude from our findings that the use of a simple educational brochure about the medical indications and possible risks of neonatal circumcision in the immediate postnatal period has no impact on the decision-making process about neonatal circumcision.
Complete Study in RTF Format
US Military Circumcisions
I recently met a man that was circumcised on a ship during the Viet Nam
war. The surgeon was a closeted gay and he inspected the cock of
each man on board. He noted on the records who was cut or uncut, hung or not. He started with the hung guys and had them report to sickbay
and only there did the uncut man find out that he was to be circumcised that day. Some had fits about it. Some went along with the program. A friend of mine who has a huge uncut dick told me the same happened to his brother.
When I joined the army in 1948 one of the humiliating things we had to endure was an inspection of the penis for venereal disease. Typically the order would come down in the morning when the platoon sergeant would come into our barracks at 5:30 in the morning, turn on the lights and tell us to fall out in the company street in our rain coats and combat boots. This meant you wore nothing else - no underwear, socks, shirts just naked. You lined up and walked up to a station where the medics had a table and company roster. When you got up to the table you opened your raincoat and the doc would check you for sores. He would then tell you to "skin it back and milk it down" which meant that you had to retract the foreskin then squeeze your penis then slide the skin forward. This was supposed to expell pus from the urethra indicating the presence of an infection. The poor guys who had had a healthy morning erection would have pre-cum come out and were immediately suspect. It was even scarier for those who had been visiting the prostitutes who lived in the area. The army took a dim view of people who got VD and reinforced this by showing horrible movies of penises that had huges sores and were half rotted off. I was an impressionable 18 year old and it scared me so bad I was afraid even to masturbate.
When I went overseas the army used this as an excuse to check for those who had not been circumcised. At our port of debarkation they circumcised about 20 men and put them in a special compartment aboard the ship. You could always spot these guys in the messhall by the way they walked. A medic told me some of the men tried reading erotic literature (this was prior to Playboy) and much to their dismay wound up pulling stitches. The doctors told them too bad that the wound would eventually heal.
I went into the Marines when I was 17, and was circumcised at 19, but not at the request of the Corps. It was my own decision. As far as I know, no service requires circumcision to be performed after induction. I went into the Corps in 1978, and that policy certainly wasn't in effect. They didn't even suggest that I get circumcised at any point in my Marine Corps career, it was my own curiosity about circumcision and its imagined benefits that eventually led to me going to Sickbay and getting my foreskin removed. I was much more popular with the ladies after that!
While I'm sure some of the young men entering the US Armed Services were forced into circumcision, I think this is not a common happening.
When I was aboard the USS Hancock in 1976 for a reserve tour, circumcision was a common operation in the Sick Bay. The diagnosis was: REDUNDANT PREPUCE. When the ship went to sea, the doctors and corpsmen were busy. Circumcision was not forced on anyone. However, there were many uncircumcised sailors who wanted it done. Since we were out to sea, they had time to heal before returning to port. As the doctors stated, "It is good OR practice for the corpsmen. Someday there may be a disaster aboard. This surgical practice is good training for all concerned." The method used was the Gomco Clamp. Usually there were three Gomco's in the surgical pack (adult sizes, of course) and the correct size selected as the procedure began. Circumcision was the most most performed operation in the United States Navy during World War II, and also during the Korean War and the conflict in Vietnam.
I will repeat a story told to me by a close friend. He went into the service intact and it was planned that when he was discharged he would marry. Well the time came for the discharge but upon talking things over with his wife to be who was a nurse, they decided that he should be circumcised because it would be better for both of them. He had the army surgeon do the job but the doctor must have wanted an extremely high and tight cut made because the friend had troubles with the stitches. He broke the stitches three times and had to go to the local hospital twice since he had by then been discharged. Finally, he had had it with the problem and went to his college football coach who he knew bandaged up many a wound for those hurt on the football field. The former coach did the bandaging and it was left for nearly three weeks. When the bandages were taken off, he was in good shape and he was very pleased with the results. Of course, the wedding was delayed util he healed but he still maintains that it was worth it. What does it look like today? I one time saw it in the shower room and it is very tight when flaccid (about 1 1/2 inch back) but don't know what it would be erect.
I was born in the Midwest to strict Catholic parents. Sex was never discussed in our house. What little bit I did learn about sex was in biology class in school one year. My father was born on a farm and was uncut. I did manage to see his penis one day while we were at an amusement park and we shared a urinal next to each other. He did not retract the foreskin to urinate. I was not taught how to retract the foreskin to clean it as a child.
One of the first times I had the skin retracted when soft was during a "short arm" inspection in the Navy boot camp in preparation for food service week we all went through. Myself and several other uncut guys were found to have "dirty dicks" and we were sent back to the barracks to clean them and then report back to the corpsman for re-inspection. After that, I learned to retract the foreskin in the shower at night. I became very faithful about keeping my foreskin clean.
After having sex with some prostitutes while the ship visited ports in the Far East, I contracted a minor infection under the foreskin. The corps man and doctor on the ship treated me for several weeks to get rid of it. At that point in time, the doctor recommended that I think about getting circumcised upon the ship's return to San Diego. I decided that it was time to get it done. I did not enjoy fucking because the foreskin was tight on my cock. I might add at this point that I have the type of cock that is very small when soft, but enlarges about two to three times its size when hard. My cock head is much larger than the shaft. I think that is why the foreskin would not return to cover the head without much difficulty.
When the ship returned to San Diego, I was sent to the Naval hospital, and the doctor there arranged an appointment for me to be circumcised. At the appointed time, I reported to the ward. During that afternoon, the doctor examined each one of us who was there to be cut. He wanted to insure that we were not infected under the foreskin. That evening, a corpsman came around and took each one of us into the head (bathroom) and laid us on a table and shaved all of our pubic hair off. It was difficult not to get a hard-on while the corpsman was handling my cock and balls. After that was done, I did enjoy one final jack-off with my foreskin that evening. I knew it was going to be a little while before I was going to be able to jack-off again.
The next morning, a nurse came around and gave each one of us a shot to numb us. It put us on a trip where we were not too caring about what was going on around us. One at a time we were wheeled into a small operating room and placed up on the table. A corpsman was going to be doing the circumcision. He examined my cock and got it just a little bit hard. He then gave me a shot at the very base of my cock. It hurt for a very little bit. In a minute or so, my cock was numb. He then erected a small tent over my chest so I could not watch (I did not want to anyway), and proceeded to cut the foreskin off. He was done in about 20 minutes or so. He showed me my cock and it was puffed and swollen. It was bandaged and taped up toward my stomach to stem the flow of blood. It remained that way all through that evening.
Upon return to the ward, we were encouraged to drink anything we wanted, and I opted for beer. The object was to keep the urethra open and the urine flowing in case of swelling. I passed the piss requirement with flying colors. The next morning, the doctor came around and took the bandages off and inspected the work. We were discharged and sent back to our ships. I remained in bed for a couple of days to allow the scar to heal up. I guess that was not really necessary, but I opted for the rest. The head of my cock was very sensitive at the time. When I finally put my shorts on, it felt like the incisions were bleeding, but they were not. The head of my cock peeled like a mild case of sunburn after several days. It was difficult to keep it soft and not think about sex. I did manage to jack off about seven days after the operation. It did stretch the skin, but I needed that relief. It took about three or four weeks before I felt comfortable getting a hard-on and not being afraid of busting something open.
It is much easier to keep clean now, and I'm glad Uncle Sam circumcised me.
I've been doing circumcisions since I was a medic in the Army - mostly at Fort Bragg and then in Korea in the 1970's. In Army hospitals, a medic could "tutor" under a Medical Officer and then carry on. Circs became my specailty and the patients were plentiful. Mostly healthy, 18 to 21 year olds who the Army wanted to prepare for jungle warfare by removing their foreskins. Mostly guys from the midwest or the south where infant circ was obviously not as common. The Gomco (or cookie cutter as we called it) was the "weapon" of choice and after observing a few, I took over and my mentor was so impressed with my handy work that I took over the practice, doing as many as 20 in a day. High and tight was the style of the day and just like a military haircut, the soldier was never asked "how do you want it?" I did ask how much they wanted to feel - some didn't want to feel anything, but some (like the Green Berets) wanted to take it "like a man". I did pride myself in my suturing and follow up and was proud of every job.
When I arrived in Korea at the 121 Evac, I found that my previous boss at Bragg had called ahead to arrange for the Urology doc to meet me at the door. By day 2, I was dropping them left and right but not in the same quantity as at Bragg. With this duty came many privileges usually reserved for officers and I ate it up.
I really never counted but I rarely did less than 12 a day and sometimes 20 or more. I was not the only one performing the circs - but the only non-physician that was doing them. We were a big preparation center for soldiers going overseas to S.E.Asia and many were done to prepare them for jungle survival.
I did do some experimenting just to break the boredom. I would cut looser sometimes but that was frowned upon. Mostly I experimented with pain control and how much local to inject and how slowly to close the clamp and different topical applications. I also did a lot of study on different guys "threshold of pain" and how they reacted differently to the same procedure. I really didn't like the Green Berets because they treated anyone not a Beret as inferior, so I like to shame them in to taking their cut "like a man" without any anesthetic. I was not being mean or sadistic, because they really liked the challenge. They would grip the table and tears would run down their cheeks before they would admit they needed some local anesthetic injected.
Even better was watching their face turn red with embarrassment when I would prep them with warm Phisohex water and they would get an erection. They certainly didn't want anyone to think they were enjoying having another guy wash their dick! But actually it was easier to scrub it when it was hard, and it went down immediately when the insturments came out (or the syringe).
I started to save the skins in a jar of formalin solution, but the doc got wind of that and said it was sick and made me get rid of them. I thought maybe I'd save them up and take them to the leather shop and have something made. I had thought about a wallet - that turned into a suitcase when you rubbed it.
Until a few weeks ago, I thought I was the first member of my family EVER to be circumcised (at age 13). I made that comment to my dad and he said "ask your Uncle Bob about HIS circumcision". I was really surprised because I had seen photos of dad and his four brothers skinny dipping at the pond on the farm in Michigan and I knew none of them had met the Moyel on day 8 (we're not Jewish). I got Bob off to the side and asked him "what about this?" I thought I was first! He's a little hard of hearing from "the big guns" on the ship in WWII.
As a 17 year old kid, grandma had signed consent and Bob went into the Navy just before the War. He was a nice looking blond kid who, in his Navy picture, kind of looks like a Brad Pitt. Bob was a little reluctant to part with this story and I have a feeling not too many people know about it. On his first assignment, he was on a large ship (I forget which one) and was headed for the southern hemisphere. As they were about to cross the equator, all hands were called on deck for a "crossing ceremony". One of the officers called Uncle Bob up to the front to a sort of stage that had been put together for the occasion. There were guys dressed in various costumes including one as King Neptune. Neptune told Bob that he had been selected for a real "honor". In front of hundreds of other guys, he was told to strip and lay on the table. Neptune (who turned out to be the ships surgeon) told Bob that he was about to be circumcised as a ritual of crossing. Knowing how my dad and uncles were raised, I have no doubt that Bob was the virgin boy they were looking for. The doc told him not to cry out as everyone on ship was watching for his reaction. Without further ado, and with a little anesthetic locally at the base of his penis, Uncle Bob became THE first in our family to shed his baby skin. Amongst cheers from the multitude, the foreskin was placed in some sort of a chalice and passed overhead, and thrown overboard to "appease Neptune" for a safe crossing. The surgeon then completed the job and dressed the circ.
Unc was confined to his bunk for a couple days but interestingly, was treated like royalty for the rest of the voyage. He had none of the regular duties (kitchen, watch etc) and even at his own assignment with the guns, was not allowed to do anything "physical". He never had to buy a drink - everyone wanted to show their appreciation for his contribution for their safe trip. He reports no problems with the circ, no bleeding, infection etc. He's not sure what the doc used to perform the circ as he "couldn't look" but remembers "shiny instruments" clicking around his genitals in the bright sunlight. The only problem (and the reason for his silence over the years) was the embarrassment of being circumcised in front of hundreds of guys. I told him I though it was neat. He was aware that I had done many in the Army, but still couldn't talk about it with me. I'm sure this was the most unusual of the thousands and thousands of military circumcisions done during that era.
Foreskin A Closer look is very informative and is one of the best books available on Circ. It is published by Alyson Publications. The title is "Foreskin A Closer Look" ISBN 1-55583-212-1 and it cost $9.95 as a quality trade paperback in 1993.
In Chapter Two: Casualties of War, on page 79 is the following indented true account:
A few days before the crossing the pollywogs [men who had never before crossed the line] were ordered to go through a short arm inspection. Those who were uncircumcised had to write their name and serial number on a piece of paper and put it in a barrel. As the ship approached the Line all sorts of punishments were meted out to the pollywogs, but the star attraction was the fellow whose name was pulled out of the barrel. He was circumcised by King Neptunus as the ship crossed over the Line and all 1500 shipmates watched atop deck. This passage comes after accounts of surgeons circling sailors to use the skins as fishbait; and of a biggest penis contest in the which the winner with a long foreskin was circed because a fight broke out between those who said the skin overhang didn't count and those who said it did. The latter story having appeared in Argosy magazine as the article "A Foreskin Is Missing." There follows the story of the surgeon advertising for sale in the "East Village Other" his jar of skins he had circed as a navy doctor.
Adult Circumcision in the US Navy
Detailed sceifitific discussion with photos of adult naval personnel being circumcised.
A scientific paper by:
Full text available at: http://www.aafp.org/afp/990315ap/1514.html
"Medical Department, United States Army, Surgery in World War II"
This is excerpted from a book "Medical Department, United States Army, Surgery in World War II, Urology" published in 1987. Since this is a U.S. government document there is no problem with copyright; it may be freely reproduced. Items in square brackets  are my abridgements and paraphrases of passages that were longer than I wanted to quote directly.
p. 52 under venereal disease, chancroid, chapter by John F. Patton, M.D.
"Hot soaks in the presence of a balanoposthitis were helpful in preparation for circumcision and reduced the time element.
A word should be said here about circumcision. Any penile lesion in the presence of a redundant prepuce may present a problem and also invites secondary infection. Phimosis was a common complication of chancroid, and dorsal slits were often necessary, followed by circumcision after the local infection subsided. Phimosis and paraphimosis unrelated to veneral disease were also encountered frequently. Soldiers in combat were seldom able to practice personal hygiene. Higher headquarters sometimes questioned the number of circumcisions performed in the theater, with emphasis on days lost from duty. But all were performed from medical necessity, and none were done electively, to the authors knowledge. Many circumcisions, performed because of necessity in the active theaters, should have been done prophylactically before the soldier left the zone of interior."
p. 64, continuing the same chapter under Mediterranean Theater of Operations
"Of the 7318 cases of chancroid,...The problem of balanitis and secondary phimosis required dorsal slits and/or circumcision in many cases. Over 1000 circumcisions were performed at the center, approximately one-half of which were necessary in the chancroid group."
In chapter 6, Infections and Related Conditions, by Charles Montgomery
Stewart, M.D. p. 100ff
[several paragraphs about balanoposthitis. It starts out mild, but without facilities for personal hygiene it gets worse, can lead to gangrene, septicemia, and death. Recurrent attacks increase phimosis by local scarring.] "Treatment requires prompt, regular, strict personal clenliness... In advanced stages if there is phimosis or paraphimosis a dorsal slit must be done to permit intensive, direct local therapy. ... Finally, to prevent recurrence, circumcision should be mandatory when the local infection and inflammation have cleared." [repeated attacks can cause foreskin to attach to glans, which requires complete separation and circumcision. Erosive balanitis is a serious condition requiring immediate treatment. Then gets to ]
During the years 1942-1945, inclusive, 22,709 patients were admitted to Army hospitals for balanitis. Balanitis and the various types of balano-posthitis are extremely rare in the circumcised male. The ideal prophylactic would be routine circumcision. This recommendation would seem to present a task of insurmountable proportions should circumcision be required of all uncircumcised personnel. However, when the enormous man-hour loss from disease peculiar to the uncircumcised male is critically appraised in every World War II hospital record, routine prophylactic circumcision should require no greater argument to justify it.
Those personnel whose man-hour losses increased because of inability to change existing peronal hygiene conditions in the various fields of operation were eventually admitted to the hospital for intensive local treatment and, finally, for circumcision.
During intermittent periods, when combat casualty admissions were at a minimum, it was not unusual to schedule 10 or 15 patients for circumcsion in a single morning. This surgery ws performed under local anesthesia, and at times supplemented with vocal anesthesia.
The term "phimosis" denotes a congenital or acquired narrowing of the opening of the prepuce; it is often associated with a foreskin of unusual length which is sometimes adherent to the glans penis. The narrowed orifice of the prepuce sometimes causes retention of secretions, resulting in irritation and balanitis. It may interfere with forceful voiding. The relation between phimosis and venereal ulcers is well established, and the retention of local secretions may be a precursor to the development of epitheliomas and papillomas. Paraphimosis is a common complication of unrelieved phimosis.
Eventually the treatment is circumcision. Before circumcision, balanitis must be treated as previously described. Stubborn balanitis may require a dorsal slit before local inflammation can be controlled sufficiently to permit circumcision.
In the China-Burma-India theater, it was the authors experience and belief that the patient with phimosis eventually developed balanitis. Daily personal cleanliness was an impossibility among field personnel. The soldier with phimosis invaribly became incapacitated from persistent or recurrent balanitis, with eventual loss of man-hours because of hospitilization for necessary local treatment and a final permanent cure by circumcision. Circumcision in the adult is not the benign procedure it might appear to be. These patients were incapacitated from returning to full duty for a minimum of 10 days postoperatively.
When the foreskin is lengthy and the orifice is tight and narrow, treatment, in the absence of balanitis, may be dilatation of the orifice and freeing of adhesions. Dilatation can be attempted by gently stretching the orifice with forceps followed by gradual retraction of the prepuce. Adhesions may be separated by blunt dissection with the use of a blunt-tipped probe.
Dorsal incision may be mandatory when adequate retraction of the prepuce is impossible. A closed forceps is inserted between the prepuce and the glans penis on the dorsum, care being taken that the forceps is not in the urethra. With the forceps opened slightly, the prepuce can be slit with scissors. The prepuce should then be freed from the glans, and any retained secretions should be carefully removed by gentle swabbing with gauze soaked in saline or mild antiseptic solution. Bleeding points along the dorsal edges should then be adequately controlled. In the absence of balanitis, circumcision may then be performed. Details for proper circumcision are adequately described in any urological surgery textbook. However, the following important points regarding circumcision should be mentioned: (1) Excessive tissue should not be left about the frenum; this is to avoid formation of a fibrotic lump in this area.
(2) Extreme care must be exercised to avoid removal of too much skin.
Carelessness may result in partial denudation of the penile shaft.
(3) Sufficient preputial skin edge must be left to cover the sensitive papillae of the corona. (4) Hemostasis must be adequate.
By definition, paraphimosis obtains when the prepuce with its narrow orifice has been fully retracted and cannot be drawn back over the glans. Swelliing occurs rapidly in collar form, affecting the mucous membrane behind the corona. When uncorrected, ulceration of the constricting band occurs. Pain and anxiety increase, and difficulty in voiding may result. Gangrene of the glans penis is rare, but it may occur.
Treatment consists of reduction by manipulation which should be accomplished as soon as possible; it is a painful procedure that often requires anesthesia. [procedure described] If manipulation as described proves unsuccessful, a dorsal slit must be performed. Unless circumcision is performed after the swelling and local inflammation disappear, recurrence may be expected.
Hospital admission statistics for U.S. Army active-duty personnel during World War II list paraphimosis and phimosis admissions at 110,562. That these conditions combined run numerically second to nonspecific urethritis as cause for hospital admission is not so startling when the degree of incapacity caused by phimosis and paraphimosis is recalled. These disturbances occur only in active-duty personnel who have not been circumcised, and in the the authors opinion, the enormous potential man-hour loss from diseases peculiar to the uncircumcised male would justify routine prophylactic circumcision."
pp. 120-121 about condylomas, or so-called venereal warts. paragraph concludes with "Circumcision may be necessary to obtain a permanent cure."
pp. 145-146, general discussion at end of chapter.
"During the 1942-1945 interval, 13,522 patients with a diagnosis of condyloma acuminatum were hospitalized. Armed forces urological historians should be impressed with the fact that the redundant prepuce again can be pronounced guilty as a consistent contributor to the etiology and high incidence of this disease. Hospital admissions for paraphimosis, phimosis, balanitis, and condyloma acuminatum during the 1942-1945 period totaled 146,793. Had these patients been circumcised before induction this total would probably have been close to zero."
chapter on Genitoruinary Neoplasms by Vincent Vermooten, M.D.
p. 183 under Neoplastic Diseases of the Penis
"Neoplastic diseases of the penis in the armed forces during World War II were, for the most part, confined to such lesions as venereal warts and condylomas, which were not malignant in the sense that they do not metastasize, but may be considered malignant if local destruction of tissue is considered. Carcinomas are so rare in this age group that they call for no comment.
Venereal warts were found in uncircumcised men, so circumcision leaving only a minimal amount of prepuce, together with local fulgurations or merely curettage of the wart, was all that was necessary. Very little progress in the management or diagnosis of this condition was made during the war except that the need for circumcision in a soldier was made very clear. Because keeping the foreskin clean was very difficult in the field many soldiers with only a minimal tendency toward phimosis were likely to develop balanoposthitis, and in the presence of venereal warts, inflammation would almost certainly develop."
chapter "Reflections" by Ormond S. Culp, M.D., and John F. Patton, M.D.
"During 1942-1945 almost 150,000 soldiers were hospitalized for medical reasons with phimosis, paraphimosis, and/or balanitis; they were unable to maintain adequate local hygiene under combat conditions. The man-hours lost as a result of circumcisions and adjuvant therapy were costly to the war effort and exasperated the commanding officers. Time and money could have been saved had prophylactic circumcision been performed before the men were shipped overseas."
--------------------------------------------The novel Virgin Soldiers by Leslie Thomas describes a bunch of National Service squaddies in the fifties getting themselves circumcised. Thomas seems to be rather in favour of it - according to his autobiography he is cut.
I am a student of history and have some knowledge of the history of Circumcision in the US Military. From what I have read General Washington had a general under him who suffered from severe phimosis. As a result the military code states "No persons shall become and Officer who has phimosis."
Since circ. is the standard cure for phimosis this must be the source for the military preference for circ. When I was in the military there were a number of men who were circed, although they usually elected the procedure. Some however, mourned the loss of their foreskins, particularly if it was removed by order of the commander.
General Patton was, perhaps, the wealthiest man in the United States Army, marrying into a very prominent family. He was famous for many things, a brillant general in many ways, but was anti Semetic; however, he could not stand uncircumcised men. Patton would frequently order that the wards be filled up with uncircumcised men & circumcised! Read the materials available on his private life & one can readily see that this is true, although no one, to be the best of my knowledge, ever explained why he held such attitudes.
Vern, Ph.D. History
I joined the army in 1948 and after basic
training and schooling I was assigned to the 1st Cavalry in Japan. I was sent to
Seattle to catch the troop transport. The troop transport was a relatively small
ship that was used to carry troops and dependents. Enlisted men were assigned to
the bow of the ship and officers and dependents in the aft. Almost as soon as we
boarded, medical staff started giving us "short arm" inspections. This is
euphemistic term for penis inspections for venereal diseases. They were also
making note of men who were not circumcised. The fourth day out a group of 8 men
were called to the hospital and told they were to be circumcised. In those days
you did not question the army. Your body was theirs and they could do what they
wanted. After two days or so they were released. A medic who told me this story
said that as a nasty trick they would give the guys some very erotic books to
read and had fun watching them cope with painful erections. You could spot the
circumcised guys by the way they used a sort of waddling walk. After the first
batch had been released the second group was called in and the process
continued. I was lucky as I had myself circumcised about 1 month before joining
the army at the suggestion of a friend. My relatively fresh circ scar drew some
attention in the showers as it had not fully healed. The doc did a sloppy job
and did not take stitches so I had an open gap that
needed to grow together. My scar was still red at the time.
and the Law